Smith, Alison; Gray, Juliet
Sarcopenia is an important health issue for older people. It is closely linked with frailty and malnutrition and can significantly reduce both health and quality of life for those affected. Sarcopenic decline in muscle mass can start as early as the fourth and fifth decade of life, so the maintenance of muscle mass throughout adulthood, through regular physical activity and a balanced diet, should be an important consideration in reducing the risk of sarcopenia in older age. Maintaining regular exercise throughout older age remains key to the treatment of sarcopenia, as does an adequate intake of nutrients, including high-quality protein and vitamin D. A significant proportion of older people fail to meet the recommended requirements for protein; it has also been suggested that the requirements in existing recommendations could be higher. Evidence is emerging that an adequate intake of protein at each meal may be required to optimise muscle synthesis in older people. Eggs are an inexpensive, widely available and easily digestible source of high-quality protein and contain a significant proportion of leucine, an amino acid that is important for muscle synthesis, as well as many other nutrients of significance for older people, including vitamin D and omega-3 fatty acids. For many older people, eggs are a familiar and acceptable protein food at breakfast and other meals. Encouraging both those approaching older age and older people to include eggs more frequently, as part of a healthy, balanced diet and in addition to physical activity, could help them maintain their muscle strength and function, thereby preserving their functional capacity and reducing morbidity, mortality and healthcare costs associated with sarcopenia.
Smith, Alison; Gray, Juliet
Sarcopenia is an important health issue for older people. It is closely linked with frailty and malnutrition and can significantly reduce both health and quality of life for those affected. Sarcopenic decline in muscle mass can start as early as the fourth and fifth decade of life, so the maintenance of muscle mass throughout adulthood, through regular physical activity and a balanced diet, should be an important consideration in reducing the risk of sarcopenia in older age. Maintaining regular exercise throughout older age remains key to the treatment of sarcopenia, as does an adequate intake of nutrients, including high-quality protein and vitamin D. A significant proportion of older people fail to meet the recommended requirements for protein; it has also been suggested that the requirements in existing recommendations could be higher. Evidence is emerging that an adequate intake of protein at each meal may be required to optimise muscle synthesis in older people. Eggs are an inexpensive, widely available and easily digestible source of high-quality protein and contain a significant proportion of leucine, an amino acid that is important for muscle synthesis, as well as many other nutrients of significance for older people, including vitamin D and omega-3 fatty acids. For many older people, eggs are a familiar and acceptable protein food at breakfast and other meals. Encouraging both those approaching older age and older people to include eggs more frequently, as part of a healthy, balanced diet and in addition to physical activity, could help them maintain their muscle strength and function, thereby preserving their functional capacity and reducing morbidity, mortality and healthcare costs associated with sarcopenia. PMID:27270199
Cross, Nathan; Terpening, Zoe; Rogers, Naomi L; Duffy, Shantel L; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L
Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes. PMID:26096839
Full Text Available Abstract Background The search for preventive methods to mitigate functional decline and unwanted relocation by older adults living in the community is important. Preventive home visit (PHV models use infrequent but regular visits to older adults by trained practitioners with the goal of maintaining function and quality of life. Evidence about PHV efficacy is mixed but generally supportive. Yet interventions have rarely combined a comprehensive (biopsychosocial occupational therapy intervention protocol with a home visit to older adults. There is a particular need in the USA to create and examine such a protocol. Methods/Design The study is a single-blind randomized controlled pilot trial designed to assess the feasibility, and to obtain preliminary efficacy estimates, of an intervention consisting of preventive home visits to community-dwelling older adults. An occupational therapy-based preventive home visit (PHV intervention was developed and is being implemented and evaluated using a repeated measures design. We recruited a sample of 110 from a population of older adults (75+ who were screened and found to be at-risk for functional decline. Participants are currently living in the community (not in assisted living or a skilled nursing facility in one of three central North Carolina counties. After consent, participants were randomly assigned into experimental and comparison groups. The experimental group receives the intervention 4 times over a 12 month follow-up period while the comparison group receives a minimal intervention of mailed printed materials. Pre- and post-intervention measures are being gathered by questionnaires administered face-to-face by a treatment-blinded research associate. Key outcome measures include functional ability, participation, life satisfaction, self-rated health, and depression. Additional information is collected from participants in the experimental group during the intervention to assess the feasibility of
The purpose of this study was to compare the effectiveness of three 15-min bouts of postmeal walking with 45 min of sustained walking on 24-h glycemic control in older persons at risk for glucose intolerance. Inactive older (=60 years of age) participants (N = 10) were recruited from the community a...
Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin
Objective The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people. Design A cross-sectional pilot study was conducted. Setting An urban setting in Kuala Lumpur. Participants 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers. Primary outcome measure The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff. Results The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers. Conclusions The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers. PMID:27531736
Steeg, L. van de; IJkema, R.; Langelaan, M.; Wagner, C.
Background: Delirium occurs frequently in older hospitalised patients and is associated with several adverse outcomes. Ignorance among healthcare professionals and a failure to recognise patients suffering from delirium have been identified as the possible causes of poor care. The objective of the s
In a recent discussion about government proposals on care for older people (July 2009), the Radio 4 news presenter referred to a possible need to return to the attitude that it's the family's responsibility to look after its older members. Yet there is often already an expectation that the family – by which is usually meant children or grandchildren – can be relied upon to take an active part in the social life and any care arrangements for their older members. Indeed, social policy in much o...
R. Morgan; Pendleton, N; Clague, J E; Horan, M A
BACKGROUND: Little is known of the nature and origins of the attitudes that older people have towards ageing, disease, and medical treatments. Several studies on older people in the community have suggested under-reporting of symptoms. There may be several reasons for this, including the possibility that some older people regard disease processes as a natural feature of ageing and, consequently, feel that medical intervention may have little to offer. AIM: To investigate the perceptions of ol...
Drenth - van Maanen, A.C.
Appropriate prescribing is the result of pharmacotherapeutic decision-making to maximise the net health benefit of treatment, given the resources available. Several risk factors for inappropriate prescribing in older people have been identified, such as polypharmacy, impaired renal function, and frequent transfers between healthcare settings. The objectives of the studies described in this thesis were to describe the frequency and nature of risk factors for inappropriate prescribing in older ...
Drenth - van Maanen, A.C.
Appropriate prescribing is the result of pharmacotherapeutic decision-making to maximise the net health benefit of treatment, given the resources available. Several risk factors for inappropriate prescribing in older people have been identified, such as polypharmacy, impaired renal function, and fre
Between 30% and 60% of older patients experience functional decline after hospitalization, resulting in a decline in health-related quality of life and autonomy. This is associated with increased risk of readmission, nursing home placement and mortality, increased length of hospital stay and increas
The current paper examines the design process that led to an unusually successful interactive tutorial for older people. The paper describes the issues that make designing for older people different. These include differences between the designer and the target population and the difficulty that older people have in interacting with low-fidelity…
Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).
... many people are affected or at risk for lactose intolerance? Skip sharing on social media links Share this: ... lactose do not get symptoms. 1 Who gets lactose intolerance and who is at risk for it? Lactose ...
Blain, H; Rambourg, P; Le Quellec, A; Ayach, L; Biboulet, P; Bismuth, M; Blain, A; Boulenger, J-P; Celton, B; Combe, B; Dauvilliers, Y; Davy, J-M; Geny, C; Hemmi, P; Hillaire-Buys, D; Jalabert, A; Jung, B; Leclercq, F; Léglise, M-S; Morel, J; Mourad, G; Ponrouch, M-P; Puisieux, F; Quantin, X; Quéré, I; Renard, E; Ribstein, J; Roch-Torreilles, I; Rolland, Y; Rosant, D; Terminet, A; Thuret, R; Villiet, M; Deshormières, N; Bourret, R; Bousquet, J; Jonquet, O; Millat, B
Drug-induced adverse effects are one of the main avoidable causes of hospitalization in older people. Numerous lists of potentially inappropriate medications for older people have been published, as national and international guidelines for appropriate prescribing in numerous diseases and for different age categories. The present review describes the general rules for an appropriate prescribing in older people and summarizes, for the main conditions encountered in older people, medications that are too often under-prescribed, the precautions of use of the main drugs that induce adverse effects, and drugs for which the benefit to risk ratio is unfavourable in older people. All these data are assembled in educational tables designed to be printed in a practical pocket format and used in daily practice by prescribers, whether physicians, surgeons or pharmacists.
Lippi, Giuseppe; Sanchis-Gomar, Fabian; Montagnana, Martina
Due to the progressive ageing of the worldwide population, prevention and treatment of late-life dysfunctions, including functional decline and mobility limitations, represent leading targets of scientists and clinicians, but are also receiving growing attention from governments and healthcare systems. The early identification of elderly patients more prone to physical decline represents a crucial step for establishing preventive measures. Although functional capacity can easily be assessed, the use of additional criteria that anticipate the onset of mobility limitations seems much more advantageous. The most challenging issues in the identification of biological markers for assessing the risk of functional decline in the elderly originates from the complex and multifaceted pathogenesis of sarcopenia and the resulting physiological decrement, so that bridging the gap between basic research and clinical practice may appear intricate. Nevertheless, several lines of evidence now confirm the existence of negative associations between functional mobility and values of hemoglobin, total and HDL-cholesterol, vitamin D, testosterone, adiponectin and antioxidants such carotenoids, vitamin C and E, selenium and magnesium, whereas positive associations have been reported with the values of uric acid, white blood cells, plasma and blood viscosity, erythrocyte sedimentation rate (ESR), triglycerides, homocysteine, plasma glucose, glycated hemoglobin (HbA1c), markers of renal functions (i.e., creatine and cystatin C), insulin-like growth factor-1 (IGF-1), as well as several inflammatory (e.g., C reactive protein, Intereleukin-6, Interleukin- 1 receptor antagonist), hemostatic (e.g., fibrinogen, Von Willebrand Factor, factors VIII and IX) and oxidative (oxidized lipoproteins, 8-oxo-7,8-2'-deoxyguanosine, protein carbonylation) biomarkers. In the foreseeable future, proteomic studies might predictably help identify novel associations between putative biomarkers and functional decline. PMID:24050159
Deuter, Kate; Procter, Nicholas; Evans, David; Jaworski, Katrina
This discussion paper identifies and examines several tensions inherent in traditional approaches to understanding older people's suicide. Predicted future increases in the absolute number of elderly suicides are subject to careful interpretation due to the underreporting of suicides in older age groups. Furthermore, a significant number of studies of older people's death by suicide examine risk factors or a combination of risk factors in retrospect only, while current approaches to suicide prevention in the elderly place disproportionate emphasis on the identification and treatment of depression. Taken together, such tensions give rise to a monologic view of research and practice, ultimately limiting our potential for understanding older people's experience of suicide and suicidal behaviour. New approaches are necessary if we are to move beyond the current narrow focus that prevails. Fresh thinking, which draws on older people's experience of attempting to die by suicide, might offer critical insight into socially-constructed meanings attributed to suicide and suicidal behaviour by older people. Specifically, identification through research into the protective mechanisms that are relevant and available to older people who have been suicidal is urgently needed to effectively guide mental health nurses and health-care professionals in therapeutic engagement and intervention. PMID:26762697
Full Text Available In response to the review article written by Pavuluri and May  and to the original article by Tomasino et al  we will comment the recent neuroimaging findings of insular dysfunctions in Schizophrenia and Bipolar Disorders, focusing on people at genetic risk for developing psychotic symptoms. A disrupted insular functioning was reported in several studies, even though the results were not univocal with respect to the direction of the effect (some studies reported a reduced activation, other an augmented activation and the lateralization of the observed alterations (left, right or bilateral. We will conclude that an altered function of the insula during both cognitive and emotional task may be a candidate vulnerability marker for psychotic disorders.
Dean, Moira; Raats, Monique M.; Grunert, Klaus G.
This chapter discusses food-related satisfaction with life of older people, identifying some of the determinants and barriers to satisfaction with food-related quality of life, and discusses possible ways of enhancing older people's quality of life in the domain of food. Despite being strongly as...... of health, social networks, income and skills change. Changes in resources can be expected to have an impact on satisfaction with life....
Alessi, Cathy; Vitiello, Michael V.
Up to 40% of older adults have insomnia, with difficulty getting to sleep, early waking, or feeling unrefreshed on waking. The prevalence of insomnia increases with age. Other risk factors include medical and psychiatric illnesses, psychological factors, stress, daytime napping, and hyperarousal.Primary insomnia is a chronic and relapsing condition that may increase the risks of accidents.Primary insomnia is chronic insomnia without specific underlying medical, psychiatric, or other sleep ...
Sharma, A.; HOWARD, A. A.; Klein, R S; SCHOENBAUM, E. E.; Buono, D; Webber, M P
We performed a cross-sectional analysis of factors associated with negative body image among 550 older men with or at-risk for HIV infection, including demographics, depression, illicit drug use, and antiretroviral therapy adherence. Overall, 31 per cent of participants reported negative body image, which was independently associated with increased BMI, self-rated fair/poor health, depression, and erectile dysfunction, but not HIV status. Screening for and treating depression, sexual dysfunct...
Moya, Tatiana; Fleitlich-Bilyk, Bacy; Goodman, Robert
A representative sample of 7-14-year-old young people in southeast Brazil (N=1251) was assessed using standardized parent and youth interviews, thereby identifying an "at-risk" group of young people who met one or more DSM-IV criteria for anorexia and/or bulimia nervosa. These young people were compared with an age and gender matched comparison…
Older people have more functional limitations than younger people and they form a segment of the population that is more dependent on mobility devices than other age groups. Since they spend most of their time at home, their dwelling is an important environmental arena for performing everyday...... research, practice and policy in a global context for the benefit of the health and well-being of older people with functional limitations. Moreover, the results provide new knowledge and invite reflections on central concepts and methodology relevant to psychometrics and research on person-environment fit....... activities. Barriers in the environment can limit or hinder activity performance. Therefore, older people are sensitive to the accessibility of the environment. To ensure housing accessibility, it is critical that professionals are provided with valid and reliable assessment instruments to identify...
van den Berg, Julia F.; Kok, Rob M.; van Marwijk, Harm W. J.; van der Mast, Roos C.; Naarding, Paul; Oude Voshaar, Richard C.; Stek, Max L.; Verhaak, Peter F. M.; de Waal, Margot W. M.; Comijs, Hannie C.
OBJECTIVES: To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. DESIGN: Cross-sectional study. SETTING: Netherlands Study of Depression in Older Persons (NESDO). PARTICI
Baer, Britta; Bhushan, Anjana; Taleb, Hala Abou; Vasquez, Javier; Thomas, Rebekah
A focus on the right to the enjoyment of the highest attainable standard of health (hereinafter, "the right to health") draws attention to the health needs of older people, including the most marginalized among them. Many factors that influence vulnerability or impede the enjoyment of health and access to quality services result from an inability to freely exercise these human rights. A human rights approach can help to address the legal, social, and structural barriers to good health for older persons, clarifying the legal obligations of State and non-State actors to uphold and respect these rights. However, despite growing impetus for action, this area has historically received limited attention. Drawing on practice examples from different regions, this article unpacks the meaning of the right to health and other related human rights of older people in practice, covering both health care and underlying determinants of their health. Questions of availability, accessibility, acceptability, and quality are highlighted from the perspective of older people's health and well-being. The article brings together knowledge, principles, norms, and standards from the human rights law, health, and ageing arenas. By making links between these arenas, it is hoped that the article fills a gap in thinking on how to achieve the progressive realization of the right to health of older people and the effective promotion and protection of their other related human rights, which are crucial for the enjoyment of health. PMID:26994261
Barry, Maree; Nugent, Linda
Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork. PMID:26669407
Petersen, Poul Erik; Yamamoto, Tatsuo
changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia...... to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health....... National public health programmes should incorporate oral health promotion and disease prevention based on the common risk factors approach. Control of oral disease and illness in older adults should be strengthened through organization of affordable oral health services, which meet their needs. The needs...
Principi, Andrea; Lamura, Giovanni
This article provides information on trends in formal and informal adult education in Italy, with a particular focus on the older learners (over 65). Main providers, programs, objectives/motivations, and financial and legal framework are described. In general, over-65-year-old people were found to be underrepresented in participation. They were…
Peel, Nancye M.; Wilson, Cecilia
This article describes the experience of interviewing frail older people in a research project investigating hip fracture risk factors. Specific methodological strategies to maximize participation and data quality and to facilitate the interview process related to participant inclusion criteria, initial approach, questionnaire format, and…
Haustein, Sonja; Siren, Anu
-dependent segment, restricted in mobility; (3) a mobile multimodal segment; (4) and a segment depending on public transport and other services. Second, we examined the single factors used in the reviewed segmentation studies, with focus on whether there is evidence in the literature for the factors’ effect on older......The expanding older population is increasingly diverse with regard to, for example, age, income, location, and health. Within transport research, this diversity has recently been addressed in studies that segment the older population into homogeneous groups based on combinations of various...... demographic, health-related, or transport-related factors. This paper reviews these studies and compares the segments of older people that different studies have identified. First, as a result of a systematic comparison, we identified four generic segments: (1) an active car-oriented segment; (2) a car...
Skovgaard Larsen, Jette L; Frandsen, Hanne; Erlangsen, Annette
BACKGROUND: Safety plans have been suggested as an intervention for people at risk of suicide. Given the impulsive character of suicidal ideation, a safety plan in the format of a mobile phone application is likely to be more available and useful than traditional paper versions. AIMS: The study...... describes MYPLAN, a mobile phone application designed to support people at risk of suicide by letting them create a safety plan. METHOD: MYPLAN was developed in collaboration with clinical psychiatric staff at Danish suicide preventive clinics. The mobile application lets the user create an individualized......,000 times. Users at risk of suicide as well as clinical staff have provided positive feedback on the mobile application. CONCLUSION: Support via mobile phone applications might be particularly useful for younger age groups at risk of suicide as well as in areas or countries where support options are lacking...
Aims. To critically examine the nursing care offered to older people who have been delirious. Background. Delirium occurs as a result of physiological imbalances resulting in an alteration in consciousness and cognitive impairment. Delirium is a prevalent and serious cognitive disorder experienced by older people. While there is a vast number of studies published utilizing quantitative methods, there remains a dearth of research relating to delirium in older people from a qualitative perspective. Design. A qualitative research design that utilized a critical gerontological framework underpinned this study. This framework drew on aspects of postmodernism and Foucault's understanding of discourse. Methods. Data sources included published documents on delirium, semi-structured taped interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, Registered Nurses and a hospital doctor. A postmodern discourse analytic approach was used to interrogate the 20 sets of data collected. Findings. Textual analysis revealed the presence of two major discourses impacting on being an older person with delirium. These were identified as a nursing discourse of delirium and a personal discourse of delirium. A nursing discourse of delirium was largely focussed on the biomedical processes that resulted in a delirious episode. Conversely, a personal discourse of delirium highlights that there are other ways of 'knowing' about delirium through considering the narratives of older adults, and their families, when offering a nursing service to this group of people. Relevance to clinical practice. Nursing needs to critically examine all aspects of nursing care as it applies to older people who have delirium to ensure the rhetorical claims of the profession become the reality for consumers of health services. The use of critical gerontology provides nurses with the tools to challenge the status quo and uncover the
Depression is the most common mental health condition in people aged 65 and over. It can have a detrimental effect on quality of life and reduce patients' ability to manage their health. Nurses caring for older people with physical health problems are in an ideal position to identify depression; this article outlines how general receive the appropriate mental health care. nurses can do so and ensure their patientsepression can occur as a result of major life changes. It affects an estimated two million people over the age of 65 in the UK and is the most common mental illness
Wadolowska, L.; Danowska-Oziewicz, M.; Niedzwiedzka, E.;
Food patterns of Polish older people were separated and described. The research included 422 people aged 65+ years, living in 5 geographical locations. Participants of the study were selected in quota sampling. Criteria for recruitment included sex, age (65-^74 or 75+ years) and family status...... (living alone or living with other people). Respondents were asked questions about consumption of 55 food products. The factor analysis allowed for separating 21 food patterns. They included from 1 to 3 groups of products, intake of which was mutually dependant. Big number of separated food patterns...
Vass, M; Hendriksen, C
It is well known that problems with compliance rise exponentially when more that 4 drugs are prescribed. The rising use of prescription medicine forces the GP to balance the benefit of evidence group-based appropriate drug use against the problems arising when medication is given to older people...... is recommended at every encounter, and time consuming comprehensive follow-up will be demanded, 'polypharmacy consultations' surely will be built into GP contracts in the future. The authors state that a number of pharmacological regimens for older people are outperformed by non-pharmacological treatment...... and to consider different approaches when evaluating evidence of risk and benefit for the individual. Old people are facing a considerable risk of adverse drug reactions and recent initiatives, including the Continuous Medical Educational Efforts Programme, address issues of inappropriate prescribing practices...
Full Text Available We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.
Clayton, Pamela M., Ed.; Fojcik, Vavrinec; Greco, Silvana; Hulkko, Johanna; Kelly, Eimer; Kostka, Miroslav; McGill, Paul; Machackova, D.; Maiello, Marco; Makela, Eija; Sinorova, Lenka; Troska, Robert; Ward, Mary
This document contains 7 papers that evolved from 44 case studies of access to vocational guidance for people at risk of social exclusion in 5 European countries. The following papers are included: "Introduction" (Pamela Clayton); "Access to Vocational Guidance in Italy" (Silvana Greco, Marco Maiello); "Access to Vocational Guidance in Ireland"…
... https://medlineplus.gov/news/fullstory_161150.html How Older People Can Head Off Dangerous Drug Interactions Taking multiple ... serious drug interactions are a daily threat to older people who take multiple medications and supplements, according to ...
Xu, Ziyan; Mayer, Benjamin; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Dvorsky, Diane; Metzler, Sibylle; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas
Suicidality is common among individuals at risk of psychosis. Emerging findings suggest that mental illness stigma contributes to suicidality. However, it is unclear whether stigma variables are associated with suicidality among young people at risk of psychosis. This longitudinal study assessed perceived public stigma and the cognitive appraisal of stigma as a stressor (stigma stress) as predictors of suicidal ideation among individuals at risk of psychosis over the period of one year. One hundred and seventy-two participants between 13 and 35 years of age were included who were at high or ultra-high risk of psychosis or at risk of bipolar disorder. At one-year follow-up, data were available from 73 completers. In multiple logistic regressions an increase of stigma stress (but not of perceived stigma) over one year was significantly associated with suicidal ideation at one-year follow-up, controlling for age, gender, symptoms, comorbid depression and suicidal ideation at baseline. Interventions to reduce public stigma and stigma stress could therefore improve suicide prevention among young people at risk of psychosis. PMID:27419651
Full Text Available This article examines the needs of older people as well as manifestations of their activity. Third Generation Universities, which are being created around the world, make it possible to actualize the needs of older people. Through the example of the Society in Plotsk, the author examines the activity of older people attending a Third Generation University.
Full Text Available Comprehensive geriatric assessment (CGA has become associated with a set of approaches to service provision in the care of older people. The models can be used in a variety of settings, including hospital inpatients, ambulatory care and nursing home care. In CGA programmes the multidisciplinary, multidimensional nature of the assessment of health, rehabilitation and social care needs is formalised, often using standardised assessment instruments. The results of these formal assessments are then either used to inform or prompt treatment and management recommendations which may be carried out in dedicated inpatient units (Geriatric Evaluation and Management Units- GEMU, provided as recommendations to the referring physician or team (Geriatric Consultation Service, or delivered in the patient’s home or other ambulatory care setting such as the day hospital or outpatient clinic. During the past 5 years or so, a key issue in the delivery of comprehensive assessment processes is the notion that they should be targeted to frail older people. In this context, frailty is now a well-defined and measurable concept, which has been shown to associate with key clinical syndromes in disease presentation. Measures of frailty can therefore be used to identify “need” for multidimensional assessment. Further, measures of frailty have been shown in some populations to be more effective predictors of outcome (principally mortality than conventional clinical measures (such as diagnosis, specific disease severity or age. Being able to relate measures of frailty and comprehensive assessment to outcomes in the UK will help us to develop and target appropriate health care technologies more effectively and efficiently to the benefit of older people in need of inpatient hospital care. So; this study is to examine Interaction between CGA, Frailty and Clinical Syndrome and their Effects on Outcomes in Elderly hospitalized patients in Barnsley Hospital. Sheffield, UK.
Older people diagnosed with dementia can have complex needs, especially when they exhibit agitated behaviour. Patients with agitated behaviour challenge the delivery of health care. Often the behaviour is a symptom of unmet needs in this population (Dewing 2010). It is important for nurses to understand the underlying causes and apply evidence-based interventions in their nursing practice to promote health, safety and the highest quality of life possible. This article defines and classifies agitated behaviours, discusses implications for their management and then presents evidence-based interventions nurses can use. The interventions are categorised according to each of the five senses.
Guyonnet, Sophie; Rolland, Yves
Malnutrition risk increases with age and level of care. Despite significant medical advances, malnutrition remains a significant and highly prevalent public health problem of developed countries. Earlier identification and appropriate nutrition support may help to reverse or halt the malnutrition trajectory and the negative outcomes associated with poor nutritional status. A nutrition screening process is recommended to help detect people with protein-energy malnutrition (PEM) or at malnutrition risk. Evidence supports that oral nutritional supplements and dietary counseling can increase dietary intake and improve quality of life in elderly with PEM or at malnutrition risk. This article examines nutritional screening and assessment tools designated for older adults. PMID:26195101
Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy
Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy. PMID:26179452
Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy
Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy.
Terezinha da Silva
It is described in this study, the situation of older people in Mozambique (Africa), mainly manifestations of family and social exclusion experienced by older women. Throughout several life stories, in different contexts, it is shown the abandon face the older people by the family and the community. With few exceptions the older women receive no support, being many times accused of witchcraft and assassinated. In spite of the fact bad treatment also applied to men, it is clear in the study th...
Woodside, Jayne V; McGrath, Alanna J; Lyner, Natalie; McKinley, Michelle C
As the proportion of older people increases, so will chronic disease incidence and the proportion of the population living with disability. Therefore, new approaches to maintain health for as long as possible in this age group are required. Carotenoids are a group of polyphenolic compounds found predominantly in fruit and vegetables that have been proposed to have anti-inflammatory and antioxidant effects. Such properties may impact on the risk diseases which predominate in older people, and also ageing-related physiological changes. Working out the effect of carotenoid intake versus fruit and vegetable intake is difficult, and the strong correlation between individual carotenoid intakes also complicates any attempt to examine individual carotenoid health effects. Similarly, research to determine whether carotenoids consumed as supplements have similar benefits to increased dietary intake through whole foods, is still required. However, reviewing the recent evidence suggests that carotenoid intake and status are relatively consistently associated with reduced CVD risk, although β-carotene supplementation does not reduce CVD risk and increases lung cancer risk. Increased lycopene intake may reduce prostate cancer progression, with a potential role for carotenoids at other cancer sites. Lutein and zeaxanthin have a plausible role in the maintenance of eye health, whilst an association between carotenoid intake and cognitive and physical health appears possible, although research is limited to date. Given this accruing evidence base to support a specific role for certain carotenoids and ageing, current dietary advice to consume a diet rich in fruit and vegetables would appear prudent, and efforts maintained to encourage increased intake.
markdownabstract__Abstract__ Chapter 1 General introduction There is an increasing group of older people with intellectual disability in The Netherlands, reaching almost the same life expectancy as the general population. Age-related diseases, such as cardiovascular disease, cancer and dementia are now the most encountered diseases and causes of death in older people with intellectual disabilities. Although cardiovascular disease is a major risk for older people with intellectual disabilities...
TABATABAEI, Seyyede Farzane; TOUZANDEHJAN, Omid
Abstract. The problem of accommodating traffic is important when its inappropriateness is one of the main problems of older people and now most of the public places, passages, streets, parks and, entertainment places are inappropriate for them and they cannot easily enter the community and use facilities. If we do not consider urban poor conditions as well as physical and psychological problems that many older people suffer from at the age disability, in the next few decades the older people ...
Leite Silmara AO
Full Text Available Abstract Purpose There is a significant association between insulin resistance and low cardiorespiratory fitness in nondiabetic subjects. In a population with risk factors for type 2 diabetes (T2DM, before they are insulin resistant, we investigated low exercise capacity (VO2max as an early marker of impaired insulin sensitivity in order to determine earlier interventions to prevent development of insulin resistance syndrome (IRS and T2DM. Methods Cross-sectional analyses of data on 369 (78 men and 291 women people at risk for IRS and T2DM, aged 45.6 +/- 10 years (20-65 years old from the Community Diabetes Prevention Project in Minnesota were carried out. The cardiorespiratory fitness (VO2max by respiratory gas exchange and bicycle ergometer were measured in our at risk non insulin resistant population and compared with a control group living in the same geographic area. Both groups were equally sedentary, matched for age, gender and BMI. Results The most prevalent abnormality in the study population was markedly low VO2max when compared with general work site screening control group, (n = 177; 137F; 40 M, mean age 40 ± 11 years; BMI = 27.8 ± 6.1 kg/m2. Individuals at risk for IRS and T2DM had a VO2max (22 ± 6 ml/kg/min 15% lower than the control group VO2max (26 ± 9 ml/kg/min (p 2max was inversely correlated with HOMA-IR (r = -0.30, p Conclusions Decreased VO2max is correlated with impaired insulin sensitivity and was the most prevalent abnormality in a population at risk for IRS and T2DM but without overt disease. This raises the possibility that decreased VO2 max is among the earliest indicators of IRS and T2DM therefore, an important risk factor for disease progression.
Older people face many difficult challenges that amount to a deplorable violation of their basic human rights (poverty, discrimination, denial of social services, etc.). However, the world has been slow to react. Factors that limit global responses to the challenges of aging include: limited political will, the prevalence of neo-liberalism, and NGOs' longstanding advocacy for other seemingly "more" disadvantaged groups. Such oppression of and discrimination against older people require a concerted world-wide response. We contend that the introduction of an international convention on the human rights of older people is most relevant. Reinforced by a potent international monitoring system, the convention should contain comprehensive and legally binding provisions that require participating states to promote older people's rights. It is argued that international law would be a powerful force in defending and protecting older persons, operating as a baseline for establishing underlying values for national aging policies and linking older persons' concerns with other segments of society.
Older people face many difficult challenges that amount to a deplorable violation of their basic human rights (poverty, discrimination, denial of social services, etc.). However, the world has been slow to react. Factors that limit global responses to the challenges of aging include: limited political will, the prevalence of neo-liberalism, and NGOs' longstanding advocacy for other seemingly "more" disadvantaged groups. Such oppression of and discrimination against older people require a concerted world-wide response. We contend that the introduction of an international convention on the human rights of older people is most relevant. Reinforced by a potent international monitoring system, the convention should contain comprehensive and legally binding provisions that require participating states to promote older people's rights. It is argued that international law would be a powerful force in defending and protecting older persons, operating as a baseline for establishing underlying values for national aging policies and linking older persons' concerns with other segments of society. PMID:18198162
The author describes the management of depression in older people with visual impairment. The concept of depression is defined, and the main classifications are outlined. The signs and symptoms of depression are presented and approaches to treatment are discussed. The role of the nurse in managing depression in older people with sight loss is discussed.
Hughes, Mark; Heycox, Karen
This article discusses the use of observation for reflective practice with older people, particularly the benefits and challenges of this learning tool. It outlines a study with 26 third-year Bachelor of Social Work students who undertook an elective course on reflective practice with older people. Using qualitative document analysis, the authors…
Hayes, Nicky; Dearnley, Barbara
User involvement is high on the NHS agenda. At King's College Hospital, London, older people helped to develop the Improving Hospital Care for Older People project by producing teaching and learning materials for staff using e-learning. The project was set up by holding focus groups with older people. Staff surveys were also conducted to explore views and identify issues to be addressed. Older people's representatives were selected and directly involved in developing learning materials. This article describes the process of working together and includes the personal reflections of some of the key players. It discusses barriers to effective user involvement work between staff and older people, and identifies some benefits and opportunities presented by this approach. PMID:17518196
Full Text Available The existing literature on social exclusion among older people, though relatively limited, suggests that disadvantage among older people is cumulative in nature. Some aspects of disadvantage starting at early life stages have long-term consequences. As such, older people with disadvantages may be subject to higher risks of persistent social exclusion. This article aims to improve understanding of social exclusion and its persistence among senior Australians in three ways. Firstly, the incidence of social exclusion among older people is analysed using selected indicators. Secondly, the study examines whether an older person experiencing social exclusion at one time is more likely to experience it again (persistence. Thirdly, it investigates what factors may be protecting older people from social exclusion. The analysis is conducted using the first eight waves of the Household, Income and Labour Dynamics in Australia (HILDA Survey. The sample of older people is disaggregated into a younger group (55–64 years at wave 1 and an older group (65+ years. The article suggests that higher education and income, as well as better health conditions and previous employment experiences, are important protective factors from social exclusion for older Australians.
Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine
LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people. PMID:26223452
Allan, Charlotte E; Valkanova, Vyara; Ebmeier, Klaus P
Depression is more common in old age than dementia yet is underdiagnosed and undertreated. It is important to recognise that patients may not always present in a typical way, features that may indicate depression include anxiety, a preoccupation with somatic symptoms, and a change in function. The presence of understandable triggers and causes should not deter GPs from offering treatment, as long as symptoms are pervasive and continuously persist beyond two weeks. Age-related disabilities and changes to physical health are major risk factors for depression in older people. Vascular diseases, including stroke, MI and diabetes increase the risk of depression, both through direct effects on the brain and the psychological effects. Likewise, dementia is a risk factor for depression. Psychological factors such as loneliness and loss of a valued role, as well as social factors related to retirement, bereavement and reduced independence may also increase the risk. Patients with a previous history of depression and anxiety disorders are at increased risk of depression in later life. Assessment and diagnosis are largely based on a careful history. This should focus on eliciting current features of depression, which have been present for at least two weeks, and are associated with a significant change in function. It is important to exclude organic disorders including anaemia, B12 and folate deficiency, and hypothyroidism that may mimic symptoms of depressive disorder. Referral to specialist mental health services is indicated in the following cases: diagnostic difficulty, poor response to treatment, psychotic symptoms, significant psychiatric comorbidity or a risk of self-neglect or suicide.
Munk, T; Tolstrup, U; Beck, A M;
BACKGROUND: Many older patients are undernourished after hospitalisation. Undernutrition impacts negatively on physical function and the ability of older patients to perform activities of daily living at home after discharge from acute hospital. The present study aimed to evaluate the evidence...... for an effect of individualised dietary counselling following discharge from acute hospital to home on physical function, and, second, on readmissions, mortality, nutritional status, nutritional intake and quality of life (QoL), in nutritionally at-risk older patients. METHODS: A systematic review of randomised.......01 kg, 95% CI = 0.08-1.95, P = 0.03). Meta-analyses revealed no significant effect on physical function assessed using hand grip strength, and similarly on mortality. Narrative summation of effects on physical function using other instruments revealed inconsistent effects. Meta-analyses were...
This article presents the results of a collaborative project between the British Pain Society and British Geriatric Society to produce guidelines on the management of pain in older adults. The guidelines are the first of their kind in the UK and aim to provide best practice for the management of pain to all health professionals working with older adults in any care setting.
Kam, P K
The democratic elections that took place in Hong Kong before and after 1997 presented a unique opportunity for older people, politicians and government officials to take action to promote the participation of older people. There were, however, few significant projects undertaken to this end. This paper reports on recent research on political participation of older people in Hong Kong which found that they were active in voting but they were passive in other forms of participation. Factors affecting participation are more significantly related to politicians' mobilization than to civic education or work done by centres for the elderly. In the field, there is little awareness of using more effective strategies to address older people's political powerlessness. Strategies identified include: educational talks in local elderly centres, mock election games and meeting with candidates from different political parties. All these activities were locally based and not well articulated, and there were few concerted efforts to promote the political power and influence of older people at the central level. The present situation of older people in Hong Kong remains one of political powerlessness and the piecemeal strategies used to address the issue have so far had little impact. This paper suggests that political powerlessness is not a natural result of old age. It is a problem which is socially constructed. An analysis of the factors shaping this situation is presented. It also presents some suggested strategies for gerontological practice in promoting political empowerment among older people in Hong Kong.
There is an increasing emphasis on strategies designed to combat the exclusion of older people from society. The development of social policies oriented towards community care and community living has important consequences for housing policies and urban planning policies. How can the general...... housing stock and local neighbourhood facilites be made more responsive to the demands of older people? How can housing and planning measures contribute to the integration of older people in local communities? How can urban renewal be implemented in elderly-friendly forms? What forms of coordination...
In the Netherlands, the number of people aged 70 and above has increased in the previous decades, and will continue to do so in the coming years. Nowadays, older people are often healthy and active, and strive for a high quality of life. However, in an aging population new problems arise: many peopl
Terezinha da Silva
Full Text Available It is described in this study, the situation of older people in Mozambique (Africa, mainly manifestations of family and social exclusion experienced by older women. Throughout several life stories, in different contexts, it is shown the abandon face the older people by the family and the community. With few exceptions the older women receive no support, being many times accused of witchcraft and assassinated. In spite of the fact bad treatment also applied to men, it is clear in the study that the major victims are older women. Highlighting violence is showed of various ways and acts in silence and the crimes are not taking into consideration, does the author refer to a study carried out in 2000, year of the great floods in Mozambique in which the older people were affected to the great extent. In this article the author was concerned in contextualizing the causes and the worsening situation of the violence against older people in the HIV/AIDS situation. Although Mozambique has ratified various international and regional instruments and adopted national policies and programmes for protection and defense of Human rights of older people, the current situation is a matter of concern. Finally, launches a call for violence against the elderly are reported and with zero tolerance.
Hafford-Letchfield, Trish; Couchman, Wendy; Webster, Maxine; Avery, Peter
This paper describes an intergenerational project developed in partnership between a social work degree program and an Older People's Theatre group. Bringing together a small group of students, older actors, and film makers, methods from drama and the arts were utilised to explore the topic of intimacy and sexuality in later life. The project…
Hansen, Anna; Zipsane, Henrik
Is it morally acceptable for the heritage sector to see the growing population of senior citizens as a developing market? Jamtli is an open air museum in the north of Sweden. The main target group is families with children, but an increasing number of activities for older adults are being offered. The growing population of older people is a…
Wiles, Janine L.; Leibing, Annette; Guberman, Nancy; Reeve, Jeanne; Allen, Ruth E. S.
Purpose: This study illuminates the concept of "aging in place" in terms of functional, symbolic, and emotional attachments and meanings of homes, neighbourhoods, and communities. It investigates how older people understand the meaning of "aging in place," a term widely used in aging policy and research but underexplored with older people…
Heinrich, June Sark
There is a strong case to be made for mainstreaming older people into regular classes and schools rather than segregating them in special, separate groups on the basis of age. Many older Americans are in need of elementary-secondary level training in order to become functionally literate. Similarly, the continually changing nature of work has…
Walckiers, Denise; Van der Heyden, Johan; Tafforeau, Jean
Background Older people are a growing population. They live longer, but often have multiple chronic diseases. As a consequence, they are taking many different kind of medicines, while their vulnerability to pharmaceutical products is increased. The objective of this study is to describe the medicine utilization pattern in people aged 65 years and older in Belgium, and to estimate the prevalence and the determinants of excessive polypharmacy. Methods Data were used from the Belgian Health Inte...
Caryl Nowson; Stella O'Connell
Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensa...
Baus, Adam; Zullig, Keith; Long, Dustin; Mullett, Charles; Pollard, Cecil; Taylor, Henry; Coben, Jeffrey
Nationally, nearly 40 percent of community-dwelling adults age 65 and older fall at least once a year, making unintentional falls the leading cause of both fatal and nonfatal injuries among this age group. Addressing this public health problem in primary care offers promise. However, challenges in incorporating fall risk screening into primary care result in a problem of missed opportunities for screening, counseling, intervention, and ultimately prevention. Given these barriers, this study examines the potential for the innovative use of routinely collected electronic health record data to provide enhanced clinical decision support in busy, often resource-thin primary care environments. Using de-identified data from a sample of West Virginia primary care centers, we find that it is both feasible and worthwhile to repurpose routinely collected data for the purpose of identification of older adults at risk of falls. Searching of both free-text and semistructured data was particularly valuable. PMID:27134607
Martin, A J
BACKGROUND: It has been established internationally that road traffic accidents (RTAs) involving older drivers follow clearly different patterns of timing, location and outcomes from those of younger age groups. Older pedestrians are also a vulnerable group and fewer analyses have been undertaken of the phenomenology of their injuries and fatalities. We studied the pattern of pedestrian RTAs in Ireland over a five-year period with the aim of identifying differences between older pedestrians (aged 65 or older) and younger adults. METHODS: We examined the datasets of the Irish National Road Authority (now the Road Safety Authority) from 1998-2002. We analysed patterns of crashes involving older pedestrians (aged 65) and compared them with younger adults (aged 18-64). RESULTS: Older people represented 36% (n = 134) of pedestrian fatalities and 23% of serious injuries while they only account for 19% of total RTAs. Mortality in RTA is more than doubled for older pedestrians compared to younger adults (RR 2.30). Most accidents involving older pedestrians happen in daylight with good visibility (56%) and in good weather conditions (77%). CONCLUSIONS: Older pedestrians are particularly vulnerable in RTAs. These occur more frequently during daylight hours and in good weather conditions. This may point to a need for prevention strategies that are targeted at the traffic environment and other road users rather than at older people.
Neal, C. A.; Babb, J.; Brantley, S.; Kauahikaua, J. P.
From June 2014 through March 2015, Kīlauea Volcano's Púu ´Ō´ō vent on the East Rift Zone produced a tube-fed pāhoehoe lava flow -the "June 27th flow" - that extended 20 km downslope. Within 2 months of onset, flow trajectory towards populated areas in the Puna District caused much concern. The USGS Hawaiian Volcano Observatory (HVO) issued a news release of increased hazard on August 22 and began participating in public meetings organized by Hawai`i County Mayor and Civil Defense two days later. On September 4, HVO upgraded the volcano alert level to WARNING based on an increased potential for lava to reach homes and infrastructure. Ultimately, direct impacts were modest: lava destroyed one unoccupied home and one utility pole, crossed a rural roadway, and partially inundated a waste transfer station, a cemetery, and agricultural land. Anticipation that lava could reach Pāhoa Village and cross the only major access highway, however, caused significant disruption. HVO scientists employed numerous methods to communicate science and hazard information to officials and the at-risk public: daily (or more frequent) written updates of the lava activity, flow front locations and advance rates; frequent updates of web-hosted maps and images; use of the 'lines of steepest descent' method to indicate likely lava flow paths; consistent participation in well-attended community meetings; bi-weekly briefings to County, State, and Federal officials; correspondence with the public via email and recorded phone messages; participation in press conferences and congressional briefings; and weekly newspaper articles (Volcano Watch). Communication lessons both learned and reinforced include: (1) direct, frequent interaction between scientists and officials and at-risk public builds critical trust and understanding; (2) images, maps, and presentations must be tailored to audience needs; (3) many people are unfamiliar with maps (oblique aerial photographs were more effective); (4
Constipation is a distressing disorder that is common among older patients in hospital. It is often underdiagnosed and undertreated, and can lead to increased morbidity and prolonged hospital stays. In most cases this common problem can be treated successfully if the correct management plan is adopted. This article reviews the prevention and management strategies available to address the issue.
Peterson, Candida C.
Elementary school students and university students indicated they preferred younger male and female (under 35) to older teachers. Personality and competence were given as reasons for their preferences by sixth graders and university students. Younger children gave no explanation nor did they indicate teacher appearance or resemblance to well-known…
Hernandez-Encuentra, Eulalia; Pousada, Modesta; Gomez-Zuniga, Beni
This study examined the use that older, regular users of computers make of information and computer technology in their daily lives. Opinions from such users were obtained regarding what they want these technologies to offer them in the future. By means of a discussion group and an online questionnaire, our critical case examined a group of mature…
Soenen, Stijn; Chapman, Ian M
Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations and activity, neurotransmitters, and cytokines. A greater understanding of this decrease in appetite and energy intake during aging, and the responsible mechanisms, may aid the search for ways to treat undernutrition and weight loss in older people.
Yamada, Yukari; Vass, Mikkel; Hvas, Lotte;
To describe what characterizes preventive home visits with collaborative relationships among non-disabled home-dwelling older people in Japan. Background. Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding...... communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan. Relevance to clinical practice. Education should be emphasized, because preventive home visitor...... on documented knowledge in health and social domains combined with an overall 'caring approach' and (iii) practical actions which imply an 'immediate concrete response to identified needs or problems' and 'individually tailored advice' to suit the older person's daily life. Conclusions. Preventive home visitor...
Mänty, Minna; Rantanen, Taina; Era, Pertti;
different measures of fatigue are associated with depressive symptoms among general older populations. The purpose of this study is to describe the prevalence of depressive symptoms among community-dwelling older adults reporting mobility-related or general feelings fatigue. The study population consisted......Fatigue is considered an important indicator of aging-related declines in health and functional abilities. Previous studies have indicated strong associations between fatigue and depressive symptoms among younger populations and in patient groups with specific diseases. However, it is not known how...... of 75-year-old community-living individuals (n = 561). Both, mobility-related and general fatigue, were associated in a stepwise relationship with depressive symptoms: a higher level of fatigue was related to higher level of depressive symptoms. Especially major general fatigue was strongly associated...
Chen, Yu; While, Alison E; Hicks, Allan
Objective: To investigate physical activity among older people living alone in Shanghai, People's Republic of China, and key factors contributing to their physical activity. Methods: A cross-sectional questionnaire survey was administered in nine communities in Shanghai, using a stratified random cluster sample: 521 community-dwelling older…
Persson, Ann; While, Alison
Objective: To investigate the duration, intensity and type of physical activity undertaken by people aged 60 years and over in relation to their reported levels of participation in social activities and their perceptions of their neighbourhood. Design: A cross-sectional questionnaire survey of older people attending two luncheon and eight social…
Hooven, Carole; Pike, Kenneth; Walsh, Elaine
We examined data from 162 families who participated in the prevention program Parents and Youth with Schools, which targeted at-risk high school youth and parents, to understand parent retention in the 15-session Parents as Partners program. We obtained reports from youth, parents and parent interventionists, which included both time-invariant and time-varying data regarding demographic factors; parent, youth and family characteristics; and parents' response to intervention. Utilizing event history analysis, we examined data sequentially in order to determine those variables that predicted continued parent attendance. In the model examining all areas simultaneously, the predictors of parent retention across the full program were parent minority status and age, teen anger and parent-teen conflict over school attendance, as well as parents' reports of group support and interventionists' report of parents' commitment. Overall, the analyses indicated that participants' characteristics, as well as their measureable response to the intervention, can alert researchers to potential program disengagement. Monitoring indicators of disengagement will help researchers focus resources early in the intervention process in order to maximize parent attendance and increase the success of prevention programs. PMID:23975209
Lu, Luo; Kao, Shu-Fang; Hsieh, Ying-Hui
The aim of this research was to examine attitudinal barriers to the managerial intention to hire older workers (aged 60 and above). Structured questionnaires were used to collect data from a sample of managers with hiring power (N = 305). We found that (a) positive attitudes towards older people in general, perceived subjective norm, personal…
The aim of this research was to examine attitudinal barriers to the employment of Taiwanese older workers (aged 60 and above). Face-to-face interviews were conducted to collect data using structured questionnaires from a sample of full-time employees (N = 258). We found that: (1) positive attitudes toward older people in general, perceived…
Francis JCM Konings; Jolanda JP Mathijssen; Jasper M Schellingerhout; Ike HT Kroesbergen; Joyce Goede de; Ien AM Goor de
Background: Dehydration of elderly people living independently is a very important public health issue. This study compares two interventions to prevent dehydration in elderly people at risk: an educational intervention and an educational intervention in combination with a drink reminder device. Methods: This is an experimental two-armed parallel study. A Public Health Service develops the interventions and will be partnering with a general practice and a university to evaluate the effect...
Full Text Available Abstract Background The demands and consequences of caregiving are considerable. However, such outcomes are not commonly investigated in the evaluation of interventions targeting frailty. This study aims to explore family carers’ reactions to caregiving during an intervention targeting frailty in community living older people. Method A study of carers (n=119 embedded in a 12 month randomised controlled intervention targeting frailty in people 70 years or older, compared to usual care. Reactions to caregiving were measured in the domains of health, finance, self-esteem, family support and daily schedule. Anxiety and depression levels were also evaluated. Carer outcomes were measured at baseline, 6 months and 12 months and at 3 months post frailty intervention. Results Carers of frail older people in the intervention group showed a sustained improvement in health scores during the intervention targeting frailty, while health scores for carers of the frail older people in the control group, decreased and therefore their health worsened (F=2.956, p=0.034. The carers of the frail older people in the intervention group reported overall better health (F=5.303, p=0.023 and self-esteem (F=4.158, p=0.044, and co-resident carers reported higher self-esteem (F=4.088, p=0.046. Anxiety levels increased for carers in both intervention and control groups (F=2.819, p=0.04. Conclusion The inclusion of carers in trials targeting frail older people may assist in the identification of at-risk carers and facilitate the provision of information and support that will assist them to continue providing care. Further research that explores the features of frailty interventions that impact on the caregiving experience is recommended. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12608000565347
Vervaeke, Hylke K.E.; Benschop, Annemieke; Van Den Brink, Wim; Korf, Dirk J.
Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged up to 18 years who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to…
H.K.E. Vervaeke; A. Benschop; W. van den Brink; D.J. Korf
Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged ≥ 18 who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in t
Full Text Available Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise. Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations.
Snooks, Helen A; Halter, Mary; Close, Jacqueline C T; Cheung, Wai‐Yee; Moore, Fionna; Roberts, Stephen E
Introduction A high number of emergency (999) calls are made for older people who fall, with many patients not subsequently conveyed to hospital. Ambulance crews do not generally have protocols or training to leave people at home, and systems for referral are rare. The quality and safety of current practice is explored in this study, in which for the first time, the short‐term outcomes of older people left at home by emergency ambulance crews after a fall are described. Results will inform the development of care for this population. Methods Emergency ambulance data in London were analysed for patterns of attendance and call outcomes in 2003–4. All older people who were attended by emergency ambulance staff after a fall in September and October 2003, within three London areas, were identified. Those who were not conveyed to hospital were followed up; healthcare contacts and deaths within the following 2 weeks were identified. Results During 2003–4, 8% of all 999 calls in London were for older people who had fallen (n = 60 064), with 40% not then conveyed to hospital. Of 2151 emergency calls attended in the study areas during September and October 2003, 534 were for people aged ⩾65 who had fallen. Of these, 194 (36.3%) were left at home. 86 (49%) people made healthcare contacts within the 2‐week follow‐up period, with 83 (47%) people calling 999 again at least once. There was an increased risk of death (standard mortality ratio 5.4) and of hospital admission (4.7) compared with the general population of the same age in London. Comment The rate of subsequent emergency healthcare contacts and increased risk of death and hospitalisation for older people who fall and who are left at home after a 999 call are alarming. Further research is needed to explore appropriate models for delivery of care for this vulnerable group. PMID:17142584
This report documents the negative impacts of several projects financed by Canada's Export Development Corporation (EDC), how these investments put people and the environment at risk, and highlights the need for ensuring that EDC, an agency of the Canadian Government, is compelled to uphold public policies and international standards protecting human rights, the environment and the social needs of communities. By way of proving its case, authors of this report describe several international projects --the Three Gorges Dam in China; the Urra Hydro Project in Colombia; the Marcopper Mine in the Philippines; the BioBio Dam in Chile; the Ok Tedi Copper Mine in Papua New Guinea; the Yacyreta Dam in Argentina and Paraguay; and CANDU reactors in Argentina, China, Romania, South Korea and Turkey -- as proof of human rights violations and environmental disasters in which EDC has been an accessory. It is emphasized that unlike the World Bank and the U.S. export credit agencies, EDC is not required to undertake environmental assessment, or to take into account the impact on human rights or communities of project which they help to finance. The authors recommend amendments to the Export Development Act that would require the EDC to disclose information about proposed project at least 60 days before approval by the Board, including description of the project, the terms of financing, along with any environmental, social and human rights information collected. EDC should be required to establish an autonomous accountability mechanism, using the mechanisms of the World Bank Group as a model to track and guide EDC's policy implementation, and to receive and address complaints from external parties affected by EDC-supported activities. EDC should require social, environmental and human rights assessments, using World Bank standards and methodology as the base, and ensure implementation of recommendations by separately specifying them in the contract. EDC should not be
subsequently assessed two months post-bereavement. They were compared with a control group of 276 married elderly people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES=.35......; Cohen's d=.74). It was also concluded that 37% of the bereaved and 22% of the control group had mild to severe depression (ES=.19; Cohen's d=.37). The results suggested that late life spousal bereavement, in some cases, does result in PTSD, and that the disorder is as common in elderly bereaved people...... Late life bereavement has been associated with psychological problems, mainly depression. A few studies indicated that Posttraumatic Stress Disorder (PTSD) was an important issue to investigate in late life bereavement reactions. This study aimed to assess the prevalence of PTSD in recently...
Conroy, Simon P; Turpin, Sarah
Urgent care for older people is a major public health issue and attracts much policy attention. Despite many efforts to curb demand, many older people with frailty and urgent care needs to access acute hospital services. The predominant model of care delivered in acute hospitals tends to be medically focussed, yet the evidence-based approaches that appear to be effective invoke a holistic model of care, delivered by interdisciplinary teams embedding geriatric competencies into their service. This article reviews the role for holistic care-termed Comprehensive Geriatric Assessment in the research literature-and how it can be used as an organising framework to guide future iterations of acute services to be better able to meet the multifaceted needs of older people. PMID:27496917
Thetford, Clare; Bennett, Kate M; Hodge, Suzanne; Knox, Paul C; Robinson, Jude
Some people fare better than others when faced with adversity; they appear to be more 'resilient'. This article explores the concept of resilience in the context of vision impairment using two linked sets of narrative interview data from 2007 to 2010. Three case studies were analysed in detail using a framework approach based upon a social-ecological model of resilience and vision impairment. Within the model a range of assets and resources are identified which influence an individual's capacity for resilience. A set of criteria were used to establish the extent to which each individual appeared to be resilient at each point in time. Analysis revealed that it is not merely the presence or absence of individual, social, and community resources - but how these resources interact with each other - that influences resilience and can create a risk to wellbeing. To possess only some of these resources is not sufficient; there is a co-dependency between these resources which requires the presence of other resources for resilience to be achieved. Resilience is not a fixed state; individuals can become more or less resilient as their circumstances and resources change over time. We suggest that the concept of resilience has much to offer the field of vision impairment as it allows the identification of enablers as well as areas of barriers to improving people's health and wellbeing and suggests further opportunities for service providers to engage with clients, even those who appear to be supported, as people's social, economic and emotional landscapes continue to change over time, rather than identifying deficit. PMID:26568213
LoGiudice, D; Watson, R
Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration. PMID:25367725
Bissett, Susan; Preshaw, Philip
The authors provide an overview of oral health, why it is important for older people and how poor oral health can affect nutritional status and quality of life. Practical advice is given on assessment of oral health; cleaning of natural teeth and dentures; and care of oral problems that commonly affect older people. An oral healthcare education session is recommended to provide hands-on advice to caregivers. The article is not intended as an exhaustive reference and the reader should always ask for professional dental advice and assistance if in doubt about any aspect of oral care. PMID:22256725
Matias M Pulopulos
Full Text Available In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS. The cortisol awakening response (CAR is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93, we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase, but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people.
Pulopulos, Matias M; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia
In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847
Pulopulos, Matias M.; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia
In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847
Barnes, Marian; Bennett, Gaynor
Involving frail older users of health and social care services in decision making presents particular challenges for those committed to hearing the voices of service users. Age Concern Scotland initiated a project in Fife, the User Panels project, intended to enable older people who were unable to leave their homes without assistance to meet together to develop a collective voice expressing the needs and experiences of older service users. This paper reports on an evaluation of that project. It considers methodological questions posed by the evaluation of projects which aim to empower users, as well as discussing key findings from the evaluation. Older people were recruited through contacts in service agencies and other local organizations. The largest group was aged between 86 and 90 years and all were experiencing difficulties relating to poor health, physical frailty or disability. The project was based on a belief in the value of meeting together as a means through which people could develop the confidence to express their views. Those who became members of the panels valued this experience and reported intrinsic benefits related to the social contact, opportunities for learning and development of self-esteem. Evidence concerning enhanced capacity to exercise control over key aspects of their lives was less convincing. The work of the panels was generally well received by local social work and health agencies and had influenced local action in some areas. Responses to some issues raised by the panels generated a less positive response and the article considers reasons for this. The model is considered to demonstrate benefits both for the older people who become involved and for officials seeking to improve the sensitivity of services to the needs of older people. PMID:11560582
Aspinal, Fiona; Glasby, Jon; Rostgaard, Tine; Tuntland, Hanne; Westendorp, Rudi G J
As the overwhelming majority of older people prefer to remain in their own homes and communities, innovative service provision aims to promote independence of older people despite incremental age associated frailty. Reablement is one such service intervention that is rapidly being adopted across high-income countries and projected to result in significant cost-savings in public health expenditure by decreasing premature admission to acute care settings and long-term institutionalisation. It is an intensive, time-limited intervention provided in people's homes or in community settings, often multi-disciplinary in nature, focussing on supporting people to regain skills around daily activities. It is goal-orientated, holistic and person-centred irrespective of diagnosis, age and individual capacities. Reablement is an inclusive approach that seeks to work with all kinds of frail people but requires skilled professionals who are willing to adapt their practise, as well as receptive older people, families and care staff. Although reablement may just seem the right thing to do, studies on the outcomes of this knowledge-based practice are inconsistent-yet there is an emerging evidence and practice base that suggests that reablement improves performance in daily activities. This innovative service however may lead to hidden side effects such as social isolation and a paradoxical increase in hospital admissions. Some of the necessary evaluative research is already underway, the results of which will help fill some of the evidence gaps outlined here. PMID:27209329
Full Text Available Tanvir Ahmed, Nadim HaboubiAdult and Elderly Medicine, Nevill Hall Hospital, Abergavenny, Wales, UKAbstract: Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.Keywords: malnutrition, older people, anorexia of aging, sarcopinia, nutritional assessment
Full Text Available Solveig T Tomstad1, Ulrika Söderhamn2, Geir Arild Espnes3, Olle Söderhamn21Department of Social Work and Health Science, Faculty of Sciences and Technology Management, NTNU, Trondheim, Norway and Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 2Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, NorwayBackground: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people.Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues.Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years in southern Norway. The study group included 158 (35.1% participants. Data were analysed using statistical methods.Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help
Pearlin, Leonard I.; Nguyen, Kim B.; Schieman, Scott; Milkie, Melissa A.
In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past…
Clinical pharmacy interventions for older people with polypharmacy can be divided in dispensing services (aimed at support of medication management), e.g. multidose dispensing systems, and medication reviews (aimed at appropriateness of the pharmacotherapy. The objective of this thesis is to describ
Principi, Andrea; Chiatti, Carlos; Lamura, Giovanni; Frerichs, Frerich
This article reviews recent international literature on the opportunities and restrictions experienced by older people to act as volunteers in civil society organizations. Our aim was to develop a conceptual framework applicable to the European ageing society. This aim was pursued through a computerized database search focused on studies analyzing…
Robinson, Sally; Howatson-Jones, Lioba
Worldwide demographic change means that the responsibility for an aging population will fall to younger generations. This narrative literature review comprises an international examination of what has been published about children's views of older people between 1980 and 2011. Sixty-nine academic articles were inductively analyzed, and the…
Lin, Xiaoping; Bryant, Christina; Boldero, Jennifer
Measuring medical and allied health students' attitudes towards older people has been identified as an important research area. The present study compared the use of implicit and explicit attitude measures. Sixty-five undergraduates completed one explicit measure, the Fraboni Scale of Ageism (FSA), (Fraboni, Saltstone, & Hughes, 1990) and one…
Zijlstra, Wiebren; Aminian, Kamiar
A major challenge for researchers and clinicians who address health issues in the ageing population is to monitor functioning, and to timely initiate interventions that aim to prevent loss of functional abilities and to improve the quality of life of older people. With the progress of technologies i
C.F. de Winter (Channa)
markdownabstract__Abstract__ Chapter 1 General introduction There is an increasing group of older people with intellectual disability in The Netherlands, reaching almost the same life expectancy as the general population. Age-related diseases, such as cardiovascular disease, cancer and dementia are
Pijl, M.; Henneman, L.; Claassen, E.A.M.; Detmar, S.B.; Nijpels, M.G.A.A.M.; Timmermans, D.R.M.
INTRODUCTION: The aim of this study was to explore the perceptions of causes, risk, and control with regard to diabetes and the role of family history among people at increased risk for type 2 diabetes. METHODS: Semistructured interviews were conducted among people aged 57 to 72 years with (n = 9) a
Anticancer drugs themselves can cause adverse health effects when administered to human patients. In addition, it has become apparent that personnel in human medicine, occupationally exposed to these anticancer drugs, may also be at risk. The past decades, the use of chemotherapy in veterinary medicine has been gaining popularity. Consequently, an increasing number of people in veterinary medicine may be exposed to anticancer drugs. This raises the question whether veterinary personnel and ow...
Full Text Available This paper analyzes how older people, living in Spain, use smartphones and smartphone applications. Using a mixed methods approach, we compare quantitative results obtained by tracking mobile app usage amongst different generational samples with qualitative, focus-group discussions with active smartphone users. A sample of Spanish smartphone users were tracked during one month in the winter of 2014 (238 individuals, aged 20 to 76 years-old. This was followed by three focus group sessions conducted in the spring of 2015, with 24 individuals aged 55 to 81. As we learned, WhatsApp is currently the most popular application used by people of all ages, including older adults. Smartphones increasingly are playing a central role in the life of older participants, although the frequency of app access is negatively correlated with age. On the other hand, as our data indicates, older adults also use a number of different types of apps that are distinct from that of younger users. Older participants access personal information manager apps (calendar, address book and notes more often than other age groups. And comparatively, older participants use the smartphone less often in stable locations (home, office, relatives’ home with Wifi than somewhere else and with mobile data. As we argue, differences in age seem to reflect the evolution in personal interests and communication patterns that change as we grow older. Our study captures new trends in smartphone usage amongst this cohort. It also indicates how a combination of methods may help to assess the validity of the log and qualitative data. We highlight the relevance of conducting careful generational studies in smartphone use and some of the potentials and limitations of making predictive studies of ICT use as we change throughout the life course. Finally, we assert the value of the inclusion of older representatives within research, which ultimately may influence public decisions and the design of new
Full Text Available We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality.We conducted a multicentre, open-label interventional, stratified (centre, parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5. Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes.Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation age of 78.0 y (4·9, 51.2% male, mean MNA 20.2 (2.1. Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%, lymphoma (14.9%, lung (10.4%, and pancreas (17.0%. Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01. At the second visit, the energy target was achieved in 57 (40.4% patients and the protein target in 66 (46.8% with the intervention compared respectively to 13 (13.5% and 20 (20.8% in the controls. Death occurred during the first year in 143 patients (42.56%, without difference according to the intervention (p = 0.79. No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups.Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect.ClinicalTrials.gov NCT
Pijl, Miranda; Henneman, Lidewij; Claassen, Liesbeth; Timmermans, Danielle R. M.; Detmar, Symone B.; Nijpels, Giel
Introduction The aim of this study was to explore the perceptions of causes, risk, and control with regard to diabetes and the role of family history among people at increased risk for type 2 diabetes. Methods Semistructured interviews were conducted among people aged 57 to 72 years with (n = 9) and without (n = 12) a family history of diabetes. Results Participants mentioned different causes for diabetes; these were often a combination of genetic and behavioral factors. Some participants wit...
Walls, A W G; Steele, J G
The oral health of older people is changing with reducing numbers of people relying on complete dentures for function, and retaining some natural teeth. Despite this there are substantial numbers of older people whose ability to chew foods is compromised by their oral health status, either because they have few or no natural teeth. This alteration results in individuals selecting a diet that they can chew in comfort. Such diets are low in fruits and vegetables intake with associated reduction in both non-starch polysaccharide and micronutrient intakes. There is also a trend for reduced dietary intake overall. Salivary flow and function may have an impact in relation to the ability to chew and swallow. Whilst there are few differences in salivary function in fit healthy unmedicated subjects, disease resulting in reduced salivary flow and particularly polypharmacy, with xerostomia as a side effect, are likely to have a role in older people. This paper explores the relationships between oral health status and food's choice and discusses the potential consequences for the individual of such dietary change. PMID:15563930
Saarnak, Christopher; Braae, Uffe Christian; Mukaratirwa, S.;
considered, on national scale, to be co-endemic with schistosomiasis. The co-endemicity dataset was then combined with modelled data on population density for 2015 derived from the WorldPop database. We used the open source GIS software QGIS and GRASS to overlay the two datasets and identified the number......This study investigates the number of people in Sub-Saharan Africa living in areas where two neglected tropical diseases, cysticercosis and schistosomiasis, are co-endemic. The World Health Organisation is aiming for elimination of schistosomiasis by 2020 through mass drug administration (MDA......). However, the drug used for this, praziquantel, has been reported to cause dramatic side effects among people suffering from neurocysticercosis. Both diseases are presumed to be widely distributed on the continent, but the co-endemicity is unclear. We carried out a meta-analysis of the literature of T...
Saarnak, Christopher; Braae, Uffe Christian; Magnussen, Pascal;
countries were identified. The co-endemicity dataset was then combined with modelled data on population density for 2015 derived from the WorldPop database (http://www.worldpop.org). We used the open source GIS software QGIS and GRASS to overlay the two datasets and identified the number of people living......The World Health Organisation (WHO) is aiming for elimination of schistosomiasis by 2020 through mass drug administration (MDA). However, the drug used for this, praziquantel, has been reported to cause dramatic side effects, even death, among people suffering from neurocysticercosis (NCC). Both...... surveys were discarded. The presence of T. solium was georeferenced with an online gazetteer using information on place names in the published literature. We found 117 reports of T. solium cysticercosis/taeniosis in Africa from 1970 to 2012. A total of 538 districts (admin level 4 or equivalent) in 25...
Andresen, Mette; Puggaard, Lis
information about the effectiveness of individually tailored programmes according to perceptions of autonomy registered in institutionalised physically frail older people. This will add knowledge to assist response to present and future challenges in relation to health promotion initiatives for this group.......BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...... themselves perceive autonomy in daily life. Further, there are no studies on the extent to which this perception can be influenced positively by participating in an individually tailored programme based on residents' own wishes for daily activities. METHODS AND DESIGN: A total of 9 nursing homes and 55...
Draper, Peter; Wray, Jane; Burley, Sandra
The authors discuss ways in which nurses speak to older people. Research shows that the words nurses use can have a powerful effect on the wellbeing of older people. An experimental project developed at the University of Hull is described in which creative writing techniques were used to increase nursing students' and staff's sensitivity to the importance of language in care. The project enabled participants to co-create a body of work that was subsequently displayed in the faculty reception, and it showed how trusting relationships could be developed between participants. The authors are working to extend the project by finding ways to embed creative writing in the undergraduate nursing curriculum. PMID:24171621
being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition.Conclusion: Health professionals should focus on the health-promoting factors that reinforce older people's ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person's self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens.Keywords: activity, aged, health promotion, mental health, perceived health, undernutrition
Abdulla, Aza; Adams, Nicola; Bone, Margaret; Elliott, Alison M; Gaffin, Jean; Jones, Derek; Knaggs, Roger; Martin, Denis; Sampson, Liz; Schofield, Pat
This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research. The assessment of pain in older people has not been covered within this guidance and can be found in a separate document (http://www.britishpainsociety.org/pub_professional.htm#assessmentpop). Substantial differences in the population, methods and definitions used in published research makes it difficult to compare across studies and impossible to determine the definitive prevalence of pain in older people. There are inconsistencies within the literature as to whether or not pain increases or decreases in this age group, and whether this is influenced by gender. There is, however, some evidence that the prevalence of pain is higher within residential care settings. The three most common sites of pain in older people are the back; leg/knee or hip and 'other' joints. In common with the working-age population, the attitudes and beliefs of older people influence all aspects of their pain experience. Stoicism is particularly evident within this cohort of people. Evidence from the literature search suggests that paracetamol should be considered as first-line treatment for the management of both acute and persistent pain, particularly that which is of musculoskeletal origin, due to its demonstrated efficacy and good safety profile. There are few absolute contraindications and relative cautions to prescribing paracetamol. It is, however, important that the maximum daily dose (4 g/24 h) is not exceeded. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in older people after other safer treatments have not provided sufficient pain relief. The lowest dose should be provided
Public policy on responding to the ageing “crisis” typically involves a focus on preventative interventions in primary care, tackling inequalities and increasing use of informal and voluntary care networks. Yet at present, the experiences of lesbian, gay, bisexual and trans (LGB&T) older people remains under-researched, despite evidence of increased risk of mortality and morbidity in LGBT populations (Williams et al., 2013; Addis et. al, 2009). Voluntary sector surveys (River, 2011; Guasp, un...
Bradley, Marie C; Motterlini, Nicola; Padmanabhan, Shivani; Cahir, Caitriona; Williams, Tim; Fahey, Tom; Hughes, Carmel M
Background: Potentially inappropriate prescribing (PIP) in older people is associated with increases in morbidity, hospitalisation and mortality. The objective of this study was to estimate the prevalence of and factors associated with PIP, among those aged ≥70 years, in the United Kingdom, using a comprehensive set of prescribing indicators and comparing these to estimates obtained from a truncated set of the same indicators.Methods: A retrospective cross-sectional study was carried out in t...
Boucher, Barbara J
This report reviews evidence on disorders related to inadequate vitamin D repletion in older people. Vitamin D is as essential for bone health in adults as in children, preventing osteomalacia and muscle weakness and protecting against falls and low-impact fractures. Vitamin D is provided by skin synthesis by UVB-irradiation from summer sunshine and to a small extent by absorption from food. However, these processes become less efficient with age. Loss of mobility or residential care restrict...
Pulopulos, Matias M; Hidalgo, Vanesa; Almela, Mercedes; Puig-Perez, Sara; Villada, Carolina; Salvador, Alicia
Worse cognitive performance in older people has been associated with hypothalamic-pituitary-adrenal axis dysregulation (in particular, higher cortisol levels). Analysis of hair cortisol concentrations (HCC) is a novel method to measure long-term cortisol exposure, and its relationship with cognition in healthy older people has not yet been studied. We investigated whether HCC (measured in hair scalp) and diurnal salivary cortisol levels (awakening, 30min after awakening, and evening, across two days) were related to cognitive performance (assessed with the Trail-making Test A and B, Digit Span Forward and Backward, word list-RAVLT and Stories subtest of the Rivermead) in 57 healthy older people (mean age=64.75 years, SD=4.17). Results showed that lower HCC were consistently related to worse working memory, learning, short-term verbal memory (RAVLT first trial and immediate recall) and long-term verbal memory. In contrast, higher mean levels and higher diurnal area under the curve of diurnal salivary cortisol were related to worse attention and short-term verbal memory (immediate story recall), respectively. Interestingly, a higher ratio of mean levels of diurnal salivary cortisol over HCC were related to worse performance on working memory and short-term verbal memory, suggesting that those individuals with lower long-term cortisol exposure might be more vulnerable to the negative effect of HPA-axis dysregulation on these cognitive processes. Our findings suggest that both low long-term cortisol exposure and a possible dysregulation of the diurnal rhythm of the HPA-axis may account, at least in part, for the inter-individual variability in cognitive performance in healthy older people.
Best practice recommendations: Despite the weak quality of the majority of studies included in this review, as evaluated according to the criteria set for randomised controlled trials, the small increase in weight gain and the decrease in mortality - for undernurished groups only - provides justification for continuing the prescription of protein and energy supplements. However, other interventions intended to improve nutritional status should be integrated. These could include providi...
Martin-Khan, Melinda; Burkett, Ellen; Schnitker, Linda; Jones, Richard N.; Gray,Leonard C
Background Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important g...
Martin-Khan, Melinda; Burkett, Ellen; Schnitker, Linda; Jones, Richard N.; Gray,Leonard C
Background: Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important ...
Epidemiological studies suggest that anxiety and depression are less common in older than younger adults. One in ten people aged > or = 65 fulfils the diagnostic criteria for at least one common mental disorder. Older depressed patients have an increased risk of both cardiac and all-cause mortality. Both anxiety and depression in older patients are often unrecognised and untreated, and have a poor prognosis. There is a progressive decline in the prevalence of common mental disorders above the age of 55. Anxiety and depression often occur together, and share many risk factors. However, anxiety tends to follow threats or traumatic events, whereas depression follows loss events. Chronic diseases, cognitive impairment, pain and functional disability are risk factors for the onset of depression, but not anxiety. Depression is between two and three times more common among those with a chronic physical health problem. Even patients with major depression often remain unrecognised and untreated. Generalised anxiety disorder (GAD) is by far the most common anxiety disorder in older people but most GAD patients are not recognised in primary care and only a third of them receive any form of treatment. Older patients often deny feeling anxious or depressed and are more likely to present with insomnia, irritability, agitation and multiple somatic complaints. GPs may erroneously believe that depression is a normal reaction to the losses of old age, and may be reluctant to initiate treatment. A good case can be made for replacing the PHQ-9 with the 15-item version of the Geriatric Depression Scale which almost entirely avoids somatic questions. This is a screening not a diagnostic tool and does not evaluate symptom severity. PMID:22720455
Gallagher Paul F
Full Text Available Abstract Inappropriate prescribing (IP in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs, morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
Epidemiological studies suggest that anxiety and depression are less common in older than younger adults. One in ten people aged > or = 65 fulfils the diagnostic criteria for at least one common mental disorder. Older depressed patients have an increased risk of both cardiac and all-cause mortality. Both anxiety and depression in older patients are often unrecognised and untreated, and have a poor prognosis. There is a progressive decline in the prevalence of common mental disorders above the age of 55. Anxiety and depression often occur together, and share many risk factors. However, anxiety tends to follow threats or traumatic events, whereas depression follows loss events. Chronic diseases, cognitive impairment, pain and functional disability are risk factors for the onset of depression, but not anxiety. Depression is between two and three times more common among those with a chronic physical health problem. Even patients with major depression often remain unrecognised and untreated. Generalised anxiety disorder (GAD) is by far the most common anxiety disorder in older people but most GAD patients are not recognised in primary care and only a third of them receive any form of treatment. Older patients often deny feeling anxious or depressed and are more likely to present with insomnia, irritability, agitation and multiple somatic complaints. GPs may erroneously believe that depression is a normal reaction to the losses of old age, and may be reluctant to initiate treatment. A good case can be made for replacing the PHQ-9 with the 15-item version of the Geriatric Depression Scale which almost entirely avoids somatic questions. This is a screening not a diagnostic tool and does not evaluate symptom severity.
Hamilton, Hilary J
Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
This paper examines how the rights associated with citizenship for older people and people at the end of life may be restricted, particularly in conservative communitarian views of citizenship, which demands economic participation as a condition of citizenship and devalues dependence on others. It identifies the characteristics of a citizenship social work, which implements radical communitarian values that favour participation and engagement as a source of solidarity in society. ...
Full Text Available With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia’s central business district (CBD. Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development.
Ahmed, Tanvir; Haboubi, Nadim
Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements. PMID:20711440
Racine, Annie M.; Clark, Lindsay R.; Berman, Sara E.; Koscik, Rebecca L.; Mueller, Kimberly D.; Norton, Derek; Nicholas, Christopher R.; Blennow, Kaj; Zetterberg, Henrik; Jedynak, Bruno; Bilgel, Murat; Carlsson, Cynthia M.; Christian, Bradley T.; Asthana, Sanjay; Johnson, Sterling C.
It is not known whether computerized cognitive assessments, like the CogState battery, are sensitive to preclinical cognitive changes or pathology in people at risk for Alzheimer’s disease (AD). In 469 late middle-aged participants from the Wisconsin Registry for Alzheimer’s Prevention (mean age 63.8±7 years at testing; 67% female; 39% APOE4+), we examined relationships between a CogState abbreviated battery (CAB) of seven tests and demographic characteristics, traditional paper-based neuropsychological tests as well as a composite cognitive impairment index, cognitive impairment status (determined by consensus review); and biomarkers for amyloid and tau (CSF phosphorylated-tau/Aβ42 and global PET-PiB burden) and neural injury (CSF neurofilament light protein). CSF and PET-PiB were collected in n=71 and n=91 participants, respectively, approximately four years prior to CAB testing. For comparison, we examined three traditional tests of delayed memory in parallel. Similar to studies in older samples, the CAB was less influenced by demographic factors than traditional tests. CAB tests were generally correlated with most paper-based cognitive tests examined and mapped onto the same cognitive domains. Greater composite cognitive impairment index was associated with worse performance on all CAB tests. Cognitively impaired participants performed significantly worse compared to normal controls on all but one CAB test. Poorer One Card Learning test performance was associated with higher levels of CSF phosphorylated-tau/Aβ42. These results support the use of the CogState battery as measures of early cognitive impairment in studies of people at risk for AD. PMID:27589532
Villar, Feliciano; Celdran, Montserrat; Pinazo, Sacramento; Triado, Carme
The aim of this study was to explore university lecturers' descriptions of their teaching experience with older students. Twelve teachers of the Nau Gran (a university program for older people [UPOP] in Valencia, Spain) were interviewed. We analyzed their responses to questions about their experience of teaching older adults, the rewarding aspects…
Villar, Feliciano; Faba, Josep
The goal of this study was to explore stereotypes of older people as expressed in drawings by a sample of primary school children. Sixty children from fourth to sixth grades (30 boys and 30 girls aged 9 to 12 years) were asked to draw a young man, a young woman, an old man, and an old woman. The drawings were content analyzed. Children in our…
Dickinson, Angela; Wills, Wendy; Meah, Angela; Short, Frances
Foodborne illness (FBI) is a major public health problem in the UK. Recent increases in cases of listeriosis in older people have focused attention on consumer food-related practices. Previous studies highlight poor relationships between what people know, what they say they do and what they actually do in the kitchen. The aim of the Kitchen Life study was to examine what actually happens in the domestic kitchen to assess whether and how this has the potential to influence food safety in the home. Drawing on a qualitative ethnographic approach, methods included a kitchen tour, photography, observation, video observation, informal interviews and diary methods. Ten households with older people (aged 60+) were recruited across the UK. It was found that trust in the food supply, use of food-labelling (including use-by dates), sensory logics (such as the feel or smell of food) and food waste were factors with the potential to influence risk of foodborne illness. Practices shifted with changing circumstances, including increased frailty, bereavement, living alone, receiving help with care and acquiring new knowledge, meaning that the risk of and vulnerability to foodborne illness is not straightforward.
Gilbert, Tony; Farrand, Paul; Lankshear, Gloria
This article reports on interview data gathered from 27 young people involved with a street-level service for young people considered "at risk" of diagnosis of personality disorder. Interviews with a self-selecting sample of young people explored the events that led to their initial contact with the service. Using Silverman's…
Sivberg, B. V.; L. Fagerström; B. M. Nordström; Thorsell, K. B. E.
In order to measure actual care needs in relation to resources required to fulfill these needs, an instrument (Time in Care) with which to evaluate care needs and determine the time needed for various care activities has been developed with the aim of assessing nursing intensity in municipal care for older people. Interreliability (ICC = 0.854) of time measurements (n = 10'546) of 32 nursing activities in relation to evaluated care levels in two nursing homes (staff n = 81) has been determine...
Turner, Sue; Cooper Ueki, Madeline
Background: This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Methods: Using the broad themes housing, employment, social inclusion and isolation, care and…
Ceci, Christine; Purkis, Mary Ellen; Björnsdóttir, Kristin
This paper examines the issue of what thinking is necessary in order to advance a notion of accommodation in the organization and provision of supportive home care for older people. Accommodation in this context is understood as responsiveness to the singularity of older adults, and we consider how this idea might be used to support opportunities for (independent) living for elders as they age and become frailer. To elaborate the question we draw on examples from our empirical work - ethnographic studies of home care practice undertaken in Canada and Iceland - and consider these examples in light of critical philosophical and social theory, particularly Agamben's (1993) work, The Coming Community. This is a relevant frame through which to consider the potential for the accommodation of the unique needs of older adults in home care because it helps us to problematize the systems through which care is accomplished and the current, dominant terms of relations between individuals and collectives. We argue that giving substance to a notion of accommodation contributes an important dimension to aligned ideas, such as patient-centeredness in care, by working to shift the intentionality of these practices. That is, accommodation, as an orientation to care practices, contests the organizational impulse to carry on in the usual way. PMID:23273554
Menz Hylton B
Full Text Available Abstract Background Plantar hyperkeratotic lesions are common in older people and are associated with pain, mobility impairment and functional limitations. However, little has been documented in relation to the frequency or distribution of these lesions. The aim of this study was to document the occurrence of plantar hyperkeratotic lesions and the patterns in which they occur in a random sample of older people. Methods A medical history questionnaire was administered to a random sample of 301 people living independently in the community (117 men, 184 women aged between 70 and 95 years (mean 77.2, SD 4.9, who also underwent a clinical assessment of foot problems, including the documentation of plantar lesion locations, toe deformities and the presence and severity of hallux valgus. Results Of the 301 participants, 180 (60% had at least one plantar hyperkeratotic lesion. Those with plantar lesions were more likely to be female (χ2 = 18.75, p 2 = 6.15, p vs 36.3 ± 8.4°; t = 2.68, df = 286, p vs 4.8 ± 1.3 hours, t = -2.46, df = 299, p = 0.01. No associations were found between the presence of plantar lesions and body mass index, obesity, foot posture, dominant foot or forefoot pain. A total of 53 different lesions patterns were observed, with the most common lesion pattern being "roll-off" hyperkeratosis on the medial aspect of the 1st metatarsophalangeal joint (MPJ, accounting for 12% of all lesion patterns. "Roll-off" lesions under the 1st MPJ and interphalangeal joint were significantly associated with moderate to severe hallux valgus (p p Conclusion Plantar hyperkeratotic lesions affect 60% of older people and are associated with female gender, hallux valgus, toe deformity, increased ankle flexibility and time spent on feet, but are not associated with obesity, limb dominance, forefoot pain or foot posture. Although there are a wide range of lesion distribution patterns, most can be classified into medial, central or lateral groups. Further
Shaw, K.; Cartwright, C.; Craig, J.
Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the…
de Guzman, Allan B.; Shim, Hye-Eun; Sia, Charmin Kathleen M.; Siazon, Wilbart Harvey S.; Sibal, Mary Joyce Ann P.; Siglos, Joanna Brigitte Lorraine C.; Simeon, Francis Marlo C.
Ego integrity, the last developmental task in Erikson's psychological theory, develops naturally among older people. However, the presence of loss-like physical disability-can considerably affect the quality of life, interactions, and well being of older adults. Hence, older people with physical disabilities need more assistance in accomplishing…
Yoon, Eunkyung; Kolomer, Stacey R.
Older persons are living longer and healthier and, thus, are capable of being more productive and less dependent. Despite this trend, young people persistently hold the age-old negative stereotypes about older persons. The goals of this study were to develop a valid, reliable measure of social values of older people and to assess its utility as…
Maria Mercedes Diaz Rodriguez
Full Text Available The city of León has pioneered the development of community health programs, developing comprehensive health programs such as the project ‘A New Initiative for the Americas’, a university hospital, a hospital ‘Mother´s Friend’, teaching assistance municipality, including many others. In the last five years, a group of professionals from different fields of medicine, psychology, and social work has focused on the task of working together with the community, National Police, My Family, MINED, as well as national and international NGOs to study the youth phenomenon and its impact on society. There have been five meetings with teenagers and young people promoted by the Departmental Board of Save the Children and Youth Leonesa, where the UNAN León is actively participating. Based on these meetings, a possibility of a descriptive cross-sectional study on the characterization of young people at risk of social exclusion of the peripheral area of the city of Leon arose, and the results are revealing.
Stahl, Sarah T.; Albert, Steven M.; Dew, Mary Amanda; Lockovich, Michael H.; Reynolds, Charles F.
Prevention of major depressive disorder is important because current treatments are only partially adequate in reducing symptom burden and promoting health-related quality of life. Lifestyle interventions may be a desirable prevention strategy for reasons of patient preference, particularly among older patients from minority groups. Using evidence from a randomized depression prevention trial for older adults, the authors found that coaching in healthy dietary practices was potentially effect...
Full Text Available BACKGROUND: China has the largest number of people with diabetes in the world. Over the last 30 years China has experienced rapid economic growth and a growing income gap between rich and poor. The population is ageing, however diabetes in older people has not been well studied to date. In this study we determined incidence and predictors of diabetes in older Chinese people. METHODS: During 2001, using a standard interview method, we examined 1,317 adults aged ≥65 years who did not have diabetes in the city of Hefei, and characterized baseline risk factors. Over 7.5 years of follow up, we documented incident diabetes using self-reported doctor diagnosis and the cause of death in the whole cohort, and HbA(1C ≥48 mmol/mol in a nested case-control sample. A multivariate Cox regression model was employed to investigate risk of diabetes in relation to baseline risk factors. RESULTS: During follow up, 119 persons had newly diagnosed diabetes. World age-standardised incidence of diabetes was 24.5 (95% CI 19.5-29.5 per 1,000 person-years. Risk of diabetes was significantly and positively associated with income, waist circumference and body mass index, smoking and uncontrolled hypertension, but negatively associated with having a hobby of walking and frequency of visiting children/other relatives and contacting neighbours/friends. Higher income was significantly associated with increased diabetes risk regardless of cardiovascular and psychosocial risk factors. Compared to those with middle income and no psychosocial risk factors, the hazard ratio for incident diabetes among participants with high income and psychosocial risk was 2.13 (95% CI 1.02-4.45. CONCLUSIONS: Increasing incidence of diabetes in relation to high income has become an important public health issue in China. Maintaining social networks and gentle physical activities and reducing psychosocial factors may be integrated into current multi-faceted preventive strategies for curbing the
Full Text Available Background: Approaches for investigating health-promoting lifestyle generally focus on physical activity and regular diet. To explore the perspectives of Iranian elders regarding health, healthy eating and physical activity (PA this study was conducted in 2012. Methods: Participants in this qualitative study were selected through purposeful sampling. Ten focus groups were conducted with 60 older adults in 3 elderly centers in Tehran. A moderator’s guideline that consisted of general and specific questions was used. Focus groups were audio recorded, transcribed verbatim and analysis was performed using conventional content analysis. Results: Participants explained their perspectives regarding health, healthy eating and PA in the following 5 categories: meaning of health was represented based on issues such as absence of pain and disorder, complete body wellbeing, staying away from hazards, complete individual satisfaction, experiencing positive events, effective communication, faithfulness and trust in God. The healthy eating category was featured by adequate eating, age balanced diet, refraining from under or over nutrition and sensible consumption of fruits and vegetables. The PA was described - according to the level of performing outdoor activities or household tasks. Expressions about the perceived benefits and barriers of healthy eating and PA were aligned the two remaining categories. Conclusions: Participants have referred to the association between both PA and dietary practices and health. Understanding how older people define physical activity and nutritional behavior and recognition of the most important perceived benefits and barriers that might contribute to have a healthy eating or adequate PA profile could procure insight into the type of interventions that are required to promote healthy lifestyle among Iranian older adults.
People over 65 (or older people) are a growing proportion of the population in many developed countries including Australia. In the last 10 to 12 years interest from this group in the use of Information and Communication Technologies (ICT) and the Internet has also grown considerably. ICT has much to offer older people as a means of keeping in…
Yardley, L.; Donovan-Hall, M.; Francis, K.; Todd, C.
The aim of this study was to gain an understanding of older people's perceptions of falls prevention advice, and how best to design communications that will encourage older people to take action to prevent falls. Focus groups and interviews were carried out with 66 people aged 61-94 years recruited from a variety of settings, using falls…
Full Text Available OBJECTIVES AND METHODS: As part of the European project VINTAGE, a systematic review of scientific literature was undertaken to document the evidence base on the impact of alcohol on the health and well-being of older people, and on effective policies and preventive approaches to face the problem in this steadily increasing segment of the population. RESULTS: 369 references were identified, from which 78 papers were selected. CONCLUSIONS: The review confirms the paucity of data on this topic and the need for more specific research. Although there is scarce evidence, the elderly seems to respond equally well to alcohol policy, screening instruments and brief interventions as do younger adults. According to a lifecycle approach, a future focus on the middle aged is also recommended.
Full Text Available Deprescribing has been proposed as a way to reduce polypharmacy in frail older people. We aimed to reduce the number of medicines consumed by people living in residential aged care facilities (RACF. Secondary objectives were to explore the effect of deprescribing on survival, falls, fractures, hospital admissions, cognitive, physical, and bowel function, quality of life, and sleep.Ninety-five people aged over 65 years living in four RACF in rural mid-west Western Australia were randomised in an open study. The intervention group (n = 47 received a deprescribing intervention, the planned cessation of non-beneficial medicines. The control group (n = 48 received usual care. Participants were monitored for twelve months from randomisation. Primary outcome was change in the mean number of unique regular medicines. All outcomes were assessed at baseline, six, and twelve months.Study participants had a mean age of 84.3 ± 6.9 years and 52% were female. Intervention group participants consumed 9.6 ± 5.0 and control group participants consumed 9.5 ± 3.6 unique regular medicines at baseline. Of the 348 medicines targeted for deprescribing (7.4 ± 3.8 per person, 78% of regular medicines, 207 medicines (4.4 ± 3.4 per person, 59% of targeted medicines were successfully discontinued. The mean change in number of regular medicines at 12 months was -1.9 ± 4.1 in intervention group participants and +0.1 ± 3.5 in control group participants (estimated difference 2.0 ± 0.9, 95%CI 0.08, 3.8, p = 0.04. Twelve intervention participants and 19 control participants died within 12 months of randomisation (26% versus 40% mortality, p = 0.16, HR 0.60, 95%CI 0.30 to 1.22 There were no significant differences between groups in other secondary outcomes. The main limitations of this study were the open design and small participant numbers.Deprescribing reduced the number of regular medicines consumed by frail older people living in residential care with no significant
Ng, Annie W Y; Chan, Alan H S; Ho, Vincy W S
This study examined the benefits of pharmaceutical pictograms for improving comprehension of medication information for older people. Fifty Hong Kong Chinese older people completed a medical information comprehension task for five drugs. Participants in the control group were presented with text labels while those in the experimental group were given the text labels plus supplementary pharmaceutical pictograms, and then all reported their understanding of the medication information conveyed. Lower educated older people had poorer understanding of medication information. The addition of pharmaceutical pictograms significantly improved the comprehension of medication information for older people. The majority of older people tested with pictograms favored adding pictograms to text and thought the pictograms were useful for conveying medical information rather than using written text alone. The findings suggested that pharmaceutical and health care professionals should include pharmaceutical pictograms on labels to better convey instructions on medication to older people.
Full Text Available Vitus Nyigo,1 Andrew Kilale,2 Stella Kilima,1 Elizabeth H Shayo,1 Kesheni P Senkoro,1 Jonathan Mshana,1 Adiel K Mushi,1 Lucas Matemba,1 Julius Massaga11National Institute for Medical Research, 2Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania Introduction: According to the 2011–2012 HIV and Malaria Indicator Survey, the prevalence of HIV infection in Tanzania is 5.1%, with limited information on its magnitude among older people, as the community believes that the elderly are not at risk. Consequently, little attention is given to the fight against HIV and AIDS in this group. The present study investigated the magnitude of HIV and AIDS infection among older people in rural and urban areas of the Tanzania mainland. Subjects and methods: The study was conducted in Mufindi and Babati districts of Iringa and Manyara regions, respectively, through multistage sampling procedures. Dried blood spot cards were used to collect blood samples for HIV testing among consenting participants. HIV testing was done and retested using different enzyme-linked immunosorbent assay kits. Results: A total of 720 individuals, 340 (47.2% males and 380 (52.8% females, were randomly selected, of whom 714 (99.2% consented to HIV testing while six (0.8% refused to donate blood. The age ranged from 50 to 98 years, with a mean age of 64.2 years. Overall, a total of 56 (7.8% participants were HIV-positive. Females had a higher prevalence (8.3% than males (7.4%, with Mufindi district recording the higher rate (11.3% compared to the 3.7% of Babati district. The prevalence was higher in the rural population (9.4% compared to 6.4% of their urban counterparts. Conclusion: Although HIV/AIDS is considered a disease of individuals aged 15–49 years, the overall prevalence among the older people aged 50 years and above for Mufindi and Babati districts was higher than the national prevalence in the general population. These findings
Evron, Lotte; Schultz-Larsen, Kirsten; Fristrup, Tine
Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In order to transform...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare....
Evron, L.; Schultz-Larsen, K.; Fristrup, T.
Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In order to transform...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare Udgivelsesdato: 2009/9...
Rabiee, Parvaneh; Baxter, Kate; Glendinning, Caroline
Summary: English policy emphasises personalised and flexible social care support using ‘Personal Budgets’ (PB) – preferably as cash direct payments. However, most older people opt for their council to manage personal budgets on their behalf. It is not clear what benefits of personalisation are available to this group of older people. This article reports research into the choices available to older people using managed personal budgets to fund home care services in three councils. It focuses ...
Cianelli, Rosina; Villegas, Natalia; Lawson, Sarah; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda; Yaya, Alexandra
Hispanic women who are 50 years of age and older have been shown to be at increased risk of acquiring HIV infection due to age and culturally related issues. The purpose of our study was to investigate factors that increase HIV risk among older Hispanic women (OHW) as a basis for development or adaptation of an age and culturally tailored intervention designed to prevent HIV-related risk behaviors. We used a qualitative descriptive approach. Five focus groups were conducted in Miami, Florida, with 50 participants. Focus group discussions centered around eight major themes: intimate partner violence (IPV), perimenopausal-postmenopausal-related biological changes, cultural factors that interfere with HIV prevention, emotional and psychological changes, HIV knowledge, HIV risk perception, HIV risk behaviors, and HIV testing. Findings from our study stressed the importance of nurses' roles in educating OHW regarding IPV and HIV prevention.
Ballin, Liora; Balandin, Susan
Background: There is a large body of research focusing on the experiences of loneliness of older adults, yet little is known about the loneliness experiences of older adults with lifelong disability. In this paper, the authors present some findings from a larger qualitative study on the loneliness experiences of older people with cerebral palsy.…
Horton, Khim; Dickinson, Angela
This grounded-theory study explored the perceptions of Chinese older people, living in England, on falls and fear of falling, and identified facilitators and barriers to fall prevention interventions. With a sample of 30 Chinese older people, we conducted two focus groups and 10 in-depth interviews in Mandarin or Cantonese. Interview transcripts, back translated, were analyzed using N6. Constant comparative analysis highlighted a range of health-seeking behaviors after a fall: Chinese older people were reluctant to use formal health services; talking about falls was avoided; older people hid falls from their adult children to avoid worrying them; and fatalistic views about falls and poor knowledge about availability and content of interventions were prevalent. Cost of interventions was important. Chinese older adults valued their independence, and cultural intergenerational relations had an impact on taking action to prevent falls. Cultural diversity affects older adults' acceptance of fall prevention interventions.
Julian C. L. Lai
Full Text Available Psychobiological research on aging in humans has been confounded by individual differences that have not been adequately characterized in the literature. This paper is an attempt to shed light on this issue by examining the impact of social network characteristics predictive of successful aging on salivary cortisol among 78 older Chinese people in Hong Kong. Eight salivary cortisol samples were collected each day for two consecutive days from immediately after awakening to 12 hours later. Two components of the cortisol diurnal cycle, response to awakening and diurnal decline, were examined in relation to social network characteristics including size, emotional support, and cultivation. ANOVAs with repeated measured were run to examine influences of the three social network characteristics on the cortisol awakening response and diurnal decline, with the effects of gender, age, socioeconomic status, and waking time controlled. Results indicated that those who spent more time and effort in developing and strengthening their social ties (i.e., those high in “cultivation” exhibited a significantly greater rise in cortisol in the morning and a significantly steeper decline over the day, thus attesting to more effective activation and deactivation of the HPA axis. Network cultivation reflected a positive motivation to nurture social relationships more than the other two network characteristics. Its effect on cortisol might stem from the positivity underlying the motivation.
Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Mun, Chan Yoke; Ng, Chee Kyun
Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. PMID:25914527
Høst, Dorte; Hendriksen, Carsten; Borup, Ina
This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes.......This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes....
Maarel-Wierink, C.D. van der; Vanobbergen, J.N.; Bronkhorst, E.M.; Schols, J.M.; Baat, C. de
OBJECTIVE: To systematically review the literature on oral health care interventions in frail older people and the effect on the incidence of aspiration pneumonia. BACKGROUND: Oral health care seems to play an important role in the prevention of aspiration pneumonia in frail older people. METHODS: P
Milbourne, Paul; Doheny, Shane
This paper explores the relations between older people, poverty and place in rural Britain. It develops previous work on rural poverty that has pointed both to the significance of older people within the rural poor population and to their denials of poverty. The paper also connects with recent discussions on the complexity of relations between…
Gutheil, Irene A.; Heyman, Janna C.
This study examined an intervention to help high-functioning community-dwelling older people communicate their wishes for care at the end of life with someone they would trust to make health care decisions for them if necessary. Groups consisted of dyads of older people and their potential or designated health care agents randomly assigned to the…
Y.M. Drewes; J.M. Koenen; W. de Ruijter; D.J.A. van Dijk - van Dijk; G.M. van der Weele; B.J.C. Middelkoop; R. Reis; W.J.J. Assendelft; J. Gussekloo
Background: Preventive care traditionally aims to prevent diseases or injuries. For older people, different aims of prevention, such as maintenance of independence and wellbeing, are increasingly important. Aim: To explore GPs' perspectives on preventive care for older people. Design and setting: Qu
Petersen, P E; Kandelman, D; Arpin, S;
The aim of this report is (1) to provide a global overview of oral health conditions in older people, use of oral health services, and self care practices; (2) to explore what types of oral health services are available to older people, and (3) to identify some major barriers to and opportunities...
Martorell, Ingrid; Medrano, Marc; Sole, Cristian; Vila, Neus; Cabeza, Luisa F.
With the increasing number of older people in the world and their interest in education, universities play an important role in providing effective learning methodologies. This paper presents a new instructional methodology implementing inquiry-based learning (IBL) in two courses focused on alternative energies in the Program for Older People at…
In January 2007 the Department of Education and Science approached AONTAS about conducting preliminary research into the lifelong learning needs of older people in Ireland. The findings of the research will be submitted to inform the Department's plans to address the educational needs of older people. In drafting this discussion paper, AONTAS has…
Sayago, Sergio; Forbes, Paula; Blat, Josep
A growing ageing population and an increasing reliance on information and communication technologies (ICT) to conduct activities associated with daily living means that addressing how older people learn to use ICT is timely and important. By drawing on a four-year ethnographical study with 420 older people in two different environments, this paper…
Williams, Angie; Wadleigh, Paul Mark; Ylanne, Virpi
The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an "a priori" framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106) impressions, trait…
Nyman, Samuel R.
This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of…
Laditka, Sarah B.; Laditka, James N.; Houck, Margaret M.; Olatosi, Bankole A.
Attitudes toward older people can influence how they are treated and their cognitive and physical health. The populations of the United States and many other countries have become more ethnically diverse, and are aging. Yet little research examines how ethnic diversity affects attitudes toward older people. Our study addresses this research gap.…
Allen, Ruth E. S.; Wiles, Janine L.
This research explored how older people describe their paths to late-life childlessness. In-depth accounts from 38 childless older people, age 63-93, highlight the complex journeys and diverse meanings of childlessness for male and female participants, single and partnered, including some who had outlived children. Positioning theory is used to…
McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla
The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…
Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James
Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…
Buffel, Tine; Verte, Dominique; De Donder, Liesbeth; De Witte, Nico; Dury, Sarah; Vanwing, Tom; Bolsenbroek, Anouk
This article presents a theoretical framework for exploring the dynamics between older people and their immediate social living environment. After introducing a gerontological perspective that goes beyond "microfication," a literature review presents findings from studies that have explored the role of place and locality for older people. Next,…
Vass, M; Hendriksen, C
This paper discusses GP perspectives on the principles underlying rational pharmacotherapy for older people. The rising use of prescription medicine forces the GP to balance the benefit of evidence group-based appropriate drug use against the problems arising when medication is given to older...... state that a number of pharmacological regimens for older people are outperformed by non-pharmacological treatment alternatives involving competent individualised counselling and public provision of easy (transportation) possibilities for joining centres offering staff and equipment for physical...
Piantadosi, Cynthia; Chapman, Ian M; Naganathan, Vasi; Hunter, Peter; Cameron, Ian D.; Visvanathan, Renuka
Background The difficulty of recruiting older people to clinical trials is well described, but there is limited information about effective ways to screen and recruit older people into trials, and the reasons for their reluctance to enrol. This paper examines recruitment efforts for a community-based health intervention study that targeted older adults. Methods One year randomized control trial. Undernourished men and women, aged ≥ 65 years and living independently in the community were recru...
Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles
This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program's…
Chouliaras, Leonidas; Topiwala, Anya; Cristescu, Tamara; Ebmeier, Klaus P
Common causes of memory loss in older people are mild cognitive impairment, the various types of dementia, and psychiatric illness, mainly depression. Around 10% of patients with mild cognitive impairment progress to dementia each year. Alzheimer's disease accounts for 60-80% of cases. Other common types of dementia are vascular, fronto-temporal, Lewy body, Parkinson's, and mixed type dementia. There is evidence to suggest that dementia pathology is established before the onset of symptoms, and thus mild cognitive impairment can be considered as a predementia stage. NICE guidance suggests examination of: attention, concentration, short- and long-term memory, praxis, language and executive function. Particular attention should be paid to any signs of neglect, state of dress, agitation or poor attention. Dysphasia and difficulty in naming objects is often present. Mood symptoms (including suicidal ideation) may be primary or comorbid. Abnormal thoughts and perceptions should be probed for, as psychotic symptoms are common. Primary care options for cognitive testing include the General Practitioner Assessment of Cognition or the Abbreviated Mental Test Score. Physical examination should include observation of gait, inspection for tremor; examination for rigidity, bradykinesia, frontal release signs, upper motor neurone lesions, pulse and BP. Structural brain imaging can improve diagnostic accuracy, exclude other pathologies and act as a prognostic marker of dementia progression but the overlap in structural changes between the dementias makes imaging alone insufficient for diagnostic purposes. NICE guidelines recommend referral to a memory clinic for patients with mild cognitive impairment, those at high risk of dementia, such as patients with learning disabilities, Parkinson's disease, or patients who have had several strokes. PMID:25726616
Hossein Matlabi; Abdolreza Shaghaghi; Shahriar Amiri
Background: Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practicability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran. Methods: Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and muscle-strengthening activity was planned for t...
This study investigates the relation between leisure activities and the social status of the elderly based on a heterogeneous sample of the Dutch population. Close relationships are also analyzed to identify which people could serve as successful stimulators of leisure participation. The social profile confirms that older people have fewer social contacts and often feel lonely. This study shows that leisure activities explain a significant part of older people's social connectedness. Voluntar...
Witham, Miles D; Donnan, Peter T.; Thenmalar Vadiveloo; Sniehotta, Falko F.; Crombie, Iain K; Zhiqiang Feng; McMurdo, Marion E. T.
BACKGROUND: Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. METHODS: We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical...
Covey, Herbert C.
Describes disengagement, activity, lifespan, subcultural, and continuity theories of social gerontology in light of participation in higher education by older students. Argues that continuity theory holds the most promise in accounting for older students. Emphasizes the need to stress the positive roles of old age. (JAC)
Cyrille P Launay
Full Text Available The aims of this study were 1 to confirm that combinations of brief geriatric assessment (BGA items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED; and 2 to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS.Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day, use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year. The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry.Area under receiver operating characteristic (ROC curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010. Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (P<0.003. Prognostic value for prolonged LHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4 and a low likelihood ratio of positive test under 5.6.Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.
Puvill, Thomas; Lindenberg, Jolanda; Slaets, Joris P J;
BACKGROUND: Self-rated health is assumed to closely reflect actual health status, but older people's shifting norms and values may influence this association. We investigated how older people's change in self-ratings, in comparison to their retrospective appreciation and change in nurse ratings...... appreciation of health by older people is superior to change in self-ratings and nurse-ratings in reflecting change in physical health, possibly because similar norms and values are applied in the assessment. The nurse's norms, like the norms of older people, may shift with the ageing of the researched cohort....... Asking people to retrospectively appreciate their change in health is a valuable addition to usual enquiries in practice and research....
Full Text Available Abstract Background In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1 HIV infected and on antiretroviral therapy (ART for at least 1 year; 2 HIV infected and not yet eligible for ART; 3 older people who had lost a child due to HIV/AIDS; 4 older people who have an adult child with HIV/AIDS; 5 older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion The systematic exploration of health and well being among older people, using eight self-reported and
Full Text Available Bjørg Dale, Ulrika SöderhamnCentre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, NorwayBackground: Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care.Methods: An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons' own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO instrument was filled out at baseline and 6 months after the self-care talks.Results: The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care.Conclusion: Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.Keywords: adapting, decision-making, knowledge, self-care talks
Menz, Hylton B; Auhl, Maria; Ristevski, Sonja; Frescos, Nicoletta; Munteanu, Shannon E
Background Ill-fitting footwear is a common problem in older people. The objective of this study was to determine the accuracy of shoe fitting in older people by comparing the dimensions of allocated shoes to foot dimensions obtained with a three-dimensional (3D) scanner. Methods The shoe sizes of 56 older people were determined with the Brannock device®, and weightbearing foot scans were obtained with the FotoScan 3D scanner (Precision 3D Ltd, Weston-super-mare, UK). Participants were provid...
Anticancer drugs themselves can cause adverse health effects when administered to human patients. In addition, it has become apparent that personnel in human medicine, occupationally exposed to these anticancer drugs, may also be at risk. The past decades, the use of chemotherapy in veterinary medic
The health of Aboriginal Australians is poorer than that of all other Indigenous cultures in developed nations, and recent studies suggest high rates of dementia and other conditions that are common in old age. This has implications for health promotion, provision of services and planning for older age in these communities. This article provides an overview on the health of Older Aboriginal Australians. PMID:27155822
Full Text Available Alzheimer’s disease (AD is the most common form of dementia in old age, and is characterized by prominent impairment of episodic memory. Recent functional imaging studies in AD have demonstrated alterations in a distributed network of brain regions supporting memory function, including regions of the default mode network. Previous positron emission tomography studies of older individuals at risk for AD have revealed hypometabolism of association cortical regions similar to the metabolic abnormalities seen in AD patients. In recent functional magnetic resonance imaging (fMRI studies of AD, corresponding brain default mode regions have also been found to demonstrate an abnormal fMRI task-induced deactivation response pattern. That is, the relative decreases in fMRI signal normally observed in the default mode regions in healthy subjects performing a cognitive task are not seen in AD patients, or may even be reversed to a paradoxical activation response. Our recent studies have revealed alterations in the pattern of deactivation also in elderly individuals at risk for AD by virtue of their APOE e4 genotype, or evidence of mild cognitive impairment (MCI. In agreement with recent reports from other groups, these studies demonstrate that the pattern of fMRI task-induced deactivation is progressively disrupted along the continuum from normal aging to MCI and to clinical AD and more impaired in e4 carriers compared to non-carriers. These findings will be discussed in the context of current literature regarding functional imaging of the default network in AD and at-risk populations.
Zarkin, G A; Lindrooth, R C; Demiralp, B; Wechsberg, W
OBJECTIVE: To estimate the costs, effectiveness, and cost-effectiveness of prevention interventions for out-of-treatment substance abusers at risk for HIV. This is the first cost-effectiveness study of an AIDS intervention that focuses on drug use as an outcome. STUDY DESIGN: We examined data from the North Carolina Cooperative Agreement site (NC CoOp). All individuals in the study were given the revised NIDA standard intervention and randomly assigned to either a longer, more personalized en...
Mänty, Minna Regina
The purpose of this study was to examine the early signs of mobility decline and falls in older people. In addition, the effects of physical activity counseling on the development of mobility limitation in an older community-dwelling population were studied. Data from two larger studies were used......: Screening and Counseling for Physical activity and Mobility among Older People, SCAMOB, a 2-year single-blinded randomized controlled trial (n=632) with a 1.5-year post-intervention follow-up, focused on 75 to 81-year-old community-dwelling people and the FITSA study, a 3-year prospective observational...... to promote mobility, which is a crucial prerequisite for maintaining independence in the community in old age. Keywords: Aging, mobility limitation, falls, risk assessment, physical activity, promotion, older people...
Kazbare, Laura; Bech-Larsen, Tino
Purpose: The aim of this study was to identify barriers to healthy eating among older people and children/adolescents. Method: Four focus groups; two with older people and two with children/adolescents were conducted in Denmark. The focus groups were moderated to discuss the experienced......, absence of observable direct immediate results, social impact (for older people - the impact of family members and social image; for children and adolescents - the influence of parents and peers). For children and adolescents, availability and temptation of unhealthy foods and unavailability of good...... and palatable healthy foods appeared to be significant implementation barriers. Older people tended to emphasize that their eating habits, craving for unhealthy food and practical issues hindered healthy eating. In general, in the absence of health problems (and, in some cases, in the presence of illnesses...
Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high
Ariza-Vega, Patrocinio; Kristensen, Morten Tange; Martín-Martín, Lydia;
OBJECTIVE: To determine one year mortality and predisposing factors in older people who had surgery after a hip fracture. DESIGN: Prospective cohort study. SETTING: Public acute hospital, trauma service. PARTICIPANTS: A total of 281 patients, 65 years or older, admitted with a hip fracture within...
Jang, Miseon; Lee, Yeunsook
This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…
Burholt, Vanessa; Scharf, Thomas; Walsh, Kieran
This article examines the imagery and imaginaries of islander identity and makes an original contribution to the fields of gerontology and nissology. Drawing on data collected through in-depth interviews with 19 older residents of two small-island communities located off the island of Ireland, we address the central roles played by older people in…
Mänty, Minna; Mendes de Leon, Carlos F.; Rantanen, Taina;
Background. Fatigue is an important early marker of functional decline among older people, but the mechanisms underlying this association are not fully understood. The purpose of the present study was to examine the association between mobility-related fatigue and walking speed and to test...... among men (b = −.04, p older adults...
Oude Voshaar, R.C.; Purandare, N.; Hardicre, J.; McCollum, C.N.; Burns, A.
OBJECTIVE: To examine whether asymptomatic spontaneous cerebral emboli (SCE) predicts subsequent depression in older people. METHODS: Prospective cohort study with 2.5 years of follow-up including 96 nondepressed older subjects in primary care. Presence of SCE was measured at baseline by transcrania
Hijmans, J.M.; Zijlstra, W.; Geertzen, J.H.; Hof, A.L.; Postema, K.
This study investigates the effects of foot and ankle compression on joint position sense (JPS) and balance in older people and young adults. 12 independently living healthy older persons (77-93 years) were recruited from a senior accommodation facility. 15 young adults (19-24 years) also participat
Barton, S; Karner, C.; Salih, F.; Baldwin, D S; Edwards, S.J.
Background Anxiety and related disorders include generalised anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder and phobic disorders (intense fear of an object or situation). These disorders share the psychological and physical symptoms of anxiety, but each disorder has its own set of characteristic symptoms. Anxiety disorders can be difficult to recognise, particularly in older people (those aged over 65 years). Older people tend to be more rel...
Toçi, Ervin; Burazeri, Genc; Sorensen, Kristine; Jerliu, Naim; Ramadani, Naser; Roshi, Enver; Brand, Helmut
Aims: Health literacy among older people has received little attention in transitional countries of Southeast Europe. Our aim was to assess the level and socioeconomic correlates of health literacy among older people in Kosovo, a post-war country in the Western Balkans. Study Design: Cross-sectional study. Place and Duration of Study: Kosovo, between January-March 2011. Methods: This nationwide survey, conducted in Kosovo in 2011, included 1753 individuals aged ≥65 years (886 men, 867 wome...
Gussekloo, Jacobijn; de Bont, L E; von Faber, M; Eekhof, J A; de Laat, J A; Hulshof, J H; Van Dongen, E; Westendorp, R. G.
BACKGROUND: Very few older people with severe hearing loss use hearing aids to reduce the negative consequences of reduced hearing in daily functioning. AIM: Assessment of a screening test and a standardised auditory rehabilitation programme for older people from the general population with untreated severe hearing loss. DESIGN OF STUDY: Intervention study and qualitative exploration. SETTING: Leiden 85-Plus Study, a prospective population-based study of 85-year-old inhabitants of Leiden, the...
Dahlberg, Lena; Mckee, Kevin J
Objectives Loneliness is an important influence on quality of life in old age and has been conceptualised as consisting of two dimensions, social and emotional. This article describes analyses that sought to produce models of social and emotional loneliness in older people, using demographic, psychological and health, and social variables. Method Older people (aged 65+, n = 1255) from the Barnsley metropolitan area of the United Kingdom were recruited randomly from within a stratified samplin...
Burgess Leonie; George Stacey; Ratcliffe Julie; Laver Kate; Crotty Maria
Abstract Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE) before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style f...
Poulsen, Tine; Siersma, Volkert Dirk; Christensen, Ulla;
To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline.......To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline....
Notenboom, Kim; Beers, Erna; Van Riet-Nales, Diana A.; Egberts, Toine C. G.; Leufkens, Hubert G. M.; Jansen, Paul A F; Bouvy, Marcel L
Objectives To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. Design Qualitative study with semistructured face-to-face interviews. Setting A community pharmacy and a geriatric outpatient ward. Participants Community-dwelling people aged 70 and older (N = 59). Measurements Participants were interviewed at home. Two researchers ...
Verdelho, Ana; Madureira, Sofia; Moleiro, Carla;
Depressive symptoms (DS) have been associated with increased risk of cognitive decline. Our aim was to evaluate the longitudinal influence of DS on cognition in independent older people, accounting for the severity of white matter changes (WMC).......Depressive symptoms (DS) have been associated with increased risk of cognitive decline. Our aim was to evaluate the longitudinal influence of DS on cognition in independent older people, accounting for the severity of white matter changes (WMC)....
Subjective memory complaints are common in older people. They are inconsistently related to current cognitive impairment, but are more consistently correlated to future development of dementia. Subjective memory complaints are also related to depression and personality traits. Many patients...... with dementia have impaired awareness of deficits even in the early stages of dementia and therefore do not complain about memory problems. Reports about impaired memory in older people should lead to diagnostic examination Udgivelsesdato: 2008/5/12...
Doebler, Stefanie; Glasgow, Nina
Objectives: There are few studies on relationships between deprivation and the self-reported health of people aged over 64 years, and no studies fully representative of Northern Ireland’s older population. This paper addresses this gap. Methods: Deprivation of older people as reported in the 2001 and 2011 Censuses and the relationship with self-reported health are analyzed over a ten-year span using multilevel modeling. The data are from the Northern Ireland Longitudinal Study (NILS) linked t...
Occupational engagement among older people is important to investigate as older people are the fastest growing segment in our society, and because occupational engagement is viewed within occupational therapy as one of the basic premises for health. Three perspectives of engagement are highlighted in this thesis: evaluation of occupational engagement, the repertoire of occupational engagement, and finally, the relation between occupational engagement and life satisfaction. The overall aim of ...
Tomlin A; Sinclair A
Ali Tomlin, Alan Sinclair Institute of Diabetes for Older People, University of Bedfordshire, Luton, Bedfordshire, UK Abstract: Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impa...
Andrea Montagnani; Roberto Nardi; Michela Cercignani; Valerio Verdiani
Vitamin D and calcium are essential for bone health. An adequate calcium-phosphorus product determines a high quality mineralization long lifetime. In older people, both calcium and vitamin D levels may be lower causing osteomalacia and/or osteoporosis with a higher risk of fracture. Epidemiological data have clearly associated serum vitamin D lower levels (deficiency) with bone fracture in older people, however, not univocal data exist in regard to a beneficial effect of vitamin D supplement...
Sener, Arzu; Oztop, Hulya; Dogan, Nuri; Guven, Seval
This study examined the influence of socioeconomic (age, education, marital status, income, and health) and demographic variables and the quantity and quality of relationships with adult children, grandchildren, siblings and friends on life satisfaction of the elderly. Participants were 200 persons older than 60 years of age. Hierarchical…
Nolan, Brian; Winston, Nessa
Housing is an important aspect of living standards and quality of life for older persons, but the housing-related problems they may face encompass rather different circumstances, relating to the condition of the dwelling, how well equipped it is, whether housing costs represent a serious burden, and whether the neighbourhood environment is…
Rest, van de O.
Background It has been suggested that the intake of fish and marine n-3 polyunsaturated fatty acids could protect against age-related cognitive decline and impaired mental well-being. However, results from observational studies are inconclusive and data from randomized controlled trials in older pe
Geiger, Karin; Schneider, Nils; Bleidorn, Jutta; Klindtworth, Katharina; Jünger, Saskia; Müller-Mundt, Gabriele
Background Frail older people are an increasingly important group in primary care due to demographic change. For these patients, a palliative care approach may be useful to sustain the quality of life in the last phase of their lives. While general practitioners (GPs) play a key role in the primary care for older patients, general palliative care is still in its infancy and little is known in Germany about caring for frail older people towards the end of life. This study aims to explore the t...
Christensen, Kaare; Thinggaard, Mikael; Oksuzyan, Anna;
A rapidly increasing proportion of people in high-income countries are surviving into their tenth decade. Concern is widespread that the basis for this development is the survival of frail and disabled elderly people into very old age. To investigate this issue, we compared the cognitive...
Rosted, Elizabeth Emilie
of depression and tiredness was found, as well as prevention of readmission in the older people who were at least risk of readmission and functional decline. Thus, it is recommended that the aged care nursing specialist in the ED administers the ISAR II assessment and intervention on older persons with an ISAR...... I score of 2 or more to reveal the older persons problems, detect depression and prevent further tiredness. Not least, an important finding was that the older people who refused to participate in the study were more likely to be readmitted to hospital or to die within both 30 and 180 days after ED...... was to examine the use and effect of a two-stage model for structured nursing assessment and problem solving intervention, ISAR II, carried out immediately following discharge from ED and again after 30 days and 180 days in order to assess older peoples’ unresolved problems. This thesis comprises two separate...
Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline.
Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline. PMID:26243326
U. Taş (Ümit); E.W. Steyerberg (Ewout); S.M. Bierma-Zeinstra (Sita); A. Hofman (Albert); B.W. Koes (Bart); A.P. Verhagen (Arianne)
textabstractBackground: To develop a prediction model that predicts disability in community-dwelling older people. Insight in the predictors of disability is needed to target preventive strategies for people at increased risk. Methods. Data were obtained from the Rotterdam Study, including subjects
This paper takes as its central thesis Martha Nussbaum's normative proposition that social arrangements should be evaluated primarily according to the extent of freedom people have to promote or achieve functionings they value. Using this as a lens the paper explores the housing circumstances of older people in the UK. The paper makes three…
Yannis DionyssiotisPhysical and Social Rehabilitation Center, Amyntaio, Florina, GreeceAbstract: Falls are a serious problem facing the elderly. The prevention of falls that contribute to disability, mainly in elderly people, is an important issue. Ensuring the greatest possible functionality for elderly people is an important element in the prevention of disability. This paper analyzes the importance of falls, risk factors for falls, and interventions to prevent falls. Recent publications as...
Falls are a serious problem facing the elderly. The prevention of falls that contribute to disability, mainly in elderly people, is an important issue. Ensuring the greatest possible functionality for elderly people is an important element in the prevention of disability. This paper analyzes the importance of falls, risk factors for falls, and interventions to prevent falls. Recent publications as well as research regarding the prevention and rehabilitation for falls are reviewed.
McLachlan, Andrew J; Bath, Sally; Naganathan, Vasi; Hilmer, Sarah N; Le Couteur, David G; Gibson, Stephen J; Blyth, Fiona M
Pain is highly prevalent in frail older people who often have multiple co-morbidities and multiple medicines. Rational prescribing of analgesics in frail older people is complex due to heterogeneity in drug disposition, comorbid medical conditions, polypharmacy and variability in analgesic response in this population. A critical issue in managing older people with pain is the need for judicious choice of analgesics based on a comprehensive medical and medication history. Care is needed in the selection of analgesic medicine to avoid drug-drug or drug-disease interactions. People living with dementia and cognitive impairment have suboptimal pain relief which in part may be related to altered pharmacodynamics of analgesics and challenges in the systematic assessment of pain intensity in this patient group. In the absence of rigorously controlled trials in frail older people and those with cognitive impairment a pharmacologically-guided approach can be used to optimize pain management which requires a systematic understanding of the pharmacokinetics and pharmacodynamics of analgesics in frail older people with or without changes in cognition. PMID:21284694
With people living longer, getting sicker and entering nursing home care later in their lives, the global trends point to preventing premature institution as a major public health and social care goal. Compared with the UK--Australia, Canada and the USA have a longer track record for introducing government Acts, policies and strategies which contribute to supporting older people in maintaining their health, safety and independence. They also have government Ministers for the Aged. In the UK, it is only very recently that we are witnessing new Government programmes such as the NHS Plan and Modernizing Social Services that begin to demonstrate its more determined approach to improve the life of the older person. An ageing population brings new challenges to policy-makers and planners in the statutory sectors. Various international conferences have been held to address ways in which countries are providing or developing their services, and their research regarding older people. Yet, whatever country one considers, nursing home care continues to give rise to many concerns. Developments in the USA managed care programmes have recently come under even more scrutiny from the Federal and State governments, insurance agencies, nursing home owners and, of course, older people themselves. This article raises issues that still need to be addressed in the UK. It reports briefly on an international conference (attended during the undertaking of a Winston Churchill Fellowship) which had some forward-thinking presentations addressing existing and future care needs of older people. It then concentrates on highlighting some of the current developments in the USA care system that might be learning lessons for UK policy-makers. It concludes with some additional considerations for delivering a National Service Framework for Older People in order that "The needs of older people are at the heart of the reform programme for health and social services."
With people living longer, getting sicker and entering nursing home care later in their lives, the global trends point to preventing premature institution as a major public health and social care goal. Compared with the UK--Australia, Canada and the USA have a longer track record for introducing government Acts, policies and strategies which contribute to supporting older people in maintaining their health, safety and independence. They also have government Ministers for the Aged. In the UK, it is only very recently that we are witnessing new Government programmes such as the NHS Plan and Modernizing Social Services that begin to demonstrate its more determined approach to improve the life of the older person. An ageing population brings new challenges to policy-makers and planners in the statutory sectors. Various international conferences have been held to address ways in which countries are providing or developing their services, and their research regarding older people. Yet, whatever country one considers, nursing home care continues to give rise to many concerns. Developments in the USA managed care programmes have recently come under even more scrutiny from the Federal and State governments, insurance agencies, nursing home owners and, of course, older people themselves. This article raises issues that still need to be addressed in the UK. It reports briefly on an international conference (attended during the undertaking of a Winston Churchill Fellowship) which had some forward-thinking presentations addressing existing and future care needs of older people. It then concentrates on highlighting some of the current developments in the USA care system that might be learning lessons for UK policy-makers. It concludes with some additional considerations for delivering a National Service Framework for Older People in order that "The needs of older people are at the heart of the reform programme for health and social services." PMID:11688301
Moone, Rajean Paul; Lightfoot, Elizabeth
Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities. PMID:19459127
Moone, Rajean Paul; Lightfoot, Elizabeth
Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities.
Full Text Available Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital. Methods: Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results: Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion: Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that
Full Text Available Main goal of this paper is to provide insight into perspective of unemployed youth at risk or with potential risks in enviroment, aboutstatus and experiance of being unemployed. Krounauer model of social excluasion was taken as the base for interpretation of riskfactors related to unemployment. Mentioned model is defi ned with six dimesions: exclusion from labour market, economic exclusion,social isolation, institutional exclusion, spatial and cultural exclusion. Five focus groups with 19 unemployed youth (age from 18 to27 years from 4 cities in Croatia and from two types of institutions (croatian employment service and center for social welfare havebeen conducted. Results implicate that unemployment represents important factor for integration and independence of youth, andrelevant risk factor especially for economical exclusion. However, result shows that unemployment does not lead to social isolation asthird key dimesion in social exclusion model. These results are, to some extant, similar to results in other countries in EU, especiallyin south-east European countries (Italy, Spain, Greecee where research results show that unemployment do not neccessarily leads tosocial exclusion due to the strong family and friends support. Results can be used for the creation of public strategies in coping withrisk of (longterm youth unemployment and also with risk of their social exclusion.
Clark, M J; Fitzgerald, G
OBJECTIVE: To investigate the use of emergency and non-urgent ambulance transport services by people aged 65 years and over. SETTING: The study was undertaken in Queensland where the Queensland Ambulance Services (QAS) is the sole provider of emergency pre-hospital and non-urgent ambulance services for the entire state. METHODS: The age and sex of 351,000 emergency and non-urgent cases treated and transported by the QAS from July 1995 to June 1996 were analysed. RESULTS: People aged 65 years ...
Full Text Available Yannis DionyssiotisPhysical and Social Rehabilitation Center, Amyntaio, Florina, GreeceAbstract: Falls are a serious problem facing the elderly. The prevention of falls that contribute to disability, mainly in elderly people, is an important issue. Ensuring the greatest possible functionality for elderly people is an important element in the prevention of disability. This paper analyzes the importance of falls, risk factors for falls, and interventions to prevent falls. Recent publications as well as research regarding the prevention and rehabilitation for falls are reviewed.Keywords: falls, elderly, rehabilitation, risk factors
Full Text Available Abstract Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE before and after exposure to the intervention. Methods A DCE was administered to 21 participants in an interview style format prior to, and following several sessions of using the Wii Fit in physiotherapy. The physiotherapist prescribed the Wii Fit activities, supervised and supported the patient during the therapy sessions. Attributes included in the DCE were: mode of therapy (traditional or using the Wii Fit, amount of therapy, cost of therapy program and percentage of recovery made. Data was analysed using conditional (fixed-effects logistic regression. Results Prior to commencing the therapy program participants were most concerned about therapy time (avoiding programs that were too intensive, and the amount of recovery they would make. Following the therapy program, participants were more concerned with the mode of therapy and preferred traditional therapy programs over programs using the Wii Fit. Conclusions The usefulness of the Wii Fit as a therapy tool with hospitalised older people is limited not only by the small proportion of older people who are able to use it, but by older people's preferences for traditional approaches to therapy. Mainstream media portrayals of the popularity of the Wii Fit with older people may not reflect the true acceptability in the older hospitalised population.
Marouf, Eltayeb; Sinclair, Alan J
Type 2 diabetes mellitus affects 5.9% of the world adult population, with older people and some ethnic groups disproportionately affected. Treatment of older people with diabetes differs in many ways from that in younger adults since the majority have type 2 disease and are at particular risk of macrovascular rather than disabling microvascular disease. Insulin therapy, the most effective of diabetes medications, can reduce any level of elevated HBA1c if used in adequate doses. However, some clinicians are often reluctant to initiate insulin therapy in older people with diabetes mainly out of their concerns about adverse reactions to insulin, particularly hypoglycemia. There is evidence suggesting that insulin aspart appears to act similarly to regular human insulin in older people with type 2 diabetes mellitus. Insulin aspart can be used in the treatment of older people with diabetes, but this should be individualized. There is evidence that it improves postprandial glucose control, improves long-term metabolic control, reduces risk of major nocturnal hypoglycemia and increases patient satisfaction compared with soluble insulin.
Pulopulos, Matias M; Hidalgo, Vanesa; Puig-Perez, Sara; Salvador, Alicia
Healthy older people with a cortisol awakening response (CAR) of decreased magnitude show worse frontal cortex-related cognitive performance. Systemic hypertension has been related to a CAR of decreased magnitude. Additionally, worse executive function and processing speed have been observed in older people with systemic hypertension. This is the first study to examine the relationship between the CAR (measured with six saliva samples at home on two consecutive weekdays) and cognitive performance, in both hypertensive (n=26) and normotensive (n=28) older people (from 56 to 78years old). Hypertensive participants showed lower morning cortisol secretion, and they also woke up earlier. No differences in CAR were observed. A CAR of decreased magnitude was related to worse executive function in both hypertensive and normotensive participants, but to slower processing speed only in normotensive participants. Being treated with antihypertensive for a longer period of time was related to a CAR of increased magnitude and better performance on executive function. Our findings suggest that earlier awakening time in hypertensive older people might underlie the lower overall morning cortisol secretion observed in previous studies. Additionally, this study confirms that a dysregulation of the CAR is related to worse executive function, and it extends this association to hypertensive older people. Finally, it is worth noting that hypertension may moderate the relationship between CAR and processing speed.
Kendall, Julie C; Hartvigsen, Jan; Azari, Michael F;
people. DATA SOURCES: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, SCOPUS, CINAHL, AMED, Index to Chiropractic Literature, PsychINFO and MANTIS were searched from inception to May 2014. STUDY SELECTION: Two investigators independently screened controlled trials with dizzy participants...
de Winter, C. F.; Bastiaanse, L. P.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.
Overweight and obesity are major health problems associated with increased cardiovascular disease risk, which is not sufficiently studied in people with intellectual disability yet. The present study was part of the Healthy Ageing in Intellectual Disability (HA-ID) study. The aim of this study was to establish (1) the prevalence of overweight,…
Wassink-Vossen, S.; Collard, R.M.; Oude Voshaar, R.C.; Comijs, H.C.; Vocht, H.M. de; Naarding, P.
BACKGROUND: Knowledge about characteristics explaining low level of physical activity in late-life depression is needed to develop specific interventions aimed at improving physical health in depressed people above the age of 60. METHODS: This cross-sectional study used data from the Netherlands Stu
Allan T Chau
Full Text Available Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim was to accurately identify the prevalence of: Benign Paroxysmal Positional Vertigo (BPPV, peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy six participants aged 51 to 92 (mean ± SD = 69 ± 9.5 years were tested using the Head Thrust Dynamic Visual Acuity (htDVA test, Dizziness Handicap Inventory (DHI, as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for: htDVA score; DHI score; sinusoidal (whole-body, 0.1 - 2 Hz with peak-velocity at 30deg/s Vestibulo-Ocular Reflex (VOR gain and phase; transient (whole-body, acceleration at 150deg/s/s to a constant velocity rotation of 50deg/s VOR gain and time constant; OptoKinetic Nystagmus (OKN gain and time constant (whole-body, constant velocity rotation at 50deg/s. We found that BPPV, peripheral and central vestibular hypofunction were present in 38% and 1% of participants respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5 - 1 Hz and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction.
Chau, Allan T.; Menant, Jasmine C.; Hübner, Patrick P.; Lord, Stephen R.; Migliaccio, Americo A.
Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51–92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1–2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s2 to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5–1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940
Roe, Brenda; McCormick, Sheila; Lucas, Terri; Gallagher, Wendy; Winn, Andrea; Elkin, Sophie
Arts for health initiatives and networks are being developed in a number of countries and an international literature is emerging on the evidence of their benefits to people's health, wellbeing and quality of life. Engagement in cultural and creative arts by older people can increase their morale and self-confidence and provides opportunities for social connection. Museums and galleries are increasingly required to justify their expenditure, reach and impact and some are working in partnership with local councils, hospitals, schools and communities to improve access to their collections. There is a body of literature emerging that describes such initiatives but empirical evidence of their benefits is less developed. This article reports an evaluation of an art for health initiative - Coffee, Cake & Culture organised and delivered by Whitworth Art Gallery and Manchester Museum in 2012 for older people living in a care home and a supported living facility. The study has identified the benefits and impacts of the arts for health programme and its feasibility for older people, with or without diagnosed memory loss - dementia, living in a care home or supported living facility and their care staff. The findings demonstrate there were benefits to the older people and their care staff in terms of wellbeing, social engagement, learning, social inclusion and creativity. These benefits were immediate and continued in the short term on their return home. The majority of older people and care staff had not previously been to the art gallery or museum and the programme encouraged creative arts and cultural appreciation which promoted social inclusion, wellbeing and quality of life. The programme is feasible and important lessons were identified for future planning. Further research involving partnerships of researchers, arts for health curators, artists, care staff, older people and their families is warranted. PMID:24686287
Roe, Brenda; McCormick, Sheila; Lucas, Terri; Gallagher, Wendy; Winn, Andrea; Elkin, Sophie
Arts for health initiatives and networks are being developed in a number of countries and an international literature is emerging on the evidence of their benefits to people's health, wellbeing and quality of life. Engagement in cultural and creative arts by older people can increase their morale and self-confidence and provides opportunities for social connection. Museums and galleries are increasingly required to justify their expenditure, reach and impact and some are working in partnership with local councils, hospitals, schools and communities to improve access to their collections. There is a body of literature emerging that describes such initiatives but empirical evidence of their benefits is less developed. This article reports an evaluation of an art for health initiative - Coffee, Cake & Culture organised and delivered by Whitworth Art Gallery and Manchester Museum in 2012 for older people living in a care home and a supported living facility. The study has identified the benefits and impacts of the arts for health programme and its feasibility for older people, with or without diagnosed memory loss - dementia, living in a care home or supported living facility and their care staff. The findings demonstrate there were benefits to the older people and their care staff in terms of wellbeing, social engagement, learning, social inclusion and creativity. These benefits were immediate and continued in the short term on their return home. The majority of older people and care staff had not previously been to the art gallery or museum and the programme encouraged creative arts and cultural appreciation which promoted social inclusion, wellbeing and quality of life. The programme is feasible and important lessons were identified for future planning. Further research involving partnerships of researchers, arts for health curators, artists, care staff, older people and their families is warranted.
Andersson, Jonas E; Rönn, Magnus
. Consequently, architecture competitions that focus on the emerging ageing society could be seen as a restrained type of space for architects to digress. National welfare goals and existing means to achieve these goals act as inhibitors for an innovative spatial preparation for the ageing society.......In the context of the universal ageing process that is currently taking place in western society, the organization of architecture competitions that deals with space for dependent ageing comes of relevance. Based on the welfare regime theory, it could be argued that this type of architecture...... a spatial innovation is juxtaposed with sociopolitical reform work of the welfare regime. The present study is an explorative study of programming competition documents and winning entries that were part of the Swedish governmental initiative of 2010,” Growing older, Living well,” to innovate space...
Peel, N; Kassulke, D; McClure, R
Objective: This study aimed to identify the distribution of fall related injury in older people hospitalised for acute treatment of injury, in order to direct priorities for prevention. Setting: A follow up study was conducted in the Brisbane Metropolitan Region of Australia during 1998. Methods: Medical records of patients aged 65 years and over hospitalised with a fall related injury were reviewed. Demographic and injury data were analysed and injury rates calculated using census data as the denominator for the population at risk. Results: From age 65, hospitalised fall related injury rates increased exponentially for both males and females, with age adjusted incidence rates twice as high in women than men. Fractures accounted for 89% of admissions, with over half being to the hip. Males were significantly more likely than females to have fractured their skull, face, or ribs (p<0.01). While females were significantly more likely than males to have fractured their upper or lower limbs (p<0.01), the difference between proportions of males and females fracturing their hip was not significant. Males were more likely than females (p<0.01) to have fall related head injuries (13% of admissions). Compared with hip fractures, head injuries contributed significantly to the burden of injury in terms of severity, need for intensive care, and excess mortality. Conclusions: The frequency and impact of hip fractures warrants continued emphasis in falls program interventions for both males and females to prevent this injury. However, interventions that go beyond measures to slow and protect against bone loss are also needed to prevent fall related head injuries. PMID:12460962
Portegijs, Erja; Iwarsson, Susanne; Rantakokko, Merja; Viljanen, Anne; Rantanen, Taina
Background: Life-space mobility refers to the spatial area an individual moves through, the frequency and need for assistance. Based on the assumption that measurement scale properties are context-specific, we tested the scale distribution, responsiveness, and reproducibility of the 15-item University of Alabama at Birmingham Study of Aging Life-Space Assessment in older people in Finland, specifically accounting for season. Methods: Community-dwelling older men and women in...
Roos, Vera; Sedick, Samiera
This study explored the perceptions of older people in a residential care facility regarding how they are portrayed in the print media and the implications of such portrayal for intergenerational relations. Twenty-one older residents in a residential care facility participated voluntarily in the study (men = 9, women = 12; age range 60 to 85 years). Data were collected using exploratory interviews and focus groups followed by the thematic analysis of the data. The findings suggest that the ol...
Szczepura Ala; Wild Deidre; Nelson Sara
Abstract Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorde...
Yardley, Lucy; Kirby, Sarah; Ben-Shlomo, Yoav; Gilbert, Rebecca; Whitehead, Sarah; Todd, Chris
Objective: To determine the extent to which older people are willing to engage in different falls prevention activities, and how this may vary in different sectors of the older population. Methods: A survey sent to patients aged over 54 in ten general practices in the Southampton, Bristol and Manchester areas of the UK in 2006 yielded 5,440 respondents. The survey assessed willingness to attend classes of strength and balance training (SBT), carry out SBT at home, or accept suppo...
Elskamp, Annemijn; Hartholt, Klaas; Patka, Peter; van Beeck, Ed; Cammen, Tischa
textabstractBackground/Objectives: Falls are a major public health problem. Older persons are frequently underrepresented in trials, including falls prevention trials. Insight into possible reasons for non-participation could help to improve trial designs and participation rates among this age-group. The aim of this study was to explore reasons why older people refuse to participate in falls prevention trials. Setting: A qualitative study. Participants: Community-dwelling adults aged ≥ 65. ye...
Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high health care expenditures. In the Utrecht Proactive Frailty Intervention Trial (U-PROFIT, in Dutch:’ Om U’), we designed and evaluated a strategy for proactive patient-centred primary care of frail...
Reijo S. Tilvis
Full Text Available Background. The harmful associates of suffering from loneliness are still in dispute. Objective. To examine the association of feelings of loneliness with all-cause mortality in a general aged population. Methods. A postal questionnaire was sent to randomly selected community-dwelling of elderly people (>74 years from the Finnish National Population Register. The questionnaire included demographic characteristics, living conditions, functioning, health, and need for help. Suffering from loneliness was assessed with one question and participants were categorized as lonely or not lonely. Total mortality was retrieved from the National Population Information System. Results. Of 3687 respondents, 39% suffered from loneliness. Lonely people were more likely to be deceased during the 57-month follow-up (31% than subjects not feeling lonely (23%, <.001. Excess mortality (HR=1.38, 95% CI=1.21-1.57 of lonely people increased over time. After controlling for age and gender, the mortality risk of the lonely individuals was 1.33 (95% CI=1.17-1.51 and after further controlling for subjective health 1.17 (CI=1.02-1.33. The excess mortality was consistent in all major subgroups. Conclusion. Suffering from loneliness is common and indicates significant mortality risk in old age.
Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn;
Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people's self-ratings. We examined self......-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...
Bourbonnais, Anne; Ducharme, Francine
This article describes the social positioning of older people living with Alzheimer's disease who scream in a long-term care home. Few studies have focused on the social positions taken by older people, their family and formal caregivers during interaction and their effects on screams. A secondary data analysis was conducted using Harré and Van Langenhove's positioning theory. The results show that older people are capable of positioning and repositioning themselves in relational patterns. Family and formal caregivers position older people who scream according to their beliefs about their lived experience. They also react emotionally to older people and try to influence their behaviors. Understanding the social positioning of older people with Alzheimer's disease brought out their capacities and their caregivers' concerns for their well-being. Interventions should focus on these strengths and on promoting healthy relations in the triads to enhance quality of care in long-term care homes. PMID:24339123
Chen, Yu; Hicks, Allan; While, Alison E
China has an ageing population with the number of older people living alone increasing. Living alone may increase the risk of loneliness of older people, especially for those in China where collectivism and filial piety are emphasised. Social support may fill the need for social contacts, thereby alleviating loneliness. However, little is known about loneliness and social support of older people living alone in China. This study investigated loneliness and social support of older people living alone, by conducting a cross-sectional questionnaire survey with a stratified random cluster sample of 521 community-dwelling older people living alone in a county of Shanghai. Data were collected from November 2011 to March 2012. The instruments used included the UCLA Loneliness Scale version 3 and the Social Support Rate Scale. The participants reported a moderate level of loneliness. Their overall social support level was low compared with the Chinese norm. Children were the major source of objective and subjective support. Of the participants, 53.9% (n = 281) and 47.6% (n = 248) asked for help and confided when they were in trouble, but 84.1% (n = 438) never or rarely attended social activities. The level of loneliness and social support differed among the participants with different sociodemographic characteristics. There were negative correlations between loneliness and overall social support and its three dimensions. The findings suggest that there is a need to provide more social support to older people living alone to decrease their feelings of loneliness. Potential interventions include encouraging more frequent contacts from children, the development of one-to-one 'befriending' and group activity programmes together with identification of vulnerable subgroups.
Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Yamauchi, Keita
A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy  and the other was occupational therapy for dementia ) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future
Vuolo, Mike; Ferraro, Kenneth F; Morton, Patricia M; Yang, Ting-Ying
A growing number of studies in life course epidemiology and biodemography make use of a retrospective question tapping self-rated childhood health to assess overall physical health status. Analyzing repeated measures of self-rated childhood health from the Health and Retirement Study (HRS), this study examines several possible explanations for why respondents might change their ratings of childhood health. Results reveal that nearly one-half of the sample revised their rating of childhood health during the 10-year observation period. Whites and relatively advantaged older adults-those with more socioeconomic resources and better memory-were less likely to revise their rating of childhood health, while those who experienced multiple childhood health problems were more likely to revise their childhood health rating, either positively or negatively. Changes in current self-rated health and several incident physical health problems were also related to the revision of one's rating of childhood health, while the development of psychological disorders was associated with more negative revised ratings. We then illustrate the impact that these changes may have on an adult outcomes: namely, depressive symptoms. Whereas adult ratings of childhood health are likely to change over time, we recommend their use only if adjusting for factors associated with these changes, such as memory, psychological disorder, adult self-rated health, and socioeconomic resources.
Nessighaoui, Hichem; Géniaux, Hélène; Dantoine, Thierry; Laroche, Marie-Laure
Frailty is a complex geriatric syndrome linked to the overall decrease of physiological reserves. It could lead to disability and to an increase in mortality. Frailty could have an impact on the effect and on the use of medications. Drugs could also affect the frailty process. Currently, no specific guidelines exist for appropriately prescribing medications to frail older people. The aim of this paper is to explore the body of current knowledge about the relationship between drugs and frailty in older people and to introduce a new nosological entity: pharmacological frailty. PMID:27235650
Kate Wakeling; Jonathan Clark
Research exploring older people and the participatory arts has tended to focus on notions of biomedical impact, often coupled with appeals to evasive notions of "well-being." Rather than suggesting such approaches are invalid, this article proposes the need for their extension and proposes an alternative, critical approach to analysing older people's experience of arts participation. Based on ethnographic participant observation and intensive consultation with a cohort of older people engaged...
Full Text Available Background: Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practicability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran. Methods: Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and muscle-strengthening activity was planned for those who had not severe baseline cognitive impairment or were not too frail to undertake the survey. The General Health Questionnaire (GHQ-28 was used to measure mental health status before and after intervention through a face-to-face interview. Descriptive statistics, Wilkcoxon rank-sum, Mann–Whitney U and Chi-Square tests were employed to analyses the data. Results: The applied intervention was significantly improved status of physical health, anxiety and insomnia, social dysfunction and severe depression. Conclusion: Incorporation of physical activity promotion programs into routines of older people residential care homes in Iran is feasible but may need training of physical activity specialists to work with older people based on their physical endurance and limitations.
Burmeister, Oliver K; Bernoth, Maree; Dietsch, Elaine; Cleary, Michelle
Social interaction and connectedness is important to the mental health and wellbeing of older people. The aim of this research study was to facilitate and increase opportunities for social connectedness for older people living in regional areas through the use of technology training. Weekly technology training sessions were conducted at a Seniors Citizen's Club with a peer trainer (an experienced, retired computer teacher) and sessions were attended not only by the six study participants, but also by other club members, with up to 15 club members participating in sessions. Data analysis involved all documents generated by the project, including the individual interviews, researcher observations of training sessions, reports from the peer trainer and weekly diaries maintained by participants. Findings demonstrated that computer training at the Senior Citizens Club helped participants build group cohesion and to form tiered connections with partners, family, and friends with whom they no longer live. When the trainer is seen as a peer, and training is person-centred, older people are more receptive to learning, exploring, and experimenting with technology. Although only six people were involved in the in-depth evaluation part of the study, voluntary training with the trainer in the absence of any funding continues even to this present time. The outcome of this research reinforces the potential for technology facilitated tiered connectivity to enhance the quality of life for older people living in regional and rural Australia. PMID:27050818
Purpose: Rapidly changing demographics worldwide mean that there will be a significant increase in the number of older cancer patients requiring radiation therapy treatment in the coming decades. Education is regarded as a key factor in addressing attitudes towards older people among healthcare professionals and has been proven to influence the quality of care received. To our knowledge, there is only one previous study specifically in relation to radiation therapists (RTs), and this included a small sample of RTs. The aim of this study was to investigate the knowledge and attitudes of RTs and RT students towards older people. Methods: A cross-sectional survey design was used, consisting of: 1) demographics, 2) knowledge and 3) attitudes. Knowledge was assessed using the Facts of Aging Quiz (FAQ), while Kogan's Attitude towards Old People (KAOP) Scale was used to assess attitudes. The study population included radiation therapists (RTs) working in Ireland and undergraduate students. Results: Mean knowledge scores in this study were recorded as 11.82 (SD = 3.07)for RTs and 12.17 (SD = 2.55) for students out of a possible 24, i.e. 49% and 51%, respectively. Average attitude scores were documented as 126.12 (SD = 10.06) for RTs and 125.30 (SD = 10.28) for RT students, out of a possible 170 i.e. 74% for both qualified RTs and students. There were no significant differences between students and qualified RTs in relation to both knowledge and attitude scores. Only 44% of RTs stated that their undergraduate degree equipped them with the necessary skills to deal effectively with older patients. Conclusion: RTs have a prominent role in the provision of care to cancer patients, the majority of whom are aged 65 and older. Provision of optimal care to older people undergoing radiotherapy will require “age attuning” of the profession, both at undergraduate and postgraduate level. The findings of this research indicate that RTs and RT students have average
Full Text Available Abstract Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design The Home-Based Older People's Exercise (HOPE trial is a two arm, assessor blind pilot randomised controlled trial (RCT to assess the effectiveness of a 12 week exercise intervention (the HOPE programme designed to improve the mobility and functional abilities of frail older people living at home, compared with usual care. The primary outcome is the timed-up-and-go test (TUGT, measured at baseline and 14 weeks post-randomisation. Secondary outcomes include the Barthel Index of activities of daily living (ADL, EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D quality of life measure and the geriatric depression scale (GDS, measured at baseline and 14 weeks post-randomisation. We will record baseline frailty using the Edmonton Frail Scale (EFS, record falls and document muscle/joint pain. We will test the feasibility of collection of data to identify therapy resources required for delivery of the intervention. Discussion The HOPE trial will explore and evaluate a home-based exercise intervention for frail older people. Although previous RCTs have used operationalised, non-validated methods of measuring frailty, the HOPE trial is, to our knowledge, the first RCT of an exercise intervention for frail older people that includes a validated method of frailty assessment at baseline. Trial registration ISRCTN: ISRCTN57066881
Richardson, Jane C.; GRIME, JANET C.; Ong, Bie Nio
It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness. Consequently, our research aimed to explore OA from the perspective of wellnes...
Wimmer, Barbara C.; Bell, J Simon; Fastbom, Johan; Wiese, Michael D; Johnell, Kristina
Objectives: To investigate whether medication regimen complexity and/or polypharmacy are associated with all-cause mortality in older people. Methods: This was a population-based cohort study among community-dwelling and institutionalized people ≥60 years old (n = 3348). Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI) in 10-unit steps. Polypharmacy was assessed as a continuous variable (number of medications). Mortality data were obtaine...
Koes Bart W; Hofman Albert; Bierma-Zeinstra Sita MA; Steyerberg Ewout W; Taş Ümit; Verhagen Arianne P
Abstract Background To develop a prediction model that predicts disability in community-dwelling older people. Insight in the predictors of disability is needed to target preventive strategies for people at increased risk. Methods Data were obtained from the Rotterdam Study, including subjects of 55 years and over. Subjects who had complete data for sociodemographic factors, life style variables, health conditions, disability status at baseline and complete data for disability at follow-up we...
Landorf Karl B; Zammit Gerard V; Menz Hylton B; Munteanu Shannon E
Abstract Background Plantar calcaneal spurs are common, however their pathophysiology is poorly understood. This study aimed to evaluate the prevalence and correlates of plantar calcaneal spurs in a large sample of older people. Methods Weightbearing lateral foot radiographs of 216 people (140 women and 76 men) aged 62 to 94 years (mean age 75.9, SD 6.6) were examined for plantar calcaneal and Achilles tendon spurs. Associations between the presence of spurs and sex, body mass index, radiogra...
Marcinowicz, Ludmila; Pawlikowska, Teresa; Oleszczyk, Marek
Older patients see their general practitioners (GPs) relatively often and so recognition of their preferences can lead to improvement of quality of care in general practice. This study aimed to identify which aspects of GPs' behaviour are the most important for older people in their assessment of the quality of their visits and to explore the application of Jung's taxonomy differentiating task and affective behaviour in this context. A qualitative approach to generating data was chosen. We conducted semi-structured interviews with a sample of 30 patients aged 65 and older using GP services in two demographically diverse big cities in Poland. Participants were interviewed in 2010 according to a pre-determined topic guide. This research showed that older people assess both 'task performance' and 'affective performance' behaviours of general practitioners. There were nearly twice as many patient comments concerning affective performance behaviour relative to task performance behaviour. Older people expect that their physicians will be demonstrably friendly, kind, able to joke and have enough time for the consultation. PMID:25431547
González-Sarrías, Antonio; Larrosa, Mar; García-Conesa, María Teresa; Tomás-Barberán, Francisco A; Espín, Juan Carlos
In the last decades nutraceuticals have entered the health market as an easy and attractive means of preventing diseases. These products are of interest for an increasingly health-concerned society and may be especially relevant for preventing or delaying a number of age-related diseases, i.e. arthritis, cancer, metabolic and cardiovascular diseases, osteoporosis, cataracts, brain disorders, etc. Nutraceuticals are marketed in a variety of forms, composition and potential applications which have made their definition ambiguous and their use uncontrolled and poorly funded. Although epidemiological, animal and in vitro studies have given evidence of the potential benefits of some of these nutraceuticals or of their components, definitive proof of their effects in appropriate human clinical trials is still lacking in most cases, more critically among people above 65 years of age. We cover the well-established nutraceuticals (polyvitamins, omega-3 fatty acids, etc.) and will focus on many other 'novel' commercial nutraceuticals where the scientific evidence is more limited (food extracts, polyphenols, carotenoids, etc.). Solid scientific evidence has been reported only for a few nutraceuticals, which have some health claims approved by the European Food Safety Authority (EFSA). Further well-designed trials are needed to improve the current knowledge on the health benefits of nutraceuticals in the elderly. Overall, there are some facts, a lot of fiction and many gaps in the knowledge of nutraceutical benefits.
Victoria F. Burns
Full Text Available Objective. To explore how older people who are “aging in place” are affected when the urban neighbourhoods in which they are aging are themselves undergoing socioeconomic and demographic change. Methods. A qualitative case study was conducted in two contrasting neighbourhoods in Montréal (Québec, Canada, the analysis drawing on concepts of social exclusion and attachment. Results. Participants express variable levels of attachment to neighbourhood. Gentrification triggered processes of social exclusion among older adults: loss of social spaces dedicated to older people led to social disconnectedness, invisibility, and loss of political influence on neighbourhood planning. Conversely, certain changes in a disadvantaged neighbourhood fostered their social inclusion. Conclusion. This study thus highlights the importance of examining the impacts of neighbourhood change when exploring the dynamics of aging in place and when considering interventions to maintain quality of life of those concerned.
Burns, Victoria F; Lavoie, Jean-Pierre; Rose, Damaris
Objective. To explore how older people who are "aging in place" are affected when the urban neighbourhoods in which they are aging are themselves undergoing socioeconomic and demographic change. Methods. A qualitative case study was conducted in two contrasting neighbourhoods in Montréal (Québec, Canada), the analysis drawing on concepts of social exclusion and attachment. Results. Participants express variable levels of attachment to neighbourhood. Gentrification triggered processes of social exclusion among older adults: loss of social spaces dedicated to older people led to social disconnectedness, invisibility, and loss of political influence on neighbourhood planning. Conversely, certain changes in a disadvantaged neighbourhood fostered their social inclusion. Conclusion. This study thus highlights the importance of examining the impacts of neighbourhood change when exploring the dynamics of aging in place and when considering interventions to maintain quality of life of those concerned. PMID:22013528
This study investigates the relation between leisure activities and the social status of the elderly based on a heterogeneous sample of the Dutch population. Close relationships are also analyzed to identify which people could serve as successful stimulators of leisure participation. The social profile confirms that older people have fewer social contacts and often feel lonely. This study shows that leisure activities explain a significant part of older people's social connectedness. Voluntary work, cultural activities, holiday, sports, reading books, hobbies and shopping are found to be successful predictors for social connectedness of older people. Watching TV, listening to the radio, and spending time behind the computer (passive activities) were not associated with social connectedness. Friends correlate positively to participation in leisure activities. Partners play a role in participation in cultural activities and sports; parents play a role in participation in voluntary work and holidays; siblings play a role in voluntary work and sports; and children play a role in cultural activities, reading books, and shopping. Local communities can use these close relationships and develop special programs to increase social connectedness and hence improve quality of life for older adults. PMID:23874058
Full Text Available Abstract Background Little is known about small-area variation in healthy longevity of older people and its socioeconomic correlates. This study aimed to estimate health expectancy at 65 years (HE65 at the municipal level in Japan, and to examine its relation to area socio-demographic conditions. Methods HE65 of municipalities (N = 3361 across Japan was estimated by a linear regression formula with life expectancy at 65 years and the prevalence of those certificated as needing nursing care. The relation between HE65 and area socio-demographic indicators was examined using correlation coefficients. Results The estimated HE65 (years ranged from 13.13 to 17.39 for men and from 14.84 to 20.53 for women. HE65 was significantly positively correlated with the proportion of elderly and per capita income, and negatively correlated with the percentage of households of a single elderly person, divorce rate, and unemployment rate. These relations were stronger in large municipalities (with a population of more than 100,000 than in small and medium-size municipalities. Conclusion A decrease in healthy longevity of older people was associated with a higher percentage of households of a single elderly person and divorce rate, and lower socioeconomic conditions. This study suggests that older people in urban areas are susceptible to socio-demographic factors, and a social support network for older people living in socioeconomically disadvantaged conditions should be encouraged.
Medication administration may appear to be a 'simple' nursing task, but this audit published in Learning Disability Practice found that, due to a combination of multiple medication use and medical complexity in older people with learning disabilities, it can be more complicated than staff realise. PMID:27573967
Maarel-Wierink, C.D. van der; Vanobbergen, J.N.; Bronkhorst, E.M.; Schols, J.M.; Baat, C. de
OBJECTIVE: To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors. DESIGN: Systematic literature review. SETTING: PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligibl
Krokavcova, Martina; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.
This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (less than 45 years) and an older (greater than or equal to 45 years) age…
E. van Dongen
In this article the author shows through ethnographic data collected in a South African township how the memories of older people are memories of loss and resilience. The author describes and analyses remembering as a moral activity, which comments on the social fabric of present everyday South Afri
Blankevoort, Christiaan G.; van Heuvelen, Marieke J. G.; Scherder, Erik J. A.
Background. Physical performance tests are important for assessing the effect of physical activity interventions in older people with dementia, but their psychometric properties have not been systematically established within this specific population. Objective. The purpose of this study was to dete
Full Text Available Older people have always been a major focus for social policy and because the UK is an ageing society, their importance to the subject is likely to increase further. Like other modern welfare systems, the British welfare state originated in pension provision for older people and totally this group are the main users of the health and social services and the main recipients of social security spending. Compared with unemployed people and lone parents, older people are often viewed as a group that “deserves” specific social policy and especially, social security. However, it is sometimes said that the true test of a civilized society is how it treats its older and vulnerable groups. Despite this group's position as one of the most deserving of welfare, there are still widespread awareness of the many negative images of old age. In common with other western societies, Britain is a country in which age discrimination, or ageism, is widespread (Alcock et al, 2006.
Full Text Available Older people around the world are adopting the Internet at an increasing rate, and in the process are forming virtual community networks in a way that would not otherwise have been possible. Internet interactions by this group include e-mail, chat groups, community forums and discussion groups as well as the individual use of the Web for information purposes. Some of these virtual networks relate older people to other older people, while other networks span age groups as when, for instance, a grandmother communicates by e-mail with her grandchildren. But linking to the Internet is not always straightforward as family members, friends and the technology, along with other non-human actors, often intrude. This highlights the socio-technical nature of these networks and the need to investigate them in a way that allows this to be seen. To attempt an understanding of the formation and operation of virtual networks of older people, and the interactions involved, a socio-technical approach is required and this paper will attempt such an analysis based on research, in an Australian context, undertaken by the authors.
Li, Sicong; Southcott, Jane
Across the globe populations are ageing and living longer. Older people seek meaningful ways of occupying and enjoying their later years. Frequently, this takes the form of learning a new skill, in this case playing the piano keyboard. From the initial act of commitment to learning comes a raft of related aspects that influence the learner, their…
This article discusses best practice in the management of skin tear injuries in older people. It considers what a skin tear wound is, examines skin tear classification systems currently available and discusses management and treatment of these wounds as well as strategies to prevent the recurrence of skin tears in this patient group.
Kessels, R.P.C.; Mimpen, G.; Melis, R.J.F.; Olde Rikkert, M.G.M.
OBJECTIVES: The Revised Cambridge Cognitive Examination (CAMCOG-R) is a cognitive screen that has been used to discriminate individuals with dementia from cognitively intact older people. It consists of items assessing various cognitive domains, but the construct validity of the cognitive subscores
Kessels, R.P.C.; Mimpen, G.; Melis, R.J.F.; Olde Rikkert, M.G.M.
Objectives: The Revised Cambridge Cognitive Examination (CAMCOG-R) is a cognitive screen that has been used to discriminate individuals with dementia from cognitively intact older people. It consists of items assessing various cognitive domains, but the construct validity of the cognitive subscores
Villar, Feliciano; Celdrán, Montserrat
This article examines the reasons older Spanish people participate in nondegree educational programs and the barriers they may face when they want to do so. Data were drawn from the 2007 Survey on Adults' Involvement in Learning Activities (Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje: EADA) and correspond to a nationally representative sample of Spanish people aged between 60 and 74 years old (n=4,559). Overall, only 8.7% of the sample participated in a nondegree educational program. Predictors of participation were being a woman, being younger, having a higher educational level, and being employed. The most frequent reason given for participation was of an intrinsic nature (e.g., interest in the topic), although instrumental motives (e.g., utility of the content for daily life) were more common than suggested by previous research. As for barriers to participation, the vast majority of older people (95.6% of those who did not participate) did not even express a desire to participate. The most frequent barriers were internal (e.g., age/health restrictions). This kind of barrier was ascribed a greater importance by older and less educated groups as well as by those who participate less in cultural activities. Policies to promote older people's participation in nonformal educational activities are discussed in light of the data. PMID:25010657
This article addresses how older people understand and engage with contemporary art in the gallery context--whether there is something unique to the art, the format of the visits, the pedagogical approaches used by gallery educators, the social contact, or a combination of all these factors. It also addresses the psychosocial barriers to…
Bricker-Katz, Geraldine; Lincoln, Michelle; McCabe, Patricia
Background: Little is known about the experience of stuttering for people over 55 years of age. Recent research has established that the same types of stuttering behaviours, cognitions, and emotional consequences experienced during young adulthood persist into older age. Aims: The aims were to investigate perceptions of limitations to activity and…
Lynott, Patricia P.; Merola, Pamela R.
The purpose of this study was to examine the effects of an intergenerational program on children's attitudes toward older people. Four 4th grade classes, one each during the years 2002 through 2005, participated in the study. The elders and school children engaged in meaningful activities over a 5 month period, including the performance of a play…
Sayago, Sergio; Guijarro, Jose-Maria; Blat, Josep
This article reports on an exploratory study aimed to identify which ways of marking required and optional fields help older people fill in web forms correctly. Drawing on a pilot study and selective attention research in ageing, modified versions of widely used forms were created, in which standard asterisks were replaced with one of three…
Loughnan, Margaret; Carroll, Matthew; Tapper, Nigel J.
Older people have justifiably been highlighted as a high-risk group with respect to heat wave mortality and morbidity. However, there are older people living within the community who have developed adaptive and resilient environments around their home that provide some protection during periods of extreme heat. This study investigated the housing stock and self-reported thermal comfort of a group of older people living in a regional town in Australia during the summer of 2012. The results indicated that daily maximum living room temperature was not significantly correlated with outdoor temperature, and daily minimum living room temperature was very weakly correlated with outdoor temperature. Residents reported feeling comfortable when indoor temperature approximated 26 °C. As living room temperature increased, indoor thermal comfort decreased. Significant differences between indoor temperatures were noted for homes that were related to house characteristics such as the age of the house, the number of air-conditioning units, the pitch of the roof, home insulation and the number of heat-mitigation modifications made to the home. Brick veneer homes showed smaller diurnal changes in temperature than other building materials. With population ageing and the increasing focus on older people living in the community, the quality of the housing stock available to them will influence their risk of heat exposure during extreme weather.
Gagliardi, Cristina; Spazzafumo, Liana; Papa, Roberta; Marcellini, Fiorella
The present study examines the leisure style and leisure satisfaction of a sample of older people at baseline and after a period of 5 years. Three groups were identified by factorial and cluster analyses and labelled under the headings of: Organised Style, Surrounding Style and Indoor Style. Each group represented a different typology of leisure,…
Xiao, Lily Dongxia; Shen, Jun; Wu, Haifeng; Ding, Fu; He, Xizhen; Zhu, Yueping
A lack of knowledge in registered nurses about geriatric conditions is one of the major factors that contribute to these conditions being overlooked in hospitalized older people. In China, an innovative geriatric continuing nursing education program aimed at developing registered nurses' understanding of the complex care needs of hospitalized…
Notenboom, Kim; Beers, Erna; Van Riet-Nales, Diana A.; Egberts, Toine C G; Leufkens, Hubert G M; Jansen, Paul A F; Bouvy, Marcel L.
Objectives To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. Design Qualitative study with semistructured face-to-face interviews.
Scaf-Klomp, W.; Sanderman, R.; Ormel, J.; Kempen, G.I J M
Background: objectives of the study were i) to describe changes in depression in independently living people aged 57 or older with fall-related injuries, and ii) to examine the effect of incomplete recovery of physical functions on depression one year post-injury. Method: prospective cohort-study, i
We aimed to explore older people's subjective leisure experiences and to further examine associations of such experiences with their depressive symptoms in Taiwan. Known correlates of depression, such as demographics, physical health, and social support, were taken into account. Face-to-face interviews were conducted to collect data using…
Villar, Feliciano; Celdrán, Montserrat
This article examines the reasons older Spanish people participate in nondegree educational programs and the barriers they may face when they want to do so. Data were drawn from the 2007 Survey on Adults' Involvement in Learning Activities (Encuesta sobre la Participación de la Población Adulta en Actividades de Aprendizaje: EADA) and correspond to a nationally representative sample of Spanish people aged between 60 and 74 years old (n=4,559). Overall, only 8.7% of the sample participated in a nondegree educational program. Predictors of participation were being a woman, being younger, having a higher educational level, and being employed. The most frequent reason given for participation was of an intrinsic nature (e.g., interest in the topic), although instrumental motives (e.g., utility of the content for daily life) were more common than suggested by previous research. As for barriers to participation, the vast majority of older people (95.6% of those who did not participate) did not even express a desire to participate. The most frequent barriers were internal (e.g., age/health restrictions). This kind of barrier was ascribed a greater importance by older and less educated groups as well as by those who participate less in cultural activities. Policies to promote older people's participation in nonformal educational activities are discussed in light of the data.
Knudstrup, Mary-Ann; Møller, Kurt
The relationship between housing and the well-being of older people is a topic of growing interest. The focus is often on a specific aspect of housing, for example accessibility, location or interior design, and the perspective taken is typically that of a specific discipline. The influence...
Felix, E.; Haan, de H.; Vaandrager, L.; Koelen, M.
To support decision making regarding modifications to the current housing stock, this article explores older people's everyday lived experience of the house in the Netherlands. Twelve in-depth interviews were carried out, using diaries and a topic list. The study found physical, personal and social
Mugisha, Joseph; Scholten, Francien; Owilla, Sebastian; Naidoo, Nirmala; Seeley, Janet; Chatterji, Somnath; Kowal, Paul; Boerma, Ties
Older caregivers have major caregiving responsibilities in countries severely affected by the HIV epidemic, but little is known about their own health and well-being. We conducted this study to assess the association of caregiving responsibilities and self-perceived burden with caregivers' health, HIV status, background characteristics and care-receiving among older people in South Western Uganda. Men and women aged 50 years and older were recruited from existing cohort studies and clinic registers and interviewed at home. Health was measured through a composite score of health in eight domains, anthropometry and handgrip strength. Summary measures of caregiving responsibilities and self-reported burden were used to analyse the main associations. There were 510 participants, including 198 living with HIV. Four fifths of women and 66% of men were caregivers. Older respondents with no care responsibility had poorer scores on all health indicators (self-reported health score, body mass index and grip strength). Having a caregiving responsibility was not associated with poorer health status or quality of life. Notably, HIV-infected people, whether on antiretroviral treatment (ART) or not, had similar caregiving responsibilities and health status as others. The self-reported burden associated with caregiving was significantly associated with a poorer health score. One third of female caregivers were the single adult in the household with larger caregiving responsibilities. Many of these women are in the poorest wealth quartile of the households in the study and are therefore more likely to need assistance. Physical and financial supports were received by 70% and 63%, respectively. Those with larger caregiving responsibilities more frequently received support. Caregiving responsibilities were associated with better health status, greater satisfaction and quality of life. Older HIV-infected people, whether on ART or not, had similar caregiving responsibilities and self
Full Text Available Background: With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS and home-based CT testing, was developed, piloted and evaluated. Methods: Two STI clinic nurses encouraged 37 CT positive heterosexual young people (aged 16–25 years, called index clients, to recruit peers from their social and sexual networks using the web-based screening strategy. Eligible peers (young, living in the study area could request a home-based CT test and recruit other peers. Results: Twelve (40% index clients recruited 35 peers. Two of these peers recruited other peers (n = 7. In total, 35 recruited peers were eligible for participation; ten of them (29% requested a test and eight tested. Seven tested for the first time and one (13% was positive. Most peers were female friends (80%. Nurses were positive about using the strategy. Conclusions: The screening strategy is feasible for targeting the hidden social network. However, uptake among men and recruitment of sex-partners is low and RDS stopped early. Future studies are needed to explore the sustainability, cost-effectiveness, and impact of strategies that target people at risk who are not effectively reached by regular health care.
Kandelman, Daniel; Petersen, Poul Erik; Ueda, Hiroshi
The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings...... and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health-general health relationships is particularly important to WHO in its effort to strengthen integrated...
Wadolowska, L.; Danowska-Oziewicz, M.; Niedzwiedzka, E.;
BMI differentiation and obesity incidence in relation to food patterns of Polish older people were analysed. The research included 422 people aged 65+ years. 21 food patterns were separated by the factor analysis. On the basis of the self-reported body mass and height, the BMI and percentages...... of overweight or obese people were calculated. The increase of the BMI and overweight and obesity incidence for both sexes was unequivocally connected with eating rye. The increase of the BMI and overweight and obesity incidence depended among women on consuming pork meat and alcoholic beverages. For men...
Richardson, Jane C; Grime, Janet C; Ong, Bie Nio
It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness. Consequently, our research aimed to explore OA from the perspective of wellness. We undertook a longitudinal qualitative study to explore 'wellness and resilience' in a group of older people who reported chronic joint pain and considered themselves healthy. We interviewed 27 people and followed them up with monthly diary sheets, responding to reports of changes using their chosen contact method. This article focuses on how resilience relates to how people consider themselves to be well. Participants' experience of the adversity of their pain varied, and was influenced by context and meaning. Participants described 'keeping going' in body, mind and everyday life. Flexibility and pragmatism were key aspects of keeping going. The findings support a broader version of resilience that incorporates vulnerabilities. In the context of health care we suggest that treating the frail body should not come at the expense of undermining an older person's sense of a resilient self. PMID:25067864
K. M. Volkers
Full Text Available Background. Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. Methods. This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years. Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. Results. The full models explain 49–57% of the variance in working memory and 40–43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3–7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. Conclusions. Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482.
Knudstrup, Mary-Ann; Møller, Kurt
The relationship between housing and the well-being of older people is a topic of growing interest. The focus is often on a specific aspect of housing, for example accessibility, location or interior design, and the perspective taken is typically that of a specific discipline. The influence...... of housing on the well-being of older people is a multidimensional phenomenon, however. A large number of different factors influence well-being, and these different factors interact and are often interdependent. The aim of this project is to develop a model for a multidisciplinary approach to investigating...... of a larger research programme that aims to provide evidence-based knowledge for decision-making and planning of high quality housing for elderly people in need of care....
Hafskjold, L.; Sundler, A.J.; Holmstrom, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.
INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of
Hafskjold, L.; Sundler, A.J.; Holmström, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.
Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of
AONTAS The National Adult Learning Organisation, 2008
The overall aim of the research which informs this report is to examine the extent to which the learning needs of older people are understood and addressed within the adult and community education sector, and to explore how adult educators can be supported to develop innovative approaches and processes which engage older people in learning and…
Hanson, Elizabeth; Magnusson, Lennart; Sennemark, Eva
Purpose: This article describes an innovative practice called Blended Learning Networks (BLNs) whose aim is to enable older people, their families, and care providers to exchange knowledge, learn together, and support each other in local development work so that care is improved for older people. BLNs were established in 31 municipalities, headed…
Hallam, Susan; Creech, Andrea; Varvarigou, Maria; McQueen, Hilary
There is now an accepted need for initiatives that support older people's health and well-being. There is increasing evidence that active engagement with music has the potential to contribute to this. This research aimed to explore the characteristics of older people who participated in active music making with a view to identifying the groups…
Johansen Inger; Lindbak Morten; Stanghelle Johan K; Brekke Mette
Background The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Methods Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation ...
Alexis Zander; Erin Passmore; Chloe Mason; Chris Rissel
Introduction. Cycling can be an enjoyable way to meet physical activity recommendations and is suitable for older people; however cycling participation by older Australians is low. This qualitative study explored motivators, enablers, and barriers to cycling among older people through an age-targeted cycling promotion program. Methods. Seventeen adults who aged 50–75 years participated in a 12-week cycling promotion program which included a cycling skills course, mentor, and resource pack...
Curran, Stephen; Turner, Debbie; Musa, Shabir; Byrne, Andrew; Wattis, John
Aims The objective of the study was to provide observational clinical data on psychotropic drugs and especially hypnotics used in older people with mental illness. Method This was an observational, single-centre, one-week prevalence study of psychiatric symptoms, disorders and psychotropic/hypnotic drug use in older people with mental illness cared for by the South West Yorkshire Mental Health NHS Trust (Wakefield Locality), UK. Results A total of 593/660 older patients with mental i...
Tse, Mimi M Y; Choi, Kim C Y; Leung, Rincy S W
To meet the needs of frail older people and to promote functional longevity, providing health education and disease prevention to the elderly is important. The present study describes the development, implementation, and evaluation of an e-health program for older persons. The objective of the 4-week e-health program was to improve elders' autonomous access to and use of health-related information in the form of physical exercise videography from a government-sponsored Web site. The content of the program included participants' mastery of basic computing skills and accessing and enhancing participants' interest in seeking health-related knowledge and information via the Internet. Data were collected in weeks 1 (pretest) and 4 (posttest) using questionnaires and open-ended questions. Thirty older people participated in the study (9 males, 21 females, aged 65-80 years, with the mean age of 72). Participants' mastery of basic computer operating skills increased significantly (p e-health program would be an effective way to provide health education to older people.
Drury, Lisbeth; Hutchison, Paul; Abrams, Dominic
Research suggests that positive intergenerational contact can improve young people's attitudes towards older adults. However, today's age-segregated society may not provide ample opportunities for positive contact between younger and older adults to occur on a regular basis. In three studies, we investigated whether the positive attitudinal outcomes associated with direct contact might also stem from a more indirect form of intergenerational relationship: extended contact. In Study 1 (N = 70), extended contact was associated with more positive attitudes towards older adults even when controlling for direct intergenerational contact (contact frequency and contact quality). In Study 2 (N = 110), the positive effects of direct and extended contact on young people's age-related attitudes were mediated by reductions in intergroup anxiety and ageing anxiety. The mediational effects of intergroup anxiety were replicated in Study 3 (N = 95) and ingroup norms additionally emerged as a mediator of the positive effects of extended contact on young people's attitudes towards older adults. Discussion focuses on the implications for strategies aimed at tackling ageism. PMID:27256485
EVER since there have been families in China, it has been traditional for the elderly to spend their later years living at home with their children; if the children have married and presented their parents with grandchildren, the household may consist of a large extended family in which three to four generations live under one roof. Nowadays, many elderly Chinese still fit into this mold. According to a sampling survey taken in 1995, among households with older members, 67.64 million seniors—or 74.73 percent of the total—lived with their adult children. Though some older people live apart
O'Connor, Marie N
adverse drug reactions (ADRs) are a major cause of morbidity and healthcare utilisation in older people. The GerontoNet ADR risk score aims to identify older people at risk of ADRs during hospitalisation. We aimed to assess the clinical applicability of this score and identify other variables that predict ADRs in hospitalised older people.
Arsenijevic, Jelena; Pavlova, Milena; Rechel, Bernd; Groot, Wim
Introduction It is well-known that the prevalence of chronic diseases is high among older people, especially those who are poor. Moreover, chronic diseases can result in catastrophic health expenditure. The relationship between chronic diseases and their financial burden on households is thus double-sided, as financial difficulties can give rise to, and result from, chronic diseases. Our aim was to examine the levels of catastrophic health expenditure imposed by private out-of-pocket payments among older people diagnosed with diabetes mellitus, cardiovascular diseases and cancer in 15 European countries. Methods The SHARE dataset for individuals aged 50+ and their households, collected in 2010–2012 was used. The total number of participants included in this study was N = 51,661. The sample consisted of 43.8% male and 56.2% female participants. The average age was 67 years. We applied an instrumental variable approach for binary instrumented variables known as a treatment-effect model. Results We found that being diagnosed with diabetes mellitus and cardiovascular diseases was associated with catastrophic health expenditure among older people even in comparatively wealthy countries with developed risk-pooling mechanisms. When compared to the Netherlands (the country with the lowest share of out-of-pocket payments as a percentage of total health expenditure in our study), older people diagnosed with diabetes mellitus in Portugal, Poland, Denmark, Italy, Switzerland, Belgium, the Czech Republic and Hungary were more likely to experience catastrophic health expenditure. Similar results were observed for diagnosed cardiovascular diseases. In contrast, cancer was not associated with catastrophic health expenditure. Discussion Our study shows that older people with diagnosed chronic diseases face catastrophic health expenditure even in some of the wealthiest countries in Europe. The effect differs across chronic diseases and countries. This may be due to different socio
Full Text Available Background: Globally, it is estimated that people aged 60 and over constitute more than 11% of the population, with the corresponding proportion in developing countries being 8%. Rapid urbanisation in sub-Saharan Africa (SSA, fuelled in part by rural–urban migration and a devastating HIV/AIDS epidemic, has altered the status of older people in many SSA societies. Few studies have, however, looked at the health of older people in SSA. This study aims to describe the health and well-being of older people in two Nairobi slums. Methods: Data were collected from residents of the areas covered by the Nairobi Urban Health and Demographic Surveillance System (NUHDSS aged 50 years and over by 1 October 2006. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health form. Mean WHO Quality of Life (WHOQoL and a composite health score were computed and binary variables generated using the median as the cut-off. Logistic regression was used to determine factors associated with poor quality of life (QoL and poor health status. Results: Out of 2,696 older people resident in the NUHDSS surveillance area during the study period, data were collected on 2,072. The majority of respondents were male, aged 50–60 years. The mean WHOQoL score was 71.3 (SD 6.7 and mean composite health score was 70.6 (SD 13.9. Males had significantly better QoL and health status than females and older respondents had worse outcomes than younger ones. Sex, age, education level and marital status were significantly associated with QoL, while slum of residence was significantly associated with health status. Conclusion: The study adds to the literature on health and well-being of older people in SSA, especially those in urban informal settlements. Further studies are needed to validate the methods used for assessing health status and to provide comparisons from other settings. Health and Demographic Surveillance Systems have the potential to conduct such
Background Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by
Finch Caroline F
Full Text Available Abstract Background Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7. The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients
Howlett, Megan; Gibson, William; Hunter, Kathleen F; Chambers, Thane; Wagg, Adrian
While there is extensive literature regarding nocturnal enuresis in children and young adults, relatively little research explores this problem in older people. This scoping review sought to identify knowledge gaps and provide research direction specifically for older, institutionalized adults with nocturnal enuresis. A comprehensive search of 8 electronic databases and the gray literature was undertaken. Studies focusing on the causes, symptoms, and treatment of nocturnal enuresis in older people were retrieved. A broad search strategy including all adults was employed in order to capture all relevant publications. Articles were then excluded by title and abstract such that only those relevant to the older adult and institutionalized populations remained. Relevant articles were identified by title and language. Further reading of the abstract allowed inclusion and a final full reading of the articles allowed all authors to map research activity and identify knowledge gaps. After duplicates and nonrelevant articles were eliminated, we identified 7 articles on nursing home residents and 2 involving older people living in psychiatric institutions. Published literature focused on causes and treatment with either desmopressin or aversive behavioral therapy. No study included a comprehensive continence assessment or controlled for comorbid conditions. Identified gray literature focused on general continence information for the public and nonspecialist clinicians. We conclude that there is a dearth of evidence relevant to this troublesome condition. Gaps in the evidence base include a lack of standardized terminology and limited research focusing on the epidemiology, pathophysiology, and treatment of nocturnal enuresis, all of which suggest a rich research agenda for future investigation. PMID:27196686
Full Text Available Introduction: Type 2 diabetes mellitus (T2DM among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with type 2 diabetes mellitus. Methods: A literature search was conducted using OvidMEDLINE, PubMed, EMBASE, SPORTDiscus and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomised controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed.Results: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalised coaching, goal setting, peer support groups, use of technology and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behaviour theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies.Conclusion: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required.
Duffy, J. F.; Dijk, D. J.; Klerman, E. B.; Czeisler, C. A.
The contribution of the circadian timing system to the age-related advance of sleep-wake timing was investigated in two experiments. In a constant routine protocol, we found that the average wake time and endogenous circadian phase of 44 older subjects were earlier than that of 101 young men. However, the earlier circadian phase of the older subjects actually occurred later relative to their habitual wake time than it did in young men. These results indicate that an age-related advance of circadian phase cannot fully account for the high prevalence of early morning awakening in healthy older people. In a second study, 13 older subjects and 10 young men were scheduled to a 28-h day, such that they were scheduled to sleep at many circadian phases. Self-reported awakening from scheduled sleep episodes and cognitive throughput during the second half of the wake episode varied markedly as a function of circadian phase in both groups. The rising phase of both rhythms was advanced in the older subjects, suggesting an age-related change in the circadian regulation of sleep-wake propensity. We hypothesize that under entrained conditions, these age-related changes in the relationship between circadian phase and wake time are likely associated with self-selected light exposure at an earlier circadian phase. This earlier exposure to light could account for the earlier clock hour to which the endogenous circadian pacemaker is entrained in older people and thereby further increase their propensity to awaken at an even earlier time.
F. Xavier Gómez-Olivé
Full Text Available Background: The population in developing countries is ageing, which is likely to increase the burden of non-communicable diseases and disability. Objective: To describe factors associated with self-reported health, disability and quality of life (QoL of older people in the rural northeast of South Africa. Design: Cross-sectional survey of 6,206 individuals aged 50 and over. We used multivariate analysis to examine relationships between demographic variables and measures of self-reported health (Health Status, functional ability (WHODASi and quality of life (WHOQoL. Results: About 4,085 of 6,206 people eligible (65.8% completed the interview. Women (Odds Ratio (OR=1.30, 95% CI 1.09, 1.55, older age (OR=2.59, 95% CI 1.97, 3.40, lower education (OR=1.62, 95% CI 1.31, 2.00, single status (OR=1.18, 95% CI 1.01, 1.37 and not working at present (OR=1.29, 95% CI 1.06, 1.59 were associated with a low health status. Women were also more likely to report a higher level of disability (OR=1.38, 95% CI 1.14, 1.66, as were older people (OR=2.92, 95% CI 2.25, 3.78, those with no education (OR=1.57, 95% CI 1.26, 1.97, with single status (OR=1.25, 95% CI 1.06, 1.46 and not working at present (OR=1.33, 95% CI 1.06, 1.66. Older age (OR=1.35, 95% CI 1.06, 1.74, no education (OR=1.39, 95% CI 1.11, 1.73, single status (OR=1.28, 95% CI 1.10, 1.49, a low household asset score (OR=1.52, 95% CI 1.19, 1.94 and not working at present (OR=1.32; 95% CI 1.07, 1.64 were all associated with lower quality of life. Conclusions: This study presents the first population-based data from South Africa on health status, functional ability and quality of life among older people. Health and social services will need to be restructured to provide effective care for older people living in rural South Africa with impaired functionality and other health problems.
Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David;
. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality. METHODS: Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer......BACKGROUND: The mortality rates of older people changes with the seasons. However, it has not been properly investigated whether the seasons affect medical care expenditure (MCE) and institutionalization. Seasonal variation in MCE is plausible, as MCE rises exponentially before death...... and were linked with data from the Netherlands Institute for Social Research, and Statistics Netherlands (n = 61,495). The Seasonal and Trend decomposition using Loess (STL) method was used to divide mortality rates, MCE, and institutionalization rates into a long-term trend, seasonal variation...
This paper reports on the research findings derived from a grounded theory study that examined the processes through which community mental health nurses work with families of older people with depression. Data were collected through semistructured, in-depth interviews with six community mental health nurses and seven family caregivers of older people with depression, and observations of their interactions in natural settings. Data collection and analysis were guided by theoretical sampling and the constant comparative process. The findings indicate that the nurse-family caregiver relationship involves working towards mutuality, which is shaped by both the nurse and family caregiver. It is through the process of "shaping mutuality" that a nurse and family caregiver learn to collaborate, and achieve their individual goals and desired outcomes, both for the patient and for themselves.
Leibing, Annette; Guberman, Nancy; Wiles, Janine
There are many studies that have examined the meaning of home for older people. In this article, our aim is to add the concept of 'liminal homes' to the existing discussion: While the concept of liminal homes can be applied to a number of 'interim spaces', we focus in our study, on those older people who have to consider, or are concretely confronted with, the need to move into another living space, because of declining health. Based on interviews and photo-elicitation with 26 older lower-income seniors living in Montreal, Québec, this article demonstrates the complexity of liminality and analyzes the dynamics of this process, composed of a web of interrelated and often dichotomous elements. These include the idealized home in contrast to (sometimes imagined) institutions; declining health as opposed to the ideals of active aging and third age; and the widely promoted concept of aging in place versus the reality of being 'stuck in place' due to limited resources. The strategies employed by these older Quebeckers to remain in this state and resist a move to another living space, are the often arduous construction of a 'patchwork of care'. PMID:27131274
Brinda, Ethel Mary; Kowal, Paul; Attermann, Jørn;
BACKGROUND: Healthcare financing through out-of-pocket payments and inequities in healthcare utilisation are common in low and middle income countries (LMICs). Given the dearth of pertinent studies on these issues among older people in LMICs, we investigated the determinants of health service use......, out-of-pocket and catastrophic health expenditures among older people in one LMIC, India. METHODS: We accessed data from a nationally representative, multistage sample of 2414 people aged 65 years and older from the WHO's Study on global Ageing and adult health in India. Sociodemographic...... the number of health visits and out-of-pocket health expenditures. The prevalence of catastrophic health expenditure among older people in India was 7% (95% CI 6% to 8%). Older men and individuals with chronic diseases were at higher risk of catastrophic health expenditure, while access to health insurance...
Bundgaard, Karen Marie
Even when frail older people become unable to live on their own and manage everyday activities, they can still experience a variety of meanings within meal-related activities that contribute to quality of life. This article reports research findings that focused on the meal, from preparation...... to cleaning up. Data were collected through participant observation and by interviewing residents in a residential living unit in Denmark, and analysed using a comparative, interpretive approach. Living units are a new way of organising nursing homes. In each unit, 6-8 elderly people stay in individual flats...
Chang, Bao-Chi; Liu, Ding-Hao; Chang, Jeffrey Liao; Lee, Si-Huei; Wang, Jia-Yi
Foot pain frequently reduces physical activity and increases the risk of falls in older people. In current orthotic management of forefoot pain, metatarsal padding is the main strategy to reduce metatarsal pressure. However, pressure reductions are usually diverse and limited. The multi-step accommodative insole is fabricated by sequential foam padding on Plastazote under dynamic accommodation in daily walking. The aims of this study were to investigate the effectiveness and mechanisms of accommodative insole on plantar pressure redistribution in older people with metatarsalgia. The study was conducted on 21 old outpatients with moderate to severe metatarsalgia, using the ethylene vinyl acetate control, 9-mm flat Plastazote, and accommodative insoles with and without metatarsal and arch support. Outcome measures included pressure-related variables measured by a Pedar-X system, and pain scores assessed with a 0-10 Visual Analog Scale. The accommodative insole significantly decreased peak pressure under the metatarsal heads by 47.2% (p<0.001) and the pain scores from 8.2 to 1.1 (p<0.001). Plantar pressure analyses indicated that the effects of dynamic metatarsal contouring and cushioning on reducing peak pressure were greater than those of metatarsal padding. The temporo-spatial relationships between the toe and metatarsal head can assist in explaining an elevated metatarsal pressure and higher risk of falls in older people with toe deformities. The multi-step insole is simple in orthotic fabrication and ensures an even distribution of plantar pressure loading in walking. It can effectively relieve metatarsalgia and help to preserve regular walking activity for older people with metatarsalgia. PMID:24119776
Williams Nefyn H
Full Text Available Abstract Background As the demographic profile of the UK changes, policy makers and practitioners have to respond to health challenges presented by a progressively ageing population. The health promotion plan for older people, aged over 50 years, in Wales included eight key areas: physical activity, healthy eating, home safety and warmth, emotional health, health protection, smoking, alcohol and sexual health. The aim of this study was to describe the extent, content and regional variation of existing health promotion initiatives for older people in Wales, provided by statutory, voluntary and private sector agencies. Method A questionnaire was sent to senior health promotion specialists employed in the 22 local authority areas in Wales to ascertain details of all projects promoting health and wellbeing in the eight key areas where the priority population was aged over 50, or the majority of users were older people. Additional information was sought from project leads and websites. Results Eighteen questionnaires were returned; not all were fully completed. Four areas did not return a questionnaire. Additional information was obtained from internet searches but this mainly concerned national initiatives rather than local projects. In all, 120 projects were included, 11 were throughout Wales. Best provision was for physical activity, with 3 national and 42 local initiatives, but local provision was patchy. Healthy eating, and home safety and warmth had far fewer initiatives, as did health protection, which comprised two national immunisation campaigns. Smoking and alcohol misuse were poorly provided for, and there was no provision for older people's sexual health. Evaluation arrangements were poorly described. Half of those who responded identified unmet training needs. Conclusion The reasons for patchy provision of services were not clear. Increased efforts to improve the coverage of interventions known to be effective should be made. Rigorous
Bauer, Annette; Knapp, Martin; Wistow, Gerald; Perkins, Margaret; King, Derek; Iemmi, Valentina
Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help-at-home schemes offer a mix of community support with the aim to address a range of wellbeing needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals’ wellbeing and the economic consequences for local and central government can con...
Patterson, Susan M; Cadogan, Cathal A.; Kerse, Ngaire; Cardwell, Chris R.; Bradley, Marie C; Ryan, Cristin; Hughes, Carmel
BackgroundInappropriate polypharmacy is a particular concern in older people and is associated with negative health outcomes. Choosing the best interventions to improve appropriate polypharmacy is a priority, hence interest in appropriate polypharmacy, where many medicines may be used to achieve better clinical outcomes for patients, is growing.ObjectivesThis review sought to determine which interventions, alone or in combination, are effective in improving the appropriate use of polypharmacy...
Shaw, Catherine; McCormack, Brendan; Hughes, Carmel M
Background There is increasing interest in how culture may affect the quality of healthcare services, and previous research has shown that ‘treatment culture’—of which there are three categories (resident centred, ambiguous and traditional)—in a nursing home may influence prescribing of psychoactive medications. Objective The objective of this study was to explore and understand treatment culture in prescribing of psychoactive medications for older people with dementia in nursing homes. Metho...
Comas-Herrera, Adelina; Wittenberg, Raphael; Pickard, Linda; KNAPP, MARTIN
This study aimed to make projections, for the next 30 years, of future numbers of older people with cognitive impairment, their demand for long-term care services and the future costs of their care under a range of specified assumptions. Cognitive impairment is one of the manifestations of dementia. The most common dementia syndrome is Alzheimer’s Disease (AD), followed by vascular dementia (Henderson and Jorm, 2000). It also set out to explore the factors that are likely to affect future...
Goodman, Claire; Dening, Tom; Gordon, Adam L.; Davies, Susan L.; Meyer, Julienne; Martin, Finbarr C; Gladman, John R F; Bowman, Clive; Victor, Christina; Handley, Melanie; Gage, Heather; Iliffe, Steve; ZUBAIR, MARIA
Background Care home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was to explore the evidence for how different service delivery models for care home residents support and/or improve wellbeing and health-related outcomes in older people living and dying in care homes. Methods We conceptualised models of health care provision to care homes as comp...
Despite the high frequency and serious consequences of protein–energy malnutrition, prevention and treatment of malnutrition do not currently receive appropriate attention. Increased awareness of the importance of nutritional screening among older people is needed. The overall aim of this thesis was to extend our current knowledge about malnutrition and the consequences of a poor nutritional status in relation to preterm death, and to identify possible risk factors for developing malnutrition...
Söderström, Lisa; Rosenblad, Andreas; Adolfsson, Eva Thors; Saletti, Anja; Bergkvist, Leif
Background & aims: There is an association between malnutrition and mortality. However, it is uncertain whether this association is independent of confounders. The aim of the present study was to examine whether nutritional status, defined according to the three categories in the full Mini Nutritional Assessment (MNA) instrument, is an independent predictor of preterm death in people 65 years and older. Methods: This prospective cohort study included individuals aged >= 65 years who we...
Machón, Mónica; Vergara, Itziar; Dorronsoro, Miren; Vrotsou, Kalliopi; Larrañaga, Isabel
Background Self-perceived health (SPH) is a powerful indicator of the health status of elderly people. This issue has been widely studied in oldest populations considering altogether functionally independent and dependent individuals. The objective of this study was to describe SPH and to identify the main factors that have an impact on SPH in a sample of functionally independent community-dwelling older adults. Methods For this cross-sectional study, face-to-face interviews were carried out ...
Karki S; Bhatta DN; Aryal UR
Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the...
Bhatta, Dharma Nand
Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the...
Marston, Hannah R.; Woodbury, Ashley; Gschwind, Yves J; Kroll, Michael; Fink, Denis; Eichberg, Sabine; Kreiner, Karl; Ejupi, Andreas; Annegarn, Janneke; de Rosario, Helios; Wienholtz, Arno; Wieching, Rainer; Delbaere, Kim
Background Falls in older people represent a major age-related health challenge facing our society. Novel methods for delivery of falls prevention programs are required to increase effectiveness and adherence to these programs while containing costs. The primary aim of the Information and Communications Technology-based System to Predict and Prevent Falls (iStoppFalls) project was to develop innovative home-based technologies for continuous monitoring and exercise-based prevention of falls in...
Bell, J Simon; Lavikainen, Piia; Korhonen, Mikko; Hartikainen, Sirpa
Benzodiazepine discontinuation among community-dwelling older people: a population-based cohort study fax: +358-171-62424 (Bell, J. Simon) (Bell, J. Simon) Kuopio Research Centre of Geriatric Care, University of Eastern Finland - P.O. Box 1627 - 70211 - Kuopio - FINLAND (Bell, J. Simon) Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland - Kuopio - FINLAND (Bell, J. Simon) ...
Stuss, D T; Craik, F I; Sayer, L; Franchi, D; Alexander, M P
We examined the hypothesis that changes in memory performance of older normal participants are due to frontal lobe dysfunction by comparing three groups of normal individuals (young, middle-aged, and older) with three groups of patients who had documented lesions in specific frontal regions: unilateral right, unilateral left, and bilateral. All participants were given 4 successive learning trials on each of 3 lists of words: unrelated, related but presented in a pseudo-random order, and related and presented in a blocked format. We found significant correspondences in performance between the older normal participants and the (younger) frontal damaged groups. The qualitative nature of recall performance, particularly as measured by indices of organizational control processes, was similar between older normals and patients with frontal damage, particularly those with right frontal damage, but different from that normally exhibited by patients with focal limbic/memory dysfunction. These results add to the evidence that at least some of the decline in older people in tasks which measure executive or supervisory abilities is due to frontal system dysfunction. PMID:8893308
Elizabeth M. Wallack
Full Text Available Purpose. The aim of this study was to determine what factors most greatly contributed to healthy aging with multiple sclerosis (MS from the perspective of a large sample of older people with MS. Design and Methods. Participants (n=683; >55 years of age with symptoms >20 years provided answers to an open-ended question regarding healthy aging and were categorized into three groups, 55–64 (young, 65–74 (middle, and 75 and over (oldest old. Sociodemographic actors were compared using ANOVA. Two independent raters used the framework method of analyzing qualitative data. Results. Participants averaged 64 years of age (±6.2 with MS symptoms for 32.9 years (±9.4. 531 participants were female (78%. The majority of participants lived in their own home (n=657 with a spouse or partner (n=483. Participants described seven themes: social connections, attitude and outlook on life, lifestyle choices and habits, health care system, spirituality and religion, independence, and finances. These themes had two shared characteristics, multidimensionality and interdependence. Implications. Learning from the experiences of older adults with MS can help young and middle aged people with MS plan to age in their own homes and communities. Our data suggests that older people with MS prioritize factors that are modifiable through targeted self-management strategies.
Wallack, Elizabeth M; Wiseman, Hailey D; Ploughman, Michelle
Purpose. The aim of this study was to determine what factors most greatly contributed to healthy aging with multiple sclerosis (MS) from the perspective of a large sample of older people with MS. Design and Methods. Participants (n = 683; >55 years of age with symptoms >20 years) provided answers to an open-ended question regarding healthy aging and were categorized into three groups, 55-64 (young), 65-74 (middle), and 75 and over (oldest old). Sociodemographic actors were compared using ANOVA. Two independent raters used the framework method of analyzing qualitative data. Results. Participants averaged 64 years of age (±6.2) with MS symptoms for 32.9 years (±9.4). 531 participants were female (78%). The majority of participants lived in their own home (n = 657) with a spouse or partner (n = 483). Participants described seven themes: social connections, attitude and outlook on life, lifestyle choices and habits, health care system, spirituality and religion, independence, and finances. These themes had two shared characteristics, multidimensionality and interdependence. Implications. Learning from the experiences of older adults with MS can help young and middle aged people with MS plan to age in their own homes and communities. Our data suggests that older people with MS prioritize factors that are modifiable through targeted self-management strategies. PMID:27504201
Full Text Available Introduction Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay amongst frail older people. In this study we have undertaken a systematic review of the recent international literature (2007-present to help improve our understanding about the impact of these interventions. Methods We systematically searched the following databases: PubMed / Medline, PsycINFO, CINAHL, BioMed Central, Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified. Results A total of 48 studies were included for full review consisting of 11 meta-analyses, 9 systematic reviews, 5 structured literature reviews, 8 randomised controlled trials and 15 other studies. We classified interventions into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge. Conclusions Reducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. A stronger evidence base has emerged in recent years about a broad range of interventions which may be effective. Local agencies need to work together to implement these interventions to create a sustainable healthcare system for older people.
Full Text Available Introduction Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay amongst frail older people. In this study we have undertaken a systematic review of the recent international literature (2007-present to help improve our understanding about the impact of these interventions. Methods We systematically searched the following databases: PubMed / Medline, PsycINFO, CINAHL, BioMed Central, Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified. Results A total of 48 studies were included for full review consisting of 11 meta-analyses, 9 systematic reviews, 5 structured literature reviews, 8 randomised controlled trials and 15 other studies. We classified interventions into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge. Conclusions Reducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. A stronger evidence base has emerged in recent years about a broad range of interventions which may be effective. Local agencies need to work together to implement these interventions to create a sustainable healthcare system for older people.
Full Text Available The establishment of a system for providing appropriate long-term care services for older people is a national issue in Japan, and it will likely become a worldwide issue in the years to come. Under Japanese Long-term Care Insurance System, long-term care is provided based on long-term care programs, which were designed by care providers on the basis of long-term care service plans, which were designed by care managers. However, defined methodology for designing long-term care service plans and care programs has not been established yet. In this paper, we propose models for designing long-term care service plans and care programs for older people, both by incorporating the technical issues from previous studies and by redesigning the total methodology according to these studies. Our implementation model consists of “Function,” “Knowledge Structure,” and “Action Flow.” In addition, we developed the concrete knowledgebases based on the Knowledge Structure by visualizing, summarizing, and structuring the inherent knowledge of healthcare/welfare professionals. As the results of the workshop and retrospective verification, the adequacy of the models was suggested, while some further issues were pointed. Our models, knowledgebases, and application make it possible to ensure the quality of long-term care for older people.
Kate Mary Bennet
Full Text Available We have little robust empirical evidence that articulates what being lonely means to older people and even less knowledge about what loneliness means to older widows and widowers; this article addresses that deficit. We undertook a re-analysis of 125 interviews with older people (aged 55-98 that explored their experiences of widowhood. In this article, we focus on those interviews in which participants described themselves as experiencing loneliness by the spontaneous use of terms such as ‘‘lonely’’, ‘‘loneliness’’ or ‘‘lonesome’’. Almost half of the participants (42% described themselves in that way without any prompting from the interviewer. In terms of understanding and describing the meaning of loneliness, 50% explained loneliness in terms of absence of either their spouse, a physical presence in the house or people. One-third (34% discussed loneliness in relation to time and place: night, weekends and home, and 4% described the emotional impact of loneliness. Fifteen per cent just said they were lonely without elaboration, assuming a common understanding of what loneliness means. Our findings suggest that widowed people’s understanding and experience of loneliness resonates with the concept of ‘‘emotional’’ loneliness, resulting from the loss of significant social and emotional attachment. This has important implications for the types of interventions that may be appropriate for remediating loneliness in this group.
Davies, S; Laker, S; Ellis, L
The principles of promoting autonomy and independence underpin many approaches to improving the quality of nursing care for older people in whatever setting, and are in line with wider developments in health care such as the Patient's Charter. However, these concepts require careful definition if nursing practices which might promote autonomy and independence are to be identified. Although the generalizability of the research-based literature in this field is limited by a focus upon older people in continuing-care settings, a review of the literature found a number of indicators associated with attempts to promote patient autonomy and independence. These were grouped into the following categories: systems of care delivery which promote comprehensive individualized assessment and multidisciplinary care planning; attempts to encourage patients/clients to participate in decisions about their care; patterns of communication which avoid exerting power and control over patients/clients and attempts to modify the environment to promote independence and minimize risk. It is suggested that the review identifies a number of principles for nursing practice which can be applied in a range of care settings in order to promote the autonomy and independence of older people.
Marcia R Franco
Full Text Available Question: What relative value do older people with a previous fall or mobility-related disability attach to different attributes of exercise? Design: Prospective, best-worst scaling study. Participants: Two hundred and twenty community-dwelling people, aged 60 years or older, who presented with a previous fall or mobility-related disability. Methods: Online or face-to-face questionnaire. Outcome measures: Utility values for different exercise attributes and levels. The utility levels were calculated by asking participants to select the attribute that they considered to be the best (ie, they were most likely to want to participate in programs with this attribute and worst (ie, least likely to want to participate. The attributes included were: exercise type; time spent on exercise per day; frequency; transport type; travel time; out-of-pocket costs; reduction in the chance of falling; and improvement in the ability to undertake tasks inside and outside of home. Results: The attributes of exercise programs with the highest utility values were: home-based exercise and no need to use transport, followed by an improvement of 60% in the ability to do daily tasks at home, no costs, and decreasing the chances of falling to 0%. The attributes with the lowest utility were travel time of 30 minutes or more and out-of-pocket costs of AUD50 per session. Conclusion: The type of exercise, travel time and costs are more highly valued by older people than the health benefits. These findings suggest that physical activity engagement strategies need to go beyond education about health benefits and focus on improving accessibility to exercise programs. Exercise that can be undertaken at or close to home without any cost is most likely to be taken up by older people with past falls and/or mobility-related disability. [Franco MR, Howard K, Sherrington C, Ferreira PH, Rose J, Gomes JL, Ferreira ML (2015 Eliciting older people's preferences for exercise programs: a best
Full Text Available Orientation: The relocation of older people to residential facilities has implications for their relationships.Research purpose: This article reports older residents’ perceptions of effective relationships.Motivation for the study: Effective relationships protect against loneliness and depression and contribute to well-being. The facility was identified by a social worker as a showcase for effective relationships, but it was not clear what these consist of.Research approach, design and method: The World Café, a qualitative, participatory action research method, was applied to an economically deprived, urban facility caring for older people in Gauteng, South Africa. Three positively framed questions elicited perceptions from participants (nine men, ten women, aged 65–89. Visual and textual data were obtained and thematically analysed until saturation had been achieved. Themes were then subjected to deductive direct content analysis in terms of Self-Interactional Group Theory (SIGT.Main findings: Older residents perceive care managers as friendly and trustworthy and co-residents as caring. Care managers were seen as flexible, empathetic and congruent leaders and they confirmed residents. Relationships between residents were parallel-defined with relational qualities such as empathy and unconditional acceptance. Residents’ needs for privacy were honoured and they felt confirmed. Group dynamics were underpinned by caring and a stimulating environment provided opportunities for engagement.Practical/managerial implications: Relationships between managers and consumers are facilitated by flexibility, empathy, congruence and unconditional acceptance. Supportive group dynamics develop when people confirm and accept one another. A stimulating environment that encourages continuous and close interpersonal contact contributes to effective relationships.Contribution/value-add: Effective relationships should be understood on different levels.
Ejupi, Andreas; Brodie, Matthew; Gschwind, Yves J; Schoene, Daniel; Lord, Stephen; Delbaere, Kim
Accidental falls remain an important problem in older people. Stepping is a common task to avoid a fall and requires good interplay between sensory functions, central processing and motor execution. Increased choice stepping reaction time has been associated with recurrent falls in older people. The aim of this study was to examine if a sensor-based Exergame Choice Stepping Reaction Time test can successfully discriminate older fallers from non-fallers. The stepping test was conducted in a cohort of 104 community-dwelling older people (mean age: 80.7 ± 7.0 years). Participants were asked to step laterally as quickly as possible after a light stimulus appeared on a TV screen. Spatial and temporal measurements of the lower and upper body were derived from a low-cost and portable 3D-depth sensor (i.e. Microsoft Kinect) and 3D-accelerometer. Fallers had a slower stepping reaction time (970 ± 228 ms vs. 858 ± 123 ms, P = 0.001) and a slower reaction of their upper body (719 ± 289 ms vs. 631 ± 166 ms, P = 0.052) compared to non-fallers. It took fallers significantly longer than non-fallers to recover their balance after initiating the step (2147 ± 800 ms vs. 1841 ± 591 ms, P = 0.029). This study demonstrated that a sensor-based, low-cost and easy to administer stepping test, with the potential to be used in clinical practice or regular unsupervised home assessments, was able to identify significant differences between performances by fallers and non-fallers. PMID:25571596
Full Text Available There is a lack of research on the everyday lives of older people in developing countries. This exploratory study used structured observation and content analysis to examine the presence of older people in public fora and considered the methods’ potential for understanding older people’s social integration and inclusion. Structured observation occurred of public social spaces in six cities each located in a different developing country and in one city in the United Kingdom, together with content analysis of the presence of people in newspaper pictures and on television in the selected countries. Results indicated that across all fieldwork sites and data sources, there was a low presence of older people, with women considerably less present than men in developing countries. There was variation across fieldwork sites in older people’s presence by place and time of day and in their accompanied status. The presence of older people in images drawn from newspapers was associated with the news/non-news nature of the source. The utility of the study’s methodological approach is considered, as is the degree to which the presence of older people in public fora might relate to social integration and inclusion in different cultural contexts.
van Hoof, J. [Hogeschool Utrecht University of Applied Sciences, Faculty of Health Care, Research Centre for Innovation in Health Care, Bolognalaan 101, 3584 CJ Utrecht (Netherlands); Eindhoven University of Technology, Department of Architecture, Building and Planning, Den Dolech 2, 5612 AZ Eindhoven (Netherlands); Kort, H.S.M. [Hogeschool Utrecht University of Applied Sciences, Faculty of Health Care, Research Centre for Innovation in Health Care, Bolognalaan 101, 3584 CJ Utrecht (Netherlands); Vilans, Catharijnesingel 47, 3511 GC Utrecht (Netherlands); Hensen, J.L.M.; Rutten, P.G.S. [Eindhoven University of Technology, Department of Architecture, Building and Planning, Den Dolech 2, 5612 AZ Eindhoven (Netherlands); Duijnstee, M.S.H. [Hogeschool Utrecht University of Applied Sciences, Faculty of Health Care, Research Centre for Innovation in Health Care, Bolognalaan 101, 3584 CJ Utrecht (Netherlands); Academy of Health Sciences Utrecht, Universiteitsweg 98, 3584 CG Utrecht (Netherlands)
People with dementia may have an altered sensitivity to indoor environmental conditions compared to other older adults and younger counterparts. This paper, based on literature review and qualitative research, provides an overview of needs regarding thermal comfort and the design and implementation of heating, ventilation and air conditioning systems for people with dementia and other relevant stakeholders through the combined use of the International Classification of Functioning, Disability and Health, and the Model of Integrated Building Design. In principle, older adults do not perceive thermal comfort differently from younger adults. Due to the pathology of people with dementia, as well as their altered thermoregulation, the perception of the thermal environment might be changed. Many people with dementia express their discomfort through certain behaviour that is considered a problem for both family and professional carers. Ethical concerns are raised as well in terms of who is in charge over the thermal conditions, and the protection against temperature extremes in hot summers or cold winters. When implementing heating, ventilation and air conditioning systems one should consider aspects like user-technology interaction, diverging needs and preferences within group settings, safety issues, and minimising negative behavioural reactions and draught due to suboptimal positioning of outlets. At the same time, technology puts demands on installers who need to learn how to work with customers with dementia and their family carers. (author)
Prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP) definition: findings from the Hertfordshire Cohort Study (HCS)
Patel, Harnish P; Syddall, Holly Emma; Jameson, Karen; Robinson, Sian; Denison, Hayley; Roberts, Helen C.; Edwards, Mark; Dennison, Elaine; Cooper, Cyrus; Aihie Sayer, Avan Aihie
Introduction: sarcopenia is associated with adverse health outcomes. The aim of this study was to describe the prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP) consensus definition. Methods:we applied the EWGSOP definition to 103 community-dwelling men participating in the Hertfordshire Sarcopenia Study (HSS) using both the lowest third of dual-energy X-ray absorptiometry (DXA) lean mass (LM) and ...
Miles D Witham
Full Text Available BACKGROUND: Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. METHODS: We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain, and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space, psychological variables (anxiety, depression, perceived behavioural control, social variables (number of close contacts and health status measured using the SF-36 questionnaire. RESULTS: 547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity. CONCLUSIONS: In older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables.
Full Text Available Abstract Background If brief and easy to use self report screening tools are available to identify frail elderly, this may avoid costs and unnecessary assessment of healthy people. This study investigates the predictive validity of three self-report instruments for identifying community-dwelling frail elderly. Methods This is a prospective study with 1-year follow-up among community-dwelling elderly aged 70 or older (n = 430 to test sensitivity, specificity, and positive and negative predicted values of the Groningen Frailty Indicator, Tilburg Frailty Indicator and Sherbrooke Postal Questionnaire on development of disabilities, hospital admission and mortality. Odds ratios were calculated to compare frail versus non-frail groups for their risk for the adverse outcomes. Results Adjusted odds ratios show that those identified as frail have more than twice the risk (GFI, 2.62; TFI, 2.00; SPQ, 2,49 for developing disabilities compared to the non-frail group; those identified as frail by the TFI and SPQ have more than twice the risk of being admitted to a hospital. Sensitivity and specificity for development of disabilities are 71% and 63% (GFI, 62% and 71% (TFI and 83% and 48% (SPQ. Regarding mortality, sensitivity for all tools are about 70% and specificity between 41% and 61%. For hospital admission, SPQ scores the highest for sensitivity (76%. Conclusion All three instruments do have potential to identify older persons at risk, but their predictive power is not sufficient yet. Further research on these and other instruments is needed to improve targeting frail elderly.
Host, Alison; McMahon, Anne-Therese; Walton, Karen; Charlton, Karen
Unyielding, disproportionate growth in the 65 years and older age group has precipitated serious concern about the propensity of health and aged-care services to cope in the very near future. Preservation of health and independence for as long as possible into later life will be necessary to attenuate demand for such services. Maintenance of nutritional status is acknowledged as fundamental for achievement of this aim. Determinants of food choice within this age group need to be identified and better understood to facilitate the development of pertinent strategies for encouraging nutritional intakes supportive of optimal health. A systematic review of the literature consistent with PRISMA guidelines was performed to identify articles investigating influences on food choice among older people. Articles were limited to those published between 1996 and 2014 and to studies conducted within countries where the dominant cultural, political and economic situations were comparable to those in Australia. Twenty-four articles were identified and subjected to qualitative analysis. Several themes were revealed and grouped into three broad domains: (i) changes associated with ageing; (ii) psychosocial aspects; and (iii) personal resources. Food choice among older people is determined by a complex interaction between multiple factors. Findings suggest the need for further investigations involving larger, more demographically diverse samples of participants, with the inclusion of a direct observational component in the study design. PMID:27153249
Schoufour, Josje D.; Mitnitski, Arnold; Rockwood, Kenneth; Evenhuis, Heleen M.; Echteld, Michael A.
Background: Although there is no strict definition of frailty, it is generally accepted as a state of high vulnerability for adverse health outcomes at older age. Associations between frailty and mortality, dependence, and hospitalization have been shown. We measured the frailty level of older people with intellectual disabilities (ID).…
Tsutsumimoto, Kota; Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Suzuki, Takao
Background/Aims An understanding of the association between gray matter volume and executive functioning could provide strategies to reduce dementia risk in older people with mild cognitive impairment (MCI). Methods In a cross-sectional analysis, we assessed executive functioning in 83 older people with MCI using three standard neuropsychological tests: set shifting (difference between Trail Making Test Parts B and A), working memory (difference between Digit Span forward and backward from th...
Cameron Ian D; Hunter Peter; Naganathan Vasi; Visvanathan Renuka; Piantadosi Cynthia; Lange Kylie; Karnon Jonathan; Chapman Ian M
Abstract Background Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully conf...
Janssen, Bienke M.; Van Regenmortel, Tine; Abma, Tineke A.
Many older people in western countries express a desire to live independently and stay in control of their lives for as long as possible in spite of the afflictions that may accompany old age. Consequently, older people require care at home and additional support. In some care situations, tension and ambiguity may arise between professionals and clients whose views on risk prevention or health promotion may differ. Following Antonovsky’s salutogenic framework, different perspectives between p...
Manias, Elizabeth; Hughes, Carmel
In clinical practice, pharmacists play a very important role in identifying and correcting medication discrepancies as older patients move across transition points of care. With increasing complexity of health care needs of older people, these discrepancies are likely to increase. The major concern with identifying and correcting medication discrepancies is that medication reconciliation is considered a retrospective problem--that is, dealing with medication discrepancies after they have occurred. It is argued here that a more proactive stance should be taken where doctors, nurses and pharmacists collectively work together to prevent medication discrepancies from happening in the first place. Improved involvement of patients and family members will help to facilitate better management of medications across transition points of care. Efficient use of information technology aids, such as electronic medication reconciliation tools, should also assist with organizational systems problems associated with the working culture, heavy workloads, and staff and skill mix of health professionals.
Full Text Available Purpose: PRISMA is an innovative co-ordination-type Integrated Service Delivery System developed to improve continuity and increase the efficacy and efficiency of services, especially for older and disabled populations. Description: The mechanisms and tools developed and implemented by PRISMA include: (1 co-ordination between decision-makers and managers, (2 a single entry point, (3 a case management process, (4 individualised service plans, (5 a single assessment instrument based on the clients' functional autonomy, and (6 a computerised clinical chart for communicating between institutions for client monitoring purposes. Preliminary results: The efficacy of this model has been tested in a pilot project that showed a decreased incidence of functional decline, a decreased burden for caregivers and a smaller proportion of older people wishing to be institutionalised. Conclusion: The on-going implementation and effectiveness study will show evidence of its real value and its impact on clienteles and cost.
Vass, M; Avlund, K; Hendriksen, C;
In Denmark, political decisions improved the implementation of 'preventative thinking' into every-day clinical work. The potential benefits of preventive efforts have been supported by legislative and administrative incentives, and an ongoing effort to remain focused on the benefits of these init......In Denmark, political decisions improved the implementation of 'preventative thinking' into every-day clinical work. The potential benefits of preventive efforts have been supported by legislative and administrative incentives, and an ongoing effort to remain focused on the benefits...... older persons not normally seen in the health care system. In-home assessment is not just a health check, but also an opportunity to meet individual needs that may be of importance for older people to stay independent. Preventive home visits may be part of an overall culture and strategy to avoid...
Hartescu, Iuliana; Morgan, Kevin; Stevinson, Clare D
A minimum level of activity likely to improve sleep outcomes among older people has not previously been explored. In a representative UK sample aged 65+ (n = 926), cross-sectional regressions controlling for appropriate confounders showed that walking at or above the internationally recommended threshold of ≥ 150 min per week was significantly associated with a lower likelihood of reporting insomnia symptoms (OR = 0.67, 95% CI = 0.45-0.91, p walking levels at baseline significantly predicted a lower likelihood of reporting sleep onset (OR = 0.64, 95% CI = 0.42-0.97, p sleep maintenance (OR = 0.63, 95% CI = 0.41-0.95, p sleep quality in older adults. PMID:26291553
Grajczyk, A; Zöllner, O
This study has been prompted by the relatively small body of knowledge on the media use of the elderly. The aim of this study was to show how people 50 years and older use the medium television in Germany. Therefore, the 1996 television usership data collected in a representative 'peoplemeter' panel of about 4,800 German television households have been surveyed, processed and analyzed using standard audience research software. In 1996, Germans 50 years and above watched on average 233 min television per day. The older a person, the longer he or she watches television. Individuals 65 years and older watch television for 253 min per day. This subgroup appears to comprise the most intensive users of the medium. Men 65 years and above may be depicted as the heaviest weekend TV watchers, older women as the medium's closest followers from Monday to Friday. Television program broadcast late in the afternoon and early in the evening have by far the best chances to be chosen by seniors. The affinity of the elderly for the medium can be explained by its potential for offering entertainment, information, and companionship, being a substitute for primary interpersonal communication, a tool for structuring time patterns and keeping up the rhythms of long-established everyday rituals. On the one hand, television can be a 'lifeline' and a 'window to the outside world' for people with little opportunity for direct, unmediated social contact, thus possibly raising their satisfaction of life. On the other hand, prolonged TV use may be seen as an indicator for the degree of loneliness and neglect of the elderly. PMID:9592692
Higginson Irene J
Full Text Available Abstract Background Although older people are increasingly cared for in nursing homes towards the end of life, there is a dearth of research exploring the views of residents. There are however, a number of challenges and methodological issues involved in doing this. The aim of this paper is to discuss some of these, along with residents' views on taking part in a study of the perceptions of dignity of older people in care homes and make recommendations for future research in these settings. Methods Qualitative interviews were used to obtain the views on maintaining dignity of 18 people aged 75 years and over, living in two private nursing homes in South East London. Detailed field notes on experiences of recruiting and interviewing participants were kept. Results Challenges included taking informed consent (completing reply slips and having a 'reasonable' understanding of their participation; finding opportunities to conduct interviews; involvement of care home staff and residents' families and trying to maintain privacy during the interviews. Most residents were positive about their participation in the study, however, five had concerns either before or during their interviews. Although 15 residents seemed to feel free to air their views, three seemed reluctant to express their opinions on their care in the home. Conclusion Although we experienced many challenges to conducting this study, they were not insurmountable, and once overcome, allowed this often unheard vulnerable group to express their views, with potential long-term benefits for future delivery of care.
The ageing populations of the Western world present a wide range of economic, social, and cultural implications, and given the challenges posed by deteriorating maintenance ratios, the scenario is somewhat worrying. In this paper, I investigate whether Martha C. Nussbaum's capabilities approach could secure dignity for older people in long-term care, despite the per capita decreases in resources. My key research question asks, 'What implications does Nussbaum's list of central human capabilities have for practical social care?' My methodology combines Nussbaum's list with ethnographic data gathered from a Finnish sheltered home for older people. On the basis of this study, it seems that the capabilities approach is a plausible framework for the ethics of care because it highlights differences in the ability to function and thus differences in opportunities to pursue a good life. The ideas presented in this article could assist social policy planners and executives in creating policies and practices that help old people to maintain their dignity until the end of their days.
Harrison, L; Heywood, F
Housing issues are of fundamental importance to the health and independence of older people in Britain, but this concept is not reflected in planning for health, housing, or community care. An analysis of community care plans and public health reports reflects how little attention the majority give either to the importance of housing or to the potential of primary care as a means of information exchange between older people and planning processes. Interviews with practitioners and policy makers in four cities, combined with a review of the considerable literature on planning and joint planning in the health and social services, helped to identify the problems in achieving more integrated systems. Structural blockages as fundamental as the definitions of 'health' and 'housing', the attitude of society to manual work, the hidden nature of the problems of older people, and the failure of planning to categorize according to the level of need are identified and summarized in a chart showing how these factors are linked and self-reinforcing. The article concludes with a vision of how things might work more effectively without requiring unrealistic changes. The authors offer a challenge to planners and joint commissioners to gather different kinds of information on need; to have long-term, as well as short-term, strategies; to think broadly across categories of issue; and to be prepared to invest money in new ways. Most significantly, by redefining the role of the Director of Public Health, we identify a focal point at which the responsibility and authority for coordinating, championing, and review could lie. PMID:10939090
Full Text Available Abstract Background Dignity has become a central concern in UK health policy in relation to older and vulnerable people. The empirical and theoretical literature relating to dignity is extensive and as likely to confound and confuse as to clarify the meaning of dignity for nurses in practice. The aim of this paper is critically to examine the literature and to address the following questions: What does dignity mean? What promotes and diminishes dignity? And how might dignity be operationalised in the care of older people? This paper critically reviews the theoretical and empirical literature relating to dignity and clarifies the meaning and implications of dignity in relation to the care of older people. If nurses are to provide dignified care clarification is an essential first step. Methods This is a review article, critically examining papers reporting theoretical perspectives and empirical studies relating to dignity. The following databases were searched: Assia, BHI, CINAHL, Social Services Abstracts, IBSS, Web of Knowledge Social Sciences Citation Index and Arts & Humanities Citation Index and location of books a chapters in philosophy literature. An analytical approach was adopted to the publications reviewed, focusing on the objectives of the review. Results and discussion We review a range of theoretical and empirical accounts of dignity and identify key dignity promoting factors evident in the literature, including staff attitudes and behaviour; environment; culture of care; and the performance of specific care activities. Although there is scope to learn more about cultural aspects of dignity we know a good deal about dignity in care in general terms. Conclusion We argue that what is required is to provide sufficient support and education to help nurses understand dignity and adequate resources to operationalise dignity in their everyday practice. Using the themes identified from our review we offer proposals for the direction of
Blat, Josep; Sayago, Sergio; Kälviäinen, Mirja;
Culture is crucial in understanding how people use technologies and designing better ones. However, very little is known about cross-cultural aspects of Information and Communication Technologies (ICT) use by older people (60+), despite the heterogeneity of this user group. This short paper...... addresses this issue by drawing on an ethnographical study of ICT use conducted with over 120 people, aged 67-71, in four European countries: Finland, Denmark, Italy and Spain, over a 6-month period. The preliminary results show that making a social, independent and worth use of ICT are common aspects...... across the four countries, despite the so-called heterogeneity of older people as ICT users. This short paper also touches on two key aspects which emerged from the study, engaging older people in research and the evolution of some barriers to technology use....
Constipation is a common presenting problem within the community setting, but its treatment is often unsatisfactory. It is important for nurses to remember that constipation is a symptom and not a disease. For older adults, constipation can have a gradual onset over a number of years, with many people 'self-medicating' with over-the-counter laxatives and herbal products, which then result in the need for daily laxatives. This article will consider best practice for the assessment, treatment, and prevention of constipation in adults within the community.
Shogo Kato; Satoko Tsuru; Yoshinori Iizuka
The establishment of a system for providing appropriate long-term care services for older people is a national issue in Japan, and it will likely become a worldwide issue in the years to come. Under Japanese Long-term Care Insurance System, long-term care is provided based on long-term care programs, which were designed by care providers on the basis of long-term care service plans, which were designed by care managers. However, defined methodology for designing long-term care service plans a...
Wallack, Elizabeth M.; Wiseman, Hailey D.; Ploughman, Michelle
Purpose. The aim of this study was to determine what factors most greatly contributed to healthy aging with multiple sclerosis (MS) from the perspective of a large sample of older people with MS. Design and Methods. Participants (n=683; >55 years of age with symptoms >20 years) provided answers to an open-ended question regarding healthy aging and were categorized into three groups, 55–64 (young), 65–74 (middle), and 75 and over (oldest old). Sociodemographic actors were compared using ANOVA....
Jorg Heukelbach; Peter Leggat; José Gomes Bezerra Filho; Luciene Ribeiro Gaião; Maria Eneide Leitão de Almeida
In this study we describe the dental status and oral hygiene practices in institutionalized older people and identify factors associated with poor dental status. A cross-sectional study was performed in a nursing home in Fortaleza, the capital of Ceará State (northeast Brazil). The number of decayed, missing, and filled teeth (DMFT) was assessed in the residents of the nursing home (n=167; mean age = 76.6 years). The mean DMFT value was 29.7; the mean number of missing teeth was 28.4. Ni...
Full Text Available Ali Tomlin, Alan Sinclair Institute of Diabetes for Older People, University of Bedfordshire, Luton, Bedfordshire, UK Abstract: Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impairment. This review aims to bring together current research that has investigated both cognition and diabetes self-management together. The Cumulative Index to Nursing and Allied Health (Cinahl, Excerpta Medica Database (Embase, Medical Literature Analysis and Retrieval System (Medline, and Psychological Information (PsychInfo databases were searched. Studies were included if they featured older people with type 2 diabetes and had looked for associations between at least one distinct measure of cognition and at least one distinct measure of diabetes self-management. English language publications from the year 2000 were included. Cognitive measures of executive function, memory, and low scores on tests of global cognitive functioning showed significant correlations with multiple areas of diabetes self-management, including diabetes-specific numeracy ability, diabetes knowledge, insulin adjustment skills, ability to learn to perform insulin injections, worse adherence to medications, decreased frequency of self-care activities, missed appointments, decreased frequency of diabetes monitoring, and increased inaccuracies in reporting blood glucose monitoring. The nature of the subjects studied was quite variable in terms of their disease duration, previous medical histories, associated medical comorbidities, and educational level attained prior to being diagnosed with diabetes. The majority of studies were of an associational nature and not findings confirmed by
Liu, Hong-Wei; Bian, Su-Yan; Zhu, Qi-Wei; Zhao, Yue-Xiang
Background Although statins are well tolerated by most aged people, their potential carcinogenicity is considered as one of the biggest factors limiting the use of statins. The aim of the present study was to determine the risk of cancer in people aged over 60 years receiving statin therapy. Methods A comprehensive search for articles published up to December 2015 was performed, reviews of each randomized controlled trials (RCTs) that compared the effects of statin mono-therapy with placebo on the risk of cancer in people aged > 60 years were conducted and data abstracted. All the included studies were evaluated for publication bias and heterogeneity. Pooled odds ratios (OR) estimates and 95% confidence intervals (CIs) were calculated using the random effects model. Results A total of 12 RCTs, involving 62,927 patients (31,517 in statin therapy group and 31,410 in control group), with a follow-up duration of 1.9–5.4 years, contributed to the analysis. The statin therapy did not affect the overall incidence of cancer (OR = 1.03, 95% CI: 0.94–1.14, P = 0.52); subgroup analyses showed that neither the variety nor the chemical properties of the statins accounted for the incidence of cancer in older people. Conclusions Our meta-analysis findings do not support a potential cancer risk of statin treatment in people over 60 years old. Further targeted researches with a longer follow-up duration are warranted to confirm this issue.
Klimova, Blanka; Simonova, Ivana; Poulova, Petra; Truhlarova, Zuzana; Kuca, Kamil
Rising standards of living and good quality health care have contributed to people living longer. According to the Eurostat agency (Benácová & Valenta, 2009), in the next 50 years there will be twice as many older people worldwide. The aging process, however, brings about new economic and social issues. Therefore, there is constant effort to…
Full Text Available The proportion of older people in the general population has increased and will continue to increase during the coming decade. Therefore, a positive attitude towards older people is important. The aim of the study was to gain knowledge about attitudes towards older people among health care students and health care staff in Swedish elder care settings. The study includes a convenience sample of 928 respondents comprised of health care students and three groups of professional caregivers [registered nurses (RNs with university degrees, certified nursing assistants (CNAs, nurses] in a variety of health care settings in Sweden. The participants completed the Kogan’s Old People (KOPS Scale with 17 positive (OP+ and 17 negative (OP– statements. The statements score ranged from 17 to 85 respectively. A significant (P<0.05 difference in both positive and negative scores was observed among the three professional caregiver groups. RNs had the highest positive score (OP+:64 as well as the lowest negative score (OP–:36. Health care students in semester one had the most unfavourable attitude toward older people (OP–:41 while students in semester two had the most favourable attitude toward older people (OP+:62. RNs reported both a higher positive score as well as lower negative score compared to nurses without an academic degree and CNAs. In addition, we found that progression in one’s health care education contributes to reduce unfavourable attitudes toward older people. Health care professionals need to have the right skills to manage a more demanding role in the future in order to offer effective services for older people. A skilled workforce of health professionals is therefore very necessary.
The relationship between social connection and health is widely recognised. However, there is a paucity of literature regarding the impact of district nursing care on social connection for people with a chronic illness such as type 2 diabetes mellitus (T2DM). Using a mixed-method approach, an exploration of the perceptions of older people living in the community with T2DM regarding their health and social connections was carried out. Findings revealed a strong relationship between the clients and the district nurse. The district nurse is an important aspect of clients' social connection. For some clients where their social connection is limited, the district nurse is a central element. When the district nurse is the major social connection, problems can arise for the client, especially when they are being discharged or changes are made to their care.
Full Text Available There has been increasing interest in the influence of diet on cognition in the elderly. This study examined the cross-sectional association between dietary patterns and cognition in a sample of 249 people aged 65–90 years with mild cognitive impairment (MCI. Two dietary patterns; whole and processed food; were identified using factor analysis from a 107-item; self-completed Food Frequency Questionnaire. Logistic regression analyses showed that participants in the highest tertile of the processed food pattern score were more likely to have poorer cognitive functioning; in the lowest tertile of executive function (OR 2.55; 95% CI: 1.08–6.03; as assessed by the Cambridge Cognitive Examination. In a group of older people with MCI; a diet high in processed foods was associated with some level of cognitive impairment.
Full Text Available Research exploring older people and the participatory arts has tended to focus on notions of biomedical impact, often coupled with appeals to evasive notions of "well-being." Rather than suggesting such approaches are invalid, this article proposes the need for their extension and proposes an alternative, critical approach to analysing older people's experience of arts participation. Based on ethnographic participant observation and intensive consultation with a cohort of older people engaged in a programme of creative music and dance, we explore the complex processes and possibilities of transformation that the participatory arts can initiate, examining how performance can create intriguing linkages between past, present and future experiences. Taking a phenomenological approach to the study of memory, recollection, reminiscence and future anticipation, we discuss how arts participation can "actualise" potential memories in older participants, examining how and why this kind of expressive activity animates the idea of "virtual" selves (after Bergson.
Maria Gabriella Melchiorre
Full Text Available BACKGROUND: Social support has a strong impact on individuals, not least on older individuals with health problems. A lack of support network and poor family or social relations may be crucial in later life, and represent risk factors for elder abuse. This study focused on the associations between social support, demographics/socio-economics, health variables and elder mistreatment. METHODS: The cross-sectional data was collected by means of interviews or interviews/self-response during January-July 2009, among a sample of 4,467 not demented individuals aged 60-84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden. RESULTS: Multivariate analyses showed that women and persons living in large households and with a spouse/partner or other persons were more likely to experience high levels of social support. Moreover, frequent use of health care services and low scores on depression or discomfort due to physical complaints were indicators of high social support. Low levels of social support were related to older age and abuse, particularly psychological abuse. CONCLUSIONS: High levels of social support may represent a protective factor in reducing both the vulnerability of older people and risk of elder mistreatment. On the basis of these results, policy makers, clinicians and researchers could act by developing intervention programmes that facilitate friendships and social activities in old age.
Full Text Available Vitamin D and calcium are essential for bone health. An adequate calcium-phosphorus product determines a high quality mineralization long lifetime. In older people, both calcium and vitamin D levels may be lower causing osteomalacia and/or osteoporosis with a higher risk of fracture. Epidemiological data have clearly associated serum vitamin D lower levels (deficiency with bone fracture in older people, however, not univocal data exist in regard to a beneficial effect of vitamin D supplementation in general population. Although not systematic, the present review aims to make a narrative synthesis of the most recent published data on vitamin D effect not only on bone, classical target associated with vitamin D studies, but namely on extraskeletal diseases. In fact, recently, there has been an increasing interest on this latter issue with surprising findings. Vitamin D, and in particular its deficiency, seems to have a role in pathophysiological pathways in several diseases involving cardiovascular, central nervous system and neoplastic process. On the other hand, vitamin D supplementation may modify the outcome of a wide range of illnesses. Up to date the data are conflicting mainly because of difficulty to establish a consensus on the threshold of vitamin D deficit. The US Institute of Medicine recommends to distinguish a level of insufficiency [defined as 30-50 nmol/L or 16-25 ng/mL of 25(OHD] and another of deficiency identified by 25(OHD levels lower than 30 nmol/L (or <16 ng/mL. This latter level is considered a minimum level necessary in older adults to minimize the risk of falls, fracture and probably to have some effects of vitamin D supplementation in extraskeletal diseases. Although there are no absolute certainties in such issue, the most recent data suggest that vitamin D deficiency, and its supplementation, may play an important role in a wide range of diseases other than in bone metabolic diseases in older but not in general
McCausland, Darren; McCallion, Philip; Cleary, Eimear; McCarron, Mary
Background: The literature on influences of community versus congregated settings raises questions about how social inclusion can be optimised for people with intellectual disability. This study examines social contacts for older people with intellectual disability in Ireland, examining differences in social connection for adults with intellectual…
Inoue, Yosuke; Stickley, Andrew; Yazawa, Aki; Shirai, Kokoro; Amemiya, Airi; Kondo, Naoki; Kondo, Katsunori; Ojima, Toshiyuki; Hanazato, Masamichi; Suzuki, Norimichi; Fujiwara, Takeo
Previous studies have found an association between neighborhood characteristics (i.e., aspects of the physical and social environment) and the incidence of cardiovascular disease (CVD) and elevated CVD risk. This study investigated the relationship between neighborhood characteristics and CVD risk among older people in Japan where research on this association is scarce. Data came from the Japan Gerontological Evaluation Study project; questionnaire data collected from 3,810 people aged 65 years or older living in 20 primary school districts in Aichi prefecture, Japan, was linked to a computed composite CVD risk score based on biomarker data (i.e., hemoglobin A1c, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and estimated glomerular filtration rate). A sex-stratified multilevel linear regression analysis revealed that for male participants, living in neighborhoods with a higher perceived occurrence of traffic accidents and reduced personal safety was associated with an elevated CVD risk (coefficient = 1.08 per interquartile range increase, 95% confidence interval [CI] = 0.30 to 1.86) whereas males living in neighborhoods with a higher perceived proximity of exercise facilities had a lower risk (coefficient = −1.00, 95% CI = −1.78 to −0.21). For females, there was no statistically significant association between neighborhood characteristics and CVD risk. This study suggests that aspects of the neighborhood environment might be important for CVD morbidity and mortality in Japan, particularly among men. PMID:27716825
Luciene Ribeiro Gaião
Full Text Available In this study we describe the dental status and oral hygiene practices in institutionalized older people and identify factors associated with poor dental status. A cross-sectional study was performed in a nursing home in Fortaleza, the capital of Ceará State (northeast Brazil. The number of decayed, missing, and filled teeth (DMFT was assessed in the residents of the nursing home (=167; mean age = 76.6 years. The mean DMFT value was 29.7; the mean number of missing teeth was 28.4. Ninety-three (58.1% were edentulous. Almost 90% practiced oral hygiene, but only about half used a toothbrush. Only 8% had visited a dentist in the preceding three months. Most of the variables regarding oral hygiene habits (such as the use of toothbrush, frequency of oral hygiene per day, regular tooth brushing after meals did not show any significant association with the DMFT. In multivariate regression analysis, age, general literacy level, and practice of oral hygiene were independently associated with the DMFT (2=0.13. Institutionalized older people in northeast Brazil have poor dental status, and oral hygiene practices are insufficient. Dental health education is needed focusing on the special needs of this neglected and socioeconomically deprived population to improve their quality of life.
Full Text Available Introduction: There is a need for integrated care and smooth collaboration between care-providing organisations and professions to create a continuum of care for frail older people. However, collaboration between organisations and professions is often problematic. The aim of this study was to examine the process of implementing a new continuum of care model in a complex organisational context, and illuminate some of the challenges involved. The introduced model strived to connect three organisations responsible for delivering health and social care to older people: the regional hospital, primary health care and municipal eldercare.Methods: The actions of the actors involved in the process of implementing the model were understood to be shaped by the actors' understanding, commitment and ability. This article is based on 44 qualitative interviews performed on four occasions with 26 key actors at three organisational levels within these three organisations.Results and conclusions: The results point to the importance of paying regard to the different cultures of the organisations when implementing a new model. The role of upper management emerged as very important. Furthermore, to be accepted, the model has to be experienced as effectively dealing with real problems in the everyday practice of the actors in the organisations, from the bottom to the top.
Hanna Maria van Dijk
Full Text Available Background: Although the need for integrated neighborhood approaches (INAs is widely recognized, we lack insight into strategies like INA. We describe diverse Dutch INA partners’ experiences to provide integrated person- and population-centered support to community-dwelling older people using an adapted version of Valentijn and colleagues’ integrated care model. Our main objective was to explore the experiences with INA participation. We sought to increase our understanding of the challenges facing these partners and identify factors facilitating and inhibiting integration within and among multiple levels. Methods: Twenty-one interviews with INA partners (including local health and social care organizations, older people, municipal officers, and a health insurer were conducted and subjected to latent content analysis. Results: This study showed that integrated care and support provision through an INA is a complex, dynamic process requiring multilevel alignment of activities. The INA achieved integration at the personal, service, and professional levels only occasionally. Micro-level bottom-up initiatives were not aligned with top-down incentives, forcing community workers to establish integration 'despite' rather than because of meso- and macro-level contexts. Conclusions: Top-down incentives should be better aligned with bottom-up initiatives. This study further demonstrated the importance of community-level engagement in integrated care and support provision.
Anderson, Elizabeth Susan; Pollard, Lorraine; Conroy, Simon; Clague-Baker, Nicola
Integrated services which utilise the expertise of team members along care pathways are evolving. Changes in service structure and subsequent team working arrangements can be a challenge for practitioners expected to redefine how they work with one another. These services are particularly important for the care of frail older people. This exploratory study of one newly forming team presents the views of staff involved in establishing an interprofessional healthcare advisory team for older people within an acute hospital admissions unit. Staff experiences of forming a new service are aligned to a model of team development. The findings are presented as themes relating to the stages of team development and identify the challenges of setting up an integrated service alongside existing services. In particular, team process issues relating to the clarity of goals, role clarification, leadership, team culture and identity. Managers must allow time to ensure new services evolve before setting up evaluation studies for efficiency and effectiveness which might prove against the potential for interprofessional teamworking. PMID:24199595
Older people are intensive users of hospital and long-term care services. This paper explores the extent to which these services are substitutes. A small area analysis was used with both care home and (tariff cost-weighted) hospital utilisation for older people aggregated to electoral wards in England.Health and social-care structural equations were specified using a theoretical model. The estimation accounted for the skewed and censored nature of the data. For health utilisation, both a fixed effects instrumental variables GMM model and a generalised estimating equations (GEE) model were fitted, the later on a log dependent variable with predicted values of social care utilisation used to account for endogeneity (bootstrapping was used to derive standard errors). In addition to a GMM model, the social-care estimation used both two-part and tobit models (also with predicted health utilisation and bootstrapping).The results indicate that for each additional pound1 spent on care homes, hospital expenditure falls by pound0.35. Also, pound1 additional hospital spend corresponds to just over pound0.35 reduction on care home spend. With these cost substitution effects offsetting, a transfer of resources to care homes is efficient if the resultant outcome gain is greater than the outcome loss from reduced hospital use. PMID:19206085
Full Text Available Timothy CY Kwok1,2, Xue Bai1,3, Henry SR Kao4,5, Jessie CY Li1, Florence KY Ho11Jockey Club Centre for Positive Ageing; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong; 3Department of Social Work and Social Administration; 4Department of Psychology, The University of Hong Kong, Hong Kong; 5Department of Psychology, Fu Jen Catholic University, TaiwanBackground: This pilot study investigated the effects of calligraphy therapy on cognitive function in older Hong Kong Chinese people with mild cognitive impairment.Methods: A single-blind, randomized controlled trial was carried out in a sample of 31 adults aged 65 years or older with mild cognitive impairment. They were randomly assigned to receive either intensive calligraphy training led by a trained research assistant for eight weeks (calligraphy group, n = 14 or no calligraphy treatment (control group, n = 17. Participants' cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (CMMSE before and after calligraphy treatment. Repeated measures analysis of variance and paired samples t-tests were used to analyze the data.Results: A significant interaction effect of time and intervention was detected [F (1, 29 = 9.11, P = 0.005, η2= 0.24]. The calligraphy group was found to have a prominent increase in CMMSE global score, and scores in the cognitive areas of orientation, attention, and calculation after two months (∆M = 2.36, P < 0.01, whereas their counterparts in the control group experienced a decline in CMMSE score (∆M = -0.41, P < 0.05.Conclusion: Calligraphy therapy was effective for enhancing cognitive function in older people with mild cognitive impairment and should be incorporated as part of routine programs in both community and residential care settings.Keywords: calligraphy therapy, Chinese elderly, mild cognitive impairment, cognitive function, randomized controlled trial
Full Text Available Working at old ages is regarded as a good way to keep one's health according to the idea of productive aging. However, there is not enough evidence yet whether retirement is good or bad, or the kind of effects it has on the health of older adults aged 65 and over. We examined it by using a recent data of Wako city, a suburb area near Tokyo in Japan.One thousand seven hundred sixty-eight participants answered to 3 waves of survey questionnaires: 2008, 2010, and 2012, successively. We considered 3 indicators of health; self-rated health, mental health (GDS15 and HLFC (Higher-Level Functional Capacity: TMIG-IC. In cross-sectional analysis, we compared these 3 indicators by three groups: full-time worker, part-time worker, and non-worker. In longitudinal analysis, we compared these three indicators by two groups: subjects who successively worked in 2008, 2010, 2012, and subjects who worked in 2008 but retired before 2010. We used one-way and two way repeated measures ANCOVA for these analyses, respectively.It was significantly clear that retirement worsened both mental health and HLFC in people aged 65 years and over; especially, mental health worsened rapidly and HLFC gradually. However, these indicators didn't worsen in subjects who changed from full-time jobs to part-time jobs. Quitting from part-time jobs deteriorated mental health gradually and HLFC moderately compared to full-time jobs.The results support the activity theory that older adults who quit from full-time jobs deteriorated both mental health and HLFC, though at different speeds. If they make a transit to part-time jobs, the deterioration would be moderate. It shows that working is an effective way of social participation for older people aged 65 years and over in Japan.
Full Text Available BACKGROUND: The ever-increasing older population and its association with serious overweight problems have garnered much attention. The correlation between being overweight and socioeconomic status factors could be helpful for understanding the inequalities among the overweight population. We examined the correlation between being overweight and some key variables, such as demographics, socioeconomic status, general health status, and health behavior in a large sample of older individuals, by each gender. METHODS: We used data from the 2008 Korean Longitudinal Study of Aging and it included 8,157 participants who were 45 years or older. To understand the relationship between the overweight participants in accordance to demographic and socioeconomic characteristics, health status, and health behaviors, a weighted chi-square test and logistic regression analysis were conducted by separating variables related to overweight, according to the genders. RESULTS: The number of people in the normal group was 6,347 (77.8%, while the people who were considered overweight were 1,810 (22.2%. Women (n = 4,583 constituted 52.7% of the subject, 24.9% of whom were classified as overweight. Meanwhile, 20.6% of the 47.3% (n = 3,574 of the sample who were men were classified as overweight. Participants between the ages of 45 and 64 with chronic diseases were more likely to be overweight. Men in the 4th quartile of household income were more likely to be overweight than those who were in the 1st quartile, in contrast, while unemployed women with lower education levels and urban residents were at greater risk for being overweight. CONCLUSIONS: Among the men, health status and health behavior appeared to show a correlation with being overweight; however, among women, socioeconomic status factors were strongly related to being overweight. These findings appear to support the association of gender-specifics with the prevalence of being overweight.
Full Text Available Background: Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective: To describe the health status and identify factors associated with self-rated health (SRH among older adults in a rural community in northern Ghana. Methods: The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results: The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion: The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess
Janssen, Bienke M; Van Regenmortel, Tine; Abma, Tineke A
Many older people in western countries express a desire to live independently and stay in control of their lives for as long as possible in spite of the afflictions that may accompany old age. Consequently, older people require care at home and additional support. In some care situations, tension and ambiguity may arise between professionals and clients whose views on risk prevention or health promotion may differ. Following Antonovsky's salutogenic framework, different perspectives between professionals and clients on the pathways that lead to health promotion might lead to mechanisms that explain the origin of these tensions and how they may ultimately lead to reduced responsiveness of older clients to engage in care. This is illustrated with a case study of an older woman living in the community, Mrs Jansen, and her health and social care professionals. The study shows that despite good intentions, engagement, clear division of tasks and tailored care, the responsiveness to receive care can indeed not always be taken for granted. We conclude that to harmonize differences in perspectives between professionals and older people, attention should be given to the way older people endow meaning to the demanding circumstances they encounter (comprehensibility), their perceived feelings of control (manageability), as well as their motivation to comprehend and manage events (meaningfulness). Therefore, it is important that both clients and professionals have an open mind and attempt to understand each others' perspective, and have a dialogue with each other, taking the life narrative of clients into account. PMID:22228192
Papp, Kathryn V.; Amariglio, Rebecca E.; Mormino, Elizabeth; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.
Objectives Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer’s disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. Methods A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ−/ND−), Stage 1 (Aβ+/ND−), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer’s associated pathology (SNAP; Aβ−/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Results Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Conclusions Clinically
Millns Sizer, Stephanie; Burton, Robert L; Harris, Ann
The increasing longevity of the world's population implies the requirement for a nursing workforce who are appropriately equipped to care for older people when they are ill. Although attitudes toward this field of nursing appear to be positive amongst nursing students, fewer students choose the care of ill older people as a career upon qualification; the need to assure the future nursing workforce in this field has been acknowledged globally. In view of the ageing of the world population, there is a need to encourage the care of ill older people as a positive career choice (Koh, 2012). Factors both within the practical learning environment and the environment where students receive theoretical instruction, may potentially impact upon nursing students' attitudes towards caring for ill older people and their career intentions. It is against this background that this review was conducted, in order to identify reasons for this prevailing negativity. It is intended that the review will shed light on strategies to improve these perceptions, showing a career in caring for ill older people in a more positive light. PMID:27428691
Millns Sizer, Stephanie; Burton, Robert L; Harris, Ann
The increasing longevity of the world's population implies the requirement for a nursing workforce who are appropriately equipped to care for older people when they are ill. Although attitudes toward this field of nursing appear to be positive amongst nursing students, fewer students choose the care of ill older people as a career upon qualification; the need to assure the future nursing workforce in this field has been acknowledged globally. In view of the ageing of the world population, there is a need to encourage the care of ill older people as a positive career choice (Koh, 2012). Factors both within the practical learning environment and the environment where students receive theoretical instruction, may potentially impact upon nursing students' attitudes towards caring for ill older people and their career intentions. It is against this background that this review was conducted, in order to identify reasons for this prevailing negativity. It is intended that the review will shed light on strategies to improve these perceptions, showing a career in caring for ill older people in a more positive light.
Janssen, David; Jongen, Wesley; Schröder-Bäck, Peter
In this case study, European quality benchmarks were used to explore the contemporary quality of the long-term care provision for older people in the Belgian region of Flanders and the Netherlands following recent policy reforms. Semi-structured qualitative interviews were conducted with various experts on the long-term care provision. The results show that in the wake of the economic crisis and the reforms that followed, certain vulnerable groups of older people in Belgium and the Netherlands are at risk of being deprived of long-term care that is available, affordable and person-centred. Various suggestions were provided on how to improve the quality of the long-term care provision. The main conclusion drawn in this study is that while national and regional governments set the stage through regulatory frameworks and financing mechanisms, it is subsequently up to long-term care organisations, local social networks and informal caregivers to give substance to a high quality long-term care provision. An increased reliance on social networks and informal caregivers is seen as vital to ensure the sustainability of the long-term care systems in Belgium and in the Netherlands, although this simultaneously introduces new predicaments and difficulties. Structural governmental measures have to be introduced to support and protect informal caregivers and informal care networks. PMID:27531456
Southwell, Jenni; Boreham, Paul; Laffan, Warren
Local gambling venues are an important contemporary context for older people's gambling in many parts of the world typically being more accessible to this segment of the population than traditional, centralised gambling venues, such as casinos. This study, undertaken in South East Queensland, analyses older people's electronic gaming machine (EGM) behaviour and motivations, specifically in the context of licensed social and recreational clubs-a popular local gambling venue in many parts of Australia. The study gathered data via a postal survey of 80 managers of licensed clubs, interviews with Gambling Help services and a survey of 414 people aged 60+ who regularly play EGMs, self-administered on site at local clubs. The analysis undertaken suggests that certain age-related circumstances of older people-such as being without a partner, having a disability that impacts on everyday activities, having a low annual income, and no longer participating in the workforce-are associated with higher overall levels of motivation for playing EGMs and greater reliance on EGMs to meet social, recreational and mental health needs. Over a quarter of the older people surveyed (27%) reported drawing on their savings to fund their EGM gambling. Certain categories of older people, including those who were without a partner and those with a disability, were more likely to report drawing on their savings to fund EGM play and betting more than they could afford to lose, pointing to age-related vulnerabilities older people may experience to the negative impacts of gambling given the greater likelihood of their dependency on smaller, fixed incomes. The explanatory contribution of a range of demographic and motivational variables on problem/moderate risk gambling status was computed via a logistic regression model. Younger age (60-69), male gender, single marital status and being motivated to play EGMs to experience excitement and to win money all emerged as significant predictors in the
Soini, H; Routasalo, P; Lagstrom, H
Older adults are a potentially vulnerable group for malnutrition. This cross-sectional pilot study aims to assess the nutritional status of elderly patients living at home and receiving home health care services. The data were collected from patient care plans, the Mini Nutritional Assessment (MNA), and a questionnaire on eating problems. In addition, serum nutritional status indicators were measured, and an oral examination including quantitative saliva measurement was carried out. Out of 71 eligible patients 51 (72%) patients aged 76-93 years participated. MNA results showed that 47% were at risk of malnutrition. Care plans for 26 patients made reference to questions of nutrition but provided no detailed forward planning. The mean serum albumin value was 39.1 +/- 3.8 g/l, seven patients had a value lower than 35 g/l. MNA scores were significantly lower for female patients with haemoglobin values lower than 120 g/l (p = 0.027). The dentist's estimation of dry mouth and subjective problems in energy intake were significantly associated with lower MNA scores (p = 0.049 and p = 0.015). Subjects with functioning natural dentition had higher body mass index (BMI) scores than others (p = 0.0485). The results point at the importance of using screening tools such as the MNA for purposes of nutritional assessment, the estimation of oral problems such as dry mouth, chewing and swallowing problems, and advance planning in nutritional issues within the field of home care. PMID:15980925
Farag, Inez; Sherrington, Cathie; Ferreira, Manuela; Howard, Kirsten
Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australi...
Orr, Noreen; Wagstaffe, Alexandra; Briscoe, Simon; Garside, Ruth
Background Despite the increased scholarly interest in the senses and sensory experiences, the topic of older people’s sensory engagement with nature is currently under researched. This paper reviews and synthesises qualitative research evidence about how older people, including those living with dementia, describe their sensory engagement with the natural world. Methods Ten databases were searched from 1990 to September 2014: MEDLINE (Ovid), MEDLINE-in-Process (Ovid), PsycINFO (Ovid), CINAHL...
Schneider Nils; Schumacher Martin; Brueckner Torben
Abstract Background Providing appropriate palliative care for older people is a major task for health care systems worldwide, and up to now it has also been one of the most neglected. Focusing on the German health care system, we sought to explore the attitudes of health professionals regarding their understanding of palliative care for older patients and its implementation. Methods In a qualitative study design, focus groups were established consisting of general practitioners, geriatricians...
Farag Inez; Sherrington Cathie; Ferreira Manuela; Howard Kirsten
Abstract Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in...
Schoene, Daniel; Lord, Stephen R; Delbaere, Kim; Severino, Connie; Davies, Thomas A.; Smith, Stuart T
Background Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people. Purpose To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and assoc...
Valdes Hernandez, Maria; Allerhand, Michael; Glatz, Andreas; Clayson, L; Munoz-Maniega, Susana; Gow, Alan; Royle, Natalie; Bastin, Mark; Starr, John; Deary, Ian; Wardlaw, Joanna
Background and purpose Several studies have reported associations between brain iron deposits (IDs), white matter hyperintensities (WMHs) and cognitive ability in older individuals. Whether the association between brain IDs and cognitive abilities in older people is mediated by or independent of total brain tissue damage represented by WMHs visible on structural magnetic resonance imaging (MRI) was examined. Methods Data from 676 community-dwelling individuals from the Lothian Birth Cohort 19...
Engbers, Marissa J; Karasu, Alev; Blom, Jeanet W; Cushman, Mary; Rosendaal, Frits R; van Hylckama Vlieg, Astrid
Venous thrombosis is common in older age, with an incidence of 0·5-1% per year in those aged >70 years. Stasis of blood flow is an important contributor to the development of thrombosis and may be due to venous insufficiency in the legs. The risk of thrombosis associated with clinical features of venous insufficiency, i.e., varicose veins, leg ulcers and leg oedema, obtained with a standardized interview was assessed in the Age and Thrombosis Acquired and Genetic risk factors in the Elderly (AT-AGE) study. The AT-AGE study is a case-control study in individuals aged 70 years and older (401 cases with a first-time venous thrombosis and 431 control subjects). We calculated odds ratios (ORs) and corresponding 95% confidence intervals (CI) adjusted for age, sex and study centre. Varicose veins and leg ulcer were associated with a 1·6-fold (95% CI 1·2-2·3) and 3·3-fold increased risk of thrombosis (95% CI 1·6-6·7), respectively, while the risk was increased 3·0-fold (95% CI 2·1-4·5) in the presence of leg oedema. The risk of thrombosis was highest when all three risk factors occurred simultaneously (OR: 10·5; 95% CI 1·3-86·1). In conclusion, clinical features of venous insufficiency, i.e., varicose veins, leg ulcers and leg oedema, are risk factors for venous thrombosis in older people.
Luo, Minxia; Chui, Ernest Wing-Tak
While Western discourses regarding productive aging emphasize individuals' contributions to economic productivity, the Confucian cultural heritage of the Chinese community may provide an alternative perspective. This qualitative study explores interpretations of what constitutes productive aging, based on a series of in-depth interviews with older Chinese people in Hong Kong. It shows that some of these individuals adopted a passive and indirect interpretation of productive aging, distinct from that found in Western countries. The Confucianism-based, collectivist, normative order underpinning Hong Kong society disposed these older people to adopting a self-restrained attitude with the aim of avoiding becoming a burden to others, especially family members. Such a tendency toward self-restraint or avoidance also encompassed a compromise between ideals and reality, with the older people opting to compromise their expectations of the younger generation as a whole, their adult children in particular, in terms of respect and reciprocity.
Luo, Minxia; Chui, Ernest Wing-Tak
While Western discourses regarding productive aging emphasize individuals' contributions to economic productivity, the Confucian cultural heritage of the Chinese community may provide an alternative perspective. This qualitative study explores interpretations of what constitutes productive aging, based on a series of in-depth interviews with older Chinese people in Hong Kong. It shows that some of these individuals adopted a passive and indirect interpretation of productive aging, distinct from that found in Western countries. The Confucianism-based, collectivist, normative order underpinning Hong Kong society disposed these older people to adopting a self-restrained attitude with the aim of avoiding becoming a burden to others, especially family members. Such a tendency toward self-restraint or avoidance also encompassed a compromise between ideals and reality, with the older people opting to compromise their expectations of the younger generation as a whole, their adult children in particular, in terms of respect and reciprocity. PMID:27531450
Gyi, D E; Sims, R E; Porter, J M; Marshall, R; Case, K
A database was developed to support the creation of a computer-based tool which will support design teams in evaluating the usability of a design during early prototyping and indicate which individuals are effectively excluded or designed out. Methods are described for the collection of multivariate data on 100 real individuals covering a range of physical characteristics and capabilities. These data were tested to ensure a breadth of representation of individuals (particularly older and disabled people) in terms of anthropometry, joint constraints, postural capabilities and task behaviours. The concept of the design tool itself is explored by conducting virtual user trials in the computer-aided design environment. The novel approach of the research encourages empathy with individual users and allows generic abilities, such as bending, reaching and lifting to be assessed.
Sung, Huei-Chuan; Chang, Anne M; Abbey, Jennifer
Older people with dementia may display negative emotions, memory problems, sleep disturbance, and agitated behavior. Among these symptoms, agitated behavior has been identified by families and nursing staff as the care problem that presents the greatest challenge. Several studies have found that music therapy reduced agitated behaviors in those with dementia and recommended use of music as an effective strategy in managing this behavioral problem. Music therapy represents a lower cost, effective care approach that nursing staff can easily learn and apply to those with dementia. Furthermore, reductions in agitated behavior in dementia patients that result from music therapy can also alleviate caregiver stress and burden of care, leading to improvements in the health and quality of life of both dementia patients and their caregivers. This paper aims to introduce the principles and application of music therapy in the management of agitated behavior in those with dementia. PMID:17004208
Da Boit, Mariasole; Sibson, Rachael; Meakin, Judith R; Aspden, Richard M; Thies, Frank; Mangoni, Arduino A; Gray, Stuart Robert
Resistance exercise training is known to be effective in increasing muscle mass in older people. Acute measurement of protein metabolism data has indicated that the magnitude of response may differ between sexes. We compared adaptive responses in muscle mass and function to 18 weeks resistance exercise training in a cohort of older (>65 years) men and women. Resistance exercise training improved knee extensor maximal torque, 4 m walk time, time to complete five chair rises, muscle anatomical cross-sectional area (ACSA) and muscle quality with no effect on muscle fat/water ratio or plasma glucose, insulin, triacylglycerol, IL-6, and TNF-α Differences between sexes were observed for knee extensor maximal torque and muscle quality with greater increases observed in men versus women (P torque increased by 15.8 ± 10.6% in women and 41.7 ± 25.5% in men, whereas muscle quality increased by 8.8 ± 17.5% in women and by 33.7 ± 25.6% in men. In conclusion, this study has demonstrated a difference in the magnitude of adaptation, of some of the outcome measures employed, in response to 18 weeks of resistance exercise training between men and women. The mechanisms underlying this observation remain to be established.
Hoi Le V
Full Text Available Abstract Background The proportion of people in Vietnam aged 60 and above has increased rapidly in recent decades. However, there is a lack of evidence, particularly in rural settings, on their health-related quality of life (HRQoL within the context of socioeconomic changes and health-sector reform in the country. This study assesses the level and determinants of HRQoL in a rural district in order to provide evidence for designing and implementing appropriate health policies. Methods In 2007, 2,873 people aged 60+ living in 2,240 households randomly selected from the FilaBavi demographic surveillance site (DSS were interviewed using a generic EQ-5D questionnaire to assess their HRQoL. Socioeconomic characteristics of the people and their households were extracted from the DSS's re-census that year, and the EQ-5D index was calculated based on the time trade-off tariff. Multilevel-multivariate linear regression analysis was performed to measure the affect of socioeconomic factors on HRQoL. Results The EQ-5D index at old age was found to be 0.876 (95%CI: 0.870-0.882. Age between 60-69 or 70-79 years, position as household head, working until old age, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on the deterioration of HRQoL at older ages, mainly due to reduction in physical rather than mental functions. Educational disparity in HRQoL is low, and exists mostly between basic and higher levels of education. Being a household head and working at old age are advantageous for attaining better quality of life in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical utilities. Long-term living conditions more likely affect HRQoL than short-term economic conditions. Conclusions HRQoL at old age is at a high level, and varies substantially according to socioeconomic factors. Its determinants should be addressed in social and
Landorf Karl B
Full Text Available Abstract Background Plantar calcaneal spurs are common, however their pathophysiology is poorly understood. This study aimed to evaluate the prevalence and correlates of plantar calcaneal spurs in a large sample of older people. Methods Weightbearing lateral foot radiographs of 216 people (140 women and 76 men aged 62 to 94 years (mean age 75.9, SD 6.6 were examined for plantar calcaneal and Achilles tendon spurs. Associations between the presence of spurs and sex, body mass index, radiographic measures of foot posture, self-reported co-morbidities and current or previous heel pain were then explored. Results Of the 216 participants, 119 (55% had at least one plantar calcaneal spur and 103 (48% had at least one Achilles tendon spur. Those with plantar calcaneal spurs were more likely to have Achilles tendon spurs (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.2 to 3.5. Prevalence of spurs did not differ according to sex. Participants with plantar calcaneal spurs were more likely to be obese (OR = 7.9, 95% CI 3.6 to 17.0, report osteoarthritis (OR = 2.6, 95% CI 1.6 to 4.8 and have current or previous heel pain (OR = 4.6, 95% CI 2.3 to 9.4. No relationship was found between the presence of calcaneal spurs and radiographic measures of foot posture. Conclusion Calcaneal spurs are common in older men and women and are related to obesity, osteoarthritis and current or previous heel pain, but are unrelated to radiographic measurements of foot posture. These findings support the theory that plantar calcaneal spurs may be an adaptive response to vertical compression of the heel rather than longitudinal traction at the calcaneal enthesis.
Thermal sensations of space, namely temperature, humidity and the movement of air, can be difficult to separate from other sensory information such as the sound of fans or ventilation equipment, or the smell of damp or cool fresh air. Despite this factor, efforts to reduce the consumption of energy through the installation of low-carbon technologies including sealed whole-building systems frequently isolate the thermal environment and fail to recognise and respond to the influence of other sensory information on personal preferences and behaviours. Older people represent an increasing proportion of the UK's population, can be faced with a range of physiological challenges associated with ageing, and sometimes have long-established personal preferences. Drawing from data collected across the Conditioning Demand Project, this paper explores the embodied nature of older people's experiences of low-carbon and more traditional thermal technologies in private residences, extra-care housing and residential care-homes, focussing specifically upon auditory and olfactory stimulus. Exploring the management of the sensory experience across these settings, we analyse each case to inform the development of new design and policy approaches to tackling housing for older people. In doing so, we further build connections between energy research and debates around sensory urbanism. -- Highlights: •Some thermal technologies present particular sensory issues and problems for older people. •Older people use a range of sensory stimuli in evaluating and controlling thermal environments. •Older people use non-thermal sensory information when selecting between thermal technologies. •Sensory information plays an important role in thermal technology maintenance
Elliott, Rohan A; Goeman, Dianne; Beanland, Christine; Koch, Susan
Impaired cognition has a significant impact on a person's ability to manage their medicines. The aim of this paper is to provide a narrative review of contemporary literature on medicines management by people with dementia or cognitive impairment living in the community, methods for assessing their capacity to safely manage medicines, and strategies for supporting independent medicines management. Studies and reviews addressing medicines management by people with dementia or cognitive impairment published between 2003 and 2013 were identified via searches of Medline and other databases. The literature indicates that as cognitive impairment progresses, the ability to plan, organise, and execute medicine management tasks is impaired, leading to increased risk of unintentional non-adherence, medication errors, preventable medication-related hospital admissions and dependence on family carers or community nursing services to assist with medicines management. Impaired functional capacity may not be detected by health professionals in routine clinical encounters. Assessment of patients' (or carers') ability to safely manage medicines is not undertaken routinely, and when it is there is variability in the methods used. Self-report and informant report may be helpful, but can be unreliable or prone to bias. Measures of cognitive function are useful, but may lack sensitivity and specificity. Direct observation, using a structured, standardised performance-based tool, may help to determine whether a person is able to manage their medicines and identify barriers to adherence such as inability to open medicine packaging. A range of strategies have been used to support independent medicines management in people with cognitive impairment, but there is little high-quality research underpinning these strategies. Further studies are needed to develop and evaluate approaches to facilitate safe medicines management by older people with cognitive impairment and their carers. PMID
Herbert Jan Albert Rolden
Full Text Available The mortality rates of older people changes with the seasons. However, it has not been properly investigated whether the seasons affect medical care expenditure (MCE and institutionalization. Seasonal variation in MCE is plausible, as MCE rises exponentially before death. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality.Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer and were linked with data from the Netherlands Institute for Social Research, and Statistics Netherlands (n = 61,495. The Seasonal and Trend decomposition using Loess (STL method was used to divide mortality rates, MCE, and institutionalization rates into a long-term trend, seasonal variation, and remaining variation. For every season we calculated the 95% confidence interval compared to the long-term trend using Welch's t-test.The mortality rates of older people differ significantly between the seasons, and are 21% higher in the winter compared to the summer. MCE rises with 13% from the summer to the winter; this seasonal difference is higher for the non-deceased than for the deceased group (14% vs. 6%. Seasonal variation in mortality is more pronounced in men and people in residential care. Seasonal variation in MCE is more pronounced in women. Institutionalization rates are significantly higher in the winter, but the other seasons show no significant impact.Seasonal changes affect mortality and the level of MCE of older people; institutionalization rates peak in the winter. Seasonal variation in MCE exists independently from patterns in mortality. Seasonal variation in mortality is similar for both institutionalized and community-dwelling elderly. Policy-makers, epidemiologists and health economists are urged to acknowledge and include the impact of the seasons in future
Hijmans, J.M.; Geertzen, J.H.B.; Dijkstra, P.U.; Postema, K.
The objective of this paper is to identify and review all publications on effects ankle and/or foot appliances (AFA) on balance in older people (> 60 years) and patients with peripheral nervous system disorders (PNSD). These two groups account for the majority of the population with deteriorated bal
Smidt, Dorte; Torpet, Lis Andersen; Nauntofte, Birgitte;
Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AML. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010; 38: 422-435. © 2010 John Wiley & Sons A/S Abstract - Objective: To investigate...... the associations between age, gender, systemic diseases, medications and labial and whole salivary flow rates in older people. Methods: Unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 389 randomly selected community-dwelling Danish women...
This thesis investigates whether community care policy and service delivery is rhetoric or reality. The social policy and under-pinning ideologies that surround community care are reviewed. Important benchmarks are presented in the form of a chronology and aetiology of The National Health Service and Community Care Act, 1990. An interview schedule was designed from the perspective of older people and was used with a sample of 40 older people, 20 at Luton in an inner-city setting and 20 in Red...
Yamada, Yukari; Ekmann, Anette Addy; Nilsson, Charlotte Juul;
Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic...... status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association....
Banerjee, Albert; Daly, Tamara; Armstrong, Pat; Szebehely, Marta; Armstrong, Hugh; Lafrance, Stirling
Canadian frontline careworkers are six times more likely to experience daily physical violence than their Scandinavian counterparts. This paper draws on a comparative survey of residential careworkers serving older people across three Canadian provinces (Manitoba, Nova Scotia, Ontario) and four countries that follow a Scandinavian model of social care (Denmark, Finland, Norway, Sweden) conducted between 2005 and 2006. Ninety percent of Canadian frontline careworkers experienced physical violence from residents or their relatives and 43 percent reported physical violence on a daily basis. Canadian focus groups conducted in 2007 reveal violence was often normalized as an inevitable part of elder-care. We use the concept of "structural violence" (Galtung, 1969) to raise questions about the role that systemic and organizational factors play in setting the context for violence. Structural violence refers to indirect forms of violence that are built into social structures and that prevent people from meeting their basic needs or fulfilling their potential. We applied the concept to long-term residential care and found that the poor quality of the working conditions and inadequate levels of support experienced by Canadian careworkers constitute a form of structural violence. Working conditions are detrimental to careworker's physical and mental health, and prevent careworkers from providing the quality of care they are capable of providing and understand to be part of their job. These conditions may also contribute to the physical violence workers experience, and further investigation is warranted. PMID:22204839
Full Text Available Abstract Background There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury. The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective, population-based, multi-factorial falls injury prevention program for people over 60 years of age. Methods Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States. Results The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest. Conclusions The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those that are intensively implemented.
Skelton, Dawn A; Bailey, Cathy; Howel, Denise; Cattan, Mima; Deary, Vincent; Coe, Dot; de Jong, Lex D; Gawler, Sheena; Gray, Joanne; Lampitt, Rosy; Wilkinson, Jennifer; Adams, Nicola
Introduction In the UK, 1 in 5 people aged 75 and over live with sight loss. Visually impaired older people (VIOP) have an above average incidence of falls and 1.3–1.9 times more likely to experience hip fractures, than the general population. Older people with eye diseases are ∼3 times more likely than those with good vision, to limit activities due to fear of falling. This feasibility study aims to adapt the group-based Falls Management Exercise (FaME) programme to the needs of VIOP and carry out an external pilot trial to inform the design of a future definitive randomised controlled trial. Methods and design A UK based 2-centre mixed methods, randomised, feasibility study will be conducted over 28 months. Stakeholder panels, including VIOP, will make recommendations for adaptations to an existing exercise programme (FaME), to meet the needs of VIOP, promoting uptake and adherence, while retaining required effective components of the exercise programme. 80 VIOP aged 60 and over, living at home, ambulant with or without a walking aid, will be recruited in Newcastle (n=40) and Glasgow (n=40) through National Health Service (NHS) Trusts and third sector partners. Participants randomised into the intervention arm will receive the adapted FaME programme. Participants randomised into the control arm will continue with usual activity. Outcomes are, recruitment rate, adherence and validated measures including fear of falling and quality of life. Postintervention in-depth qualitative interviews will be conducted with a purposive sample of VIOP (N=10). Postural stability instructors will be interviewed, before trial-specific training and following the intervention. Ethics and dissemination Ethics approval was secured through the National Research Ethics Service (NRES) Committee North East, Newcastle and North Tyneside 2. Glasgow Caledonian University was approved as a non-NHS site with local ethics approval. Findings will be disseminated through peer
Lives Remembered: Telling the Stories of Older People - The second anthology University of York Lives Remembered: Telling the Stories of Older People - The second anthology 117pp University of York 9780901931078 0901931071 [Formula: see text].
Lives Remembered is the second anthology of older people's reminiscences published by the University of York. Using a creative writing approach, third-year nursing students interviewed a number of nursing home residents and have written up their stories in a sympathetic and respectful manner.
Porter, G; Heslop, A; Bifandimu, F.; Sibale, E.; Tewodros, A.; Gorman, M.
This chapter explores the value of using a co-investigation approach to researching ageing and intergenerationality. In a study focused on mobility and service access among older people in Kibaha district, Tanzania, 12 people aged between 60 and 70 years from one community were recruited and given training in qualitative research. They subsequently conducted interviews and group discussions with their peers in their own community and 9 other local villages. In both the training sessions and s...
Full Text Available Abstract Background The population's views concerning influenza vaccine are important in maintaining high uptake of a vaccine that is required yearly to be effective. Little is also known about the views of the more vulnerable older population over the age of 74 years. Methods A cross-sectional survey of community dwelling people aged 75 years and over wh, previous participant was conducted using a postal questionnaire. Responses were analysed by vaccine uptake records and by socio-demographic and medical factors. Results 85% of men and 75% of women were vaccinated against influenza in the previous year. Over 80% reported being influenced by a recommendation by a health care worker. The most common reason reported for non uptake was good health (44%, or illness considered to be due to the vaccine (25%. An exploration of the crude associations with socio-economic status suggested there may be some differences in the population with these two main reasons. 81% of people reporting good health lived in owner occupied housing with central heating vs. 63% who did not state this as a reason (p = 0.04, whereas people reporting ill health due to the vaccine was associated with poorer social circumstances. 11% lived in the least deprived neighbourhood compared to 36% who did not state this as a reason (p = 0.05 and were less likely to be currently married than those who did not state this as a reason (25% vs 48% p = 0.05. Conclusion Vaccine uptake was high, but non uptake was still noted in 1 in 4 women and 1 in 7 men aged over 74 years. Around 70% reported they would not have the vaccine in the following year. The divergent reasons for non-uptake, and the positive influence from a health care worker, suggests further uptake will require education and encouragement from a health care worker tailored towards the different views for not having influenza vaccination. Non-uptake of influenza vaccine because people viewed themselves as in good health may
Cameron Ian D
Full Text Available Abstract Background Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentially important finding (NHMRC project grant number 627178. Methods/Design One year randomized control trial where subjects are allocated to either oral testosterone undecanoate and high calorie oral nutritional supplement or placebo medication and low calorie oral nutritional supplementation. 200 older community-dwelling, undernourished people [Mini Nutritional Assessment score 2: 7.5% over 3 months]. Hospital admissions, quality-adjusted life years, functional status, nutritional health, muscle strength, body composition and other variables will be assessed. Discussion The pilot study showed that combined treatment with an oral testosterone and a supplement drink was well tolerated and safe, and reduced the number of people hospitalised and duration of hospital admissions in undernourished, community dwelling older people. This is an exciting finding, as it identifies a treatment which may be of substantial benefit to many older people in our community. We now propose to conduct a multi-centre study to test these findings in a substantially larger subject group, and to determine the cost effectiveness of this treatment. Trial registration Australian Clinical Trial Registry: ACTRN 12610000356066
Williams, L; Rycroft-Malone, J; Burton, C R; Edwards, S; Fisher, D; Hall, B; McCormack, B; Nutley, S M; Seddon, D; Williams, R
Objectives This evidence review was conducted to understand how and why workforce development interventions can improve the skills and care standards of support workers in older people's services. Design Following recognised realist synthesis principles, the review was completed by (1) development of an initial programme theory; (2) retrieval, review and synthesis of evidence relating to interventions designed to develop the support workforce; (3) ‘testing out’ the synthesis findings to refine the programme theories, and establish their practical relevance/potential for implementation through stakeholder interviews; and (4) forming actionable recommendations. Participants Stakeholders who represented services, commissioners and older people were involved in workshops in an advisory capacity, and 10 participants were interviewed during the theory refinement process. Results Eight context–mechanism–outcome (CMO) configurations were identified which cumulatively comprise a new programme theory about ‘what works’ to support workforce development in older people's services. The CMOs indicate that the design and delivery of workforce development includes how to make it real to the work of those delivering support to older people; the individual support worker's personal starting points and expectations of the role; how to tap into support workers' motivations; the use of incentivisation; joining things up around workforce development; getting the right mix of people engaged in the design and delivery of workforce development programmes/interventions; taking a planned approach to workforce development, and the ways in which components of interventions reinforce one another, increasing the potential for impacts to embed and spread across organisations. Conclusions It is important to take a tailored approach to the design and delivery of workforce development that is mindful of the needs of older people, support workers, health and social care services and the
Gül Y. Özkaya
Full Text Available The purpose of this study was to investigate the effect of moderate strength and endurance training on cognition evaluated by event-related potentials (ERP in older people. Thirty-six adults, aged 60-85 years, were randomly divided into three groups: sedentary control (C, strength training (ST, and endurance training (ET. Participants performed functional fitness tests and ERP data were recorded before and after nine weeks of training. Training involved three sessions per week. Functional fitness test performance improved significantly in the ST and ET groups. The latencies of the N1, N2, and P2 components and the amplitudes of the N1P2, P2N2, and N2P3 components differed significantly between groups (p < 0.05. After training, the latencies of the P2 and N2 components at the Fz and Cz sites, decreased significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components at the Fz site and the N1P2 and N2P3 components at the Cz site, increased significantly in the ST group compared with the ET group. After training, the latencies of N1, N2, and P2 components shortened significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components increased significantly in the ST group compared with the C group. The latencies of the N2 and P2 components shortened significantly in the ET group compared with the C group, although the amplitudes of the ERP recordings did not differ significantly between groups. These data suggest that strength training might facilitate early sensory processing and cognitive functioning in older individuals
Full Text Available Abstract Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing. Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors. Results A total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors was attempting to give medication at the wrong time. Over the 3-month observation period, half (52% of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p Conclusions The incidence of medication administration errors is high in long-term residential care. A barcode medication administration system can capture medication
Andrich, Silke; Haastert, Burkhard; Neuhaus, Elke; Neidert, Kathrin; Arend, Werner; Ohmann, Christian; Grebe, Jürgen; Vogt, Andreas; Jungbluth, Pascal; Rösler, Grit; Windolf, Joachim; Icks, Andrea
Epidemiological data about pelvic fractures are limited. Until today, most studies only analyzed inpatient data. The purpose of this study was to estimate incidence rates of pelvic fractures in the German population aged 60 years or older, based on outpatient and inpatient data. We conducted a retrospective population-based observational study based on routine data from a large health insurance company in Germany. Age and sex-specific incidence rates of first fractures between 2008 and 2011 were calculated. We also standardized incidence rates with respect to age and sex in the German population. Multiple Poisson regression models were used to evaluate the association between the risk of first pelvic fracture as outcome and sex, age, calendar year and region as independent variables. The total number of patients with a first pelvic fracture corresponded to 8,041 and during the study period 5,978 insured persons needed inpatient treatment. Overall, the standardized incidence rate of all first pelvic fractures was 22.4 [95% CI 22.0-22.9] per 10,000 person-years, and the standardized incidence rate of inpatient treated fractures 16.5 [16.1-16.9]. Our adjusted regression analysis confirmed a significant sex (RR 2.38 [2.23-2.55], p year (higher risk in later years compared to 2008, p = 0.0162) and first fracture risk and a further significant association with region (RR 0.92 [0.87-0.98], p = 0.006, Westfalen-Lippe as reference). The observed incidences are considerably higher than incidences described in the international literature, even if only inpatient treated pelvic fractures are regarded. Besides which, non-inclusion of outpatient data means that a relevant proportion of pelvic fractures are not taken into account. Prevention of low energy trauma among older people remains an important issue.
Full Text Available Abstract Background Although self-rated health has been extensively studied in community older people, its determinants have seldom been investigated in institutional settings. We carried out a cross-sectional study to describe the physical, mental, and social factors associated with self-rated health in nursing homes and other geriatric facilities. Methods A representative sample of 800 subjects 65 years of age and older living in 19 public and 30 private institutions of Madrid was randomly selected through stratified cluster sampling. Residents, caregivers, physicians, and nurses were interviewed by trained geriatricians using standardized instruments to assess self-rated health, chronic illnesses, functional capacity, cognitive status, depressive symptoms, vision and hearing problems, and social support. Results Of the 669 interviewed residents (response rate 84%, 55% rated their health as good or very good. There was no association with sex or age. Residents in private facilities and those who completed primary education had significantly better health perception. The adjusted odds ratio (95% confidence interval for worse health perception was 1.18 (1.07–1.28 for each additional chronic condition, 2.37 (1.38–4.06 when comparing residents with moderate dependency to those functionally independent, and 10.45 (5.84–18.68 when comparing residents with moderate/severe depressive symptoms to those without symptoms. Visual problems were also associated with worse health perception. Similar results were obtained in subgroup analyses, except for inconsistencies in cognitively impaired individuals. Conclusion Chronic conditions, functional status, depressive symptoms and socioeconomic factors were the main determinants of perceived health among Spanish institutionalized elderly persons. Doubts remain about the proper assessment of subjective health in residents with altered cognition.
Melis, R.J.F.; Eijken, M.I.J. van; Achterberg, T. van; Teerenstra, S.; Vernooij-Dassen, M.J.F.J.; Lisdonk, E.H. van de; Olde Rikkert, M.G.M.
OBJECTIVE: caregiver effects of geriatric care models focusing primarily at the patient have not been consistently studied. We studied caregiver effects of a nurse-led comprehensive geriatric evaluation and management (GEM) programme for community-dwelling frail older people that showed-in a randomi
Weening-Verbree, L.; Huisman-de Waal, G.; van Dusseldorp, L.; van Achterberg, T.; Schoonhoven, L.
Objectives: Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the imp
Bleijenberg, Nienke; ten Dam, Valerie H.; Drubbel, Irene; Numans, Mattijs E.; de Wit, Niek J.; Schuurmans, Marieke J.
Background: In a large randomized trial, Utrecht PROactive Frailty Intervention Trial (U-PROFIT), we evaluated the effectiveness of an integrated program on the preservation of daily functioning in older people in primary care that consisted of a frailty identification tool and a multicomponent nurs
Logghe, I.H.; Verhagen, A.P.; Rademaker, A.C.; Bierma-Zeinstra, S.M.; Rossum, E. van; Faber, M.J.; Koes, B.W.
OBJECTIVE: Tai Chi (TC) is an exercise training that is becoming increasingly popular as an intervention for single fall prevention. This meta-analysis was performed to evaluate the efficacy of TC on fall rate, fear of falling and balance in older people. METHODS: Randomized controlled trials publis
Sino, C. G. M.; Sietzema, M.; Egberts, T. C. G.; Schuurmans, M. J.
Objective: to determine the medication management capacity of independently living older people (>= 75 years) on polypharmacy (>= 5 medications) in relation to their cognitive- and self-management skills. Design: Cross-sectional study. Setting: two homecare organizations in the Netherlands. Particip
Berglund, Helene; Hasson, Henna; Wilhelmson, Katarina; Dunér, Anna; Dahlin-Ivanoff, Synneve
It has been shown that frailty is associated with low levels of well-being and life satisfaction. Further exploration is needed, however, to better understand which components constitute life satisfaction for frail older people and how satisfaction is related to other life circumstances. The aim of this study was to examine relationships between frail older people's life satisfaction and their socioeconomic conditions, social networks, and health-related conditions. A cross-sectional study was conducted (n=179). A logistic regression analysis was performed, including life satisfaction as the dependent variable and 12 items as independent variables. Four of the independent variables made statistically significant contributions: financial situation (OR 3.53), social contacts (OR 2.44), risk of depression (OR 2.26), and self-rated health (OR 2.79). This study demonstrates that financial situation, self-rated health conditions and social networks are important components for frail older people's life satisfaction. Health and social care professionals and policy makers should consider this knowledge in the care and service for frail older people; and actions that benefit life satisfaction - such as social support - should be promoted. PMID:27403463
Ammann, Rahel; Vandelanotte, Corneel; de Vries, Hein; Mummery, W. Kerry
Despite the numerous health benefits, population physical activity levels are low and declining with age. A continued increase of Internet access allows for website-delivered interventions to be implemented across age-groups, though older people have typically not been considered for this type of intervention. Therefore, the purpose of this study…
Camara, C. Palmero; Eguizabal, A. Jimenez
This article examines the innovative regulations, methodologies, and institutions involved in the development of the European Higher Education Area and their implications for teaching, research, and management of University Programs for Older People. It also identifies the main tendencies, creative dimensions, and ethical commitments implicit in…
This paper considers some of the spatial challenges of doing arts projects with older people in care homes, including those living with dementia. It reflects on the author's own experience of running a performance project with residents with at a care home in North London. Drawing on Lefebvre's concept of socially produced space, it argues that…
Hamilton, Carol; Atkinson, Dorothy
This article draws on life-stories told by older people with intellectual disabilities for a research study in the Republic of Ireland. Research participants recalled their experiences of confinement, coercion and exclusion that resulted from their being labelled as having intellectual disabilities. Participants also recalled the positive…
This paper emerges from a case study of the system of statutory reviews in older people's care homes in the UK. Informed by a review of selected literature on gaining access, this paper provides a critical account of the process of negotiating access with gatekeepers (chiefly, care home managers). The negotiations were time-consuming and largely…
Winter, C. F.; Hermans, H.; Evenhuis, H. M.; Echteld, M. A.
Background: Depression, anxiety, diabetes and cardiovascular risk factors are frequent health problems among older people with intellectual disability (ID). These conditions may be bidirectionally related. Depression and anxiety may have biological effects causing glucose intolerance, fat accumulation and also lifestyle changes causing metabolic…
Yvonne M Drewes
promising instrument to select older people for geriatric care if more uniformity could be achieved. TRIAL REGISTRATION: Netherlands Trial Register NTR1946.
Kasedde, Susan; Doyle, Aoife M; Seeley, Janet A; Ross, David A
This qualitative study examines the role of older people (60 years and above) in fostering decisions for orphans and non-orphans within extended families in a rural Ugandan community heavily affected by HIV. Fieldwork conducted in 2006 provided information on the influence of HIV on fostering decisions through 48 individual in-depth interviews and two group interviews with foster-children and family members to develop detailed case studies related to 13 fostered adolescents. The adolescents included five non-orphans and eight orphans (five were double orphans because they had lost both parents). Older people play a very important role in fostering decisions as potential foster-parents, advisers, mediators and gatekeepers. They have a high level of authority over the foster-children, who are regarded as important resources within the extended family. With fewer potential caregivers available because of HIV-related deaths, the responsibility for fostering orphans has often fallen to surviving older people. Fostering is used by older people and the child's extended family as a strategy to ensure the welfare of the foster-child. When the foster-parent is an older person, it is also used to ensure physical and emotional support for the older person themselves. Support from the extended family towards foster households is widely reported to have been reduced by HIV by diminishing resources that would otherwise have been made available to support foster care. New initiatives and investment are required to complement community and family resources within well-managed social protection and welfare programmes. To be effective, such programmes will require adequate investment in administrative capacity and monitoring. They must aim to strengthen families and, recognizing that resources are limited, should prioritize the community's poorest households, rather than specifically targeting households with orphans or other foster-children. PMID:24880658
Full Text Available Abstract Background Providing appropriate palliative care for older people is a major task for health care systems worldwide, and up to now it has also been one of the most neglected. Focusing on the German health care system, we sought to explore the attitudes of health professionals regarding their understanding of palliative care for older patients and its implementation. Methods In a qualitative study design, focus groups were established consisting of general practitioners, geriatricians, palliative care physicians, palliative care nurses and general nurses (a total of 29 participants. The group discussions were recorded, transcribed, coded and analysed using the methodological approach of Qualitative Description. Results Deficiencies in teamwork and conflicting role definitions between doctors and nurses and between family practitioners and medical specialists were found to be central problems affecting the provision of appropriate palliative care for older people. It was emphasized that there are great advantages to family doctors playing a leading role, as they usually have the longest contacts to the patients. However, the professional qualifications of family doctors were to some extent criticized. The general practitioners for their part criticized the increasing specialization on the field of palliative care. All groups complained that the German compensation system gives insufficient consideration to the time-consuming care of older patients, and about excessive bureaucracy. Conclusion General practitioners are the central health professionals in the delivery of palliative care for older people. They should however be encouraged to involve specialized services such as palliative care teams where necessary. With the German health care reform of 2007, a legal framework has been created that allows for this. As far as its realization is concerned, it must be ensured that the spotlight remains on the needs of the patients and not on
Parker Stuart G
Full Text Available Abstract Background British government policy for older people focuses on a vision of active ageing and independent living. In the face of diminishing personal capacities, the use of appropriate home-based technology (HBT devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment. This study aimed to examine the use of HBT devices and the correlation between use of such devices and quality of life among older people living in extra-care housing (ECH. Methods A structured questionnaire was administered for this study. Using purposive sampling 160 older people living in extra-care housing schemes were selected from 23 schemes in England. A face-to-face interview was conducted in each participant's living unit. In order to measure quality of life, the SEIQoL-Adapted and CASP-19 were used. Results Although most basic appliances and emergency call systems were used in the living units, communally provided facilities such as personal computers, washing machines, and assisted bathing equipment in the schemes were not well utilised. Multiple regression analysis adjusted for confounders including age, sex, marital status, living arrangement and mobility use indicated a coefficient of 1.17 with 95% CI (0.05, 2.29 and p = 0.04 [SEIQoL-Adapted] and 2.83 with 95% CI (1.17, 4.50 and p = 0.001 [CASP-19]. Conclusions The findings of the present study will be value to those who are developing new form of specialised housing for older people with functional limitations and, in particular, guiding investments in technological aids. The results of the present study also indicate that the home is an essential site for developing residential technologies.
Cobelli, Nicola; Gill, Liz; Cassia, Fabio; Ugolini, Marta
Hearing loss is one of the most prevalent health impairments associated with ageing in developed countries, and it can result in social, emotional and communication dysfunction. Hearing loss in Italy is increasing, yet, despite the availability of free hearing aids and access to qualified community-based health professionals specialising in audiology services, their uptake remains low (about 15%-20%). This paper presents an investigation of the possible reasons why older people in Italy resist adopting a hearing aid. We used the literature to identify factors influencing people with hearing loss's decision-making, and drew on the theory of reasoned action to create an explanatory model. To test our hypotheses, we applied a cross-sectional design. We developed a questionnaire including 13 items related to adopting a hearing aid. Health professionals identified 400 persons aged 60-90 who were candidates for a free hearing aid. Those willing to participate were sent a copy of the questionnaire and telephoned between August and September 2009; a total of 243 responded (response rate of 60.8%). Linear regression analysis highlighted that a person's intention to adopt a hearing aid was positively related to their attitude towards its adoption, but negatively linked to their perceived subjective norms. It was found that trust in the health professional does not moderate the relationship between a person's attitude and their intention to adopt a hearing aid, but trust mitigates the relationship between a person's perceived subjective norms and their intentions. These findings underline the importance of the potential role that the healthcare professional could play in reducing the uncertainty created by external social pressures. For this purpose, stronger collaboration between the various health professionals involved in hearing aid provision, from diagnosis to fitting, is recommended. PMID:25251979
Full Text Available The purpose of this study was to describe nurses' experiences of their collaboration and relationships with family members in institutional respite care for the elderly. The family has a particularly important role in respite care, which is an extension of care provided at home. However no published studies were found on this subject. The data were collected through qualitative interviews (N=22. Content analysis of the nurses’ descriptions of their collaboration with family members yielded four main categories as follows: (1 conscious ignoring, (2 attempting to understand the family’s situation, (3 hinting at private family matters, and (4 being a friend. The results lend support to earlier findings which emphasize the complexity of relationships between nurses and family carers. A novel finding here is that these relationships may also develop into friendships. Greater emphasis must be placed on primary nursing so that the nurse and informal carer can build up a genuine relationship of trust. If periods of respite care are to help older people and their families to manage independently, it is imperative that nurses have the opportunity to visit their patients at home.
Full Text Available Falls may occur in each ontogenesis phase, but they become more frequent in the elderly and lead to serious health consequences. Dynamic changes in senior citizens’ environment and lifestyle makes studies of risk for falls necessary. To determine the relationship between the risk for falls and the objective functional and structural examination in the elderly living in Poland. The research consisted of 196 females and 61 males aged 60-88 recruited from health clinics, senior citizen centers and Universities of the Third Age between 2009-2012. Following parameters were collected: functional physical tests “30 second Chair Stand Test” and Timed Up and Go Test”, the flexor muscles and knee extensors force, the bone mineral density was measured in distal radius of the forearm with the EXA - 3000, the total risk for fall assessed by 5 tests by abbreviated version of Fallscreen test. Multiple linear regression and linear correlation were used for assessment of relationship with total estimated risk for fall and other parameters. The subjects displayed significant dimorphic differences within the range of the functional parameters and bone mineral density to the advantage of males. Only in women results revealed a significant link between the risk for falls and the dynamic balance, as well as the maximum quadricep muscle force equal. Strength of the lower limb muscles seems to be critical for decreasing the risk for fall. Special programs for strengthening this part of the body for older people should be elaborate.
Hughes, Carmel M; Lapane, Kate; Watson, Margaret C; Davies, Huw T O
Prescribing in care homes for older people has been the focus of much research and debate because of inappropriate drug choice and poor monitoring practices. In the US, this has led to the implementation of punitive and adversarial regulation that has sought to improve the quality of prescribing in this healthcare setting. This approach is unique to the US and has not been replicated elsewhere. The literature has revealed that there are limitations as to how much can be achieved with regulation that is externally imposed (an 'external factor'). Other influences, which may be categorised as 'internal factors' operating within the care home (e.g. patient, physician and care-home characteristics), also affect prescribing. However, these internal and external factors do not appear to affect prescribing uniformly, and poor prescribing practices in care homes continue to be observed. One intangible factor that has received little attention in this area of healthcare is that of organisational culture. This factor has been linked to quality and performance within other health organisations. Consideration of organisational culture within care-home settings may help to understand what drives prescribing decisions in this particularly vulnerable patient group and thus provide new directions for future strategies to promote quality care.
Cotter, P E
BACKGROUND: Falls are a common occurrence in older people and frequently lead to hospital admission. There is a current lack of cohesive fall prevention strategies in the Republic of Ireland. AIM: To demonstrate the cost of fall-related admissions to an acute hospital. METHODS: A review of Hospital Inpatient Enquiry (HIPE) data and medical case notes was performed for all fall-related admissions over a one-year period. The cost of fall-related admissions was calculated. In addition a detailed cost analysis was performed to determine the true cost of a hip fracture admission. RESULTS: There were 810 fall-related admissions, resulting in 8,300 acute bed days, and 6,220 rehabilitation bed days, costing euros 10.3 million. Fall-related readmissions resulted in 650 bed-days, bringing the total cost to euros 10.8 million. A typical hip fracture incident admission episode costs euros 14,300. CONCLUSION: Fall-related admissions of olderpeople are a significant financial burden to the health service.
Full Text Available Aim. To identify methods, index, diagnostic criteria, and corresponding cutoff points used to estimate the prevalence of sarcopenia in older people in different countries. Methods. A systematic review was carried out in accordance with PRISMA Statement. The search encompassed the MEDLINE and LILACS databases and was executed during March 2012 using the keyword sarcopenia. Results. A total of 671 studies were identified by the search strategy, and 30 meet all inclusion criteria. Specifically for dual-X-ray absorptiometry, prevalence ranged from 2.2% to 95% in men and from 0.1% to 33.9% in women. For bioelectrical impedance analysis, the range was from 6.2% to 85.4% in men and 2.8% to 23.6% in women. Regarding anthropometric and computed tomography, prevalence rates were, respectively, 14.1% and 55.9%. Conclusions. Heterogeneity in prevalence of sarcopenia was identified, due to diagnostic method choice, cutoff points, and, characteristics of the population as well as reference population. These factors should be considered in research designs to enable comparison and validation of results. Despite the limitations of most studies that indicated high prevalence rates, the results indicate the need for early detection of this syndrome.
Robben, S.H.M.; Perry, M.; Huisjes, M.; Nieuwenhuijzen, L. van; Schers, H.J.; Weel, C. van; Rikkert, M.G.; Achterberg, T. van; Heinen, M.M.; Melis, R.J.F.
ABSTRACT: BACKGROUND: Due to fragmentation of care, continuity of care is often limited in the care provided to frail older people. Further, frail older people are not always enabled to become involved in their own care. Therefore, we developed the Health and Welfare Information Portal (ZWIP), a sha
Robben, S.H.M.; Heinen, M.M.; Makai, P.; Olde Rikkert, M.G.M.; Perry, M.; Schers, H.J.; Melis, R.J.F.
REDUCING FRAGMENTATION IN THE CARE OF FRAIL OLDER PEOPLE: THE SUCCESSFUL DEVELOPMENT AND IMPLEMENTATION OF THE HEALTH AND WELFARE INFORMATION PORTAL: Our fragmented health care systems are insufficiently equipped to provide frail older people with high quality of care. Therefore, we developed the He
Robben, S.H.M.; Heinen, M.M.; Makai, P.; Olde Rikkert, M.G.M.; Perry, M.; Schers, H.J.; Melis, R.J.F.
REDUCING FRAGMENTATION IN THE CARE OF FRAIL OLDER PEOPLE: THE SUCCESSFUL DEVELOPMENT AND IMPLEMENTATION OF THE HEALTH AND WELFARE INFORMATION PORTAL: Our fragmented health care systems are insufficiently equipped to provide frail older people with high quality of care. Therefore, we developed the He
P.C. Bots-VantSpijker; J.J.M. Bruers; C.P. Bots; J.N.O. Vanobbergen; L.M.J. De Visschere; C. de Baat; J.M.G.A. Schols
Objective: The aim of this study was to investigate to what extent dentists in the Netherlands experience barriers in providing oral health care to community-dwelling older people. Background: As most publications on the barriers in providing oral health care to older people consist of surveys on or
Jønsson, Line R; Kristensen, Morten; Tibaek, Sigrid;
To examine the intrarater and interrater reliability and agreement of the Danish version of the Dynamic Gait Index (DGI) in hospitalized and community-dwelling older people with balance impairments.......To examine the intrarater and interrater reliability and agreement of the Danish version of the Dynamic Gait Index (DGI) in hospitalized and community-dwelling older people with balance impairments....
Houtjes, Wim; Meijel, Berno van; Ven, Peter van de; Deeg, Dorly; Tilburg, Theo van; Beekman, Aartjan
OBJECTIVE: This work aims to gain insight into the long-term impact of depression course on social network size and perceived loneliness in older people living in the community. METHODS: Within a large representative sample of older people in the community (Longitudinal Aging Study Amsterdam (LAS
Joseph O Mugisha
Full Text Available BACKGROUND: Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. METHODS: Participants were aged (≥ 50 years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. RESULTS: In total, 1449 people participated (response rate 72.3%. The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%, and this was higher for males (24.1%, 95% CI=20.7-27.7% than females (17.5%, 95% CI=15.0-20.1%. In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001. Unexplained anaemia was responsible for more than half of all cases (59.7%. Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82, HIV (OR 2.17, 1.32-3.57 heavy hookworm infection (OR 3.45, 1.73-6.91, low fruit consumption (OR 1.55, 1.05-2.29 and being unmarried (OR 1.37 , 95% CI 1.01-1.89. However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77. CONCLUSION: Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict
Woo, T; Yu, S; Visvanathan, R
Sarcopenia is a multi-faceted geriatric syndrome that is prevalent in the older population. It is an independent risk factor for a variety of devastating health outcomes that threaten the independence of older people. Quality of life is also very important to older people. The objective of this systematic review therefore was to determine the relationship between the biomarkers of sarcopenia (or sarcopenia) and health related quality of life in older people. Systematic searches were done using the electronic databases from MEDLINE and EMBASE. Search terms included sarcopenia, biomarkers of sarcopenia (e.g. muscle mass, grip strength, muscle performance), and health related quality of life. A total of 20 studies were finally included in this review. Only four studies were deemed of good quality. Sarcopenia was associated with poor health related quality of life in both genders from the one cross sectional study defining sarcopenia as per consensus definition. One high quality longitudinal study demonstrated that better physical performance and muscle strength was associated with a slower rate of decline in health related quality of life over six years. Muscle performance and strength were associated with health related quality of life but muscle mass was not in cross-sectional studies. Good quality and longitudinal studies where sarcopenia is defined as per consensus guidelines are required if the impact of the disease on quality of life is to be clarified.
Rimland, Joseph M.; Abraha, Iosief; Dell’Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Soiza, Roy; Gudmusson, Adalsteinn; Petrovic, Mirko; O’Mahony, Denis; Todd, Chris; Cherubini, Antonio
Background Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making. Objectives To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals. Methods We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions. Results Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis. Conclusions The aim of this overview of
Pan, Hsueh-Hsing; Li, Chung-Yi; Chen, Tzeng-Ji; Su, Tung-Ping; Wang, Kwua-Yun
Objective To elucidate the associations between polypharmacy and age- and gender-specific risks of admission for fall-related fractures. Design Nested case–control study. Setting This analysis was randomly selected from all elderly beneficiaries in 2007–2008, and represents some 30% of the whole older insurers using Taiwan's National Health Insurance Research Database. Participants We identified 5933 cases newly admitted for fall-related fractures during 2007–2008, and 29 665 random controls free from fracture. Primary and secondary outcome measures Polypharmacy was defined as the use of fall-related drugs of four or more categories of medications and prescribed related to fall within a 1-year period. Logistic regression models were employed to estimate the ORs and related 95% CIs. The interaction of polypharmacy with age and sex was assessed separately. Results Compared with those who consumed no category of medication, older people who consumed 1, 2, 3 and ≥4 categories of medications were all at significantly increased odds of developing fall-related fractures, with a significant dose–gradient pattern (β=0.7953; p for trend <0.0001). There were significant interactions between polypharmacy and age, but no significant interactions between polypharmacy and gender. The dose–gradient relationship between number of medications category and risk of fall-related fractures was more obvious in women than in men (β=0.1962 vs β=0.1873). Additionally, it was most evident in older people aged 75–84 years (β=0.2338). Conclusions This population-based study in Taiwan confirms the link between polypharmacy and increased risk of fall-related fractures in older people; and highlights that elderly women and older people aged 75–84 years will be the targeted participants for further prevention from fall-related fractures caused by polypharmacy. PMID:24682575
Keogh, Claire; O'Brien, Kirsty K; Hoban, Anthony; O'Carroll, Austin; Fahey, Tom
Background Homeless populations experience poorer physical and mental health, and more barriers to accessing adequate healthcare. This study investigates the health of this population, following the provision of a free to access primary care service for homeless people in Dublin (Safetynet). The health of this group will be compared to previous studies on homelessness conducted in Dublin prior to the establishment of this service (in 1997 and 2005). Methods Participants were recruited through...
Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Thos...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare....
Andresen, Mette; Runge, Ulla; Hoff, Morten;
the correspondence between the individual wishes for activities and the concrete content of the programs was not obvious, results indicate potential for enabling the perception of autonomy among physically disabled older nursing home residents. The clinical consequences may suggest a focus on existing traditions......OBJECTIVE. To evaluate the effect of individually tailored programs on perceived autonomy in institutionalized physically disabled older people and to describe participants' activity wishes and content of the programs. METHOD. This blinded randomized trial with follow up included a total of nine...
Full Text Available Abstract Background In order to adapt oral care and treatment to the demands of the growing group of frail dentulous older people, it is important to understand how and to which extent having natural teeth contributes to the quality of life (QoL of frail older people and how frailty influences their perspective. Methods A qualitative approach was used. Interviews with 38 Dutch frail older dentulous people were tape-recorded, transcribed, coded for content and analyzed. Additional information was collected which included age, gender, living situation, use of dental prostheses, self-reported oral health status, chronic disorders, and an index for frailty. Results Seven themes were identified in the relationship between natural teeth and the QoL of the participants: pride and achievement; intactness; sense of control; oral function; appearance; comfort; along with coping and adapting to disabilities. Having natural teeth generally had a positive effect on QoL. Positive effects through pride and achievement, intactness, and sense of control were most apparent for the most severely frail. They compared themselves with peers who are more often edentate, and valued the good state of their teeth against the background of their declining health, especially those with disabilities causing severe chronic pain or impaired fine-motor skills. The effect of coping with and adaptation to tooth loss was also most apparent for the most severely frail. There was a gender effect in that the men generally cared less about having natural teeth than women, regardless of their level of frailty. Conclusions QoL of frail older people is positively influenced by natural teeth, and this effect seems to increase with increasing frailty. Preservation of teeth contributes to a positive body image and self-worth. Oral care for frail people should aim to preserve natural teeth if possible.
Full Text Available Gustaf Boström,1 Mia Conradsson,1 Erik Rosendahl,1,2 Peter Nordström,1 Yngve Gustafson,1 Håkan Littbrand1,21Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; 2Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, SwedenBackground: This study examined associations between depressive symptoms and functional capacity, overall dependency in personal activities of daily living (ADLs, and dependency in individual ADL tasks, respectively, in people with a high mean age, large range of functional capacity, and wide spectrum of dependency in ADLs.Methods: Cross-sectional data from three studies were used. A total of 392 individuals living in community and residential care facilities were included. Mean age was 86.2 years, 72% were women, 75% were dependent in ADLs, 42% had depression, and 39% had dementia. Depressive symptoms were assessed with the 15-item Geriatric Depression Scale (GDS-15, functional capacity with the Berg Balance Scale (BBS, and ADLs with the Barthel ADL Index. Multiple linear regression analyses with comprehensive adjustments were performed between GDS-15 and BBS, GDS-15 and Barthel ADL Index, and GDS-15 and each individual ADL task, separately.Results: GDS-15 score was associated with BBS score (unstandardized b =-0.03, P=0.008, but not with Barthel ADL Index score (unstandardized b =-0.07, P=0.068. No significant interaction effects of sex, dementia, or living conditions were found in these associations. Among individual ADL tasks, dependency in transfer (unstandardized b =-1.03, P=0.007 and dressing (unstandardized b =-0.70, P=0.035 were associated with depressive symptoms.Conclusion: Functional capacity seems to be independently associated with depressive symptoms in older people living in community and residential care facilities, whereas overall ADL performance may not be associated. Dependency in the individual ADL tasks of
Souesme, Guillaume; Martinent, Guillaume; Ferrand, Claude
Based on the self-determination theory, the aim of the present study was (1) to provide a better understanding of older people's psychological needs satisfaction in geriatric care units, then to link this information with depressive symptoms and apathy; (2) to examine whether the perceived autonomy support from health care professionals differs between needs satisfaction profiles; and (3) to investigate for all participants how each need satisfaction was related to depressive symptoms and apathy. Participants (N=100; Mage=83.33years, SD=7.78, 61% female) completed the measures of psychological needs satisfaction, perceived autonomy support, geriatric depression and apathy. Sociodemographic data were also collected. Cluster analyses showed three distinct profiles: one profile with low-moderate need satisfaction, one profile with high-moderate need satisfaction and one profile with high need satisfaction. These profiles are distinct, and did not differ in terms of participants' characteristics, except gender. Multivariate analysis of covariance (MANCOVA) revealed that participants with low-moderate need satisfaction profile have significantly higher level of depressive symptoms and apathy, and lower levels of perceived autonomy support than participants of the two other profiles. Moreover, for all participants, regression analyses revealed that both competence and relatedness needs satisfaction significantly and negatively explained 28% of the variance in depressive symptoms score and 44% of the variance in apathy score. Our results highlight the interest to examine more thoroughly the variables fostering autonomy-supportive environment in geriatric care units, and to deepen the relationship between competence and relatedness needs satisfaction and depressive symptoms and apathy. PMID:27002495
Butler, Annie A; Lord, Stephen R; Fitzpatrick, Richard C
Crossing a road safely is a complex task requiring good sensorimotor function and integration of information about traffic speed, distances and one's own speed. Poor judgement through age-related sensorimotor or cognitive impairment or a predisposition to take risks could lead to errors with serious consequences. On a simulated road, 85 participants (age ≥70 years) were asked to cross in front of an approaching car with a clearance as small as considered safe in two conditions; (1) with nothing else to attend to (free crossing) and (2) with an additional ball-gathering task while waiting to cross (task crossing). Participants were categorised according to their crossing outcome (failed to cross, 'hit', exact, safe, cautious). Participants also performed two sub-studies; (1) the perception of the time-to-arrival of moving objects and (2) the perception of own gait speed. Physical and cognitive function and everyday risk-taking behaviour were also assessed. In free crossing, clearances varied but no participants were "hit" by the car. In task crossing, participants allowed smaller clearances and 10% of participants would have been hit while 13% missed the opportunity to cross altogether. Across a wide range of physical and cognitive measures, including perceived and actual gait speed, a consistent pattern was observed in the task crossing condition. The exact group performed best, the 'hit', safe and cautious groups performed less well while those who missed the opportunity (fail) performed worst. The exact group reported taking the greatest risks in everyday life whereas the remaining groups reported being cautious. In conclusion, we found older people with poorer perceptual, physical and cognitive function made inappropriate and risky decisions in a divided attention road-crossing task despite self-reports of cautious behaviour in everyday life. PMID:27054918
Brilleman Samuel L
Full Text Available Abstract Background There are well-established risk factors, such as lower education, for attrition of study participants. Consequently, the representativeness of the cohort in a longitudinal study may deteriorate over time. Death is a common form of attrition in cohort studies of older people. The aim of this paper is to examine the effects of death and other forms of attrition on risk factor prevalence in the study cohort and the target population over time. Methods Differential associations between a risk factor and death and non-death attrition are considered under various hypothetical conditions. Empirical data from the Australian Longitudinal Study on Women's Health (ALSWH for participants born in 1921-26 are used to identify associations which occur in practice, and national cross-sectional data from Australian Censuses and National Health Surveys are used to illustrate the evolution of bias over approximately ten years. Results The hypothetical situations illustrate how death and other attrition can theoretically affect changes in bias over time. Between 1996 and 2008, 28.4% of ALSWH participants died, 16.5% withdrew and 10.4% were lost to follow up. There were differential associations with various risk factors, for example, non-English speaking country of birth was associated with non-death attrition but not death whereas being underweight (body mass index Conclusions Deaths occur in both the target population and study cohort, while other forms of attrition occur only in the study cohort. Therefore non-death attrition may cause greater bias than death in longitudinal studies. However although more than a quarter of the oldest participants in the ALSWH died in the 12 years following recruitment, differences from the national population changed only slightly.
Elliott, Rohan A; Lee, Cik Yin; Beanland, Christine; Vakil, Krishna; Goeman, Dianne
Background Increasing numbers of older people are receiving support with medicines management from community nursing services (CNSs) to enable them to live in their own homes. Little is known about these people and the support they receive. Objectives To explore the characteristics of older people referred for medicines management support, type of support provided, medication errors and adverse medication events (AMEs). Methods A retrospective observational study of a random sample of 100 old...
Gschwind, Yves J; Schoene, Daniel; Lord, Stephen R; Ejupi, Andreas; Valenzuela, Trinidad; Aal, Konstantin; Woodbury, Ashley; Delbaere, Kim
Background There is good evidence that balance challenging exercises can reduce falls in older people. However, older people often find it difficult to incorporate such programs in their daily life. Videogame technology has been proposed to promote enjoyable, balance-challenging exercise. As part of a larger analysis, we compared feasibility and efficacy of two exergame interventions: step-mat-training (SMT) and Microsoft-Kinect® (KIN) exergames. Methods 148 community-dwelling people, aged 65...
This paper shares outcomes from the evaluation of a community project where comedy activities were introduced into a day centre for older people with dementia as a result of a partnership between the day centre, a local university and a specialist comedy provider. Four workshops were provided using improvisatory activities and comedy, as a medium to engage older people in reflecting on aspects of their care environment. The main output resulted in a 30 minute 'mockumentary' of the 'Her Majesty the Queen' visiting the day centre, in the form of a digital reusable learning object to be used by social work and mental health professionals. The evaluation demonstrated some additional outcomes for those involved and highlighted the benefits of laughter and fun in promoting a positive climate. PMID:24337643
Although every culture follows its own indigenous elder care practices, Korea has retained a unique way of supporting elder parents, specifically, and older people in general. When the care of older people in Korea became significantly challenging, it was determined to launch a controversial law to promote the tradition of filial piety. The main content of the law consists of requiring the government to take action to encourage filial piety and to support those adult children who care for their parents. Although this legislation has the potential to promote the practice of filial piety, the nature of the law is largely rhetorical and symbolic rather than practical, and as a result, its workability and efficiency are limited. PMID:25941771
Roberto Luis Shinmoto Torres
Full Text Available Aging populations are increasing worldwide and strategies to minimize the impact of falls on older people need to be examined. Falls in hospitals are common and current hospital technological implementations use localized sensors on beds and chairs to alert caregivers of unsupervised patient ambulations; however, such systems have high false alarm rates. We investigate the recognition of bed and chair exits in real-time using a wireless wearable sensor worn by healthy older volunteers. Fourteen healthy older participants joined in supervised trials. They wore a batteryless, lightweight and wireless sensor over their attire and performed a set of broadly scripted activities. We developed a movement monitoring approach for the recognition of bed and chair exits based on a machine learning activity predictor. We investigated the effectiveness of our approach in generating bed and chair exit alerts in two possible clinical deployments (Room 1 and Room 2. The system obtained recall results above 93% (Room 2 and 94% (Room 1 for bed and chair exits, respectively. Precision was >78% and 67%, respectively, while F-score was >84% and 77% for bed and chair exits, respectively. This system has potential for real-time monitoring but further research in the final target population of older people is necessary.
Berglund, Helene; Hasson, Henna; Wilhelmson, Katarina; Dunér, Anna; Dahlin-Ivanoff, Synneve
It has been shown that frailty is associated with low levels of well-being and life satisfaction. Further exploration is needed, however, to better understand which components constitute life satisfaction for frail older people and how satisfaction is related to other life circumstances. The aim of this study was to examine relationships between frail older people’s life satisfaction and their socioeconomic conditions, social networks, and health-related conditions. A cross-sectional study was conducted (n=179). A logistic regression analysis was performed, including life satisfaction as the dependent variable and 12 items as independent variables. Four of the independent variables made statistically significant contributions: financial situation (OR 3.53), social contacts (OR 2.44), risk of depression (OR 2.26), and self-rated health (OR 2.79). This study demonstrates that financial situation, self-rated health conditions and social networks are important components for frail older people’s life satisfaction. Health and social care professionals and policy makers should consider this knowledge in the care and service for frail older people; and actions that benefit life satisfaction – such as social support – should be promoted. PMID:27403463
Shergold, Ian; Parkhurst, Graham
Rural dwelling and older age are both associated with a higher risk of social exclusion, with accessibility identified as having an important facilitating role. The interactions between transport-related exclusion and older age, particularly in a rural context, are considered though analysis of quantitative and qualitative data collected from over…
Ioalascon, G; Di Pietro, G.; Gimigliano, F; Letizia Mauro, G; A. Moretti(Fermilab, Batavia, IL, USA); Giamattei, MT; Ortolani, S.; U. Tarantino; Brandi, ML
Sarcopenia is the age-associated loss of skeletal muscle mass and function. It is a major clinical problem for older people and research in understanding of pathogenesis, clinical consequences, management, and socioeconomic burden of this condition is growing exponentially. The causes of sarcopenia are multifactorial, including inflammation, insulin resistance, changing endocrine function, chronic diseases, nutritional deficiencies and low levels of physical activity. Operational definition o...
Ireland is at 53°N, and its population risk of vitamin D deficiency is high. Previous Irish studies suggested a significant seasonality of serum 25-hydroxyvitamin D [25(OH)D] and a beneficial effect of supplementation in raising 25(OH)D levels. However, in Irish older people, little is known about the magnitude of the supplementation effect and whether supplementation affects 25(OH)D seasonality.
Kasedde, Susan; Doyle, Aoife M.; Seeley, Janet A.; David A Ross
This qualitative study examines the role of older people (60 years and above) in fostering decisions for orphans and non-orphans within extended families in a rural Ugandan community heavily affected by HIV. Fieldwork conducted in 2006 provided information on the influence of HIV on fostering decisions through 48 individual in-depth interviews and two group interviews with foster-children and family members to develop detailed case studies related to 13 fostered adolescents. The adolescents i...
Gale, Catharine R.; Rachel Cooper; Leone Craig; Jane Elliott; Diana Kuh; Marcus Richards; Starr, John M; Lawrence J Whalley; Deary, Ian J
Background: poorer cognitive ability in youth is a risk factor for later mental health problems but it is largely unknown whether cognitive ability, in youth or in later life, is predictive of mental wellbeing. The purpose of this study was to investigate whether cognitive ability at age 11 years, cognitive ability in later life, or lifetime cognitive change are associated with mental wellbeing in older people. Methods: we used data on 8191 men and women aged 50 to 87 years from four coho...