WorldWideScience

Sample records for community-based elderly population

  1. Overview of community-based studies of depression screening interventions among the elderly population in Japan.

    Science.gov (United States)

    Sakashita, Tomoe; Oyama, Hirofumi

    2016-01-01

    In most Western and Asian countries, a higher risk of suicide is found among elderly people than those in other age groups. However, the treatment needs of elderly people who are at risk of committing suicide are not well understood. We conducted an overview of studies that assessed the impact of suicide prevention interventions on suicide rates in elderly people in Japan. We interpreted the results of these studies, as well as prominent findings associated with other successful interventions, within a framework of the suicidal process and preventive strategies. We assessed six quasi-experimental studies of community-based interventions providing universal depression screening, subsequent care, and education to elderly people in Japan, and performed a combined analysis of outcome data. Screening interventions were associated with lower suicide rates. We also found a gender difference in the response to subsequent psychiatric or primary care. Two types of interventions decreased the rate of suicide among elderly people: crisis helplines and screening interventions. These interventions featured a close link between universal, selective, and indicated prevention strategies, which reflect different approaches tailored to the size and risk profile of the target individuals. Successful interventions appear to hinge on systematic links between multi-level prevention interventions. Multi-level interventions for depression screening may result in lower suicide rates among elderly individuals in communities, although primary care interventions alone appear to be insufficient in men. The benefit of linked multi-level prevention interventions may highlight the importance of the multiple steps and components of the suicidal process.

  2. Incident chronic kidney disease and newly developed complications related to renal dysfunction in an elderly population during 5 years: a community-based elderly population cohort study.

    Science.gov (United States)

    Ahn, Shin Young; Ryu, Jiwon; Baek, Seon Ha; Kim, Sejoong; Na, Ki Young; Kim, Ki Woong; Chae, Dong-Wan; Chin, Ho Jun

    2013-01-01

    Few studies have evaluated the association between incident chronic kidney disease (CKD) and related complications, especially in elderly population. We attempted to verify the association between GFR and concurrent CKD complications and elucidate the temporal relationship between incident CKD and new CKD complications in a community-based prospective elderly cohort. We analyzed the available data from 984 participants in the Korean Longitudinal Study on Health and Aging. Participants were categorized into 6 groups according to eGFR at baseline examination (≥90, 75-89, 60-74, 45-59, 30-44, and elderly prospective cohort, CKD diagnosed by current criteria is related to an increase in the number of concurrent CKD complications and the development of new CKD complications.

  3. Psychiatric morbidity, quality of life, and perceived social support among elderly population: a community-based study

    Directory of Open Access Journals (Sweden)

    Pallavi Kwan

    2016-01-01

    Full Text Available Background: The growth in the elderly population means an inevitable increase in general physical health, psychobiological and mental health-related problems. Aim of the study: The present study aims to examine psychiatric morbidity, quality of life, and perceived social support among elderly population. Research design: A cross-sectional community-based study was conducted. People in age group of 60 years and above, who were permanent members of their respective households of Ranga Pukri Para and Dekargaon village in Tezpur, Sonitpur district of Assam, were the sample for the present study. One thousand four hundred and ninety adult populations had been identified as sample frame from the electorate list. One hundred and four people of age 60 years and above had been identified from the list for the study purpose. Random sampling method was used for selection of the sample. Semi-structured socio-demographic datasheet, General Health Questionnaire-12 (GHQ-12, CAGE questionnaire, Multidimensional Scale of Perceived Social Support, and World Health Organization Quality of Life (WHOQOL-BREF scale were administered to the respondents. Results: Based on the GHQ-12 score, it was found that 24% of the respondents showed an indication of mental health problems and from the CAGE score, it indicated that 13% of the respondents were found to be misusing or was in dependence in alcohol. The result from the present study indicated that elderly population was getting more family social support, followed by friends and from significant others. The result indicated that the mean score was low in the domain of social relationships. Environment domain was high followed by physical health and psychological domains of WHOQOL-BREF. Conclusion: In the elderly population, overall health can be influenced by multiple factors, including a person’s physical, psychological, behavioural, and social factors. The mental health professionals can provide resources, services

  4. Incident chronic kidney disease and newly developed complications related to renal dysfunction in an elderly population during 5 years: a community-based elderly population cohort study.

    Directory of Open Access Journals (Sweden)

    Shin Young Ahn

    Full Text Available BACKGROUND: Few studies have evaluated the association between incident chronic kidney disease (CKD and related complications, especially in elderly population. We attempted to verify the association between GFR and concurrent CKD complications and elucidate the temporal relationship between incident CKD and new CKD complications in a community-based prospective elderly cohort. METHOD: We analyzed the available data from 984 participants in the Korean Longitudinal Study on Health and Aging. Participants were categorized into 6 groups according to eGFR at baseline examination (≥90, 75-89, 60-74, 45-59, 30-44, and <30 ml/min/1.73 m(2. RESULT: The mean age of study population was 76 ± 9.1 years and mean eGFR was 72.3 ± 17.0 ml/min/1.73 m(2. Compared to eGFR group 1, the odds ratio (OR for hypertension was 2.363 (95% CI, 1.299-4.298 in group 4, 5.191 (2.074-12.995 in group 5, and 13.675 (1.611-115.806 in group 6; for anemia, 7.842 (2.265-27.153 in group 5 and 13.019 (2.920-58.047 in group 6; for acidosis, 69.580 (6.770-715.147 in group 6; and for hyperkalemia, 19.177 (1.798-204.474 in group 6. Over a 5-year observational period, CKD developed in 34 (9.6% among 354 participants with GFR ≥ 60 ml/min/1.73 m(2 at basal examination. The estimated mean number of new complications according to analysis of co-variance was 0.52 (95% CI, 0.35-0.68 in subjects with incident CKD and 0.24 (0.19-0.29 in subjects without CKD (p = 0.002. Subjects with incident CKD had a 2.792-fold higher risk of developing new CKD complications. A GFR level of 52.4 ml/min/1.73 m(2 (p = 0.032 predicted the development of a new CKD complication with a 90% sensitivity. CONCLUSION: In an elderly prospective cohort, CKD diagnosed by current criteria is related to an increase in the number of concurrent CKD complications and the development of new CKD complications.

  5. Successful collection of stool samples for microbiome analyses from a large community-based population of elderly men

    Directory of Open Access Journals (Sweden)

    Melanie Abrahamson

    2017-09-01

    Full Text Available The relationship of the gastrointestinal microbiome to health and disease is of major research interest, including the effects of the gut microbiota on age related conditions. Here we report on the outcome of a project to collect stool samples on a large number of community dwelling elderly men using the OMNIgene-GUT stool/feces collection kit (OMR-200, DNA Genotek, Ottawa, Canada. Among 1328 men who were eligible for stool collection, 982 (74% agreed to participate and 951 submitted samples. The collection process was reported to be acceptable, almost all samples obtained were adequate, the process of sample handling by mail was uniformly successful. The DNA obtained provided excellent results in microbiome analyses, yielding an abundance of species and a diversity of taxa as would be predicted. Our results suggest that population studies of older participants involving remote stool sample collection are feasible. These approaches would allow large scale research projects of the association of the gut microbiota with important clinical outcomes.

  6. Risk factors for falls among elderly: A community-based study

    OpenAIRE

    Savita S Patil; S P Suryanarayana; Rajaram Dinesh; N S Shivraj; N S Murthy

    2015-01-01

    Context: Majority of falls are multifactorial and results from a complex interplay of predisposing and precipitating factors. Falls and their sequelae are potentially preventable. Aims: To determine the risk factors for falls among the elderly. Settings and Design: A community-based cross-sectional study in urban part of Bengaluru. Subjects and Methods: Study conducted for a period of 1-year, among elderly population 60 years and above, were residents since 1-year. Complete enumeration by cen...

  7. HEALTH STATUS OF ELDERLY A COMMUNITY BASED STUDY

    Directory of Open Access Journals (Sweden)

    Vartika Saxena

    2013-01-01

    Full Text Available Background: People at or over the age of 60, constitute above 7.7% of total population. Traditionally this segment of population depends on their children for their health and social welfare, However owing to the social and cultural changes that are taking place within the Indian society, this support may not be as readily available, as it is believed. With the changing demography of India, there is urgent need to look at the health status of elderly for planning appropriate health facilities for them. Objectives: To study biosocial, nutritional and chronic disease risk factor profile of elderly population. Methods: Cross-sectional Study was conducted in Doiwala block of Dehradun district, Uttarakhand. 122 elderly persons of age 60 years and above were interviewed on predesigned questionnaire by house to house visit in the selected village. Results: Overall prevalence of risk factors found to be higher amongst elderly females. Unutrition was higher amongst elderly males. In all, 48.6% elderly were underweight ,10.3% were overweight and 5.6% cases were in obese category. As per the Waist and hip ratio 47.2% elderly belonged to the moderate to high risk category. 30.8% people were hypertensive. Conclusions: Prevalence of high-risk factors for chronic diseases is quite high amongst elderly population, especially amongst elderly females.

  8. Physical activity in daily life in physically independent elderly participating in community-based exercise program.

    Science.gov (United States)

    Hernandes, Nidia A; Probst, Vanessa S; Da Silva, Rubens A; Januário, Renata S B; Pitta, Fabio; Teixeira, Denilson C

    2013-01-01

    It is unclear whether participation in exercise programs specifically developed for elderly translates into a more active lifestyle. To compare the objectively measured level of physical activity in daily life (PADL) between physically independent elderly who participate or do not participate in community-based exercise programs; and to evaluate which factors are associated with the higher level of PADL in these subjects. 134 elderly participants in community-based exercise programs (PG) and 104 non-participants (NPG) had their level of PADL measured using pedometers during 7 days. 6-minute walking test (6MWT), incremental shuttle walking test (ISWT), muscle strength, flexibility and balance. The PG had higher 1-week mean daily step count than NPG (8314 [IQR 5971-10060] vs. 6250 [IQR 4346-8207] steps/day, pphysically active subjects (>8000 steps/day) in PG than in NPG (37% vs. 16%, respectively; pdaily steps count (model r(2)=0.56, pphysically independent elderly, a higher level of physical activity in daily life occurs in those who participate in community-based exercise programs, regardless of the weekday and including non-program days. Participation of elderly in community-based exercise programs should be more systematically available and encouraged due to its close link to higher activity levels and better exercise capacity.

  9. Outcomes of Community-Based Screening for Depression and Suicide Prevention among Japanese Elders

    Science.gov (United States)

    Oyama, Hirofumi; Fujita, Motoi; Goto, Masahiro; Shibuya, Hiroshi; Sakashita, Tomoe

    2006-01-01

    Purpose: In this study we evaluate outcomes of a community-based program to prevent suicide among elderly individuals aged 65 and older. Design and Methods: We used a quasi-experimental design with intervention and referent municipalities. The program included a 7-year implementation of depression screening with follow-up by general practitioners…

  10. Association between renal function and cardiovascular and all-cause mortality in the community-based elderly population: results from the Specific Health Check and Guidance Program in Japan.

    Science.gov (United States)

    Kon, Soichiro; Konta, Tsuneo; Ichikawa, Kazunobu; Asahi, Koichi; Yamagata, Kunihiro; Fujimoto, Shouichi; Tsuruya, Kazuhiko; Narita, Ichiei; Kasahara, Masato; Shibagaki, Yugo; Iseki, Kunitoshi; Moriyama, Toshiki; Kondo, Masahide; Watanabe, Tsuyoshi

    2017-07-25

    Chronic kidney disease is a significant risk factor for end-stage kidney disease, cardiovascular events, and premature death. However, the prognostic value of low estimated glomerular filtration rate (eGFR) in the elderly is debatable. We determined eGFR using the Japanese equation in 132,160 elderly subjects (65-75 years) who attended the special health checkup (Tokutei-Kenshin) in 2008 and investigated the association between baseline eGFR and 5-year all-cause and cardiovascular mortality. The median (SD) eGFR was 70.5 ± 15.3 mL/min/1.73 m(2). During follow-up, we noted 2045 all-cause deaths including 408 from cardiovascular events. A J-shaped curve was obtained when all-cause and cardiovascular mortality rates were compared with decreases in eGFR, with the highest mortality observed for eGFR cardiovascular mortality than those with eGFR >90 mL/min/1.73 m(2) [hazard ratio (HR) 1.43, 95% confidence interval (CI) 1.06-1.91 for all-cause mortality, HR 2.28, 95% CI 1.28-4.03 for cardiovascular mortality]. Sex-based subgroup analyses showed similar results for both men and women. We conclude that eGFR cardiovascular mortality in the elderly population.

  11. C-reactive protein (CRP) is a predictor of high medical-care expenditures in a community-based elderly population aged 70 years and over: the Tsurugaya project.

    Science.gov (United States)

    Niu, Kaijun; Hozawa, Atsushi; Guo, Hui; Ohmori-Matsuda, Kaori; Cui, Yufei; Ebihara, Satoru; Nakaya, Naoki; Kuriyama, Shinichi; Tsuboya, Toru; Kakizaki, Masako; Ohrui, Takashi; Arai, Hiroyuki; Tsuji, Ichiro; Nagatomi, Ryoichi

    2012-01-01

    Because CRP is a strong independent predictor of various diseases, it was hypothesized that CRP may be a useful predictor or treatment target for medical-care expenditures. The aim of this study was to investigate the relationship between CRP and medical-care expenditures in a community-dwelling elderly population. This prospective cohort study was conducted including 925 Japanese subjects aged ≥70 years. A high-sensitivity CRP assay was used by applying the nephelometric method. Hospitalizations, outpatient visits, and expenditures were ascertained through computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance (NHI) Association. Since medical-care expenditures were not normally distributed, the category of high medical-care expenditures (>75th percentile of medical-care expenditures: inpatient expenditures >$494/month; outpatient expenditure >$522/month; total expenditures >$1103/month) was used to examine the relation of CRP levels with medical-care expenditures. Multiple logistic regression analysis was used to examine the relationship between CRP cutoff points (low concentrations: community-dwelling elderly. Further study is required to clarify whether reducing CRP by intervention is a cost-effective measure. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Relationships of pancreatic beta-cell function with microalbuminuria and glomerular filtration rate in middle-aged and elderly population without type 2 diabetes mellitus: a Chinese community-based analysis.

    Science.gov (United States)

    Fu, Shihui; Zhou, Shanjing; Luo, Leiming; Ye, Ping

    2017-01-01

    Relationships of pancreatic beta-cell function abnormality with microalbuminuria (MA) and glomerular filtration rate (GFR) may differ by age, ethnicity and accompanied diseases. Previous studies were generally conducted in Western adult patients with type 2 diabetes mellitus (T2DM), and it is uncertain whether pancreatic beta-cell function is associated with MA and GFR in Chinese community-dwelling middle-aged and elderly population without T2DM. We therefore examined the relationships of pancreatic beta-cell function with two indices of renal damage, MA and GFR, in Chinese community-dwelling middle-aged and elderly population without T2DM. This analysis focused on 380 Beijing residents older than 45 years who were free of T2DM and completed the evaluation of pancreatic beta-cell function. Median age was 67 (49-80) years. Levels of triglyceride, diastolic blood pressure and homeostasis model assessment-beta (HOMA-beta) index were positively related to urine microalbumin (P0.05 for all). Modeling the pancreatic beta-cell function with different adjusted variables provided the same conclusion of association with MA; beta-cell function was positively associated with MA. Additionally, there was a specific difference in the adjusted associations of pancreatic beta-cell function with MA and GFR <60 mL/min/1.73 m2; beta-cell function was not independently associated with GFR <60 mL/min/1.73 m2. This result indicated that abnormal pancreatic beta-cell function plays an important role in the development of MA.

  13. The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

    Directory of Open Access Journals (Sweden)

    Chao Jianqian

    2012-12-01

    Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

  14. A prospective, community-based study on virologic assessment among elderly people with and without symptoms of acute respiratory infection

    NARCIS (Netherlands)

    Graat, J.M.; Schouten, E.G.; Heijnen, M.L.; Kok, F.J.; Pallast, E.G.; Greeff, de S.C.; Dorigo-Zetsma, J.W.

    2003-01-01

    Background and Objective: Community-based elderly studies concerning microbiology of acute respiratory infections are scarce. Data on subclinical infections are even totally absent, although asymptomatic persons might act as a source of respiratory infections. Methods: In a 1-year community-based

  15. The use of community-based social services by elderly people at risk of institutionalization: An evaluation

    NARCIS (Netherlands)

    van Bilsen, P.M.A.; Hamers, J.P.H.; Groot, W.; Spreeuwenberg, C.

    2008-01-01

    Objective: To examine the use of community-based social services by elderly people at risk of institutionalization, who prefer to remain at home. Methods: A study with a longitudinal design (measurements at two points in time) was conducted. Results: One hundred and thirty-four elderly people (mean

  16. Establishing community-based integrated care for elderly patients through interprofessional teamwork: a qualitative analysis

    Science.gov (United States)

    Asakawa, Tomohiro; Kawabata, Hidenobu; Kisa, Kengo; Terashita, Takayoshi; Murakami, Manabu; Otaki, Junji

    2017-01-01

    Background Working in multidisciplinary teams is indispensable for ensuring high-quality care for elderly people in Japan’s rapidly aging society. However, health professionals often experience difficulty collaborating in practice because of their different educational backgrounds, ideas, and the roles of each profession. In this qualitative descriptive study, we reveal how to build interdisciplinary collaboration in multidisciplinary teams. Methods Semi-structured interviews were conducted with a total of 26 medical professionals, including physicians, nurses, public health nurses, medical social workers, and clerical personnel. Each participant worked as a team member of community-based integrated care. The central topic of the interviews was what the participants needed to establish collaboration during the care of elderly residents. Each interview lasted for about 60 minutes. All the interviews were recorded, transcribed verbatim, and subjected to content analysis. Results The analysis yielded the following three categories concerning the necessary elements of building collaboration: 1) two types of meeting configuration; 2) building good communication; and 3) effective leadership. The two meetings described in the first category – “community care meetings” and “individual care meetings” – were aimed at bringing together the disciplines and discussing individual cases, respectively. Building good communication referred to the activities that help professionals understand each other’s ideas and roles within community-based integrated care. Effective leadership referred to the presence of two distinctive human resources that could coordinate disciplines and move the team forward to achieve goals. Conclusion Taken together, our results indicate that these three factors are important for establishing collaborative medical teams according to health professionals. Regular meetings and good communication facilitated by effective leadership can promote

  17. Evaluating a community-based participatory research project for elderly mental healthcare in rural America

    Directory of Open Access Journals (Sweden)

    Dean Blevins

    2008-09-01

    Full Text Available Dean Blevins1,2,3, Bridget Morton4, Rene McGovern5,61South Central Mental Illness Research, Education, and Clinical Center (SC-MIRECC, Central Arkansas Veterans Healthcare System; 2University of Arkansas for Medical Sciences; 3University of Phoenix, Little Rock Campus, Little Rock, AR; 4Northeast Missouri Health Network, Kirksville, MO; 5A.T. Still University/Kirksville College of Osteopathic Medicine, Kirksville, MO; 6Case Western Reserve University, Cleveland, OHAbstract: The purpose of this evaluation was to explore the collaborative nature of partners in a rural mental health program for the elderly, and to test an adapted method of assessing the collaborative process. Sixteen collaborative partners were interviewed to explore ratings of collaboration across 6 domains identified as critical to participatory research. Results indicate that the context of rural Missouri and uniqueness of the program necessitated an approach to collaboration that began with a top-down approach, but greater community responsibility developed over time. Partners recognized the efforts of the program’s directors to seek input. Most were satisfied with their roles and the degree of success achieved by the program, although several wanted to have more input in the future in some domains, but not in others. Interviews revealed numerous barriers to achieving sustainability. Methods to improve the assessment of collaboration are discussed and areas for improvement are offered.Keywords: community-based participatory research, elderly, mental health, older adults, rural

  18. Effectiveness of comprehensive social support interventions among elderly patients with tuberculosis in communities in China: a community-based trial.

    Science.gov (United States)

    Li, Xuhui; Wang, Bin; Tan, Dixin; Li, Mengyu; Zhang, Dandan; Tang, Cong; Cai, Xiaonan; Yan, Yaqiong; Zhang, Sheng; Jin, Bo; Yu, Songlin; Liang, Xunchang; Chu, Qian; Xu, Yihua

    2018-01-19

    With the increasing of ageing population, tuberculosis in the elderly brings a challenge for the tuberculosis (TB) control in China. Enough social support can promote the treatment adherence and outcome of the elderly patients with TB. Exploring effective interventions to improve the social support of patients is of great significance for TB management and control. A community-based, repeated measurement trial was conducted. Patients with TB >65 years of age were allocated into the intervention or control group. Patients in the intervention group received comprehensive social support interventions, while those in the control group received health education alone. The social support level of patients was measured at baseline and at the first, third and sixth months during the intervention to assess the effectiveness of comprehensive social support interventions. A total of 201 patients were recruited into the study. Compared with the control group, social support for patients in the intervention group increased significantly over time (β group*time =0.61, P<0.01) in the following three dimensions: objective support (β group*time =0.15, P<0.05), subjective support (β group*time =0.32, P<0.05) and support utilisation (β group*time =0.16, P<0.05). The change in the scores in the control group was not statistically significant. The intervention programme in communities, including health education, psychotherapy and family and community support interventions, can improve the social support for elderly patients with TB compared with single health education. ChiCTR-IOR-16009232. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. A community-based cross-sectional study of fatigue in middle-aged and elderly women.

    Science.gov (United States)

    Jing, Meng-Juan; Wang, Jia-Ji; Lin, Wei-Quan; Lei, Yi-Xiong; Wang, Pei-Xi

    2015-10-01

    Fatigue has been widely studied in the general population; however, limited studies have investigated it in the female population. The objectives of this community-based study were to (1) investigate the prevalence of fatigue, (2) explore the relationship between gynecological history and experiences of fatigue, and (3) identify risk factors for fatigue in middle-aged and elderly women. Based on a cross-sectional health study that employed a multi-instrument questionnaire, 1272 women aged 45years or older dwelling in the community were included. The Chinese version of Chalder Fatigue Scale (CFS) was used to assess fatigue, and socio-demographic, health-related, and gynecological data were also collected. Fatigue was defined as a total CFS score≥4. The prevalence of fatigue among women aged over 45years was 33.9%. Multivariate logistic regression analysis identified that older age, single marital status, lower education level, the presence of chronic diseases, underweight, hospitalization in the last year, postmenopause, and a higher number of live births were associated with an increased risk of fatigue (Pelderly females. Being postmenopausal and having more than three live births were the particular gynecological factors contributing to fatigue in the general population. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Establishing community-based integrated care for elderly patients through interprofessional teamwork: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Asakawa T

    2017-10-01

    Full Text Available Tomohiro Asakawa,1 Hidenobu Kawabata,1 Kengo Kisa,2 Takayoshi Terashita,3 Manabu Murakami,4 Junji Otaki1 1Department of Medical Education and General Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, 2Kutchan-Kosei General Hospital, Kutchan, Hokkaido, 3Graduate School of Radiological Technology Gunma Prefectural College of Health Sciences, Kamioki-machi, Maebashi, Gunma, 4International Relations Office, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan Background: Working in multidisciplinary teams is indispensable for ensuring high-quality care for elderly people in Japan’s rapidly aging society. However, health professionals often experience difficulty collaborating in practice because of their different educational backgrounds, ideas, and the roles of each profession. In this qualitative descriptive study, we reveal how to build interdisciplinary collaboration in multidisciplinary teams. Methods: Semi-structured interviews were conducted with a total of 26 medical professionals, including physicians, nurses, public health nurses, medical social workers, and clerical personnel. Each participant worked as a team member of community-based integrated care. The central topic of the interviews was what the participants needed to establish collaboration during the care of elderly residents. Each interview lasted for about 60 minutes. All the interviews were recorded, transcribed verbatim, and subjected to content analysis. Results: The analysis yielded the following three categories concerning the necessary elements of building collaboration: 1 two types of meeting configuration; 2 building good communication; and 3 effective leadership. The two meetings described in the first category – “community care meetings” and “individual care meetings” – were aimed at bringing together the disciplines and discussing individual cases, respectively. Building good communication referred to the activities

  1. Community-based health efforts for the prevention of falls in the elderly.

    LENUS (Irish Health Repository)

    Hanley, Alan

    2012-01-31

    Falls are a major public health problem in the elderly population. The associated health care cost is great. It has therefore become an important public health matter to evaluate those interventions that might be effective in reducing the risk of falls. Risk factors that predict an increased risk of falling are described. We discuss interventions that can be employed in the community to reduce the risk of falls and associated injuries by discipline, including physiotherapy, occupational therapy, and physician-led interventions. We also discuss the cost-effectiveness of such interventions.

  2. Research on a community-based platform for promoting health and physical fitness in the elderly community.

    Directory of Open Access Journals (Sweden)

    Tsai-Hsuan Tsai

    Full Text Available This study aims to assess the acceptability of a fitness testing platform (iFit for installation in an assisted living community with the aim of promoting fitness and slowing the onset of frailty. The iFit platform develops a means of testing Bureau of Health Promotion mandated health assessment items for the elderly (including flexibility tests, grip strength tests, balance tests, and reaction time tests and integrates wireless remote sensors in a game-like environment to capture and store subject response data, thus providing individuals in elderly care contexts with a greater awareness of their own physical condition. In this study, we specifically evaluated the users' intention of using the iFit using a technology acceptance model (TAM. A total of 101 elderly subjects (27 males and 74 females were recruited. A survey was conducted to measure technology acceptance, to verify that the platform could be used as intended to promote fitness among the elderly. Results indicate that perceived usefulness, perceived ease of use and usage attitude positively impact behavioral intention to use the platform. The iFit platform can offer user-friendly solutions for a community-based fitness care and monitoring of elderly subjects. In summary, iFit was determined by three key drivers and discussed as follows: risk factors among the frail elderly, mechanism for slowing the advance frailty, and technology acceptance and support for promoting physical fitness.

  3. Recruitment Strategies and Costs Associated with Community-Based Research in a Mexican-Origin Population

    Science.gov (United States)

    Mendez-Luck, Carolyn A.; Trejo, Laura; Miranda, Jeanne; Jimenez, Elizabeth; Quiter, Elaine S.; Mangione, Carol M.

    2011-01-01

    Purpose: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic-community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study…

  4. Depression and Associated Factors in the Elderly Cadres in Fuzhou, China: A Community-based Study

    Directory of Open Access Journals (Sweden)

    Lan Cong

    2015-03-01

    Conclusion: Depression is common among Chinese elderly cadres. Our results confirmed that late-life depression remains complex, and lack of social engagement and low family support were associated with increased risk of GD.

  5. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan

    Directory of Open Access Journals (Sweden)

    Olivares-Tirado Pedro

    2012-08-01

    Full Text Available Abstract Background Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI, making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals. In Japan, many studies regarding factors associated with LTC service utilization have been conducted, however, limited evidence about the effect of LTC services on the progression of recipient disability is available. Methods Data were obtained from databases of the LTC insurer of City A. To examine the effect of in-home and community-based services on disability status of recipients, a survival analysis in a cohort of moderately disabled elderly people, was conducted. Results The mean age of participants was 81 years old, and females represented 69% of the participants. A decline or an improvement in functional status, was observed in 43% and 27% of the sample, respectively. After controlling for other variables, women had a significantly greater probability of improving their functional status during all phases of the observation period. The use of “one service” and the amount of services utilized (days/month, were marginally (p =  Conclusions The observed effects of in-home and community-based services on disability transition status were considered fairly modest and weak, in terms of their ability to improve or to prevent a decline in functional status. We suggest two mechanisms to explain these findings. First, disability transition as a measure of disability progression may not be specific enough to assess

  6. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan.

    Science.gov (United States)

    Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo

    2012-08-04

    Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals. In Japan, many studies regarding factors associated with LTC service utilization have been conducted, however, limited evidence about the effect of LTC services on the progression of recipient disability is available. Data were obtained from databases of the LTC insurer of City A. To examine the effect of in-home and community-based services on disability status of recipients, a survival analysis in a cohort of moderately disabled elderly people, was conducted. The mean age of participants was 81 years old, and females represented 69% of the participants. A decline or an improvement in functional status, was observed in 43% and 27% of the sample, respectively. After controlling for other variables, women had a significantly greater probability of improving their functional status during all phases of the observation period. The use of "one service" and the amount of services utilized (days/month), were marginally (p = functional status at 12 months into the observation period. The observed effects of in-home and community-based services on disability transition status were considered fairly modest and weak, in terms of their ability to improve or to prevent a decline in functional status. We suggest two mechanisms to explain these findings. First, disability transition as a measure of disability progression may not be specific enough to assess changes in functional

  7. [Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people].

    Science.gov (United States)

    Bae, Jeongyee; Cho, Seong Il

    2014-12-01

    The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program. Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

  8. Blood pressure and mortality in elderly people aged 85 and older: Community based study

    NARCIS (Netherlands)

    Boshuizen, H.C.; Izaks, G.J.; Buuren, S. van; Ligthart, G.J.

    1998-01-01

    Objective: To determine whether the inverse relation between blood pressure and all cause mortality in elderly people over 85 years of age can be explained by adjusting for health status, and to determine whether high blood pressure is a risk factor for mortality when the effects of poor health are

  9. Recruitment Strategies and Costs Associated With Community-Based Research in a Mexican-Origin Population

    OpenAIRE

    Mendez-Luck, Carolyn A.; Trejo, Laura; Miranda, Jeanne; Jimenez, Elizabeth; Quiter, Elaine S; Mangione, Carol M.

    2011-01-01

    Purpose: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic–community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study methodology to categorize recruitment methods, examine community partnerships, and calculate study costs. Results: We employed several recruitment methods to...

  10. Recruitment strategies and costs associated with community-based research in a Mexican-origin population

    OpenAIRE

    Mendez-Luck, CA; Trejo, L.; Miranda, J; Jimenez, E.; Quiter, ES; Mangione, CM

    2011-01-01

    Purpose: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic-community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study methodology to categorize recruitment methods, examine community partnerships, and calculate study costs.Results: We employed several recruitment methods to ...

  11. Strategies to enhance participant recruitment and retention in research involving a community-based population

    OpenAIRE

    McCullagh, Marjorie C.; Sanon, Marie-Anne; Cohen, Michael A

    2014-01-01

    Challenges associated with recruiting and retaining community-based populations in research studies have been recognized yet remain of major concern for researchers. There is a need for exchange of recruitment and retention techniques that inform recruitment and retention strategies. Here, the authors discuss a variety of methods that were successful in exceeding target recruitment and retention goals in a randomized clinical trial of hearing protector use among farm operators. Recruitment an...

  12. Advancing community-based research with urban American Indian populations: multidisciplinary perspectives.

    Science.gov (United States)

    Hartmann, William E; Wendt, Dennis C; Saftner, Melissa A; Marcus, John; Momper, Sandra L

    2014-09-01

    The US has witnessed significant growth among urban American Indian (AI) populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations.

  13. Evaluating a community-based participatory research project for elderly mental healthcare in rural America.

    Science.gov (United States)

    Blevins, Dean; Morton, Bridget; McGovern, Rene

    2008-01-01

    The purpose of this evaluation was to explore the collaborative nature of partners in a rural mental health program for the elderly, and to test an adapted method of assessing the collaborative process. Sixteen collaborative partners were interviewed to explore ratings of collaboration across 6 domains identified as critical to participatory research. Results indicate that the context of rural Missouri and uniqueness of the program necessitated an approach to collaboration that began with a top-down approach, but greater community responsibility developed over time. Partners recognized the efforts of the program's directors to seek input. Most were satisfied with their roles and the degree of success achieved by the program, although several wanted to have more input in the future in some domains, but not in others. Interviews revealed numerous barriers to achieving sustainability. Methods to improve the assessment of collaboration are discussed and areas for improvement are offered.

  14. Fall risk in an active elderly population

    DEFF Research Database (Denmark)

    Læssøe, Uffe; Hoeck, Hans C.; Simonsen, Ole

    2007-01-01

    BACKGROUND: Falls amongst elderly people are often associated with fractures. Training of balance and physical performance can reduce fall risk; however, it remains a challenge to identify individuals at increased risk of falling to whom this training should be offered. It is believed that fall...... risk can be assessed by testing balance performance. In this study a test battery of physiological parameters related to balance and falls was designed to address fall risk in a community dwelling elderly population. RESULTS: Ninety-four elderly males and females between 70 and 80 years of age were...... of community dwelling elderly. Falling is a complex phenomenon of multifactorial origin. The crucial factor in relation to fall risk is the redundancy of balance capacity against the balance demands of the individuals levels of fall-risky lifestyle and behavior. This calls for an approach to fall risk...

  15. Effects of a community-based salt reduction program in a regional Australian population.

    Science.gov (United States)

    Land, Mary-Anne; Wu, Jason H Y; Selwyn, Adriana; Crino, Michelle; Woodward, Mark; Chalmers, John; Webster, Jacqui; Nowson, Caryl; Jeffery, Paul; Smith, Wayne; Flood, Victoria; Neal, Bruce

    2016-05-11

    Salt reduction is a public health priority but there are few studies testing the efficacy of plausible salt reduction programs. A multi-faceted, community-based salt reduction program using the Communication for Behavioral Impact framework was implemented in Lithgow, Australia. Single 24-h urine samples were obtained from 419 individuals at baseline (2011) and from 572 at follow-up (2014). Information about knowledge and behaviors relating to salt was also collected. Survey participants were on average 56 years old and 58 % female. Mean salt intake estimated from 24-h urine samples fell from 8.8 g/day (SD = 3.6 g/day) in 2011 to 8.0 (3.6) g/day in 2014 (-0.80, 95 % confidence interval -1.2 to -0.3;p salt reduction (64 % vs. 78 %; p salt substitute at the end of the intervention period and 90 % had heard about the program. Findings were robust to multivariable adjustment. Implementation of this multi-faceted community-based program was associated with a ~10 % reduction in salt consumption in an Australian regional town. These findings highlight the potential of well-designed health promotion programs to compliment other population-based strategies to bring about much-needed reductions in salt consumption. NCT02105727 .

  16. Strategies to enhance participant recruitment and retention in research involving a community-based population.

    Science.gov (United States)

    McCullagh, Marjorie C; Sanon, Marie-Anne; Cohen, Michael A

    2014-11-01

    Challenges associated with recruiting and retaining community-based populations in research studies have been recognized yet remain of major concern for researchers. There is a need for exchange of recruitment and retention techniques that inform recruitment and retention strategies. Here, the authors discuss a variety of methods that were successful in exceeding target recruitment and retention goals in a randomized clinical trial of hearing protector use among farm operators. Recruitment and retention strategies were 1) based on a philosophy of mutually beneficial engagement in the research process, 2) culturally appropriate, 3) tailored to the unique needs of partnering agencies, and 4) developed and refined in a cyclical and iterative process. Sponsoring organizations are interested in cost-effective recruitment and retention strategies, particularly relating to culturally and ethnically diverse groups. These approaches may result in enhanced subject recruitment and retention, concomitant containment of study costs, and timely accomplishment of study aims. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Fasting time and lipid levels in a community-based population: a cross-sectional study.

    Science.gov (United States)

    Sidhu, Davinder; Naugler, Christopher

    2012-12-10

    Although current guidelines recommend measuring lipid levels in a fasting state, recent studies suggest that nonfasting lipid profiles change minimally in response to food intake and may be superior to fasting levels in predicting adverse cardiovascular outcomes. The objective of this study was to investigate the association between fasting times and lipid levels. Cross-sectional examination of laboratory data, including fasting duration (in hours) and lipid results, was performed over a 6-month period in 2011 in a large community-based cohort. Data were obtained from Calgary Laboratory Services, Calgary, Alberta, Canada, the sole supplier of laboratory services for Calgary and surrounding areas (source population, 1.4 million persons). The main outcome measures were mean levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and triglycerides for fasting intervals from 1 hour to more than 16 hours. After differences in individual ages were controlled for, linear regression models were used to estimate the mean levels of cholesterol subclasses at different fasting times. A total of 209,180 individuals (111,048 females and 98,132 males) were included in the study. The mean levels of total cholesterol and high-density lipoprotein cholesterol differed little among individuals with various fasting times. The mean calculated low-density lipoprotein cholesterol levels showed slightly greater variations of up to 10% among groups of patients with different fasting intervals, and the mean triglyceride levels showed variations of up to 20%. Fasting times showed little association with lipid subclass levels in a community-based population, which suggests that fasting for routine lipid levels is largely unnecessary.

  18. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial.

    Science.gov (United States)

    Clemson, Lindy; Cumming, Robert G; Kendig, Hal; Swann, Megan; Heard, Robert; Taylor, Kirsty

    2004-09-01

    To test whether Stepping On, a multifaceted community-based program using a small-group learning environment, is effective in reducing falls in at-risk people living at home. A randomized trial with subjects followed for 14 months. The interventions were conducted in community venues, with a follow-up home visit. Three hundred ten community residents aged 70 and older who had had a fall in the previous 12 months or were concerned about falling. The Stepping On program aims to improve fall self-efficacy, encourage behavioral change, and reduce falls. Key aspects of the program are improving lower-limb balance and strength, improving home and community environmental and behavioral safety, encouraging regular visual screening, making adaptations to low vision, and encouraging medication review. Two-hour sessions were conducted weekly for 7 weeks, with a follow-up occupational therapy home visit. The primary outcome measure was falls, ascertained using a monthly calendar mailed by each participant. The intervention group experienced a 31% reduction in falls (relative risk (RR)=0.69, 95% confidence interval (CI)=0.50-0.96; P=.025). This was a clinically meaningful result demonstrating that the Stepping On program was effective for community-residing elderly people. Secondary analysis of subgroups showed that it was particularly effective for men (n=80; RR=0.32, 95% CI=0.17-0.59). The results of this study renew attention to the idea that cognitive-behavioral learning in a small-group environment can reduce falls. Stepping On offers a successful fall-prevention option. Copyright 2004 American Geriatrics Society

  19. A community based study of NCD risk factors among adult population in Dehradun, India

    Directory of Open Access Journals (Sweden)

    Himanshu Agarwal

    2016-06-01

    Full Text Available Background: A Non-Communicable disease (NCD is one which is non-infectious and non-transmissible among people. NCDs account for leading causes of death and disease burden worldwide. To decrease the burden of NCDs experts stress on the importance of prevention and control with respect to modifiable risk factors. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure and high cholesterol as the most important risk factors for NCDs.(1  Aims & Objectives: 1. To know the prevalence of risk factors leading to NCDs in the study population. 2. To know the socio-demographic correlates associated with risk factors of NCDs. 3. To suggest appropriate recommendations regarding modifiable risk factors of NCDs in study population. Material & Methods: A Cross-sectional study, Community-based study among 18+ population in field practice areas of Community Medicine Department, SGRRIM&HS, Dehradun. Sample Size: 300 each in urban and rural, total 60. Results: The prevalence of Smoking was 11.3%, Smokeless tobacco use 10.5%, Alcohol use 13.2%, Unhealthy diet 99.5%, Low physical activity 0.8%, High BMI (≥ 25 kg/m2 51.2%, above normal waist-hip ratio 57.0%, Raised blood pressure 58.5% and raised blood sugar 25.2%. Conclusion: Smoking is significantly associated with age, sex and occupation. Raised blood pressure is significantly associated with age, sex and social class.

  20. A multi-city community based smoking research intervention project in the African-American population.

    Science.gov (United States)

    Darity, William A; Chen, Ted T L; Tuthill, Robert W; Buchanan, David R; Winder, Alvin E; Stanek, Edward; Cernada, George P; Pastides, Harris

    To carry out a community-based research approach to determine the most effective educational interventions to reduce smoking among African-American smokers. The intervention included preparation of the community, planning and developing a model of change, and developing a community-based intervention. The study population consisted of 2,544 randomly selected adult African-American smokers residing in four sites in the northeastern and southeastern parts of the United States. The research design provided a comparison of active intervention sites with passive control sites as well as low income and moderate income areas. Point prevalence of non-smoking at the time of interview; Period prevalence of non-smoking at the time of interview; Period prevalence of quit attempts in the prior six months; Number of smoke-free days in the prior six months; Number of cigarettes smoked daily at the time of interview. Based upon a survey eighteen months after baseline data was collected, all four measures of cigarette smoking behavior showed a strong statistically significant reduction of personal smoking behavior among those receiving active interventions versus the passive group. On the basis of process variable analysis, direct contact with the project staff in the prior six months was significantly higher in the active intervention areas. There was only a small non-significant increase in personal smoking behavior in moderate income groups as opposed to low income groups. An analysis of process variables strongly suggests that, within this African-American Community, "hands on" or "face to face" approaches along with mass media, mailings, and other less personal approaches were more effective in reducing personal smoking behavior than media, mailings, and other impersonal approaches alone addressed to large audiences.

  1. Normal lymphocyte immunophenotype in an elderly population

    Directory of Open Access Journals (Sweden)

    Sâmia Macedo Queiroz Mota Castellão Tavares

    2014-06-01

    Full Text Available OBJECTIVE: The aim of this work was to evaluate the lymphocyte immunophenotype in an elderly population.METHODS: This study enrolled 35 over 60-year-old volunteers and a control group composed of 35 young adults. The study included elderly without diseases that might affect the functioning of the immune system. These individuals were consulted by doctors and after a physical examination, laboratory tests were performed using a Beckman Coulter (r flow cytometer. The GraphPad Prism computer program was employed for statistical analysis with the level of significance being set for p-values <0.05.RESULTS: There is a statistically significant reduction in the number of lymphocytes (CD8 +, CD2 + and CD3 + cells in the elderly compared to young adults. These low rates are explained by changes attributed to aging and may be partly responsible for the reduction in the cellular immune response, lower proliferative activity and the low cytotoxicity of lymphocytes.CONCLUSION: These parameters showed greater impairment of adaptive immunity in the elderly population and can therefore explain the greater fragility of the aged body to developing diseases.

  2. A community based participatory approach to improving health in a Hispanic population

    Directory of Open Access Journals (Sweden)

    Urquieta de Hernandez Brisa

    2011-04-01

    Full Text Available Abstract Background The Charlotte-Mecklenburg region has one of the fastest growing Hispanic communities in the country. This population has experienced disparities in health outcomes and diminished ability to access healthcare services. This city is home to an established practice-based research network (PBRN that includes community representatives, health services researchers, and primary care providers. The aims of this project are: to use key principles of community-based participatory research (CBPR within a practice-based research network (PBRN to identify a single disease or condition that negatively affects the Charlotte Hispanic community; to develop a community-based intervention that positively impacts the chosen condition and improves overall community health; and to disseminate findings to all stakeholders. Methods/design This project is designed as CBPR. The CBPR process creates new social networks and connections between participants that can potentially alter patterns of healthcare utilization and other health-related behaviors. The first step is the development of equitable partnerships between community representatives, providers, and researchers. This process is central to the CBPR process and will occur at three levels -- community members trained as researchers and outreach workers, a community advisory board (CAB, and a community forum. Qualitative data on health issues facing the community -- and possible solutions -- will be collected at all three levels through focus groups, key informant interviews and surveys. The CAB will meet monthly to guide the project and oversee data collection, data analysis, participant recruitment, implementation of the community forum, and intervention deployment. The selection of the health condition and framework for the intervention will occur at the level of a community-wide forum. Outcomes of the study will be measured using indicators developed by the participants as well as geospatial

  3. Trauma Mortality Factors in the Elderly Population

    Directory of Open Access Journals (Sweden)

    Wen-Han Chang

    2008-03-01

    Full Text Available Trauma in the elderly population is frequent and is associated with significant mortality, owing not only to age-related factors, but also those complicated factors relating to lack of physical reserves, the injury severity, preexisting comorbidity, and insufficient ability for systemic compensation. Age-related mortality remains constant in the low to moderately severe injury categories compared with the severely injured groups (injury severity score, ISS, 25 or greater. The age-related insufficient physical reserves for cardiac output leave this group in the state of hypoperfusion, which is hard to identify. The circumstances around metabolic demands and lower maximum heart rate with a higher peripheral vascular resistance make the cardiovascular system reserve unable to respond, which means that a diagnosis of shock is more difficult to establish. Higher ISSs obtained at injury in the elderly population can predict higher mortality better than in younger population, but they have not been as effective in predicting mortality obtained at follow-up of elderly trauma patients compared with those at the time at injury. More aggressive care for the elderly trauma patient has been shown to decrease mortality. Because of the multiple mortality factors, a decision on treatment type following trauma in geriatric patients is unable to be made if the clinician is not alert to the pitfalls which can affect these individuals. Regardless of age or injury severity and with special considerations for those patients who arrive in a moribund condition, geriatric trauma patients should be treated with as much effort as their younger counterparts, that is, aggressively and within a certain time frame. [International Journal of Gerontology 2008; 2(1: 11–17

  4. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing.

    Science.gov (United States)

    Cao, Ruihua; Bai, Yongyi; Xu, Ruyi; Ye, Ping

    2015-01-01

    N-terminal pro-brain natriuretic peptide (NT-proBNP) is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear. This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population. We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21-96 years) from a community-based population in Beijing, People's Republic of China. In patients with high resting heart rate (≥75 beats/min), NT-proBNP was higher than in those having low resting heart rate (heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18-1.51; P=0.011). A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49-2.36; P=0.031); while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage.

  5. Development of a Community-Based Spiritual Life Review Program for Promoting Resilience of Elders Residing in Disaster-Prone Areas

    Directory of Open Access Journals (Sweden)

    Budi Satria

    2012-08-01

    Full Text Available Background: Nowadays disasters are a common occurrence in the world. The elderly are in a vulnerable condition in terms of disasters and need help to recover from the hardship caused if they are caught in such a disaster. Two significant contributors to elderly people having sufficient resilience to be able to deal with such disasters are spiritual support and social support. Purpose: To develop a program specifically for Muslim elderly in Indonesia for promoting resilience. Method: The processes of developing the program were conducted in 2011, and included a critical review of the literature, constructing the elements of the actual program, validating the contents of the program by three experts, revising the program according to the experts‟ suggestions, and finally pilot-tested the final version of the program on a group 12 elders in Banda Aceh, Indonesia. Result: The program protocol established in this program includes five stages: (1 reviewing individual spiritual life experiences using memorable photos; (2 appreciating feelings among group members (3 re-evaluating the participant‟s life by looking to the group‟s album, (4 reconstructing the participants‟ life, and (5 affirming the six spiritual dimensions of the Islamic religion by the religious leader. Keywords: Community-based, spiritual, life review, resilience, elderly, adversity.

  6. Community-based population-level interventions for promoting child oral health.

    Science.gov (United States)

    de Silva, Andrea M; Hegde, Shalika; Akudo Nwagbara, Bridget; Calache, Hanny; Gussy, Mark G; Nasser, Mona; Morrice, Hannah R; Riggs, Elisha; Leong, Pamela M; Meyenn, Lisa K; Yousefi-Nooraie, Reza

    2016-09-15

    Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for

  7. WITHDRAWN: Community-based population-level interventions for promoting child oral health.

    Science.gov (United States)

    de Silva, Andrea M; Hegde, Shalika; Akudo Nwagbara, Bridget; Calache, Hanny; Gussy, Mark G; Nasser, Mona; Morrice, Hannah R; Riggs, Elisha; Leong, Pamela M; Meyenn, Lisa K; Yousefi-Nooraie, Reza

    2016-12-22

    Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for

  8. Prevalence of Dementia and Alzheimer's Disease in a Havana Municipality: A Community-Based Study among Elderly Residents.

    Science.gov (United States)

    Llibre, Juan de Jesús; Fernández, Yuriem; Marcheco, Beatriz; Contreras, Nereyda; López, Ana M; Otero, Marta; Gil, Isis; Guerra, Milagros; García, Milagros; Bayarre, Héctor

    2009-04-01

    Alzheimer's disease, targeting elderly and at-risk populations.

  9. Intergenerational Dialogue Exchange and Action: Introducing a Community-Based Participatory Approach to Connect Youth, Adults and Elders in an Alaskan Native Community

    Directory of Open Access Journals (Sweden)

    Lisa Wexler

    2011-09-01

    Full Text Available The broad goals of the community-based participatory research (CBPR include community engagement, capacity building, developing practical solutions for community concerns and knowledge building. This article describes the data generation and sharing process as it relates to the goals of CBPR and health promotion in an American Indian/Alaska Native communities. The project described herein, “Investigating Inupiaq Cultural Resilience: A Pilot Study, “ achieved these goals in a tribal context by fostering intergenerational dialogue through data collection. The intergenerational exchange served to collect data for a community-based participatory study and provide an opportunity for communication between Elders, adults and youth. By providing an arena for intergenerational sharing, the format encouraged cross-age connections and in doing so, supported, in a broad sense, the transmission of cultural knowledge. The article describes the process and articulates the ways it supports the CBPR goals of engagement, practical relevance, knowledge generation and health promotion.

  10. Association between television viewing and the risk of metabolic syndrome in a community-based population

    Directory of Open Access Journals (Sweden)

    Liu Chiu-Shong

    2008-06-01

    Full Text Available Abstract Background As a result of metabolic syndrome becoming an important issue during recent decades, many studies have explored the risk factors contributing to its development. However, less attention has been paid to the risk associated with sedentary behavior, especially television viewing. This study examined the association between television viewing time and the risk of having metabolic syndrome in a population of Taiwanese subjects. Methods This community-based cross-sectional study included 2,353 subjects (1,144 men and 1,209 women aged 40 and over from October, 2004 to September, 2005. Information about the time spent watching TV was obtained using a self-administered questionnaire. The definition of metabolic syndrome was according to the Third Report of the National Cholesterol Education Program's Adult Treatment Panel modified for Asians. Results Compared to subjects who viewed TV 20 hr/week had a 1.50-fold (95% confidence intervals (CI: 1.10, 2.03 risk for men and a 1.93-fold (95% CI: 1.37, 2.71 risk for women of having metabolic syndrome, after adjusting for physical activity and other covariates. Stratifying by the three categories of total activity levels, TV viewing time > 20 hr/week was found to still hold a significant risk for having metabolic syndrome in the lowest of the three categories of total activity level for men and in all three categories of total activity level for women. Conclusion The findings suggest that TV viewing is an independent risk factor associated with metabolic syndrome in Taiwanese people.

  11. Fasting time and vitamin B12 levels in a community-based population.

    Science.gov (United States)

    Orton, Dennis J; Naugler, Christopher; Sadrzadeh, S M Hossein

    2016-07-01

    Vitamin B12, also known as cobalamin (Cbl), is an essential vitamin that manifests with numerous severe but non-specific symptoms in cases of deficiency. Assessing Cbl status often requires fasting, although this requirement is not standard between institutions. This study evaluated the impact of fasting on Cbl levels in a large community-based cohort in an effort to promote standardization of Cbl testing between sites. Laboratory data for Cbl, fasting time, patient age and sex were obtained from laboratory information service from Calgary Laboratory Services (CLS) for the period of April 2011 to June 2015. CLS is the sole supplier of laboratory services in the Southern Alberta region in Canada (population, approximately 1.4 million). To investigate potential sex-specific effects of fasting on Cbl levels, males and females were analyzed separately using linear regression models. A total of 346,957 individual patient results (196,849 females, 146,085 males) were obtained. The mean plasma Cbl level was 386.5 (±195.6) pmol/L and 412.0 (±220.8) pmol/L for males and females, respectively. Linear regression analysis showed fasting had no significant association with Cbl levels in females; however a statistically significant decrease of 0.9pmol/L/hour fasting (pfasting has the potential to contribute to higher rates of Cbl deficiency in men. Together, these data suggest fasting should be excluded as a requirement for evaluating plasma Cbl. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Correlates of Community-Based Colorectal Cancer Screening in a Rural Population: The Role of Fatalism.

    Science.gov (United States)

    Crosby, Richard A; Collins, Tom

    2017-09-01

    One largely unexplored barrier to colorectal cancer (CRC) screening is fatalistic beliefs about cancer. The purpose of this study was to identify correlates of ever having endoscopy screenings for CRC and to determine whether fatalism plays a unique role. Because evidence suggests that cancer-associated fatalistic beliefs may be particularly common among rural Americans, the study was conducted in a medically underserved area of rural Appalachia.  METHODS: Rural residents (N = 260) between 51 and 75 years of age, from a medically underserved area of Appalachia, Kentucky, were recruited for a cross-sectional study. The outcome measure was assessed by a single item asking whether participants ever had a colonoscopy or flexible sigmoidoscopy. Demographic and health-related correlates of this outcome were selected based on past studies of rural populations. A single item assessed perceptions of fatalism regarding CRC. Age-adjusted analyses of correlates testing significant at the bivariate level were conducted.  RESULTS: The analytic sample was limited to 135 rural residents indicating they had ever had CRC endoscopy and 107 indicating never having endoscopy. In age-adjusted analyses, only the measure of fatalism had a significant association with having endoscopy. Those endorsing the statement pertaining to fatalism were 2.3 times more likely (95% CI = 1.24-4.27, P = .008) than the remainder to indicate never having endoscopy.  CONCLUSIONS: A community-based approach to the promotion of endoscopy for CRC screening could focus on overcoming CRC-associated fatalism, thereby potentially bringing more unscreened people to endoscopy clinics. © 2017 National Rural Health Association.

  13. The ELDER Project: Educational Model and Three-Year Outcomes of a Community-Based Geriatric Education Initiative

    Science.gov (United States)

    Lange, Jean W.; Mager, Diana; Greiner, Philip A.; Saracino, Katherine

    2011-01-01

    The purpose of the ELDER (Expanded Learning and Dedication to Elders in the Region) Project was to address the needs of underserved older adults by providing worksite education to individuals who provide nursing care to older adults in community health centers, home health agencies, and long-term care facilities. Four agencies located in a Health…

  14. Oropharyngeal Dysphagia in a Community-Based Elderly Cohort: the Korean Longitudinal Study on Health and Aging

    Science.gov (United States)

    Yang, Eun Joo; Kim, Mi Hyun; Lim, Jae-young

    2013-01-01

    This study was conducted to investigate the prevalence of dysphagia and evaluated the association of dysphagia and activities of daily living in a geriatric population residing in an independent-living facility in Korea. Korean men and women 65-yr and older living in a single, typical South Korean city (n=415) were enrolled in the Korean Longitudinal Study on Health and Aging study. Dysphagia was assessed using the Standardized Swallowing Assessment. Data were collected on activities of daily living (ADL), instrumental ADL (IADL), and medical history and laboratory. The overall prevalence of dysphagia in the random sample was 33.7% (95% CI, 29.1-38.4), including 39.5% in men and 28.4% in women. The identified risk factors for dysphagia were men (OR, 3.6, P=0.023), history of stroke (OR, 2.7, P=0.042) and presence of major depressive disorder (OR, 3.0, P=0.022). Dysphagia was associated with impairment in IADL domains of preparing meals and taking medicine (P=0.013 and P=0.007, respectively). This is the first published report of the prevalence of dysphagia in older community-dwelling Koreans. Dysphagia is a common problem among elderly people that limits some IADL domains. PMID:24133362

  15. Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

    Science.gov (United States)

    Kim, Jong-Pill; Yang, Jinhyang

    The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Christina Martins Borges Lima

    Full Text Available ABSTRACT Objective: To describe the performance on basic cognitive tasks, instrumental activities of daily living, and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro (Brazil who participated in multiple physical, social, and cognitive activities at government-run community centers. Methods: A total of 264 educated older adults (> 60 years of age of both genders were evaluated by the Brief Cognitive Screening Battery (BCSB, Lawton's and Pfeffer's activities of daily living indexes, and the Geriatric Depressive Scale (GDS . Results: The mean age of the sample was 75.7 years. The participants had a mean of 9.3 years of formal education. With the exception of the Clock Drawing Test (CDT, mean scores on the cognitive tests were consistent with the values in the literature. Only 6.4% of the sample had some kind of dependence for activities of daily living. The results of the Geriatric Depression Scale (GDS-15 indicated mild symptoms of depression in 16.8% of the sample. Conclusion: This study provided important demographic, cognitive, and functional characteristics of a specific community-based sample of elderly adults in Rio de Janeiro, Brazil.

  17. Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil

    Science.gov (United States)

    Lima, Christina Martins Borges; Alves, Heloisa Veiga Dias; Mograbi, Daniel Correa; Pereira, Flávia Furtado; Fernandez, Jesus Landeira; Charchat-Fichman, Helenice

    2017-01-01

    Objective To describe the performance on basic cognitive tasks, instrumental activities of daily living, and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro (Brazil) who participated in multiple physical, social, and cognitive activities at government-run community centers. Methods A total of 264 educated older adults (> 60 years of age of both genders) were evaluated by the Brief Cognitive Screening Battery (BCSB), Lawton's and Pfeffer's activities of daily living indexes, and the Geriatric Depressive Scale (GDS). Results The mean age of the sample was 75.7 years. The participants had a mean of 9.3 years of formal education. With the exception of the Clock Drawing Test (CDT), mean scores on the cognitive tests were consistent with the values in the literature. Only 6.4% of the sample had some kind of dependence for activities of daily living. The results of the Geriatric Depression Scale (GDS-15) indicated mild symptoms of depression in 16.8% of the sample Conclusion This study provided important demographic, cognitive, and functional characteristics of a specific community-based sample of elderly adults in Rio de Janeiro, Brazil. PMID:29213494

  18. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan

    OpenAIRE

    Olivares-Tirado Pedro; Tamiya Nanako; Kashiwagi Masayo

    2012-01-01

    Abstract Background Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the e...

  19. Rhinitis in a community elderly population: relationships with age, atopy, and asthma.

    Science.gov (United States)

    Song, Woo-Jung; Kim, Mi-Yeong; Jo, Eun-Jung; Kim, Min-Hye; Kim, Tae-Hui; Kim, Sae-Hoon; Kim, Ki-Woong; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2013-11-01

    Rhinitis is one of the most frequent medical conditions. However, there is sparse epidemiologic evidence for rhinitis in the elderly population. To investigate the prevalence of rhinitis in elderly adults and its relations to asthma and other comorbidities. A cross-sectional analysis was performed using the baseline dataset of the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort in Korea (≥65 years old). Structured questionnaires were used to define rhinitis, asthma, and comorbidity, and allergen skin prick tests were used to define atopy. Health-related quality of life was assessed by short-form 36 questionnaires. In total, 982 elderly adults (98.2%) were included in the present study. The prevalence of rhinitis was 25.6% and did not decrease until 90 years of age. The prevalence of atopy was 17.2% (18.8% in participants with rhinitis), and atopy did not show a significant association with rhinitis. In multivariate logistic regression analyses, relations between asthma and rhinitis were significant. Among comorbid conditions, none were significantly associated with rhinitis. In the short-form 36 questionnaire analyses, rhinitis was independently related to a decrease in the physical aspects of quality of life. The present study found a high prevalence of nonallergic rhinitis in elderly participants, which was significantly related to asthma and quality of life. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Prevalence and Correlates of Dental Caries in an Elderly Population in Northeast China

    Science.gov (United States)

    Liu, Lu; Zhang, Ying; Wu, Wei; Cheng, Min; Li, Yan; Cheng, Ruibo

    2013-01-01

    Objectives The present study aimed to investigate the prevalence and correlates of dental caries in elderly population in northeast China. Methods A community-based, cross-sectional study among 2376 elderly subjects (age: 65–74 years) from nine urban areas and nine rural areas in three provinces of northeast China was conducted using multistage stratified random sampling per the World Health Organization oral health survey methodology. Decayed-missing-filled teeth (DMFT) and decayed-filled teeth (DFT) indices were used to evaluate the prevalence of dental caries. Face-to-face questionnaire survey on oral health was performed in a randomly selected subset (n = 1197). T test and chi square test were employed to compare groups for continuous and categorical variables, respectively. Multivariate logistic regression was used to estimate odds ratios (ORs) and corresponding confidence intervals (CIs). Results 67.5% of elderly subjects reported dental caries (average DFT = 2.68±3.40), and the prevalence was higher in urban areas (Pcaries accounted for 2.08% with a rate higher in urban areas (Pdental insurance (OR 2.050; 95% CI 1.120–3.754) with dental caries. Conclusions The prevalence of dental caries in the elderly population in northeast China is high. The elderly from urban areas who smoke and who do not have a dental insurance are at a higher risk to develop dental caries. PMID:24260129

  1. Effects of GSTM1/GSTT1 gene polymorphism and fruit & vegetable consumption on antioxidant biomarkers and cognitive function in the elderly: a community based cross-sectional study.

    Science.gov (United States)

    Yuan, Linhong; Ma, Weiwei; Liu, Jinmeng; Meng, Liping; Liu, Jixia; Li, Shuang; Han, Jing; Liu, Quanri; Feng, Lingli; Wang, Chao; Xiao, Rong

    2014-01-01

    It was reported that Glutathione S-transferase (GST) gene polymorphism and fruit and vegetable (FV) intake were associated with body antioxidant capacity. The oxidative/anti-oxidative imbalance played an important role in the pathogenesis of AD. However, the association of GST genotype, dietary FV consumption with body antioxidant biomarkers and cognitive function in the elderly is not clear. The aim of the present study was to determine the association of GST genotype, and dietary FV intake, with antioxidant biomarkers and cognitive function in the elderly. Food frequency questionnaire was used to collect data of dietary FV intakes in 504 community dwelling elderly aged from 55 to 75 years old. GSTM1 and GSTT1 genotypes were determined by using multiple-PCR method. Plasma and erythrocyte antioxidant biomarkers were measured. Cognitive function was measured by using Montreal Cognitive Assessment. Statistical analysis was applied for exploring the association of GST genotype and FV intake with antioxidant biomarkers level and cognitive function in the elderly. Individual GSTM1 or GSTT1 gene deletion affects body antioxidant biomarkers levels, including erythrocyte GST activity, plasma total antioxidant capacity, and glutathione levels. GSTM1and/or GSTT1 gene deletion have no effects on cognitive function in the surveyed participants. The effect of GST genotype on antioxidant biomarkers are FV intake dependent. There is interaction of FV intake and GST genotype on cognitive function in the elderly. GST genotype or daily FV consumption impact body antioxidant biomarkers, but not cognitive function in the elderly. There were combined effects of GST genotype and FV consumption on cognitive function in the elderly population. Large scale perspective population study is required to explore the association of GST genetic polymorphism, FV consumption and antioxidant biomarkers and cognitive function in the elderly.

  2. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing

    Directory of Open Access Journals (Sweden)

    Cao R

    2014-12-01

    Full Text Available Ruihua Cao, Yongyi Bai, Ruyi Xu, Ping Ye Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear.Objective: This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population.Methods: We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21–96 years from a community-based population in Beijing, People’s Republic of China.Results: In patients with high resting heart rate (≥75 beats/min, NT-proBNP was higher than in those having low resting heart rate (<75 beats/min. In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18–1.51; P=0.011. A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49–2.36; P=0.031; while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old.Conclusions: Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage. Keywords: resting heart rate, N-terminal pro-brain natriuretic peptide, epidemiology, cardiac function, relationship

  3. Comparison of sample characteristics in two pregnancy cohorts: community-based versus population-based recruitment methods.

    Science.gov (United States)

    Leung, Brenda My; McDonald, Sheila W; Kaplan, Bonnie J; Giesbrecht, Gerald F; Tough, Suzanne C

    2013-12-06

    One of the biggest challenges for population health studies is the recruitment of participants. Questions that investigators have asked are "who volunteers for studies?" and "does recruitment method influence characteristics of the samples?" The purpose of this paper was to compare sample characteristics of two unrelated pregnancy cohort studies taking place in the same city, in the same time period, that employed different recruitment strategies, as well as to compare the characteristics of both cohorts to provincial and national statistics derived from the Maternity Experiences Survey (MES). One pregnancy cohort used community-based recruitment (e.g. posters, pamphlets, interviews with community media and face-to-face recruitment in maternity clinics); the second pregnancy cohort used both community-based and population-based (a centralized system identifying pregnant women undergoing routine laboratory testing) strategies. The pregnancy cohorts differed in education, income, ethnicity, and foreign-born status (p recruitment of participants will not necessarily result in samples that reflect the general population, but can reflect the target population of interest. Attracting and retaining young, low resource women into urban studies about pregnancy may require alternate and innovative approaches.

  4. Influence of diurnal variation and fasting on serum iron concentrations in a community-based population.

    Science.gov (United States)

    Nguyen, Leonard T; Buse, Joshua D; Baskin, Leland; Sadrzadeh, S M Hossein; Naugler, Christopher

    2017-12-01

    Serum iron is an important clinical test to help identify cases of iron deficiency or overload. Fluctuations caused by diurnal variation and diet are thought to influence test results, which may affect clinical patient management. We examined the impact of these preanalytical factors on iron concentrations in a large community-based cohort. Serum iron concentration, blood collection time, fasting duration, patient age and sex were obtained for community-based clinical testing from the Laboratory Information Service at Calgary Laboratory Services for the period of January 2011 to December 2015. A total of 276,307 individual test results were obtained. Iron levels were relatively high over a long period from 8:00 to 15:00. Mean concentrations were highest at blood collection times of 11:00 for adult men and 12:00 for adult women and children, however iron levels peaked as late as 15:00 in teenagers. With regard to fasting, iron levels required approximately 5h post-prandial time to return to a baseline, except for children and teenage females where no significant variation was seen until after 11h fasting. After 10h fasting, iron concentrations in all patient groups gradually increased to higher levels compared to earlier fasting times. Serum iron concentrations remain reasonably stable during most daytime hours for testing purposes. In adults, blood collection after 5 to 9h fasting provides a representative estimate of a patient's iron levels. For patients who have fasted overnight, i.e. ≥12h fasting, clinicians should be aware that iron concentrations may be elevated beyond otherwise usual levels. Copyright © 2017. Published by Elsevier Inc.

  5. Community mobilization and community-based participatory research to prevent youth violence among Asian and immigrant populations.

    Science.gov (United States)

    Le, Thao N; Arifuku, Isami; Vuong, Linh; Tran, Gianna; Lustig, Deborah F; Zimring, Franklin

    2011-09-01

    Many community mobilization activities for youth violence prevention involve the researchers assisting communities in identifying, adapting, and/or tailoring evidence-based programs to fit the community needs, population, and cultural and social contexts. This article describes a slightly different framework in which the collaborative research/evaluation project emerged from the community mobilization activities. As will be discussed, this collaborative, sustained partnership was possible in the context of the Center on Culture, Immigration and Youth Violence Prevention's (UC Berkeley ACE) community mobilization activities that brought the issue of youth violence, particularly among immigrant and minority populations, to the forefront of many of the community partners' agendas. The East Bay Asian Youth Center (EBAYC) was one of the partners that came to the table, which facilitated the community-based engagement/mobilization. UC Berkeley ACE collaborated with EBAYC to evaluate an after-school program and an alternative probation program serving a diverse youth and immigrant population, including African Americans, Asians, and Hispanics. This article describes UC Berkeley ACE's community mobilization activity and the collaborative partnership with EBAYC, discusses how the evaluations incorporated community-based principles in design and practice, and presents some findings from the evaluations.

  6. Elderly Black Farm Women: A Population at Risk.

    Science.gov (United States)

    Carlton-LaNey, Iris

    1992-01-01

    Elderly black farm women are neglected segment of elderly population. Their self-reliance, mutual support, and rurality have helped keep them isolated and underserved. Ten such women recalled their productive lifestyles in oral-history interviews and described problems faced because of their advancing age, poor health, caregiving responsibilities,…

  7. Prevalence and types of androgenetic alopecia in north Anatolian population: A community-based study.

    Science.gov (United States)

    Bas, Yalcin; Seckin, Havva Yildiz; Kalkan, Göknur; Takci, Zennure; Citil, Riza; Önder, Yalcin; Sahin, Safak; Demir, Ayse Kevser

    2015-08-01

    To determine the prevalence and pattern of androgenetic alopecia in Turkey and to compare the results with different regions. The community-based study was carried out from September 2012 to June 2013 across all the 12 districts of Tokat province of Turkey. Individuals 20-years-old or older were included, and more than two first-degree relatives were excluded. Dermatological examination of all the subjects was performed by dermatologists. The degree of androgenetic alopecia was classified according to the Hamilton-Norwood and Ludwig classifications. Of the 2322 volunteers, 1288(55.46%) were women and 1034(44.53%) were men. Overall mean age was 47.3±15.3 years (range: 20-87 years). Androgenetic alopecia was detected in 740(31.8%) subjects; 247(19.17%) women and 493(47.6%) men. The prevalence of androgenetic alopecia in Turkish society was higher than Asian and African communities; and similar to the rate in European societies hair-loss.

  8. Screening a heterogeneous elderly South African population for ...

    African Journals Online (AJOL)

    Screening a heterogeneous elderly South African population for cognitive impairment: the utility and performance of the Mini-Mental State Examination, Six Item Screener, Subjective Memory Rating Scale and Deterioration Cognitive Observee.

  9. Cranial computed tomography associated with development of functional dependence in a community-based elderly population

    Energy Technology Data Exchange (ETDEWEB)

    Tsukishima, Eri; Shido, Koichi [Hokkaido Univ., Sapporo (Japan). Graduate School of Medicine; Saito, Hiroya [Asahikawa Kosei General Hospital (Japan)] (and others)

    2002-03-01

    The purpose of this study was to investigate whether changes at computed tomography (CT) imaging in the ageing brain are associated with future risks for functional dependence. One hundred sixty residents aged 69 years and older at the cranial CT and were independently living in a rural community in Hokkaido, Japan. Cranial CT was performed between 1991 and 1993, graded for ventricular enlargement, sulcal enlargement, white matter change, and small infarction. Functional status was reassessed in 1998 in each participant. Multiple logistic regression analysis was performed to estimate the association of CT changes in the ageing brain with development of functional dependence over six years. Functional dependence was found in 19 residents at the second survey. After adjusting for age, sex, medical conditions, and cognitive functioning, small infarction and ventricular enlargement were significantly associated with development of functional dependence (adjusted odds ratio=9.27 and 4.62). After controlling for age, the age-related changes on cranial CT have significant association on development of functional dependence. (author)

  10. A COMMUNITY BASED CROSS-SECTIONAL STUDY: INCREASING PREVALENCE OF TYPE 2 DIABETES AMONG RURAL ADULT POPULATION OF KARNATAKA, INDIA

    Directory of Open Access Journals (Sweden)

    Tapas Brata Tripathy

    2013-06-01

    Full Text Available A community based cross-sectional study in the age group 25 years and above conducted at the field area of primary health centre Chakenahalli, Hassan district, Karnataka, India. The population was similar in characteristics regarding occupation, socio-economic status and food habits. Total of 626 subjects were included by multi-stage sampling. Information collected by the interviewers through face to face interview, after informed consent. The individuals were assessed on anthropometric parameters and screening was done by Random Blood Glucose (RBG with a standardized technique; diagnosis of type 2 diabetes done by WHO criteria. Prevalence of diabetes was found in 11.3% males and 15% females, altogether the total prevalence was 13.09% with 8.79% self reported cases of diabetes . Hypertension was associated with 25.6% diabetic subjects. It was also observed that 28.1% of study population had BMI ≥ 25.

  11. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population

    Science.gov (United States)

    Kalichman, Leonid; Kim, David H.; Li, Ling; Guermazi, Ali; Berkin, Valery; Hunter, David J.

    2013-01-01

    Study Design Cross-sectional study. Objectives 1) to determine prevalence rates of spondylolysis, isthmic and degenerative spondylolisthesis in an unselected adult community-based population; 2) to evaluate the association of spondylolysis, isthmic and degenerative spondylolisthesis with low back pain (LBP). Summary of Background Data Spondylolysis and spondylolisthesis are prevalent in the general population; however the relationship between these conditions and LBP is controversial. Methods This study was an ancillary project to the Framingham Heart Study. A sample of 3529 participants of the Framingham Heart Study aged 40–80 years underwent multi-detector CT imaging to assess aortic calcification. 188 individuals were consecutively enrolled in this study to assess radiographic features potentially associated with LBP. The occurrence of LBP in the preceding 12 months was evaluated using a self-report questionnaire. The presence of spondylolysis and spondylolisthesis was characterized by CT imaging. We used multiple logistic regression models to examine the association between spondylolysis, spondylolisthesis and LBP, while adjusting for gender, age and BMI. Results 21 study subjects demonstrated spondylolysis on CT imaging. The male-to-female ratio was approximately 3:1. 21% of subjects with bilateral spondylolytic defects demonstrated no measurable spondylolisthesis. The male-to-female ratio of degenerative spondylolisthesis was 1:3, and the prevalence of degenerative spondylolisthesis increased from the fifth through eight decades of life. 38 subjects (20.4%) reported significant LBP. No significant association was identified between spondylolysis, isthmic spondylolisthesis, or degenerative spondylolisthesis, and the occurrence of LBP. Conclusions Based on CT imaging of an unselected community-based population, the prevalence of lumbar spondylolysis is 11.5%, nearly twice the prevalence of previous plain radiograph-based studies. This study did not reveal a

  12. [Increased physical and intellectual activity and changes in cognitive function in elderly dwellers: lessons from a community-based dementia prevention trial in Suginami Ward, Tokyo].

    Science.gov (United States)

    Taniguchij, Yu; Kousa, Yoko; Shinkai, Shoji; Uematsuj, Shino; Nagasawa, Ayako; Aoki, Masakatsu; Muto, Shin-yo; Abe, Masanobu; Fukaya, Taro; Watanabe, Naoki

    2009-11-01

    This study was conducted to examine the effect of increased physical and/or intellectual activities on changes in cognitive function in elderly dwellers. The subjects comprised 61 residents aged 65 or over living in Suginami Ward, Tokyo, who took part in a community-based dementia prevention class aimed at increasing both physical and intellectual activities. Physical activity was evaluated by the number of daily steps using a pedometer. Intellectual activity was evaluated by the number of pictures taken by a cellular phone and/or submitted through an internet "Dress" system by cellular phone. These activities were classified into two groups (higher and lower activity groups) according to whether above or below the respective median value. For assessment, the subjects underwent tests of physical and cognitive functions before and after the 7-weeks intervention. Subjects with a greater increment in physical activity during the intervention period showed a greater improvement in usual and maximal walking speed than did those with a lesser increment in physical activity. Analysis using the general linear model demonstrated that increase in physical activity independently correlated with improvement in physical function, but did not correlate with cognitive function. Subjects with a greater increment in intellectual activity showed a greater improvement in weight, BMI and trail making test-task B. This association was independent of potential confounders. Further, those who used the "Dress" system more often showed a greater improvement in stress coping tests. Analysis using a general linear model indicated that increased intellectual activity was independently associated with changes in cognitive and mental function. The present findings suggest that community-based dementia prevention classes should be stressed not only for increasing physical activity but also in order to stimulate intellectual activity.

  13. Proteinuria and rate of change in kidney function in a community-based population.

    Science.gov (United States)

    Turin, Tanvir Chowdhury; James, Matthew; Ravani, Pietro; Tonelli, Marcello; Manns, Braden J; Quinn, Robert; Jun, Min; Klarenbach, Scott; Hemmelgarn, Brenda R

    2013-10-01

    Proteinuria identifies patients at risk for adverse clinical outcomes, but it is unclear whether proteinuria correlates with the rate of renal decline. We examined the association between proteinuria and rate of change in estimated GFR (eGFR) in a cohort of 638,150 adults from a province-wide registry in Alberta, Canada, who had a measure of proteinuria and three or more outpatient serum creatinine measurements over a period of ≥1 year. An adjusted sex-specific linear mixed-effects model was used to determine the rate of change in eGFR per year for patients with normal, mild, and heavy proteinuria, stratified by baseline kidney function (eGFR ≥90, 60-89.9, 45-59.9, 30-44.9, and 15-29.9 ml/min per 1.73 m(2)). In men, heavy proteinuria and a baseline eGFR of 45-59.9 ml/min per 1.73 m(2) correlated with a change in eGFR of -2.16 (95% confidence interval [CI], -2.37 to -1.95) ml/min per 1.73 m(2) per year, whereas mild proteinuria and a baseline eGFR of 30-44.9 ml/min per 1.73 m(2) correlated with a change in eGFR of -0.51 (95% CI, -0.70 to -0.32) ml/min per 1.73 m(2) per year. Similar trends were observed for female, elderly, and diabetic patients. Notably, normal protein levels and a lower baseline eGFR (15-29.9 ml/min per 1.73 m(2)) correlated with stable or improved renal function. In conclusion, our results suggest that proteinuria of increasing severity is associated with a faster rate of renal decline, regardless of baseline eGFR, and the combined effect should be considered in patients with CKD.

  14. Age at migration and disability-free life expectancy among the elder Mexican-origin population

    Directory of Open Access Journals (Sweden)

    Marc Garcia

    2016-12-01

    Full Text Available Background: Migration selectivity is thought to shape the health profiles of Mexican immigrants. Objective: This study examines how the experience of Mexican migration to the United States affects the health process and the quality of life in old age by age at migration, specific to sex. Methods: We use 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent disability-free prior to death across eight subgroups by sex, nativity, and age at migration among Mexican-origin elderly in the United States. Results: Female migrants are at a significant disadvantage in terms of IADL disability-free life expectancy relative to US-born women, particularly late-life migrants. Conversely, mid- and late-life male migrants exhibit an advantage in ADL disability-free life expectancy compared to their US-born counterparts. Conclusions: Foreign-born Mexican elders are not a homogeneous group. This issue merits special attention in the development of community-based long-term care programs in order to appropriately target the specific needs of different subgroups of older Mexican individuals entering their last decades of life. Contribution: This study contributes to immigrant health literature by providing a more comprehensive documentation of nativity differentials, by distinguishing subgroups of Mexican elderly by sex, nativity, and age at migration.

  15. Age at migration and disability-free life expectancy among the elder Mexican-origin population.

    Science.gov (United States)

    Garcia, Marc A; Chiu, Chi-Tsun

    2016-01-01

    Migration selectivity is thought to shape the health profiles of Mexican immigrants. This study examines how the experience of Mexican migration to the United States affects the health process and the quality of life in old age by age at migration, specific to sex. We use 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent disability-free prior to death across eight subgroups by sex, nativity, and age at migration among Mexican-origin elderly in the United States. Female migrants are at a significant disadvantage in terms of IADL disability-free life expectancy relative to US-born women, particularly late-life migrants. Conversely, mid- and late-life male migrants exhibit an advantage in ADL disability-free life expectancy compared to their US-born counterparts. Foreign-born Mexican elders are not a homogeneous group. This issue merits special attention in the development of community-based long-term care programs in order to appropriately target the specific needs of different subgroups of older Mexican individuals entering their last decades of life. This study contributes to immigrant health literature by providing a more comprehensive documentation of nativity differentials, by distinguishing subgroups of Mexican elderly by sex, nativity, and age at migration.

  16. Proteinuria and Rate of Change in Kidney Function in a Community-Based Population

    Science.gov (United States)

    Turin, Tanvir Chowdhury; James, Matthew; Ravani, Pietro; Tonelli, Marcello; Manns, Braden J.; Quinn, Robert; Jun, Min; Klarenbach, Scott

    2013-01-01

    Proteinuria identifies patients at risk for adverse clinical outcomes, but it is unclear whether proteinuria correlates with the rate of renal decline. We examined the association between proteinuria and rate of change in estimated GFR (eGFR) in a cohort of 638,150 adults from a province-wide registry in Alberta, Canada, who had a measure of proteinuria and three or more outpatient serum creatinine measurements over a period of ≥1 year. An adjusted sex-specific linear mixed-effects model was used to determine the rate of change in eGFR per year for patients with normal, mild, and heavy proteinuria, stratified by baseline kidney function (eGFR ≥90, 60–89.9, 45–59.9, 30–44.9, and 15–29.9 ml/min per 1.73 m2). In men, heavy proteinuria and a baseline eGFR of 45–59.9 ml/min per 1.73 m2 correlated with a change in eGFR of −2.16 (95% confidence interval [CI], −2.37 to −1.95) ml/min per 1.73 m2 per year, whereas mild proteinuria and a baseline eGFR of 30–44.9 ml/min per 1.73 m2 correlated with a change in eGFR of −0.51 (95% CI, −0.70 to −0.32) ml/min per 1.73 m2 per year. Similar trends were observed for female, elderly, and diabetic patients. Notably, normal protein levels and a lower baseline eGFR (15–29.9 ml/min per 1.73 m2) correlated with stable or improved renal function. In conclusion, our results suggest that proteinuria of increasing severity is associated with a faster rate of renal decline, regardless of baseline eGFR, and the combined effect should be considered in patients with CKD. PMID:23833255

  17. A community-based mixed methods approach to developing behavioural health interventions among indigenous adolescent populations

    NARCIS (Netherlands)

    Tingey, L.L.

    2016-01-01

    Native American and indigenous populations experience the greatest behavioural health disparities in the world. A constellation of factors impacting Native American Tribes contributes to high rates and co-morbidity of mental health disorders, substance use and sexually transmitted infection (STI),

  18. Double burden of malnutrition among elderly population of Delhi

    Directory of Open Access Journals (Sweden)

    Anil Kumar Goswami

    2016-12-01

    Full Text Available Background: Nutritional status is an important determinant for elderly, directly influencing their susceptibility to diseases, adversely affecting their quality of life.  Aim & Objective: To assess the nutritional status of elderly persons aged ≥60 years residing in an urban resettlement colony of Delhi. Materials and Methods: A community-based cross-sectional study was conducted in a resettlement colony in Delhi. Cluster random sampling was used. Three out of ten blocks were selected randomly. All elderly persons present in the selected blocks were included.  Information on socio-demographic variables was collected. Arm span and weight were measured by trained investigators. Data was entered in MS Excel 2007 and analyzed in Stata 11.0. Multiple logistic regression was done to determine the association between nutritional status and socio-demographic variables Results: A total of 711 elderly persons were recruited. About half (53.2% had normal nutritional status, 20.8% were underweight and 19.4% were overweight and 6.6% were obese. Under-nutrition was significantly associated with gender, while overweight/obesity was found to be significantly associated with age (p<0.001, gender (p<0.001, occupation (p<0.001 and economic dependency (p< 0.001. Conclusion: Dual burden of malnutrition was seen, so there is a need to promote healthy eating and lifestyle to address both spectrum of malnutrition.

  19. Outcomes of a community-based weight management programme for morbidly obese populations.

    Science.gov (United States)

    Nield, L; Kelly, S

    2016-12-01

    Morbid obesity is an ongoing concern worldwide. There is a paucity of research reporting primary care outcomes focussed on complex and morbidly obese populations. The National Institute for Health and Care Excellence (NICE) recommends a specialist, multidisciplinary weight management team for the successful management of such populations. This is the first service evaluation reporting both primary (weight change) and secondary [body mass index (BMI), waist circumference, physical activity levels, fruit and vegetable intake, Rosenberg self-esteem score] outcomes in these patients. The present study comprised a prospective observational study of a cohort data set for patients (n = 288) attending their 3-month and 6-month (n = 115) assessment appointments at a specialist community weight management programme. Patients had a mean (SD) initial BMI of 45.5 (6.6) kg m - ²; 66% were females. Over 80% of patients attending the service lost some weight by 3 months. Average absolute weight loss was 4.11 (4.95) kg at 3 months and 6.30 (8.41) kg at 6 months, equating to 3.28% (3.82%) and 4.90% (6.26%), respectively, demonstrating a statistically significant weight change at both time points (P physical activity levels, fruit and vegetable consumption, and self-esteem levels (P < 0.001). This service was successful in aiding weight loss in morbidly obese populations. The findings of the present study support the view that weight-loss targets of 3% are realistic. © 2016 The British Dietetic Association Ltd.

  20. Community-Based Culturally Preferred Physical Activity Intervention Targeting Populations at High Risk for Type 2 Diabetes: Results and Implications.

    Science.gov (United States)

    Rowan, Chip P; Riddell, Michael C; Gledhill, Norman; Jamnik, Veronica K

    2016-12-01

    In Canada, an ageing population, obesity rates and high risk among certain ethnocultural populations are driving diabetes prevalence. Given the burden associated with type 2 diabetes and its link to modifiable risk factors, this study aimed to implement culturally preferred physical activities at the community level, targeting individuals at high risk for type 2 diabetes. Glycated hemoglobin (A1C) levels were used to detect potential improvements in glycemic control. Participants were screened for diabetes risk using a questionnaire and capillary point-of-care A1C blood testing. Participants were offered community-based physical activity classes 2 to 3 times per week for 6 months. A subset of participants (n=84) provided additional measurements. In total, 718 subjects were reached during recruitment. Substantial participant dropout took place, and 487 participants were exposed to the intervention. Among those who participated in the physical activity and provided follow up, mean A1C levels were reduced by 0.17 (p=0.002) after 3 months (n=84) and by 0.06 (p=0.35; n=49) after 6 months. The homeostatic model assessment (HOMA-beta) showed a significant improvement of 23.6% after 3 months (n=20; p=0.03) and 45.2% after 6 months (n=12; p=0.02). Resting systolic blood pressure and diastolic blood pressure plus combined hand-grip strength improved after 6 months (n=12). Implementation of this community-based, culturally preferred physical activity program presented several challenges and was associated with significant participant dropout. After considering participant dropout, the relatively small group who participated and provided follow-up measures showed improvements various physiologic measures. Despite efforts to enhance accessibility, it appears that several barriers to physical activity participation remain and need to be explored to enhance the success of future programs. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights

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

    Directory of Open Access Journals (Sweden)

    Sherin S Paul

    2015-01-01

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

  2. Mortality level and predictors in a rural Ethiopian population: community based longitudinal study.

    Directory of Open Access Journals (Sweden)

    Berhe Weldearegawi

    Full Text Available Over the last fifty years the world has seen enormous decline in mortality rates. However, in low-income countries, where vital registration systems are absent, mortality statistics are not easily available. The recent economic growth of Ethiopia and the parallel large scale healthcare investments make investigating mortality figures worthwhile.Longitudinal health and demographic surveillance data collected from September 11, 2009 to September 10, 2012 were analysed. We computed incidence of mortality, overall and stratified by background variables. Poisson regression was used to test for a linear trend in the standardized mortality rates. Cox-regression analysis was used to identify predictors of mortality. Households located at <2300 meter and ≥ 2300 meter altitude were defined to be midland and highland, respectively.An open cohort, with a baseline population of 66,438 individuals, was followed for three years to generate 194,083 person-years of observation. The crude mortality rate was 4.04 (95% CI: 3.77, 4.34 per 1,000 person-years. During the follow-up period, incidence of mortality significantly declined among under five (P<0.001 and 5-14 years old (P<0.001, whereas it increased among 65 years and above (P<0.001. Adjusted for other covariates, mortality was higher in males (hazard ratio (HR = 1.42, 95% CI: 1.22, 1.66, rural population (HR = 1.74, 95% CI: 1.32, 2.31, highland (HR = 1.20, 95% CI: 1.03, 1.40 and among those widowed (HR = 2.25, 95% CI: 1.81, 2.80 and divorced (HR = 1.80, 95% CI: 1.30, 2.48.Overall mortality rate was low. The level and patterns of mortality indicate changes in the epidemiology of major causes of death. Certain population groups had significantly higher mortality rates and further research is warranted to identify causes of higher mortality in those groups.

  3. Model for teaching population health and community-based care across diverse clinical experiences.

    Science.gov (United States)

    Van Dyk, Elizabeth J; Valentine-Maher, Sarah K; Tracy, Janet P

    2015-02-01

    The pillars constructivist model is designed to offer a unifying clinical paradigm to support consistent learning opportunities across diverse configurations of community and public health clinical sites. Thirty-six students and six faculty members participated in a mixed methods evaluation to assess the model after its inaugural semester of implementation. The evaluation methods included a rating scale that measures the model's ability to provide consistent learning opportunities at both population health and direct care sites, a case study to measure student growth within the five conceptual pillars, and a faculty focus group. Results revealed that the model served as an effective means of clinical education to support the use of multiple, small-scale public health sites. Although measurements of student growth within the pillars are inconclusive, the findings suggest efficacy. The authors recommend the continued use of the pillars constructivist model in baccalaureate programs, with further study of the author-designed evaluation tools. Copyright 2015, SLACK Incorporated.

  4. The profile of spinal injuries in the elderly population

    OpenAIRE

    Teixeira, Glaciéle de Oliveira; Oliveira, Thais Fonseca de; Frison, Verônica Baptista; Resende, Thais de Lima

    2014-01-01

    This retrospective cross-sectional study sought to: describe the profile of the elderly population who suffered spinal injury (SI) between 2005 and 2010 in Porto Alegre (RS), Brazil; compare the trauma mechanism and type of SI prevalence in both sexes; and compare the trauma mechanism in the sample's age groups. To this end, medical records were reviewed for the following data: age, sex, main mechanisms of injury and spinal levels affected. Out of 1.320 records analyzed, 370 belonged to elder...

  5. Eating disorders and their associated risk factors among Iranian population - a community based study.

    Science.gov (United States)

    Garrusi, Behshid; Baneshi, Mohammad Reza

    2012-12-10

    Many socio cultural variables could be affect eating disorders in Asian countries. In Iran, there are few researches regarding eating disorders and their contributing factors. The aim of this study is to explore frequency of eating disorders and their risk factors in an Iranian population. About 1204 participants were selected aged between fourteen to 55 years. Frequency of eating disorders and effects of variables such as demographic characteristics, Body Mass Index (BMI), use of media, body dissatisfaction, self-esteem, social comparison and social pressure for thinness in individuals with and without eating disorders, were assessed. The prevalence of eating disorders was 11.5% that included 0.8% anorexia nervosa, 6.2% full threshold bulimia nervosa, 1.4% sub threshold anorexia nervosa and 30% sub threshold binge eating disorder. Symptoms of bulimic syndrome were greater in males. In Iran, eating disorders and related problems are new issue that could be mentioned seriously The identification of these disorders and their related contributing factors are necessity of management and preventive programs planning.

  6. Normocalcemic Hyperparathyroidism and Hypoparathyroidism in Two Community-Based Nonreferral Populations

    Science.gov (United States)

    Cusano, Natalie E.; Maalouf, Naim M.; Wang, Patty Y.; Zhang, Chiyuan; Cremers, Serge C.; Haney, Elizabeth M.; Bauer, Douglas C.; Orwoll, Eric S.

    2013-01-01

    Context: Normocalcemic primary hyperparathyroidism is typically identified after referral to a specialty clinic. At diagnosis, patients demonstrate features seen in hypercalcemic primary hyperparathyroidism. Normocalcemic hypoparathyroidism has been discovered after hypocalcemia unmasked after bisphosphonate administration. Objective: We hypothesized that screening unselected, nonreferral populations, such as The Osteoporotic Fractures in Men (MrOS) study and Dallas Heart Study (DHS), would identify asymptomatic subjects with normocalcemic hyperparathyroidism and hypoparathyroidism. Methods: Normocalcemic hyperparathyroidism was defined as serum PTH greater than the upper reference range with normal albumin-adjusted serum calcium, excluding common secondary causes (renal failure [estimated glomerular filtration rate hyperparathyroidism (prevalence 0.4%) and 26 with normocalcemic hypoparathyroidism (1.1%). In 3450 men and women from DHS, we identified 108 with normocalcemic hyperparathyroidism (3.1%) and 68 with normocalcemic hypoparathyroidism (1.9%). Of the 108 normocalcemic hyperparathyroid subjects, 64 had follow-up data. Hypercalcemic primary hyperparathyroidism developed in 1 subject whereas 13 (0.6% of the follow-up cohort) showed persistently elevated PTH levels with normocalcemia. Of the 26 normocalcemic hypoparathyroid subjects with follow-up data, none developed overt hypoparathyroidism and 2 (0.09%) had persistent evidence of normocalcemic hypoparathyroidism. Conclusions: This study documents normocalcemic primary hyperparathyroidism and hypoparathyroidism identified among community-dwelling individuals. Larger studies are needed to determine the true prevalence and natural history of these parathyroid disorders. PMID:23690312

  7. Bilateral symmetry of anterior maxillary incisors: evaluation of a community-based population.

    Science.gov (United States)

    Ormianer, Z; Solodukhin, A L; Lauritano, D; Segal, P; Lavi, D; Carinci, F; Block, J

    2017-01-01

    The final outcome of dental treatment needs to be not only clinically sufficient, but also esthetically pleasing. Bilateral symmetry in the maxillary incisor teeth is of significant importance in esthetic dentistry. In restorative dentistry, symmetry refers to the appearance of balance around the dental midline. The purpose of this study was to measure and compare the maxillary incisor teeth dimensions from both sides of the dental midline, in order to asses if this symmetry occurs naturally. From the student community population at Tel Aviv University, 66 students between the ages of 20-35 (35 males, 31 females) were enrolled and gave consent. The inclusion criteria for this study were: upper maxillary incisors that have never undergone restorative or rehabilitative treatment, and no history of orthodontic treatment. Standardized digital photographs were taken, and the length and width of the maxillary central and lateral incisors were measured and proportions were calculated. SPSS was used to compare the measured differences between teeth on the left versus right of the midline. Tooth proportions were not significantly different between the left and right sides. Asymmetry was found only between the lengths of the maxillary lateral incisors (p=0.009); the width for these teeth was symmetrical. A significant statistical difference was not found on most parameters when evaluating symmetry of the upper incisors. Therefore, when treating the esthetically important anterior of the mouth, care must be taken to ensure bilateral symmetry to mirror the natural symmetry found in most patients.

  8. Are elderly dependency ratios associated with general population suicide rates?

    Science.gov (United States)

    Shah, Ajit

    2011-05-01

    The elderly population size is increasing worldwide due to falling birth rates and increasing life expectancy. It has been hypothesized that as the elderly dependency ratio (the ratio of those over the age of 65 years to those under 65) increases, there will be fewer younger people available to care for older people and this, in turn, will increase the burden on younger carers with increased levels of psychiatric morbidity leading to an increase in general population suicide rates. A cross-national study examining the relationship between elderly dependency ratios and general population suicide rates was conducted using data from the World Health Organization and the United Nations websites. The main findings were of a significant and independent positive correlation between elderly dependency ratios and general population suicide rates in both genders. The contribution of cross-national differences in psychiatric morbidity in younger carers on general population suicide rates requires further study. The prevalence of psychiatric morbidity in younger carers of older people should be examined by: (i) cross-national studies using standardized measures of psychiatric morbidity that are education-free, culture-fair and language-fair; and (ii) within-country longitudinal studies with changing elderly dependency ratios over time.

  9. Approach to Fall in Elderly Population

    Directory of Open Access Journals (Sweden)

    Mehmet Ilkin Naharci

    2009-10-01

    Full Text Available Falls are one of the geriatric syndromes which occur commonly and significantly increase morbidity and mortality rates in elderly. The incidence of falls increases with age. Falls usually occur when impairments in cognitive, behavioral, and executive function begin. The incidence of fall is between 30 and 40 percent of community-dwelling people and approximately 50 percent of individuals in the long-term care setting over the age of 65 years. Fracture (hip, arm, wrist, pelvis, head trauma or major lacerations, as defined serious wounding, occur 10-25% of elderly cases. Fall is overlooked in clinical examination due to various reasons; the patient never mentions the event to a doctor; there is no injury at the time of the fall; the doctor fails to ask the patient about a history of falls; or either doctor or patient erroneously believes that falls are an inevitable part of the aging process. Elderly give not usually any self-information about fall, for this reason, all older patients should be asked at least once per year about falls and should be assessed in terms of balance and gait disorders. There are many distinct causes for falls in old people. Falls in older individuals occur when a threat to the normal homeostatic mechanisms that maintain postural stability is superimposed on underlying age-related declines in balance, ambulation, and cardiovascular function. This factor may be an acute illness (eg, fever, water loss, arrhythmia, a new medication, an environmental stress (eg, unfamiliar surrounding, or an unsafe walking surface. The elderly person can not cope with happened additional stress. To prevent and decrease the frequency of falls, effective approaches are medical interventions, environmental modifications, education-exercise programs, and assisted device. Detection and amelioration of risk factors can significantly reduce the rate of future falls. The assessment of fall, causing mobility restriction, use of nursing home, and

  10. Decreased renal function and associated factors in cities, towns and rural areas of Tanzania: a community-based population survey.

    Science.gov (United States)

    Peck, Robert; Baisley, Kathy; Kavishe, Bazil; Were, Jackson; Mghamba, Janneth; Smeeth, Liam; Grosskurth, Heiner; Kapiga, Saidi

    2016-03-01

    Data on renal dysfunction in sub-Saharan Africa, comparing urban and rural areas, have not yet been reported. Therefore, we aimed to determine the distribution of low estimated glomerular filtration rates (eGFRs) in urban and rural Tanzania, to describe factors associated with low eGFR and to quantify fractions attributable to common risk factors. We conducted a community-based survey of 1095 randomly selected Tanzanian adults (≥18 years). A structured questionnaire and examinations were used to document sociodemographic characteristics, diet, physical activity, anthropomorphic measurements and blood pressure. Blood tests were performed for HIV infection, diabetes mellitus and creatinine. eGFR was calculated using two equations recommended for African adults. Serum creatinine was available for 1043 participants: 170 in Mwanza city, 326 in district towns and 547 in rural areas. Mean age was 35.5 years and 54% were females. The prevalence of eGFR renal function is common in Tanzania, particularly in district towns, and unique risk factors for kidney disease may exist in this population. Population-specific strategies for prevention, early diagnosis and treatment of kidney disease are needed for Africa. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  11. Non-Alzheimer neurodegenerative pathologies and their combinations are more frequent than commonly believed in the elderly brain: a community-based autopsy series.

    Science.gov (United States)

    Kovacs, Gabor G; Milenkovic, Ivan; Wöhrer, Adelheid; Höftberger, Romana; Gelpi, Ellen; Haberler, Christine; Hönigschnabl, Selma; Reiner-Concin, Angelika; Heinzl, Harald; Jungwirth, Susanne; Krampla, Wolfgang; Fischer, Peter; Budka, Herbert

    2013-09-01

    Neurodegenerative diseases are characterised by neuronal loss and cerebral deposition of proteins with altered physicochemical properties. The major proteins are amyloid-β (Aβ), tau, α-synuclein, and TDP-43. Although neuropathological studies on elderly individuals have emphasised the importance of mixed pathologies, there have been few observations on the full spectrum of proteinopathies in the ageing brain. During a community-based study we performed comprehensive mapping of neurodegeneration-related proteins and vascular pathology in the brains of 233 individuals (age at death 77-87; 73 examined clinically in detail). While all brains (from individuals with and without dementia) showed some degree of neurofibrillary degeneration, Aβ deposits were observed only in 160 (68.7 %). Further pathologies included α-synucleinopathies (24.9 %), non-Alzheimer tauopathies (23.2 %; including novel forms), TDP-43 proteinopathy (13.3 %), vascular lesions (48.9 %), and others (15.1 %; inflammation, metabolic encephalopathy, and tumours). TDP-43 proteinopathy correlated with hippocampal sclerosis (p pathology (CERAD score and Braak and Braak stages, p = 0.001). The presence of one specific variable (cerebral amyloid angiopathy, Aβ parenchymal deposits, TDP-43 proteinopathy, α-synucleinopathy, vascular lesions, non-Alzheimer type tauopathy) did not increase the probability of the co-occurrence of others (p = 0.24). The number of observed pathologies correlated with AD-neuropathologic change (p pathology and α-synucleinopathy showed strong effects but lost significance when evaluated together with AD-neuropathologic change. Non-AD neurodegenerative pathologies and their combinations have been underestimated, but are frequent in reality as demonstrated here. This should be considered in diagnostic evaluation of biomarkers, and for better clinical stratification of patients.

  12. Restless Legs Syndrome in a Nigerian Elderly Population

    Science.gov (United States)

    Fawale, Michael B.; Ismaila, Isiaka Alani; Mustapha, Adekunle F.; Komolafe, Morenikeji A.; Adedeji, Tewogbade A.

    2016-01-01

    Study Objectives: The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. Methods: The study population comprised of 633 consecutive elderly individuals aged 65–105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. Results: Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283–8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750–12.577; p = 0.002) was found. Conclusions: Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists. Citation: Fawale MB, Ismaila IA, Mustapha AF, Komolafe MA, Adedeji TA. Restless legs syndrome in a Nigerian elderly population. J Clin Sleep Med 2016;12(7):965–972. PMID:27070251

  13. Knowledge of hepatitis B among healthy population: A community-based survey from two districts of Gujarat, India

    Directory of Open Access Journals (Sweden)

    Sandul Yasobant

    2017-01-01

    Full Text Available Background: Hepatitis B is the world's most common blood-borne viral infection, accounting for 2 billion infections, 350 million carriers, and 6 lakh deaths annually. Country like India still harbors approximately 30–60 million hepatitis B virus (HBV carriers. A modest estimate would put the number of deaths occurring due to HBV infection per year in India to around 100,000. To prevent transmission and progression of the disease, proper community awareness including prevention is necessary. Therefore, this study aims to study the knowledge awareness among the healthy population about hepatitis B including knowledge regarding vaccine. Methodology: A community-based cross-sectional study was undertaken in two districts of Gujarat. Cluster sampling (30 clusters was used, and pretested questionnaire was administered to 600 (with a prevalence rate of 5% in Gujarat having design effect of 2 within 95% confidence interval and 10% nonrespondent healthy individuals, who heard about hepatitis B. Data handled and analyzed in EpiData Analysis V2.2.2.183. Results: Majority of the participants knew about symptoms whereas only 41% knew about prevention methods and few 34% knew about the mode of transmission. Although 40% sample has knowledge about the availability of vaccination, only 20% were self-vaccinated. The common reason for nonvaccination was lack of awareness. Conclusions: Only one-third of the populations in study districts are aware about hepatitis B and its vaccine. Less than one-fifth of the populations are vaccinated for hepatitis B. Important knowledge deficits about the routes of hepatitis B transmission/prevention were identified. Continued efforts should be made to develop and implement hepatitis B educational campaigns/health promotion for these communities.

  14. Build it Together and They will Come: The Case for Community-based Participatory Research with Military Populations

    Directory of Open Access Journals (Sweden)

    Ellen R. DeVoe

    2012-04-01

    Full Text Available In this article, we describe the methodology broadly known as community-based participatory research (CBPR and identify its relevance to social work intervention research with families serving in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF. Since the inception of OEF/OIF, much has been written about low rates of service utilization among military service members and families to address deployment and combat-related concerns. Barriers to participation include difficulty accessing programs, mistrust of clinicians/researchers, concerns about confidentiality, stigma, and career implications, and perceptions of program effectiveness. Because CBPR values the community’s inherent resilience and expertise about its own needs, this method can be important for the development of feasible, culturally-relevant and evidence-based prevention and intervention models for military populations. To illustrate, we provide an overview of our implementation of CBPR to develop and test a home-based reintegration program for military families with very young children. Implications for social work practice and research are discussed.

  15. Health status of an elderly population in Sharpeville, South Africa ...

    African Journals Online (AJOL)

    The objective of this cross-sectional study was a comprehensive nutrition and health assessment to provide a basis for future intervention strategies for an elderly population attending a day-care centre. Socio-demographic, health and 24-hour recall dietary intake questionnaires were administered and anthropometric and ...

  16. Study on morbidity pattern among elderly in urban population of ...

    African Journals Online (AJOL)

    McRoy

    Background: Changes have been seen in the age structure of the population due to a steady rise in life expectancy and reduction .... disorders (30.2%) and diseases of respiratory and digestive system was reported about 10% .... respiratory tract infection was noted in about 3.4% of the elderly (men 4.8% and women 2.5%),.

  17. An elderly, urban population: Their experiences and expectations of ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to determine the pharmaceutical services experiences of an elderly, urban population in relation to their expectations in community pharmacy. Design and setting: The study was a cross-sectional descriptive empirical study and was conducted by means of a structured questionnaire, ...

  18. Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

    Science.gov (United States)

    Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

    2016-01-01

    We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical

  19. A Community-Based, Environmental Chronic Disease Prevention Intervention to Improve Healthy Eating Psychosocial Factors and Behaviors in Indigenous Populations in the Canadian Arctic

    Science.gov (United States)

    Mead, Erin L.; Gittelsohn, Joel; Roache, Cindy; Corriveau, André; Sharma, Sangita

    2013-01-01

    Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention--Healthy Foods North--was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two…

  20. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan

    National Research Council Canada - National Science Library

    Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo

    2012-01-01

    ...), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals...

  1. Organizational interventions improving access to community-based primary health care for vulnerable populations: a scoping review.

    Science.gov (United States)

    Khanassov, Vladimir; Pluye, Pierre; Descoteaux, Sarah; Haggerty, Jeannie L; Russell, Grant; Gunn, Jane; Levesque, Jean-Frederic

    2016-10-10

    Access to community-based primary health care (hereafter, 'primary care') is a priority in many countries. Health care systems have emphasized policies that help the community 'get the right service in the right place at the right time'. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations. Scoping review followed an iterative process. Eligibility criteria: organizational interventions in Organisation for Economic Cooperation and Development (OECD) countries; aiming to improve access to primary care for vulnerable populations; all study designs; published from 2000 in English or French; reporting at least one outcome (avoidable hospitalization, emergency department admission, or unmet health care needs). Main bibliographic databases (Medline, Embase, CINAHL) and team members' personal files. One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the 'Patient Centered Access to Healthcare' conceptual framework (dimensions and outcomes of access to primary care), and (ii) the classification of interventions of the Cochrane Effective Practice and Organization of Care. Using pattern analysis, interventions were mapped in accordance with the presence/absence of 'dimension-outcome' patterns. Out of 8,694 records (title/abstract), 39 studies with varying designs were included. The analysis revealed the following pattern. Results of 10 studies on interventions classified as 'Formal integration of services' suggested that these interventions were associated with three dimensions of access (approachability, availability and affordability) and

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

    DEFF Research Database (Denmark)

    Vanhuysse, Pieter

    This essay reviews recent evidence on the pro-elderly social spending bias of OECD welfare states. It shows that the cross-national variance in this variable is remarkably large, with Southern Europe and countries such as Germany, Austria, Japan, the USA, and Switzerland being most heavily pro-el......, 2012) and makes a plea for institutionally and historically richly informed explanations of the political consequences and the policy feedback effects arising from population ageing.......-elderly biased. It then points out that population ageing actually cannot explain very much of this pro-elderly bias variance. For instance, countries such as Denmark, Finland and Sweden are demographically old societies, yet they boast among the lowest pro-elderly spending biases in the OECD world, due...... to their greater commitment to family-friendly policies, active labour market policies and similar pro-young policies. The essay reviews a series of similarly counter-intuitive findings about generational politics and policies as published in Ageing Populations in Post-Industrial Democracies (Vanhuysse and Goerres...

  3. Health related quality of life outcomes after total hip and knee arthroplasties in a community based population.

    Science.gov (United States)

    Jones, C A; Voaklander, D C; Johnston, D W; Suarez-Almazor, M E

    2000-07-01

    To quantify the magnitude of change seen with pain, function, and quality of life outcomes 6 months after total hip and knee arthroplasties (THA, TKA) within a community based cohort of a regional health district. An inception cohort of 504 patients who received primary THA (228) or TKA (276) was prospectively followed. All patients resided in the community and were assessed within one month prior to surgery and 6 months postoperatively. Health related quality of life measures were evaluated with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcome Survey Short Form SF-36. Perioperative factors were extracted from medical charts. Health services utilization data were collected from regional health databases. Over 75% of patients reported improvement in joint-specific pain and function, regardless of the type of joint replaced. Other health dimensions such as social function, bodily pain, physical function, vitality, and general health showed significant improvement after surgery. Those psychosocial dimensions with modest changes had baseline values comparable to age and sex adjusted normal values; whereas, bodily pain and physical function, which had large changes, had values lower than the normal values. Ninety-one percent of patients receiving THA were satisfied with their surgery, whereas 77% were satisfied with their TKA. The average length of stay was 7 days and the in-hospital complication rate was 0.34 per patient. Large improvements were reported for pain and function after joint arthroplasties, while small to moderate changes were seen in other areas related to quality of life. Patients with hip arthroplasties showed greater improvement in pain and function and were more satisfied with their outcomes than patients with knee arthroplasties. Although pain and function show large improvements, bodily pain and physical function were less than the values reported in the general population.

  4. Elder Orphans Hiding in Plain Sight: A Growing Vulnerable Population

    Directory of Open Access Journals (Sweden)

    Maria T. Carney

    2016-01-01

    Full Text Available Adults are increasingly aging alone with multiple chronic diseases and are geographically distant from family or friends. It is challenging for clinicians to identify these individuals, often struggling with managing the growing difficulties and the complexities involved in delivering care to this population. Clinicians often may not recognize or know how to address the needs that these patients have in managing their own health. While many such patients function well at baseline, the slightest insult can initiate a cascade of avoidable negative events. We have resurrected the term elder orphan to describe individuals living alone with little to no support system. Using public data sets, including the US Census and University of Michigan’s Health and Retirement Study, we estimated the prevalence of adults 65 years and older to be around 22%. Thus, in this paper, we strive to describe and quantify this growing vulnerable population and offer practical approaches to identify and develop care plans that are consistent with each person’s goals of care. The complex medical and psychosocial issues for elder orphans significantly impact the individual person, communities, and health-care expenditures. We hope to encourage professionals across disciplines to work cooperatively to screen elders and implement policies to prevent elder orphans from hiding in plain sight.

  5. Anthropometric measures and nutritional status in a healthy elderly population

    Directory of Open Access Journals (Sweden)

    Duque-López María

    2007-01-01

    Full Text Available Abstract Background Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people. Methods The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI, body circumference (arm, waist, hip and calf, waist to hip ratio (WHR, elbow amplitude and knee-heel length. Results Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p Conclusion Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the associations between health and BMI, waist circumference and WHR in the elderly.

  6. Elder

    National Research Council Canada - National Science Library

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-01-01

    ...´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described...

  7. Biochemistry reference intervals for healthy elderly population in Asmara, Eritrea.

    Science.gov (United States)

    Achila, Oliver Okoth; Semere, Paulos; Andemichael, Danait; Gherezgihier, Harerta; Mehari, Senait; Amanuel, Adiam; Yohannes, Tedalo; Yohaness, Eyob; Goje, Tzegezeab

    2017-12-19

    There is a scarcity of reference interval studies on the elderly in Africa. This study establishes reference interval for the elderly for some commonly used biochemical parameters. In this study, 255 conveniently sampled, healthy elderly, participants meeting Clinical and Laboratory Standards Institute (CLSI C28-A3) guidelines were enrolled. The results obtained may have utility in clinical diagnosis, patient management and research. In general, the consensus reference interval established in this study tended to be higher than reference interval from Caucasian populations; but lower than those obtained from reference interval studies in several African countries. This pattern was observed in a number of analytes including Alanine aminotransferase; aspartate aminotransferase; alkaline phosphatase; sodium; potassium among others. Significant sex-related variations were also observed in total bilirubin; direct bilirubin; indirect bilirubin; albumin; sodium; chloride; plasma carbon dioxide, creatinine and anion gap. The results demonstrate that reference interval for Eritrean urban population differs from those derived from other African or North American populations. In this regard, the use of reference interval values obtained from Caucasian populations may result in misdiagnosis.

  8. Compound ion salt, a novel low-sodium salt substitute: from animal study to community-based population trial.

    Science.gov (United States)

    Zhou, Xin; Liu, Jun-Xiang; Shi, Rui; Yang, Ning; Song, Dong-Lin; Pang, Wei; Li, Yu-Ming

    2009-09-01

    Salt restriction, an important approach for primary and secondary prevention of hypertension, is undermined by unsatisfactory adherence. A salt-restriction study tested the efficacy and safety of a compound ion salt (CISalt) with low sodium content in an animal model and in a community-based population. In part 1, 8-week-old male spontaneously hypertensive rats (SHRs) were fed 1% CISalt in the study group and 8% or 1% normal salt (NSalt) in controls (n = 10 each) for 12 weeks. Blood pressure (BP) and urinary electrolytes were measured every 3 weeks. After 12 weeks, collagen deposition in the heart and kidney and the levels of angiotensin II (Ang II) and nitric oxide (NO) in plasma and renal cortex were measured. In part 2, a single-blind, randomized, 6-month controlled trial with CISalt was conducted in 248 persons (age >or=65 years) in 10 rural communities. Plasma renin activity and Ang II were included in blood and urinary measures at baseline and 6 months. Reduced BP urinary protein excretion and reduced collagen in the heart and kidneys were significantly different in animals fed CISalt compared to controls. In human studies, at 6 months, mean systolic BP (SBP) was decreased by 9.6 mm Hg (95% confidence interval (CI): 13.1 to 6.1, P < 0.001) and diastolic BP (DBP) by 5.3 mm Hg (95% CI: 7.9 to 2.6, P < 0.001), respectively, compared to controls; urinary sodium excretion also decreased by 67.4 mmol/24 h (95% CI: 84.8 to 50.0, P < 0.001), and plasma renin activity was slightly increased by 0.19 ng/ml/h (95% CI: 0.04-0.33, P = 0.013). No adverse cardiovascular events were reported. In these studies, CISalt lowered BP and showed end-organ protection in hypertensive animals and BP reduction in humans. CISalt appears to be a safe and acceptable strategy to reduce BP.

  9. Chronic care case management for the frail elderly population in the United States: normative, funding and organizational aspects

    Directory of Open Access Journals (Sweden)

    Antonio Giulio de Belvis

    2004-12-01

    Full Text Available

    In the most developed countries, it is necessary to bring about significant changes to health care delivery through the strengthening of prevention, rehabilitation and the integration of the social and healthcare dimensions.

    This means moving the policy focus from “treating” to “taking care” of the sick in a broader and more integrated way, one which is more closely linked to the World Health Organization’s definition of health as physical, psychological and social well-being. This change involves the delivery of care for the elderly. Developed countries are confronting this issue by using different community-based programs to integrate acute and long-term care services for frail elderly individuals with complex health needs.

    The objective of this health policy article is to give an overview of the most recent initiatives on long-term care management for the elderly including normative, funding and organizational issues in the USA, as their public health system largely differs from those of the Western European countries.

    Particular attention is given to the PACE (Program of All Inclusive Care for the Elderly, which applies a comprehensive approach to managing the care of the frail elderly population and would represent a new framework in geriatric care. By incorporating a central core care team to manage the needs of each elderly individual, this approach recognizes the contributing factors that non-traditional health related functions play in the overall health of the individual.

    Although there is a little knowledge of this program, as it covers a very small percentage of the eligible individuals, and it may be difficult to extrapolate to other sectors of the population, PACE offers many lessons that could be applied to more effective integration of care for individuals and lead to better health outcomes.

  10. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China

    Science.gov (United States)

    Chu, Huikuan; Zhong, Likun; Li, Hai; Zhang, Xiujing; Zhang, Jingzhi; Hou, Xiaohua

    2014-01-01

    Objective. To acquire more data about the epidemiologic characteristics of constipation in different kinds of populations in China. Methods. Using “constipation” and “China” as search terms; relevant papers were searched from January 1995 to April 2014. Data on prevalence, gender, diagnostic criteria, geographical area, educational class, age, race, and physician visit results were extracted and analyzed. Results. 36 trials were included. Prevalence rates of constipation in elderly population (18.1%) and pediatric population (18.8%) were significantly higher than that in general population (8.2%). Prevalence of constipation defined by non-Rome criteria was higher than that by Rome criteria in general population. Prevalence rates of constipation were different for different geographical area. People with less education were predisposed to constipation. In pediatric population, prevalence of constipation was the lowest in children aged 2–6 years. Prevalence of constipation in ethnic minorities was higher than that in Han people. People with constipation were predisposed to FD, haemorrhoid, and GERD. Only 22.2% patients seek medical advice in general population. Conclusions. In China, prevalence of constipation was lower compared with most of other countries. The factors including female gender, diagnostic criteria, geographical area, age, educational class, and race seemed to have major effects on prevalence of constipation. PMID:25386187

  11. Fasting hyperglycaemia and in-hospital mortality in elderly population.

    Science.gov (United States)

    Iglesias, P; Polini, A; Muñoz, A; Dardano, A; Prado, F; Castiglioni, M; Guerrero, M T; Tognini, S; Macías, M C; Díez, J J; Monzani, F

    2011-03-01

    Admission hyperglycaemia has shown to be a marker of poor clinical outcome. The prevalence of admission hyperglycaemia and its relationship with in-hospital mortality in elderly population has not been clearly defined. We assessed the prevalence and prognostic significance of admission fasting hyperglycaemia in aged patients. A total of 808 elderly patients were studied. Patients were classified into group I (serum glucose 180 mg/dl). Groups II and III were considered newly recognised fasting hyperglycaemia (NRFH) in non-diabetic patients. NRFH was present in 18.6%. After excluding diabetic patients (n = 206, 25.5%), the distribution of patients (n = 602, 74.5%) was as follows: group I (n = 452, 55.9%), group II (n = 122, 15.1%) and group III (n = 28, 3.5%). In the whole cohort, median fasting glucose was lower in patients who survived [105 mg/dl (88-135)] than in those who died [127 mg/dl (93-159), p population. Both low albumin and high glucose serum concentrations were the only independent risk factors for in-hospital all-cause mortality in non-diabetic patients. In non-diabetic elderly patients admitted for acute disease, serum glucose concentration is an important, simple and independent predictor of hospital mortality. © 2011 Blackwell Publishing Ltd.

  12. Elderly population in the prison system: a look behind bars

    Directory of Open Access Journals (Sweden)

    Hércules de Oliveira Carmo

    2012-09-01

    Full Text Available This work is a present reality in this century, and that is demanding attention, especially in the context of public health and human rights - the elderly-con. A complex problem that arose for our consideration is that the person who, besides being old, and the inmate is most often in pain, due to a pathological condition related to organic factors, mental or subjective, in old age, worsens. Without being accompanied by public policies, these realities are not provided before, we now gain a greater complexity in the prison context, reveal an increase of HIV / AIDS, the presence of sexually transmitted disease, increased depression and neuropsychiatric diseases. The questions posed in this research, which attempted to answer here may well be subsumed: - How to think the nursing practices before the issue of the growing aging population with its pathologies further complexizadas in prison? The objective, therefore, this study: (i to investigate the growing presence of the elderly Brazilian penitentiary system, based on existing literature, (ii verify the potential risk factors on the health of the elderly population in the Brazilian prison system, and the weight the presence of a nursing team in this context. Urgent attention, therefore, it is required of health professionals, authorities and civil society to the complexity of aging silenced behind bars.

  13. Comparison of Outpatient Services between Elderly People with Intellectual Disabilities and the General Elderly Population in Taiwan

    Science.gov (United States)

    Hsu, Shang-Wei; Lin, Jin-Ding; Chiang, Po-Huang; Chang, Yu-Chia; Tung, Ho-Jui

    2012-01-01

    This study aims to analyze the ambulatory visit frequency and medical expenditures of the general elderly population versus the elderly with intellectual disabilities in Taiwan, while examining the effects of age, gender, urbanization and copayment status on ambulatory utilization. A cross-sectional study was conducted to analyze data from 103,183…

  14. Wildlife Population Dynamics in Human-Dominated Landscapes under Community-Based Conservation: The Example of Nakuru Wildlife Conservancy, Kenya

    Science.gov (United States)

    Ogutu, Joseph O.; Kuloba, Bernard; Piepho, Hans-Peter; Kanga, Erustus

    2017-01-01

    carnivores increased overall whereas that of herbivores first increased from 1996 to 2006 and then levelled off thereafter. Aggregate herbivore biomass increased linearly with increasing cumulative wet season rainfall. The densities of the 30 most abundant species were either strongly positively or negatively correlated with cumulative past rainfall, most commonly with the early wet season component. The collaborative wildlife conservation and management initiatives undertaken on the mosaic of private, communal and public lands were thus associated with increase or no decrease in numbers of 32 and decrease in numbers of 12 of the 44 species. Despite the decline by some species, effective community-based conservation is central to the future of wildlife in the NWC and other rangelands of Kenya and beyond and is crucially dependent on the good will, effective engagement and collective action of local communities, working in partnerships with various organizations, which, in NWC, operated under the umbrella of the Nakuru Wildlife Forum. PMID:28103269

  15. Wildlife Population Dynamics in Human-Dominated Landscapes under Community-Based Conservation: The Example of Nakuru Wildlife Conservancy, Kenya.

    Science.gov (United States)

    Ogutu, Joseph O; Kuloba, Bernard; Piepho, Hans-Peter; Kanga, Erustus

    2017-01-01

    increased overall whereas that of herbivores first increased from 1996 to 2006 and then levelled off thereafter. Aggregate herbivore biomass increased linearly with increasing cumulative wet season rainfall. The densities of the 30 most abundant species were either strongly positively or negatively correlated with cumulative past rainfall, most commonly with the early wet season component. The collaborative wildlife conservation and management initiatives undertaken on the mosaic of private, communal and public lands were thus associated with increase or no decrease in numbers of 32 and decrease in numbers of 12 of the 44 species. Despite the decline by some species, effective community-based conservation is central to the future of wildlife in the NWC and other rangelands of Kenya and beyond and is crucially dependent on the good will, effective engagement and collective action of local communities, working in partnerships with various organizations, which, in NWC, operated under the umbrella of the Nakuru Wildlife Forum.

  16. Wildlife Population Dynamics in Human-Dominated Landscapes under Community-Based Conservation: The Example of Nakuru Wildlife Conservancy, Kenya.

    Directory of Open Access Journals (Sweden)

    Joseph O Ogutu

    carnivores increased overall whereas that of herbivores first increased from 1996 to 2006 and then levelled off thereafter. Aggregate herbivore biomass increased linearly with increasing cumulative wet season rainfall. The densities of the 30 most abundant species were either strongly positively or negatively correlated with cumulative past rainfall, most commonly with the early wet season component. The collaborative wildlife conservation and management initiatives undertaken on the mosaic of private, communal and public lands were thus associated with increase or no decrease in numbers of 32 and decrease in numbers of 12 of the 44 species. Despite the decline by some species, effective community-based conservation is central to the future of wildlife in the NWC and other rangelands of Kenya and beyond and is crucially dependent on the good will, effective engagement and collective action of local communities, working in partnerships with various organizations, which, in NWC, operated under the umbrella of the Nakuru Wildlife Forum.

  17. Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

    Science.gov (United States)

    Biehl, Michelle; Takahashi, Paul Y; Cha, Stephen S; Chaudhry, Rajeev; Gajic, Ognjen; Thorsteinsdottir, Bjorg

    2016-01-01

    Rationale Identifying patients at high risk of critical illness is necessary for the development and testing of strategies to prevent critical illness. The aim of this study was to determine the relationship between high elder risk assessment (ERA) score and critical illness requiring intensive care and to see if the ERA can be used as a prediction tool to identify elderly patients at the primary care visit who are at high risk of critical illness. Methods A population-based historical cohort study was conducted in elderly patients (age >65 years) identified at the time of primary care visit in Rochester, MN, USA. Predictors including age, previous hospital days, and comorbid health conditions were identified from routine administrative data available in the electronic medical record. The main outcome was critical illness, defined as sepsis, need for mechanical ventilation, or death within 2 years of initial visit. Patients with an ERA score of 16 were considered to be at high risk. The discrimination of the ERA score was assessed using area under the receiver operating characteristic curve. Results Of the 13,457 eligible patients, 9,872 gave consent for medical record review and had full information on intensive care unit utilization. The mean age was 75.8 years (standard deviation ±7.6 years), and 58% were female, 94% were Caucasian, 62% were married, and 13% were living in nursing homes. In the overall group, 417 patients (4.2%) suffered from critical illness. In the 1,134 patients with ERA >16, 154 (14%) suffered from critical illness. An ERA score ≥16 predicted critical illness (odds ratio 6.35; 95% confidence interval 3.51–11.48). The area under the receiver operating characteristic curve was 0.75, which indicated good discrimination. Conclusion A simple model based on easily obtainable administrative data predicted critical illness in the next 2 years in elderly outpatients with up to 14% of the highest risk population suffering from critical illness

  18. Culturally sensitive care for elderly immigrants through ethnic community health workers: design and development of a community based intervention programme in the Netherlands.

    Science.gov (United States)

    Verhagen, Ilona; Ros, Wynand Jg; Steunenberg, Bas; de Wit, Niek J

    2013-03-15

    In Western countries, health and social welfare facilities are not easily accessible for elderly immigrants and their needs are suboptimally addressed. A transition is needed towards culturally sensitive services to overcome barriers to make cure and care accessible for elderly immigrants. We developed an intervention programme in which ethnic community health workers act as liaisons between immigrant elderly and local health care and social welfare services. In this study we evaluate the effectiveness and the implementation of this intervention programme. In a quasi experimental design, the effectiveness of introduction of community health workers, health needs assessment, and follow-up intervention programme will be evaluated in three (semi) urban residential areas in the Netherlands and compared with a control group. Community health workers are selected from local ethnic communities and trained for the intervention. Data on health perception, quality of life, and care consumption are collected at baseline and after the intervention programme. Elderly's informal care givers are included to examine caregiver burden. The primary outcome is use of health care and social welfare facilities by the elderly. Secondary outcomes are quality of life and functional impairments. The target number of participants is 194 immigrant elderly: 97 for the intervention group and 97 for the control group. Implementation of the intervention programme will be examined with focus groups and data registration of community health worker activities. This study can contribute to the improvement of care for elderly immigrants by developing culturally sensitive care whereby they actively participate. To enable a successful transition, proper identification and recruitment of community health workers is required. Taking this into account, the study aims to provide evidence for an approach to improve the care and access to care for elderly immigrants. Once proven effective, the community

  19. The use of community-based interventions in reducing morbidity from the psychological impact of conflict-related trauma among refugee populations: a systematic review of the literature.

    Science.gov (United States)

    Williams, Meagan E; Thompson, Sandra C

    2011-08-01

    With large numbers of refugee arrivals and numerous barriers to accessing services it is especially important that resources are efficiently and effectively directed to address the health needs of refugees. Ten databases were utilised to conduct the review, returning 156 titles which were assessed for validity based on specified criteria. The 14 critically appraised articles included in this review consist of experimental research and discussions on best practice. Articles consistently demonstrated the benefit of community-based mental health service in improving mental health outcomes. Themes of cultural awareness, language, setting, and post-migration stressors emerged across the articles. In addition, the studies also point to the gaps in research of a longitudinal nature and ones that deal with scattered populations post migration. Community-based interventions proved valuable for improving the mental health of refugees. However, additional interventions and evaluations are required to draw consistent and conclusive judgments on best practice in dealing with refugee mental health issues.

  20. The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

    Directory of Open Access Journals (Sweden)

    Yu Hatano

    2017-04-01

    Full Text Available Introduction: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities.  Methods: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system.  Results: In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy.  Conclusion: Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas.

  1. Effects of education and word reading on cognitive scores in a community-based sample of Spanish elders with diverse socioeconomic status.

    Science.gov (United States)

    Contador, Israel; Bermejo-Pareja, Félix; Del Ser, Teodoro; Benito-León, Julián

    2015-01-01

    The influence of education and oral word-reading ability on cognitive performance was examined in a sample of 1510 nondemented elders differing in socioeconomic status (SES) from three Spanish communities. All individuals were enrolled in the Neurological Disorders in Central Spain, a population-based epidemiological study in central Spain. They completed a detailed demographic survey and a short standardized neuropsychological battery assessing psychomotor speed, attention, language, and memory. The Word Accentuation Test (WAT) was used as measure of oral reading ability. The influence of education and oral reading on cognitive performance was determined by multiple linear regression models, first controlling for demographics (age and sex), and subsequently for the WAT score and education. The contribution of socioeconomic conditions was addressed by stratifying the sample into groups of high and low SES. The WAT showed a significant independent effect on cognitive scores, generally greater than that predicted by demographics. The higher predictive power of oral word reading on cognitive scores compared to education was consistent across the three communities. Although the variance explained by WAT was very similar in areas with diverse SES (low vs. high), WAT scores accounted for slightly more variance in naming and memory tasks in low SES areas. In contrast, the variance explained by WAT was higher for verbal fluency and the Trail-Making Test in areas with high SES. Oral word-reading ability predicts cognitive performance better than years of education across individuals with different SES. The influence of WAT may be modulated by SES and cognitive task properties.

  2. Trends in cancer in the elderly population in Denmark, 1980-2012

    DEFF Research Database (Denmark)

    Ewertz, Marianne; Christensen, Kaare; Engholm, Gerda

    2016-01-01

    among those aged 90 years or more. Conclusion An increase in elderly cancer patients is expected over the coming 20 years due to an increasing elderly population. Healthcare providers need to focus on developing specific strategies for treatment of elderly cancer patients in the future....

  3. Frequency of contact with non-cohabitating adult children and risk of depression in elderly: a community-based three-year longitudinal study in Korea.

    Science.gov (United States)

    Roh, Hyun Woong; Lee, Yunhwan; Lee, Kang Soo; Chang, Ki Jung; Kim, Jinhee; Lee, Soo Jin; Back, Joung Hwan; Chung, Young Ki; Lim, Ki Young; Noh, Jai Sung; Son, Sang Joon; Hong, Chang Hyung

    2015-01-01

    Our study aimed to assess the longitudinal association of frequency of contact with non-cohabitating adult children and risk of depression in the elderly. Elderly aged ≥60 years were included from Living Profiles of Older People Survey (LPOPS) in Korea. The baseline assessment, Wave 1, was conducted in 2008, and follow-up assessment, Wave 2, was conducted in 2011. We included participants who completed both waves and excluded those who met the following criteria: no adult children, living with adult children, cognitive impairment at either waves, and depression at baseline (n=4398). We defined infrequent contact as elderly is associated with frequency of contact with non-cohabitating adult children. Moreover, the efficacy of face-to-face contact and that of phone contact were similar, while the group lacking both types of contact demonstrated the highest risk of depression. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. One-leg standing test for elderly populations.

    Science.gov (United States)

    Michikawa, Takehiro; Nishiwaki, Yuji; Takebayashi, Toru; Toyama, Yoshiaki

    2009-09-01

    The one-leg standing (OLS) test is one of the balance tests used to diagnose musculoskeletal ambulation disability symptom complex (MARS), a condition newly defined by three professional Japanese medical societies in 2006 to help identify the symptoms of motor organ deterioration and establish preventive strategies. Although many studies have used the OLS test, none has shown conclusively that the test can be used as a practical marker of frailty among elderly people, especially in community settings. Based on the type of epidemiological study -- i.e., descriptive epidemiology and analytical epidemiology (observational and intervention studies) -- we reviewed evidence on three fundamental issues related to the OLS test: (1) testing procedures and reference values; (2) the associations between the OLS time and negative events; (3) improvement of the OLS time by intervention. These issues are key to any discussion of whether the OLS test can be used as a practical marker for predicting frailty in community-dwelling elderly populations. Articles were collected from MEDLINE databases using the search terms "one- leg standing" and the other names included in the same category. Because various procedures are used to carry out the OLS test, the measured values for the OLS time varied widely from study to study. Some observational studies showed that the OLS time is related to negative events such as falls, declines in activity of daily living, and other morbidity. OLS times could be improved by several interventions. This review suggests that the OLS test can be a tool for predicting frailty in community-dwelling elderly populations. However, our review should be interpreted with caution because we did not confirm the evidence level of each of the studies we selected. Further research on this topic is needed.

  5. Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

    Directory of Open Access Journals (Sweden)

    Biehl M

    2016-06-01

    Full Text Available Michelle Biehl,1 Paul Y Takahashi,2 Stephen S Cha,3 Rajeev Chaudhry,2 Ognjen Gajic,1 Bjorg Thorsteinsdottir2 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, 2Division of Primary Care Internal Medicine, 3Health Sciences Research, Mayo Clinic, Rochester, MN, USA Rationale: Identifying patients at high risk of critical illness is necessary for the development and testing of strategies to prevent critical illness. The aim of this study was to determine the relationship between high elder risk assessment (ERA score and critical illness requiring intensive care and to see if the ERA can be used as a prediction tool to identify elderly patients at the primary care visit who are at high risk of critical illness. Methods: A population-based historical cohort study was conducted in elderly patients (age >65 years identified at the time of primary care visit in Rochester, MN, USA. Predictors including age, previous hospital days, and comorbid health conditions were identified from routine administrative data available in the electronic medical record. The main outcome was critical illness, defined as sepsis, need for mechanical ventilation, or death within 2 years of initial visit. Patients with an ERA score of 16 were considered to be at high risk. The discrimination of the ERA score was assessed using area under the receiver operating characteristic curve. Results: Of the 13,457 eligible patients, 9,872 gave consent for medical record review and had full information on intensive care unit utilization. The mean age was 75.8 years (standard deviation ±7.6 years, and 58% were female, 94% were Caucasian, 62% were married, and 13% were living in nursing homes. In the overall group, 417 patients (4.2% suffered from critical illness. In the 1,134 patients with ERA >16, 154 (14% suffered from critical illness. An ERA score ≥16 predicted critical illness (odds ratio 6.35; 95% confidence interval 3.51–11.48. The area under the

  6. The elderly hypertensive population: what lies ahead of us?

    Directory of Open Access Journals (Sweden)

    Guillaume Bobrie

    2002-03-01

    Full Text Available In the next 25 years, the population aged 65 years and over will increase by 88%. Thus, postponing the adverse effects of old age for as long as possible will be a major social and economic issue. Hypertension is common in older people, with a prevalence rate of up to 60%, the majority having isolated systolic hypertension. Both isolated systolic hypertension and increased pulse pressure (PP are associated with a high cardiovascular (CV risk, and hypertension remains the biggest treatable risk factor for CV disease in the elderly and in the very old. Randomised, controlled trials have demonstrated the benefit of the treatment of hypertension in this population, such that treating just 43 subjects (95% CI: 31–69 for five years would prevent one cerebro-vascular event and treating 61 (95% CI: 39–141 would prevent one coronary event. It should be stressed that antihypertensive treatment reduces both fatal and nonfatal events and will probably prevent the onset of dementia. In other words, it reduces events that represent a major source of disability and handicap in old age and allows healthy ageing. Ongoing trials, which are addressing the preventive effect of treatment in the very elderly hypertensive, will provide further evidence as to the risk/benefit ratio in this ever increasing age group.

  7. Epidemiology of Meibomian Gland Dysfunction in an Elderly Population.

    Science.gov (United States)

    Alghamdi, Yousef A; Mercado, Carolina; McClellan, Allison L; Batawi, Hatim; Karp, Carol L; Galor, Anat

    2016-06-01

    To study the epidemiology of meibomian gland (MG) dysfunction in an elderly, predominantly male population. Prospective study of 233 subjects seen in the Miami Veterans Affairs eye clinic. Patients underwent a complete ocular surface examination, including dry eye questionnaires and tear assessments (osmolarity, tear breakup time, corneal staining, Schirmer test). The main outcome measures were correlations between MG parameters and demographics, dry eye symptoms, and tear parameters. The studied MG parameters were eyelid vascularity and meibum quality; a score ≥2 for either parameter was considered abnormal. Mean age of the 233 subjects was 63 years (SD = 11); 91% were male and 59% had at least 1 abnormal MG parameter (abnormal quality 55%; vascularity 17%). Demographically, patients with abnormal MG parameters were significantly older than their counterparts without these findings. Whites were more likely to have abnormal eyelid vascularity compared with blacks [n = 36 (31%) vs. n = 1 (1%), P < 0.0005] but no differences were noted between races with respect to meibum quality. Abnormal meibum quality, but not abnormal vascularity, was significantly associated with more severe dry eye symptoms. Similarly, abnormal meibum quality, but not eyelid vascularity, was significantly associated with worse dry eye signs, including decreased tear breakup time and increased corneal staining (P < 0.05 for all). MG dysfunction is a frequent finding in an elderly, predominantly male population with racial differences noted in the frequency of abnormal eyelid vascularity but not in MG quality. Abnormal meibum quality was significantly associated with more severe dry eye symptoms and signs.

  8. The factors associated with a self-perceived hearing handicap in elderly people with hearing impairment--results from a community-based study.

    Science.gov (United States)

    Chang, Hsin-Pin; Ho, Chin-Yu; Chou, Pesus

    2009-10-01

    Elderly persons with a physiologic hearing deficit (hearing impairment) are not necessarily socially or emotionally disturbed by the deficit in everyday life (hearing handicap). The self-perception of a hearing handicap in elderly people is a key element in seeking consultation for a hearing impairment or using hearing aids. Thus, it is important to determine the factors associated with the self-perception of a hearing handicap. The aims of the present study were to report the relation between a hearing impairment and the self-perception of a hearing handicap, and the factors associated with a self-perceived hearing handicap among a group of randomly recruited, community-dwelling elderly persons, aged 65 yr and older, in Taipei, Taiwan. A cross-sectional survey of community-dwelling elderly persons aged 65 yr and older (N = 1220) participating in an annual general purpose geriatric health examination in 2005 in Taipei. Pure-tone audiometry and a questionnaire including the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) were administered, after obtaining the subject's consent to participate in the study. Demographic information, lifestyle, self-report health status, and biochemical data were also collected. There was a moderate association (gamma(s) = 0.52) between hearing impairment and self-perceived handicap. Only 21.4% of the study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL, N = 555) perceived themselves as hearing-handicapped (HHIE-S total score >or=10). Besides hearing level, marital status (widowed) and self-perceived general health (bad or neutral) were factors that are significantly associated with a self-perceived hearing handicap among elderly subjects with moderate to profound hearing impairment. For study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL), 5.0% of those with HHIE-S or=10 used or felt that they required hearing aids (chi2 test, p handicap (HHIE-S >or=10) is an

  9. International non-governmental organizations' provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013-2014.

    Science.gov (United States)

    Soe, Kyaw Thu; Saw, Saw; van Griensven, Johan; Zhou, Shuisen; Win, Le; Chinnakali, Palanivel; Shah, Safieh; Mon, Myo Myo; Aung, Si Thu

    2017-03-24

    National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013-2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15-52%). Community-based TB

  10. Determinants of the utilization of dental services in a community-dwelling elderly Japanese population.

    Science.gov (United States)

    Ohi, Takashi; Sai, Motoyuki; Kikuchi, Masahiko; Hattori, Yoshinori; Tsuboi, Akito; Hozawa, Atsushi; Ohmori-Matsuda, Kaori; Tsuji, Ichiro; Watanabe, Makoto

    2009-07-01

    Oral health care is not only an effective strategy for the prevention, early diagnosis, and treatment of orofacial disease and disorders, but also an essential component of general health promotion programs. The current study aimed to identify the determinants of the utilization of dental services in an elderly population in Japan. A community-based comprehensive geriatric assessment, including the measurements of physical, mental, and social functioning, was conducted among elderly people aged >or= 70 years residing in a suburban area of Sendai, Japan. Oral health status and functioning, their impact on the quality of life, and dental utilization were also surveyed. Of the 1,170 participants, 418 subjects who had specific treatment needs for dental problems and reported irregular dental attendance were recommended a dental visit, and 1 year later, their compliance with the recommendation was assessed by using questionnaire. Multiple logistic regression analysis demonstrated that a higher number of remaining teeth and the use of removable dentures were significant predictors of dental utilization within 1 year. Regular utilization was associated with a higher number of remaining teeth, younger age, presence of systemic disease, absence of depressive symptoms, and higher educational attainment. Conversely, non-compliance with the treatment recommendations was associated with fewer remaining teeth, smoking, and non-utilization of dental services during the previous year. The differences in the determinants of dental attendance behavior, which may be partially associated with the insurance coverage for dental services, suggest the need for specific strategies for oral health promotion for different behavior of dental utilization.

  11. Building awareness to health insurance among the target population of community-based health insurance schemes in rural India.

    Science.gov (United States)

    Panda, Pradeep; Chakraborty, Arpita; Dror, David M

    2015-08-01

    To evaluate an insurance awareness campaign carried out before the launch of three community-based health insurance (CBHI) schemes in rural India, answering the questions: Has the awareness campaign been successful in enhancing participants' understanding of health insurance? What awareness tools were most useful from the participants' point of view? Has enhanced awareness resulted in higher enrolment? Data for this analysis originates from a baseline survey (2010) and a follow-up survey (2011) of more than 800 households in the pre- and post-campaign periods. We used the difference-in-differences method to evaluate the impact of awareness activities on insurance understanding. Assessment of usefulness of various tools was carried out based on respondents' replies regarding the tool(s) they enjoyed and found most useful. An ordinary least square regression analysis was conducted to understand whether insurance knowledge and CBHI understanding are related with enrolment in CBHI. The intervention cohort demonstrated substantially higher understanding of insurance concepts than the control group, and CBHI understanding was a positive determinant for enrolment. Respondents considered the 'Treasure-Pot' tool (an interactive game) as most useful in enhancing awareness to the effects of insurance. We conclude that awareness-raising is an important prerequisite for voluntary uptake of CBHI schemes and that interactive, contextualised awareness tools are useful in enhancing insurance understanding. © 2015 John Wiley & Sons Ltd.

  12. Medical costs of osteoporosis in the elderly Medicare population.

    Science.gov (United States)

    Blume, S W; Curtis, J R

    2011-06-01

    Prior national cost estimates of osteoporosis and fractures in the USA have been based on diverse sets of provider data or selected commercial insurance claims. Based on a random population-based sample of older adults, the US medical cost of osteoporosis and fractures is estimated at $22 billion in 2008. National cost estimates of osteoporosis and fractures in the USA have been based on diverse sets of provider data or selected commercial insurance claims. We sought to characterize prevalence and costs for osteoporosis using a random population-based sample of older adults. A cross-sectional estimate of medical cost was made with 2002 data from the Medicare Current Beneficiary Survey (MCBS). MCBS combines health interviews with claims information from all payers to profile a random sample of 12,700 Medicare recipients. Three cohorts aged 65 or over were defined: (1) patients experiencing a fracture-related claim in 2002; (2) patients with a diagnosis, medication, or self-report for osteoporosis or past hip fracture; and (3) non-case controls. The total cost of patient claims was compared to that of controls using multiple regression. Of 30.2 million elderly Medicare recipients in 2002, 1.6 million (5%) were treated for a fracture that year, and an additional 7.2 million (24%) have osteoporosis without a fracture. The estimated mean impact of fractures on annual medical cost was $8,600 (95% confidence interval, $6,400 to $10,800), implying a US cost of $14 billion ($10 to $17 billion). Half of the non-fracture osteoporosis patients received drug treatment, averaging $500 per treated patient, or $2 billion nationwide. The annual cost of osteoporosis and fractures in the US elderly was estimated at $16 billion, using a national 2002 population-based sample. This amount corroborates previous estimates based on substantially different methodologies. Projected to 2008, the national cost of osteoporosis and fractures was $22 billion.

  13. Dental caries in an elderly population in Brazil

    Directory of Open Access Journals (Sweden)

    Lilian Berta Rihs

    2009-02-01

    Full Text Available This study evaluated dental caries according to the presence of natural teeth and sociodemographic conditions of an elderly population in the state of São Paulo, Brazil. Examinations were performed according to the World Health Organization's guidelines. The sample of 1,192 elderly individuals aged 65 to 74 years was stratified according to the presence of teeth and the following variables: gender, race, age, city size and Human Development Index (HDI. The Mann Whitney and Kruskal Wallis tests were applied at a confidence level of 95% for analysis of results. In the total sample, 68.9% (n=822 were edentulous; the mean of present teeth was 3.5 and the DMFT was 30.2, being 28.5 of missing teeth. Among dentate individuals (n=370, the mean of present teeth was 11.3, the DMFT was 26.2 and the missing component accounted for 20.7 teeth. The differences observed in the evaluated conditions should be highlighted: the mean number of present teeth was higher among younger individuals (from 65 to 69 years [12.1] and among those living in cities with high HDI [12.9]; the DMFT was lower among men [24.9] and non-Caucasians [25.1]. Based on these findings, it may be concluded that specific dental programs should be established, with emphasis on oral health promotion and dental caries control, as well as public health policies that may enhance the access to the services provided.

  14. Economic burden of family caregiving for elderly population in southern Ghana: the case of a peri-urban district.

    Science.gov (United States)

    Nortey, Stephen Tettey; Aryeetey, Genevieve Cecilia; Aikins, Moses; Amendah, Djesika; Nonvignon, Justice

    2017-01-14

    Health systems in low and lower-middle income countries, particularly in sub-Sahara Africa, often lack the specialized personnel and infrastructure to provide comprehensive care for elderly/ageing populations. Close-to-client community-based approaches are a low-cost way of providing basic care and social support for elderly populations in such resource-constrained settings and family caregivers play a crucial role in that regard. However, family caregiving duties are often unremunerated and their care-related economic burden is often overlooked though this knowledge is important in designing or scaling up effective interventions. The objective of this study, therefore, was to estimate the economic burden of family caregiving for the elderly in southern Ghana. The study was a retrospective cross-sectional cost-of-care study conducted in 2015 among family caregivers for elderly registered for a support group in a peri-urban district in southern Ghana. A simple random sample of 98 respondents representative of the support group members completed an interviewer-administered questionnaire. Costs were assessed over a 1-month period. Direct costs of caregiving (including out-of-pocket costs incurred on health care) as well as productivity losses (i.e. indirect cost) to caregivers were analysed. Intangible costs were assessed using the 12-item Zarit burden interview (ZBI) tool and the financial cost dimension of the cost of care index. The estimated average cost of caregiving per month was US$186.18, 66% of which was direct cost. About 78% of the family caregivers in the study reported a high level of caregiving burden (as measured with the ZBI) with females reporting a relatively higher level than males. Further, about 87% of the family caregivers reported a high level of financial stress as a result of caregiving for their elderly relative. The study shows that support/caregiving for elderly populations imposes economic burden on families, potentially influencing the

  15. Community-Based Care

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of ... Adult Day Care Adult day care is a community-based option that has become more common. It ...

  16. “Complexities of holistic community based participatory research for a low-income, multi-ethnic population exposed to multiple built-environment stressors in Worcester, Massachusetts”

    Science.gov (United States)

    Downs, Timothy J.; Ross, Laurie; Patton, Suzanne; Rulnick, Sarah; Sinha, Deb; Mucciarone, Danielle; Calvache, Maria; Parmenter, Sarah; Subedi, Rajendra; Wysokenski, Donna; Anderson, Erin; Dezan, Rebecca; Lowe, Kate; Bowen, Jennifer; Tejani, Amee; Piersanti, Kelly; Taylor, Octavia; Goble, Robert

    2009-01-01

    Low income, multi-ethnic communities in Main South/Piedmont neighborhoods of Worcester, Massachusetts are exposed to cumulative, chronic built-environment stressors, and have limited capacity to respond, magnifying their vulnerability to adverse health outcomes. “Neighborhood STRENGTH”, our community based participatory research (CBPR) project, comprised four partners: a youth center; an environmental non-profit; a community based health center; and a university. Unlike most CBPR projects that are single topic-focused, our ‘holistic’, systems-based project targeted five priorities. The three research-focused/action-oriented components were: 1) participatory monitoring of indoor and outdoor pollution; 2) learning about health needs and concerns of residents through community based listening sessions; and 3) engaging in collaborative survey work, including a household vulnerability survey and an asthma prevalence survey for schoolchildren. The two action-focused/research-informed components were: 4) tackling persistent street trash and illegal dumping strategically; and 5) educating and empowering youth to promote environmental justice. We used a coupled CBPR-capacity building approach to design, vulnerability theory to frame, and mixed methods: quantitative environmental testing and qualitative surveys. Process and outcomes yielded important lessons: vulnerability theory helps frame issues holistically; having several topic-based projects yielded useful information, but was hard to manage and articulate to the public; access to, and engagement with, the target population was very difficult and would have benefited greatly from having representative residents who were paid at the partners' table. Engagement with residents and conflict burden varied highly across components. Notwithstanding, we built enabling capacity, strengthened our understanding of vulnerability, and are able to share valuable experiential knowledge. PMID:19762014

  17. Complexities of holistic community-based participatory research for a low income, multi-ethnic population exposed to multiple built-environment stressors in Worcester, Massachusetts.

    Science.gov (United States)

    Downs, Timothy J; Ross, Laurie; Patton, Suzanne; Rulnick, Sarah; Sinha, Deb; Mucciarone, Danielle; Calvache, Maria; Parmenter, Sarah; Subedi, Rajendra; Wysokenski, Donna; Anderson, Erin; Dezan, Rebecca; Lowe, Kate; Bowen, Jennifer; Tejani, Amee; Piersanti, Kelly; Taylor, Octavia; Goble, Robert

    2009-11-01

    Low income, multi-ethnic communities in Main South/Piedmont neighborhoods of Worcester, Massachusetts are exposed to cumulative, chronic built-environment stressors, and have limited capacity to respond, magnifying their vulnerability to adverse health outcomes. "Neighborhood STRENGTH", our community-based participatory research (CBPR) project, comprised four partners: a youth center; an environmental non-profit; a community-based health center; and a university. Unlike most CBPR projects that are single topic-focused, our 'holistic', systems-based project targeted five priorities. The three research-focused/action-oriented components were: (1) participatory monitoring of indoor and outdoor pollution; (2) learning about health needs and concerns of residents through community-based listening sessions; (3) engaging in collaborative survey work, including a household vulnerability survey and an asthma prevalence survey for schoolchildren. The two action-focused/research-informed components were: (4) tackling persistent street trash and illegal dumping strategically; and (5) educating and empowering youth to promote environmental justice. We used a coupled CBPR-capacity building approach to design, vulnerability theory to frame, and mixed methods: quantitative environmental testing and qualitative surveys. Process and outcomes yielded important lessons: vulnerability theory helps frame issues holistically; having several topic-based projects yielded useful information, but was hard to manage and articulate to the public; access to, and engagement with, the target population was very difficult and would have benefited greatly from having representative residents who were paid at the partners' table. Engagement with residents and conflict burden varied highly across components. Notwithstanding, we built enabling capacity, strengthened our understanding of vulnerability, and are able to share valuable experiential knowledge.

  18. Prevalence of dyslipidaemia and associated risk factors in a rural population in South-Western Uganda: a community based survey.

    Directory of Open Access Journals (Sweden)

    Gershim Asiki

    Full Text Available The burden of dyslipidaemia is rising in many low income countries. However, there are few data on the prevalence of, or risk factors for, dyslipidaemia in Africa.In 2011, we used the WHO Stepwise approach to collect cardiovascular risk data within a general population cohort in rural south-western Uganda. Dyslipidaemia was defined by high total cholesterol (TC ≥ 5.2 mmol/L or low high density lipoprotein cholesterol (HDL-C 6% (men aOR=3.00, 95%CI=1.37-6.59; women aOR=2.74, 95%CI=1.77-4.27. The odds of high TC was also higher among married men, and women with higher education or high BMI.Low HDL-C prevalence in this relatively young rural population is high whereas high TC prevalence is low. The consequences of dyslipidaemia in African populations remain unclear and prospective follow-up is required.

  19. Burden of chronic obstructive pulmonary disease in the elderly population.

    Science.gov (United States)

    Kobayashi, Seiichi; Yanai, Masaru; Hanagama, Masakazu; Yamanda, Shinsuke

    2014-09-01

    Chronic obstructive pulmonary disease (COPD) is a common disease and an important health care problem in older adults. The impact of age and specific geriatric issues on COPD in elderly patients has not been well established. A cross-sectional study of elderly COPD patients was conducted in Japan by using a regional COPD registry database. We compared indices of disease severity (pulmonary function, exercise tolerance, quality of life, and frequency of exacerbations), presence of comorbidities, geriatric conditions (cognitive function, mental status, and activities of daily living [ADL]), and adherence to prescribed drug regimens between elderly and younger patients with COPD. In total, 279 patients with stable COPD (median age, 74 years) were identified; 86% of these patients were elderly (65 years of age or older). Elderly COPD patients, especially those who were 75 years of age or older, had significantly more cases of dyspnea, lower exercise tolerance, and poorer ADL and a higher incidence of severe exacerbations than younger patients (all Pdisease and cancer, was significantly higher in elderly COPD patients. Elderly COPD patients had specific geriatric conditions, including cognitive impairment. Adherence to inhaled drug regimens in elderly patients was as favorable as that in younger patients. Age and specific geriatric conditions have a great negative impact on COPD in elderly patients. Geriatric conditions should be addressed in the management of elderly COPD patients. Copyright © 2014 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  20. Pet ownership and survival in the elderly hypertensive population.

    Science.gov (United States)

    Chowdhury, Enayet K; Nelson, Mark R; Jennings, Garry L R; Wing, Lindon M H; Reid, Christopher M

    2017-04-01

    To assess the association of pet ownership and all-cause and cardiovascular mortality over a long-term follow-up among elderly treated hypertensive participants. Pet-ownership data from a subcohort of the Second Australian National Blood Pressure study were used. Participants were aged 65-84 years at enrolment (1995-1997) and responded to a pet-ownership questionnaire during year 2000. Participants' survival information was determined over a median of 10.9 years that includes Second Australian National Blood Pressure in-trial period (median 4.2 years) together with posttrial follow-up period (median 6.9 years). For the current study, end points were any fatal cardiovascular event and all-cause fatal events. Of those who responded to a pet-ownership questionnaire (4039/6018 - 67%), 86% (3490/4039) owned at least one pet at any-time during their life (current or previous pet owner), with 36% (1456/4039) owning at least one pet at the time of the survey. During the follow-up period, 958 participants died including 499 deaths of cardiovascular origin. Using a Cox proportional hazard regression model adjusting for possible confounders, there was a 22 and 26% reduction in cardiovascular mortality observed among previous and current pet owners, respectively, compared with those who had never owned one. A similar nonsignificant trend was observed for all-cause mortality once adjusted for potential confounders. Pet ownership was associated with an improved cardiovascular disease survival in a treated elderly hypertensive population.

  1. Joint Association of Obesity and Hypertension with Disability in the Elderly-- A Community-Based Study of Residents in Shanghai, China.

    Science.gov (United States)

    Su, P; Ding, H; Zhang, W; Duan, G; Yang, Y; Long, J; Du, L; Xie, C; Jin, C; Hu, C; Sun, Z; Duan, Z; Gong, L; Tian, W

    2017-01-01

    Although both obesity and hypertension are known risk factors for disability, the joint association of obesity and hypertension with risk of disability is unknown. This paper is aim to examine the joint association of obesity and hypertension with risk of disability. Cross-sectional study with 8060 elderly community-dwelling individuals participating in the survey initiated by Shanghai Health and Family Planning Commission from March to September 2013. Obesity was measured using the body mass index (BMI) in World Health Organization (WHO) Asia criteria. Hypertension, based on the doctor's diagnosis, was obtained through face-to-face interview. Disability was measured using the self-reported physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scale developed by Lawton and Brody. A total of 8.97% of participants reported ADL disability, and 15.18% for IADL disability. After adjusting social demographics and chronic conditions, the risk of ADL disability was progressively greater in obese persons with hypertension (OR=1.40, 95% CI=1.05-1.89), underweight persons without hypertension (OR=2.05, 95% CI=1.29-3.25), and underweight persons with hypertension (OR=2.14, 95% CI=1.36-3.36). For IADL disability, only underweight persons with hypertension were significantly associated (OR=1.65, 95% CI=1.23-2.21). Low or extremely high BMI, independent of its metabolic consequences, is a risk factor for disability among the elderly. Simple hypertension wasn't significantly associated with disability. In addition, having hypertension significantly increased the risk of ADL disability in obese individuals and IADL disability in underweight individuals.

  2. Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese elders.

    Science.gov (United States)

    Mortimer, James A; Ding, Ding; Borenstein, Amy R; DeCarli, Charles; Guo, Qihao; Wu, Yougui; Zhao, Qianhua; Chu, Shugang

    2012-01-01

    Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly. Although greater social engagement was found to reduce dementia risk in observational studies, randomized trials of social interventions have not been reported. A representative sample of 120 elderly from Shanghai, China was randomized to four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRIs were obtained, one before the intervention period, the other after. A neuropsychological battery was administered at baseline, 20 weeks, and 40 weeks. Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests. Time-intervention group interactions for neuropsychological measures were evaluated with repeated-measures mixed models. Compared to the No Intervention group, significant increases in brain volume were seen in the Tai Chi and Social Intervention groups (p < 0.05). Improvements also were observed in several neuropsychological measures in the Tai Chi group, including the Mattis Dementia Rating Scale score (p = 0.004), the Trailmaking Test A (p = 0.002) and B (p = 0.0002), the Auditory Verbal Learning Test (p = 0.009), and verbal fluency for animals (p = 0.01). The Social Interaction group showed improvement on some, but fewer neuropsychological indices. No differences were observed between the Walking and No Intervention groups. The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise (Tai Chi). In addition, intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements.

  3. Comparison of sample characteristics in two pregnancy cohorts: community-based versus population-based recruitment methods

    OpenAIRE

    Leung, Brenda MY; Sheila W McDonald; Kaplan, Bonnie J; Giesbrecht, Gerald F.; Tough, Suzanne C.

    2013-01-01

    Background One of the biggest challenges for population health studies is the recruitment of participants. Questions that investigators have asked are “who volunteers for studies?” and “does recruitment method influence characteristics of the samples?” The purpose of this paper was to compare sample characteristics of two unrelated pregnancy cohort studies taking place in the same city, in the same time period, that employed different recruitment strategies, as well as to compare the characte...

  4. Prevalence of diabetes mellitus among the adult population in rural blocks of Haryana, India: a community-based study.

    Science.gov (United States)

    Rajput, Rajesh; Rajput, Meena; Singh, Jasminder; Bairwa, Mohan

    2012-12-01

    The aim of this was to study the prevalence of diabetes in the rural adult population of Haryana, India. A total of 2606 adults aged ≥ 18 years were randomly selected from two rural blocks of Haryana State. Those without diabetes were subjected to a 75-gram oral glucose tolerance test. Demographic, socioeconomic, and anthropometric details along with blood pressure and physical activity were recorded, and their association with the prevalence of diabetes was studied. The prevalence of newly detected diabetes was 7.3%, whereas the overall prevalence of known and newly detected diabetes was 13.3%. Multiple logistic analysis showed a statistically significant association between the prevalence of diabetes and increasing age, waist-to-hip ratio (WHR), positive family history of diabetes, low level of physical activity, and systolic blood pressure. No significant association was observed with education level and socioeconomic status. The prevalence of diabetes is rising, even in the rural population of Haryana. A positive family history of diabetes, low physical activity, and high WHR are strong predictors of diabetes in tested adult rural population of Haryana.

  5. Prevalence of presbyopia in a semi-urban population of southwest, Nigeria: a community-based survey.

    Science.gov (United States)

    Seidu, Mukaila A; Bekibele, Charles O; Ayorinde, Olutoke O

    2016-12-01

    Uncorrected presbyopia is a major cause of poor near vision in the developing countries. To determine the prevalence and demographic characteristics of presbyopia among adult populations (40 years and above) in a sub-urban population, southwest Nigeria, a population-based cross-sectional study was carried out from April to May 2014. A multi-stage sampling method was used to select eligible respondents. All participants had distance visual acuity assessment done and participants with visual acuity of less than 6/6 were refracted. Near vision was then assessed at 40 cm with distance correction in place if required. Information on near vision was obtained from the participants using interviewer administered questionnaires. Data collected were analysed using SPSS version 22. A total of 440 subjects aged 40 years and above were studied. Prevalence of presbyopia was 75 % and was significantly associated with increasing age. There was higher prevalence of presbyopia among females than males (76.3 % vs. 73.5 %), though not statistically significant. Also prevalence of presbyopia was not significantly associated with educational and occupational status in the study. This study demonstrated a high prevalence of presbyopia. There is need for improved awareness on presbyopia screening and available correction in the local government.

  6. Urine Albumin Excretion Is Associated with Cardiac Troponin T Detected with a Highly Sensitive Assay in a Community-Based Population.

    Science.gov (United States)

    Xiao, Wenkai; Ye, Ping; Cao, Ruihua; Yang, Xu; Bai, Yongyi; Wu, Hongmei

    2015-01-01

    Urine albumin excretion is an important predictor of adverse cardiovascular events. Minimally elevated levels of serum cardiac troponin T (cTnT), a marker of cardiomyocyte micronecrosis, can be detected with high sensitivity cTnT (hs-cTnT) assays. The purpose of this study was to investigate the relationship between alterations in albuminuria and serum hs-cTnT levels in a community-based population. We examined the association between the urine albumin/creatinine ratio (UACR) and hs-cTnT levels in 1354 participants without overt cardiovascular disease in a community-based, cross-sectional study in Beijing, China. With the highly sensitive assay, cTnT levels were detectable in 90.5% of our subjects. The median (interquartile range) concentrations of hs-cTnT were 7 (5-10) pg/mL. After adjustment for several factors, UACR (odds ratio: 1.40; 95% confidence interval: 1.08-1.65; P = 0.002) was associated with a higher likelihood of elevated hs-cTnT (≥14 pg/ mL), whereas the relationship between UACR and a higher presence of detectable hs-cTnT (≥ 3 pg/ mL) was not significant. In addition, a fully adjusted logistic regression analysis revealed that compared with participants in the lowest UACR quartile, those in the highest quartile had a 2.43- fold (95% CI: 1.25-5.08; P = 0.006) increased risk of elevated hs-cTnT. Higher urine albumin excretion is associated with elevated hs-cTnT among persons without clinically evident cardiovascular disease, suggesting that albuminuria may be a potential risk factor for subclinical cardiovascular disease in the general population.

  7. Prevalence of complementary and alternative medicine use in a community-based population in South Korea: a systematic review.

    Science.gov (United States)

    Seo, Hyun-Ju; Baek, Seung-Min; Kim, Sul Gi; Kim, Tae-Hun; Choi, Sun Mi

    2013-06-01

    To examine the prevalence of the use of complementary and alternative medicine (CAM) in the Republic of Korea and identify the factors responsible for variations in the reported prevalence, the socio-demographic factors associated with CAM use, and the relationship between CAM use and study methodological quality. Two international and 6 representative Korean medical databases were searched to identify cross-sectional studies that had surveyed the general Korean population in community settings to determine prevalence of CAM use. Data collection and assessment of the methodological quality of the studies were conducted by 3 independent reviewers. The prevalence of CAM use reported by the 11 studies that met the selection criteria ranged from 29% to 83%. Inclusion of Korean medicine within the definition of CAM was not found to be a significant factor in the heterogeneity, but several factors that may have contributed to it, namely, inconsistency in CAM taxonomies, recall bias, use of unrepresentative sampling strategies, and lack of pilot testing, were identified. Higher CAM use was found to be associated with female sex, high level of education, and advanced age. The inclusion of Korean medicine within the definition of CAM does not explain the heterogeneity in the reported prevalence of CAM use among the South Korean population. A standard questionnaire appropriate for the Korean context should be developed to define and classify the common CAM modalities and control for confounding factors. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  8. An e-Health Platform for the Elderly Population: The Butler System

    Science.gov (United States)

    Etchemendy, E.; Banos, R. M.; Botella, C.; Castilla, D.; Alcaniz, M.; Rasal, P.; Farfallini, L.

    2011-01-01

    The Butler system is an e-health platform designed to improve the elderly population's quality of life. The Butler system has three applications diagnostic, therapeutic and playful. The objective of this work is to present the influence of the use of the platform on elderly users' mood states and the degree of acceptance. These measures were…

  9. Breastfeeding knowledge and practices amongst mothers in a rural population of North India: a community-based study.

    Science.gov (United States)

    Kishore, M Sai Sunil; Kumar, Praveen; Aggarwal, Arun K

    2009-06-01

    National family health survey-3 of India has revealed startling lower exclusive breastfeeding (EBF) rates (16.9%) in the state of Haryana compared with national data (46%). The barriers to breastfeeding in this population are not clearly known. Therefore, a study was conducted in a rural population of the state to study their breastfeeding practices, knowledge regarding usefulness of breastfeeding and factors influencing the breastfeeding practices. In six villages of Panchkula district of Haryana, all the mothers of infants between 0-6 months were interviewed using a pretested semi-structured questionnaire. Time at initiation of breastfeeding, duration of EBF and their understanding about the usefulness of breastfeeding were assessed. Position of the baby during breastfeeding and attachment of the baby's mouth to the breast were assessed by direct observation while feeding. Breastfeeding knowledge of the mother was evaluated. Out of the 77 mothers, 30% and 10% exclusively breastfed their infants till 4 and 6 months of age, respectively. There was 'good attachment' in 42% mother-infant pairs and infants were held in 'correct position' by 60% mothers. Thirty-nine percent of the mothers had 'satisfactory' breastfeeding knowledge. On multivariate logistic regression analysis, lack of breastfeeding counseling was significantly associated with decreased rates of EBF at 4 months and 6 months (p-value 0.01 and 0.002, respectively) and 'full' breastfeeding (FBF) at 6 months of age (p-value 0.002). EBF/FBF practices and breastfeeding knowledge are suboptimal among the rural North Indian mothers. Breastfeeding counseling with emphasis on correct technique can improve the EBF/FBF rates.

  10. [Prevalence of anodontia in elderly population of Chuvashia].

    Science.gov (United States)

    Kandeĭkina, N V

    2001-01-01

    Prevalence of teeth loss was studied in a study of 784 lonely people living in homes for the elderly in Chuvashia. Teeth loss was rather frequent in the examinees. Epidemiological and clinical problems of teeth loss are analysed. A special program should be worked out on dental care for the elderly in special homes.

  11. The Prevalence of Diabetes and Prediabetes in the Adult Population of Jeddah, Saudi Arabia--A Community-Based Survey.

    Directory of Open Access Journals (Sweden)

    Suhad M Bahijri

    Full Text Available Type 2 (T2DM is believed to be common in Saudi Arabia, but data are limited. In this population survey, we determined the prevalence of T2DM and prediabetes.A representative sample among residents aged ≥ 18 years of the city of Jeddah was obtained comprising both Saudi and non-Saudi families (N = 1420. Data on dietary, clinical and socio-demographic characteristics were collected and anthropometric measurements taken. Fasting plasma glucose and glycated hemoglobin (HbA1c were used to diagnose diabetes and prediabetes employing American Diabetes Association criteria. Multiple logistic regression analysis was used to identify factors associated with T2DM.Age and sex standardized prevalence of prediabetes was 9.0% (95% CI 7.5-10.5; 9.4% (7.1-11.8 in men and 8.6% (6.6-10.6 in women. For DM it was 12.1% (10.7-13.5; 12.9% (10.7-13.5 in men and 11.4% (9.5-13.3 in women. The prevalence based on World Population as standard was 18.3% for DM and 11.9% for prediabetes. The prevalence of DM and prediabetes increased with age. Of people aged ≥50 years 46% of men and 44% of women had DM. Prediabetes and DM were associated with various measures of adiposity. DM was also associated with and family history of dyslipidemia in women, cardiovascular disease in men, and with hypertension, dyslipidemia and family history of diabetes in both sexes.Age was the strongest predictor of DM and prediabetes followed by obesity. Of people aged 50 years or over almost half had DM and another 10-15% had prediabetes leaving only a small proportion of people in this age group with normoglycemia. Since we did not use an oral glucose tolerance test the true prevalence of DM and prediabetes is thus likely to be even higher than reported here. These results demonstrate the urgent need to develop primary prevention strategies for type 2 diabetes in Saudi Arabia.

  12. Use of nutrition literacy scale in elderly minority population.

    Science.gov (United States)

    Patel, P; Panaich, S; Steinberg, J; Zalawadiya, S; Kumar, A; Aranha, A; Cardozo, L

    2013-01-01

    The major objective of our paper was to test and validate the nutritional literacy scale (NLS) in a pre-dominantly African-American geriatric population. Completion of the 2 literacy scales Short Test of Functional Health Literacy in Adults (STOHFLA) and nutritional literacy scale (NLS) during a 5-month period from September 2008 to January 2009. The Rosa Parks Geriatric Center at Detroit Medical Center/Wayne State University. The study cohort consisted of elderly (>65 years old) 150 patients that had presented to the geriatric clinic. NLS and STOHFLA were simultaneously given to the patients. The NLS consists of 28 questions regarding organic foods; calorie intake etc. and questions in each section were arranged from easier to more difficult ones. The baseline characteristics were stratified according to the NLS ( 25; p =0.001). We validated a potentially useful nutritional literacy tool that might prove to be useful intervention aimed at identifying individuals with lower levels of education and insight regarding their nutritional behaviors.

  13. Social connections and happiness among the elder population of Taiwan.

    Science.gov (United States)

    Hsu, H-C; Chang, W-C

    2015-01-01

    The purpose of this study was to examine the association between social connections and happiness among members of the elder population of Taiwan. Longitudinal panel data collected in three waves from 1999 to 2007 that are selected from national samples of Taiwanese older people were used for the analysis (n = 4731 persons). Happiness was defined as a dichotomous variable. Social connection variables included living arrangements, contacts with children/grandchildren/parents/relatives/friends, telephone contacts, providing instrumental and informational support, receiving instrumental and emotional support, and social participation. We controlled for the variables demographics, physical and mental health, economic satisfaction, and lifestyle. A generalized linear model (GLM) was applied in the analysis. Happiness remained stable over time. Receiving more emotional support and participating in social events were related to happiness at the beginning, while the effect of social participation was offset over time. Living arrangements, telephone contacts, providing social support, and receiving instrumental support were not significant. The quality of social relationships experienced is possibly more important than the quantity of social interaction for older people, and having social relationships outside the informal social network may increase happiness.

  14. The prevalence of renal impairment in the elderly hospitalized population

    Directory of Open Access Journals (Sweden)

    Maneshveri Pather

    2009-06-01

    Full Text Available Maneshveri PatherFormerly of the Department of Medicine, Clayponds Hospital, London, UKAbstract: Renal impairment has already been cited as being under-reported. A retrospective cross-sectional study was carried out. The sample population consisted of 94 inpatients aged over 60 years at Clayponds Hospital in the UK who had been admitted for rehabilitation from acute hospitals. The glomerular filtration rate (GFR was calculated using the Cockcroft–Gault formula modified for SI units. Renal impairment was found in 95.7% (95% CI: 91.8–99.6 of the sample (GFR < 90 ml/min. The study confirms that undetected renal impairment is prevalent. What is significant is that all of the subjects in this study were admitted from acute hospitals to Clayponds Hospital for rehabilitation. It is recommended that more attention be paid to the identification of patients with renal failure in hospitals owing to its significant morbidity and mortality.Keywords: renal impairment, GFR, elderly

  15. Association of glomerular filtration rate with high-sensitivity cardiac troponin T in a community-based population study in Beijing.

    Directory of Open Access Journals (Sweden)

    Fan Wang

    Full Text Available BACKGROUND: Reduced renal function is an independent risk factor for cardiovascular disease mortality, and persistently elevated cardiac troponin T (cTnT is frequently observed in patients with end-stage renal disease. In the general population the relationship between renal function and cTnT levels may not be clear because of the low sensitivity of the assay. In this study, we investigated the level of cTnT using a highly sensitive assay (hs-cTnT and evaluated the association of estimated glomerular filtration rate (eGFR with detectable hs-cTnT levels in a community-based population. METHODS: The serum hs-cTnT levels were measured in 1365 community dwelling population aged ≥45 years in Beijing, China. eGFR was determined by the Chinese modifying modification of diet in renal disease (C-MDRD equation. RESULTS: With the highly sensitive assay, cTnT levels were detectable (≥3pg/mL in 744 subjects (54.5%. The result showed that eGFR was associated with Log hs-cTnT (r = -0.14, P20% and other prognostic indicators, moderate to severe reduced eGFR was independently associated with detectable hs-cTnT, whereas normal to mildly reduced eGFR was not independently associated with detectable hs-cTnT. In addition, after adjustment for other risk factors, the high predicted Framingham CHD risk was associated with detectable hs-cTnT in the subjects with different quartile levels of eGFR. CONCLUSION: The levels of hs-cTnT are detectable in a community-based Chinese population and low eGFR is associated with detectable hs-cTnT. Moreover, eGFR and high predicted Framingham CHD risk are associated with detectable hs-cTnT in subjects with moderate-to-severe reduced renal function.

  16. Experiences and attitudes of residents regarding a community-based genome cohort study in Japan: a population-based, cross-sectional study

    National Research Council Canada - National Science Library

    Miyamoto, Keiko; Iwakuma, Miho; Nakayama, Takeo

    2016-01-01

    .... However, the association between society and research results remains controversial. This article examines the experiences and attitudes of residents regarding a community-based genomic cohort study...

  17. The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China.

    Science.gov (United States)

    Su, Peng; Ding, Hansheng; Zhang, Wei; Duan, Guangfeng; Yang, Yitong; Chen, Rong; Duan, Zengjie; Du, Lixia; Xie, Chunyan; Jin, Chunlin; Hu, Chaoqun; Sun, Zixue; Long, Junrui; Gong, Lingling; Tian, Wenhua

    2016-10-27

    Both multimorbidity and activities of daily living (ADL) disability and instrument activities of daily living (IADL) disability are common among elderly individuals. ADL/IADL disability may reduce individuals' capacities for independent living and quality of life. This study aimed to examine the association between multimorbidity and ADL/IADL disability. A multi-stage cluster sample of 2058 residents aged 80 or older was investigated in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases with ten common chronic conditions under consideration. Subjects who responded that they "need partial or full assistance" to any ADL/IADL items were defined as having ADL/IADL disability. We examined the association of multimorbidity with ADL/IADL disability, adjusted for socio-demographic characteristics by using logistic regression. Of respondents, 23.23 % had ADL disability, 37.90 % had IADL disability, and 49.17 % had multimorbidity. After adjusted socio-demographic characteristics, a graded association was showed between ADL disability and the quantity of chronic conditions: odds ratio (OR) for 1 condition, 1.53(95 % confidence interval [CI], 1.04-2.24); OR for 2 conditions, 2.06(95 % CI, 1.43-2.96); OR for 3 conditions, 3.23(95 % CI, 2.14-4.86); OR for 4 or more conditions, 5.61(95 % CI, 3.26-9.66). Similar associations were also observed between the quantity of chronic conditions and IADL disability. The quantity of chronic conditions had relatively strong association with both ADL and IADL disability. Initiating prevention of additional chronic conditions and interventions on clusters of diseases may decrease the potential risk of ADL/IADL disability. Additionally, more attention should been given to the older low-income women living with relatives/non-relatives with multimorbidity.

  18. Design and Testing of Novel Lethal Ovitrap to Reduce Populations of Aedes Mosquitoes: Community-Based Participatory Research between Industry, Academia and Communities in Peru and Thailand.

    Directory of Open Access Journals (Sweden)

    Valerie A Paz-Soldan

    Full Text Available Dengue virus (and Chikungunya and Zika viruses is transmitted by Aedes aegypti and Aedes albopictus mosquitoes and causes considerable human morbidity and mortality. As there is currently no vaccine or chemoprophylaxis to protect people from dengue virus infection, vector control is the only viable option for disease prevention. The purpose of this paper is to illustrate the design and placement process for an attractive lethal ovitrap to reduce vector populations and to describe lessons learned in the development of the trap.This study was conducted in 2010 in Iquitos, Peru and Lopburi Province, Thailand and used an iterative community-based participatory approach to adjust design specifications of the trap, based on community members' perceptions and feedback, entomological findings in the lab, and design and research team observations. Multiple focus group discussions (FGD were held over a 6 month period, stratified by age, sex and motherhood status, to inform the design process. Trap testing transitioned from the lab to within households.Through an iterative process of working with specifications from the research team, findings from the laboratory testing, and feedback from FGD, the design team narrowed trap design options from 22 to 6. Comments from the FGD centered on safety for children and pets interacting with traps, durability, maintenance issues, and aesthetics. Testing in the laboratory involved releasing groups of 50 gravid Ae. aegypti in walk-in rooms and assessing what percentage were caught in traps of different colors, with different trap cover sizes, and placed under lighter or darker locations. Two final trap models were mocked up and tested in homes for a week; one model was the top choice in both Iquitos and Lopburi.The community-based participatory process was essential for the development of novel traps that provided effective vector control, but also met the needs and concerns of community members.

  19. Design and Testing of Novel Lethal Ovitrap to Reduce Populations of Aedes Mosquitoes: Community-Based Participatory Research between Industry, Academia and Communities in Peru and Thailand.

    Science.gov (United States)

    Paz-Soldan, Valerie A; Yukich, Josh; Soonthorndhada, Amara; Giron, Maziel; Apperson, Charles S; Ponnusamy, Loganathan; Schal, Coby; Morrison, Amy C; Keating, Joseph; Wesson, Dawn M

    2016-01-01

    Dengue virus (and Chikungunya and Zika viruses) is transmitted by Aedes aegypti and Aedes albopictus mosquitoes and causes considerable human morbidity and mortality. As there is currently no vaccine or chemoprophylaxis to protect people from dengue virus infection, vector control is the only viable option for disease prevention. The purpose of this paper is to illustrate the design and placement process for an attractive lethal ovitrap to reduce vector populations and to describe lessons learned in the development of the trap. This study was conducted in 2010 in Iquitos, Peru and Lopburi Province, Thailand and used an iterative community-based participatory approach to adjust design specifications of the trap, based on community members' perceptions and feedback, entomological findings in the lab, and design and research team observations. Multiple focus group discussions (FGD) were held over a 6 month period, stratified by age, sex and motherhood status, to inform the design process. Trap testing transitioned from the lab to within households. Through an iterative process of working with specifications from the research team, findings from the laboratory testing, and feedback from FGD, the design team narrowed trap design options from 22 to 6. Comments from the FGD centered on safety for children and pets interacting with traps, durability, maintenance issues, and aesthetics. Testing in the laboratory involved releasing groups of 50 gravid Ae. aegypti in walk-in rooms and assessing what percentage were caught in traps of different colors, with different trap cover sizes, and placed under lighter or darker locations. Two final trap models were mocked up and tested in homes for a week; one model was the top choice in both Iquitos and Lopburi. The community-based participatory process was essential for the development of novel traps that provided effective vector control, but also met the needs and concerns of community members.

  20. Mortality in diabetic subjects: an eleven-year follow-up of a community-based population.

    Science.gov (United States)

    Walters, D P; Gatling, W; Houston, A C; Mullee, M A; Julious, S A; Hill, R D

    1994-12-01

    In 1979, all the known diabetic subjects (849) were identified from a community (population 81851), of whom 717 (85%) were reviewed by a single observer. Using the NHS Central Register, follow-up was completed for 98% of subjects. After 11 years, 306 (42.7%) diabetic subjects had died, of whom 65 were insulin treated and 241 were non-insulin treated. Circulatory disease accounted for 168 (54.9%) deaths, of which 124 (73.8%) were due to ischaemic heart disease. The standardized mortality ratio (SMR) for all causes of death, based on data from England and Wales, was significantly raised for both insulin-treated and non-insulin-treated patients (1.75, 95% CI 1.35 to 2.24 and 1.32, 95% CI 1.15 to 1.50, respectively). SMRs for all cause mortality were significantly greater for diabetic subjects in the 45-64 (SMR, 1.97, 95% CI 1.34 to 2.80), 65-74 (SMR 1.59, 95% CI 1.27 to 1.97 and 75 years and over (SMR 1.26, 95% CI 1.08 to 1.45) age ranges. Using a proportional hazards model, after adjusting for age and gender, systolic blood pressure and vibration threshold were significant predictors of all cause mortality in insulin-treated subjects. For non-insulin-treated subjects, blood glucose, systolic blood pressure, glycated haemoglobin, retinopathy, proteinuria, coronary artery disease, and stroke were significant baseline predictors of mortality. No association was found for serum cholesterol, body mass index, diastolic pressure or cigarette smoking in either treatment group.

  1. Incidence and risk factors for cognitive impairment in rural elderly populations in Costa Rica

    National Research Council Canada - National Science Library

    Nadel, Jeffrey L; Ulate, Diana

    2014-01-01

    .... To investigate the risk factors that predict the onset of cognitive impairment in the rural elderly of Costa Rica, a modified version of the Mini Mental State Exam-designed for illiterate populations...

  2. Strength training, level of muscular strength and functional autonomy in a population of elderly women

    National Research Council Canada - National Science Library

    da Silva, José Guilherme Fernandes Bertoni; Cader, Samária Ali; Dopico, Xurxo; Iglesias Soler, Eliseo; Martin Dantas, Estélio Henrique

    2009-01-01

    This study aimed to evaluate the effects of muscular strengthening on the level of muscular strength in the neurogenic and myogenic phases and functional autonomy in a population of healthy, sedentary, elderly women...

  3. Enculturation and attitudes toward intimate partner violence and gender roles in an asian Indian population: implications for community-based prevention.

    Science.gov (United States)

    Yoshihama, Mieko; Blazevski, Juliane; Bybee, Deborah

    2014-06-01

    This study examined the relationships among enculturation, attitudes supporting intimate partner violence (IPV-supporting attitudes), and gender role attitudes among one of the largest Asian Indian population groups in the US. Data were collected via computer-assisted telephone interviews with a random sample of Gujarati men and women aged 18-64 in Metropolitan Detroit. Using structural equation modeling, we modeled the effects of three components of enculturation (behavior, values, and community participation) on gender role attitudes and IPV-supporting attitudes among married respondents (N = 373). Analyses also accounted for the effects of respondent age, education, religious service attendance, perceived financial difficulty, and lengths of residence in the US. The second-order, overall construct of enculturation was the strongest predictor of IPV-supporting attitudes (standardized B = 0.61), but not gender role attitudes. Patriarchal gender role attitudes were positively associated with IPV-supporting attitudes (B = 0.49). In addition to the overall effect of the enculturation construct, two of the components of enculturation had specific effects. "Enculturation-values" had a specific positive indirect association with IPV-supporting attitudes, through its relationship with patriarchal gender role attitudes. However, "enculturation-community participation" was negatively associated with IPV-supporting attitudes, suggesting the importance of community-based prevention of IPV among this immigrant population group.

  4. Health status of an elderly population in Sharpeville, South Africa

    Directory of Open Access Journals (Sweden)

    Francis B Zotor

    2008-03-01

    Full Text Available The objective of this cross-sectional study was a comprehensive nutrition and health assessment to provide a basis for future intervention strategies for an elderly population attending a day-care centre. Socio-demographic, health and 24-hour recall dietary intake questionnaires were administered and anthropometric and biochemical measurements taken. The results indicate that the majority of respondents had an income of between R501 and R1 000 (South African rand per month and most of them reported an occasional lack of funds to meet basic household needs, confirming the presence of food insecurity. Daily dietary intakes (mean±Standard Deviation [SD] of the women were 5 395±2 946 kJ energy, 47±27 g protein, 28±21 g fat and 196±123 g carbohydrates compared to 8 641±3 799 kJ, 86±48 g, 49±32 g and 301±139 g of the men, respectively. The majority (83.6% of the women were overweight (body mass index [BMI] >25 or obese (BMI > 30 whilst 78% had a mid-upper arm circumference (MUAC of > 21.7 cm. Mean intakes of micronutrients were low in comparison to reference standards and serum zinc levels were suboptimal. Obesity, hypertension and raised total serum cholesterol levels indicated an increased risk for coronary heart disease. It can be concluded that a low income, household food insecurity and risk factors associated with malnutrition and non-communicable diseases were prevalent in this elderly population. Opsomming Die doelwit van hierdie dwarssnitstudie was ‘n omvattende bepaling van voeding- en gesondheidstatus om as basis te dien vir toekomstige intervensie-strategieë vir ’n groep bejaardes wat ’n dagsentrum besoek. Sosiodemografiese, gesondheid- en 24-uur herroep-dieetinname vraelyste is voltooi en antropometriese en biochemiese metings is geneem. Die resultate het bevestig dat die meerderheid respondente ‘n maandelikse inkomste van tussen R501 en R1 000 (Suid-Afrikaanse rand gehad het. Die meeste het ‘n geldtekort vir

  5. Health status of an elderly population in Sharpeville, South Africa

    Directory of Open Access Journals (Sweden)

    Wilna H Oldewage-Theron

    2008-11-01

    Full Text Available The objective of this cross-sectional study was a comprehensive nutrition and health assessment to provide a basis for future intervention strategies for an elderly population attending a day-care centre. Socio-demographic, health and 24-hour recall dietary intake questionnaires were administered and anthropometric and biochemical measurements taken. The results indicate that the majority of respondents had an income of between R501 and R1 000 (South African rand per month and most of them reported an occasional lack of funds to meet basic household needs, confirming the presence of food insecurity. Daily dietary intakes (mean±Standard Deviation [SD] of the women were 5 395±2 946 kJ energy, 47±27 g protein, 28±21 g fat and 196±123 g carbohydrates compared to 8 641±3 799 kJ, 86±48 g, 49±32 g and 301±139 g of the men, respectively. The majority (83.6% of the women were overweight (body mass index [BMI] >25 or obese (BMI > 30 whilst 78% had a mid-upper arm circumference (MUAC of > 21.7 cm. Mean intakes of micronutrients were low in comparison to reference standards and serum zinc levels were suboptimal. Obesity, hypertension and raised total serum cholesterol levels indicated an increased risk for coronary heart disease. It can be concluded that a low income, household food insecurity and risk factors associated with malnutrition and non-communicable diseases were prevalent in this elderly population. Opsomming Die doelwit van hierdie dwarssnitstudie was ‘n omvattende bepaling van voeding- en gesondheidstatus om as basis te dien vir toekomstige intervensie-strategieë vir ’n groep bejaardes wat ’n dagsentrum besoek. Sosiodemografiese, gesondheid- en 24-uur herroep-dieetinname vraelyste is voltooi en antropometriese en biochemiese metings is geneem. Die resultate het bevestig dat die meerderheid respondente ‘n maandelikse inkomste van tussen R501 en R1 000 (Suid-Afrikaanse rand gehad het. Die meeste het ‘n geldtekort vir basiese

  6. [Field observation on the effect of low-sodium and high-potassium salt substitute on blood pressure in the rural community-based population in China].

    Science.gov (United States)

    Zhang, Gao-hui; Ma, Ji-xiang; Guo, Xiao-lei; Dong, Jing; Chen, Xi; Zhang, Ji-yu; Su, Jun-ying; Tang, Jun-li; Xu, Ai-qiang

    2011-09-01

    To investigate the effect of commercial low-sodium and high-potassium salt substitutes on blood pressure in the rural community-based population in China. We conducted a quasi-experiment on 411 adults, who were 30 to 60 years of age, in 2 rural communities from Laiwu city in Shandong province of China on data from blood pressure screening. The subjects were divided into 2 groups: high blood pressure (HBP) and non-HBP (NHBP). Both groups and their family members took a low-sodium and high-potassium salt substitute for 3 months to replace the normal salt in their bodies. Blood pressure (BP) and 24-hour urinary sodium and potassium were measured regularly in the 2 groups. There was a continuously decreasing trend for BP at the end of the first month. Three months later, the mean BP decreased by 7.4 mm Hg (1 mm Hg = 0.133 kPa, t = 10.096, P = 0.000) for SBP and 3.8 mm Hg (t = 8.017, P = 0.000) for DBP in the HBP group, when compared to a 1.2 mm Hg (t = 2.507, P = 0.007) decrease on SBP and 1.0 mm Hg (t = 2.987, P = 0.002) on DBP in the NHBP group. The mean urinary sodium had a decrease of 15.5 mmol/24 h (t = 1.803, P = 0.037), but the urinary potassium increased by 4.2 mmol/24 h (t' = 2.132, P = 0.018). The result of urinary sodium appeared to be as follows: potassium ratio (Na(+)/K(+)) decreased by 1.2 (t = 2.786, P = 0.003) in the HBP group. However, in NHBP group, the mean urinary sodium decreased by 1.7 mmol/24 h (t = 0.211, P = 0.417) and urinary potassium increased by 3.7 mmol/24 h (t' = 2.207, P = 0.015), together with the decrease of Na(+)/K(+) by 0.7 (t = 1.818, P = 0.036). Results from our study clearly demonstrated that the intake of low-sodium and high-potassium salt substitute could effectively reduce the BP with good compliance among adults in the rural community-based population in China. This was an effective but non-medical method to prevent and control the high blood pressure.

  7. Amino acid requirements in children and the elderly population.

    Science.gov (United States)

    Pillai, Raja R; Kurpad, Anura V

    2012-08-01

    The factorial approach is used to measure the dietary indispensable amino acid (IAA) requirements in children, although recent measurements based on the indicator amino acid oxidation (IAAO) method have begun to generate more direct evidence. Difficulties with the factorial method are that it depends on accurate estimates of the maintenance protein requirement, as well as of protein deposition during growth. Also, a value for the efficiency of utilizing dietary protein for deposition has to be selected, based on published Nitrogen (N) balance studies. In the recent 2007 WHO/FAO/UNU report, the amino acid requirement pattern for infants was taken to be similar to the amino acid composition of breast milk. For pre-school and older children, the factorial method gave values for the scoring pattern of protein that were fairly close to the earlier 1985 WHO/FAO/UNU report for children, since growth progressively became a smaller component of the factorial calculation as age progressed. However, given that there are several assumptions in the derivation of factorial estimates, direct experimental measurements of the amino acid requirement are desirable. The IAAO method, as it is non-invasive, as made it possible to measure the IAA requirements in children. Over the last decade, some of the IAA requirements have been determined by using the IAAO method in healthy school age children; however, the data on IAA requirements in developing country populations are still being conducted. In the elderly, there are not enough data to make a separate recommendation for IAA requirements from that of adults.

  8. Elders

    National Research Council Canada - National Science Library

    Geller, Jeffrey L; Crandell, Allan E

    2014-01-01

    ... is a bildungsroman, a classic coming-of-age progression, although the two primary characters, Elder McLeod and Elder Passos, devise two very different solutions to the developmental question. In the process they are often seen as alienated and anxious as they traverse the anticipated territory of late adolescence, with its sexual energy, long...

  9. Knowledge, Attitude, and Practice of Adult Population towards Blood Donation in Gondar Town, Northwest Ethiopia: A Community Based Cross-Sectional Study

    Science.gov (United States)

    Asrie, Fikir; Melak, Tadele; Tsegay, Yakob Gebregziabher; Areba, Mohamedamin

    2016-01-01

    Background. Though World Health Organization recommends 100% voluntary blood donation, the percentage of blood collected from voluntary blood donors and the average annual blood collection rate are extremely low in Ethiopia. The role of adults is crucial to meet the demand of safe blood. Thus, this study aimed to assess knowledge, attitude, and practice of adult population towards blood donation in Gondar town, Northwest Ethiopia. Method. A community based cross-sectional study was conducted among 768 adults. Multistage sampling technique together with simple random and systematic random sampling technique was employed. Bivariate and multivariate logistic regression analysis and bivariate correlation analysis were done. Result. About 436 (56.8%), 630 (82%), and 141 (18.4%) study participants had adequate knowledge, good attitude, and experience of blood donation, respectively. Secondary and higher educational statuses were significantly associated with adequate knowledge towards blood donation. Participants who were protestant by religion were more likely to have good attitude towards blood donation. Age, self-perceived health status, and religion were significantly associated with blood donation practice. Conclusion. Knowledge and attitude towards blood donation are high. However, the level of practice is low. District and national blood banks and transfusion agency should design strategies that promote and motivate the communities to donate blood. PMID:27516920

  10. Morbidity Pattern Among Elderly Population In A Rural Area Of Dehradun In Uttaranchal

    Directory of Open Access Journals (Sweden)

    K S Negi

    2004-06-01

    Full Text Available Research Question : What is the morbidity pattern among elderly people in rural area of Dehradun?Objectives :(1     To assess the morbidity pattern among elderly population.(2     To assess the psycho-social problems among elderly people.(3     To assess the relationship between addiction and hypertension among them.Study design : Cross-Sectional.Setting : Atturwala - a rural area of district Dehradun in Uttaranchal.Participants : 332 elderly people aged 60 years and above.Statistical Analysis : Proportions, Chi-Square test.Results ; It was observed that 78.3% elderly had ophthalmic problem, 69.3% elderly had psycho-social problems followed by hypertension (49.1%, Chronic bronchitis (22% and asthma (12%. A significant relation was found between hypertention and addiction i. e. smoking and / or alcohol (p<.001. Respiratory diseases were found in 47.3% elderly persons. Depression was highly dominating problem among elderly (59.6%.

  11. The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.

    Science.gov (United States)

    Yang, Ya-Ting; Iqbal, Usman; Ko, Hua-Lin; Wu, Chia-Rong; Chiu, Hsien-Tsai; Lin, Yi-Chieh; Lin, Wender; Elsa Hsu, Yi-Hsin

    2015-06-01

    The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with aged and elderly who perceived inconvenient to access health care tended to shop in pharmacy stores compared with those with perceived convenience. Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. Joint Effect of Non-invasive Central Systolic Blood Pressure and Peripheral Systolic Blood Pressure on Incident Hypertension in a Chinese Community-based Population.

    Science.gov (United States)

    Wang, Shixuan; Zhou, Zechen; Fan, Fangfang; Qi, Litong; Jia, Jia; Sun, Pengfei; Jiang, Yimeng; Kou, Minghao; Chen, Dafang; Zhang, Yan; Huo, Yong

    2018-02-19

    Central blood pressure level is not always consistent with peripheral blood pressure level, and especially their joint effect on incident hypertension is not well established. A total of 1607 non-hypertensive subjects from an atherosclerosis cohort in Beijing, China were included. Central systolic blood pressure (cSBP) was obtained using Omron HEM-9000AI machine and peripheral systolic blood pressure (pSBP) was measured using Omron HEM-7117 electronic sphygmomanometer, separately. Hypertension was defined as BP ≥ 140/90 mmHg or self-reported hypertension or taking any antihypertension drugs at the follow-up survey. After a median follow-up of 2.3 years, incident hypertension was 13.1%. Every 1 standard deviation increase of cSBP and pSBP was associated with 1.98 (95%CI: 1.69-2.33) and 2.84 (95%CI: 2.30-3.52) times of incident hypertension after adjustment for confounders. Moreover, hypertension risk in single pSBP ≥ 120 mmHg group, single cSBP ≥ 120 mmHg group, and both pSBP and cSBP ≥ 120 mmHg group was 2.83 (95%CI: 0.98-8.16), 3.28 (95%CI: 1.24-8.70), and 11.47 (95%CI: 4.97-26.46) times higher than both pSBP and cSBP < 120 mmHg group, respectively. The joint effect of cSBP and pSBP is superior to either cSBP or pSBP to predict incident hypertension in a Chinese community-based population. Screening of central blood pressure should be considered in non-hypertensive population for the purpose of primary intervention, especially for subjects with pSBP ≥ 120 mmHg.

  13. Measuring and Comparing Hospital Accessibility for Palm Beach County's Elderly and Nonelderly Populations During a Hurricane.

    Science.gov (United States)

    Prasad, Shivangi

    2017-09-18

    To determine whether, during a hurricane, geographic accessibility to hospitals with emergency care is compromised disproportionately for the elderly than for the nonelderly. The locations of hospitals with emergency health care and a subset of those hospitals functional during a hurricane were compared with the distribution of the elderly population at the block group level in Palm Beach County, Florida. Geographic Information Systems (GIS) proximity analysis (minimum distance to closest hospital) and cumulative distribution functions were used to measure and compare hospital accessibility during normal and hurricane conditions for the elderly and nonelderly populations. Accessibility to closest functional hospital during a hurricane was compromised disproportionately for the elderly. Geographic accessibility to emergency health care is compromised disproportionately for the elderly in Palm Beach County. Compounding the risk is the likelihood of the elderly experiencing a greater health care need during a hurricane. This poses a community public health crisis and calls for effective and collaborative planning between health professionals and disaster planners to address the health care needs of the elderly. (Disaster Med Public Health Preparedness. 2017;page 1 of 5).

  14. Factors Influencing Food Choice in the Elderly Mauritian Population ...

    African Journals Online (AJOL)

    The FFQ included questions pertaining to the investigation of the degree of importance which various factors such as taste of food, routine, media, culture, ease of food availability, company or peer at meal times and nutritional knowledge had on the food choice of the elderly participants. Five degrees of importance were ...

  15. Factors Influencing Food Choice in the Elderly Mauritian Population

    African Journals Online (AJOL)

    admpather

    nutritional knowledge had on the food choice of the elderly participants. Five degrees of ... and chronic and cardiovascular diseases, which necessitate dietary modifications (Lewis,. 1986). .... The culture and religion of the family, as well as the perceived social acceptability of food were ... It is known that usually, older adults.

  16. Morbidity Pattern among the Elderly Population in a Nigerian ...

    African Journals Online (AJOL)

    Chronic disease is a major component of the burden of illness among the geriatric age group. A retrospective study of the morbidity profiles among the elderly and an assessment of the related factors are required not only to plan an appropriate geriatric health care service but also to improve the delivery of health care to the ...

  17. Tympanometry Patterns in a General Nigerian Elderly Population ...

    African Journals Online (AJOL)

    Background: Hearing is known to deteriorate with age. A lot of research is this area has provided much of information on age-related effects on anatomy and physiology of the auditory system. There is a dearth of information on the dynamics of the middle ear of the elderly Nigerian. Most commonly used test batteries for this ...

  18. Effectiveness of community-based comprehensive healthy lifestyle promotion on cardiovascular disease risk factors in a rural Vietnamese population: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Nguyen Quang

    2012-07-01

    Full Text Available Abstract Background Health promotion is a key component for primary prevention of cardiovascular disease (CVD. This study evaluated the impact of healthy lifestyle promotion campaigns on CVD risk factors (CVDRF in the general population in the context of a community-based programme on hypertension management. Methods A quasi-experimental intervention study was carried out in two rural communes of Vietnam from 2006 to 2009. In the intervention commune, a hypertensive-targeted management programme integrated with a community-targeted health promotion was initiated, while no new programme, apart from conventional healthcare services, was provided in the reference commune. Health promotion campaigns focused on smoking cessation, reducing alcohol consumption, encouraging physical activity and reducing salty diets. Repeated cross-sectional surveys in local adult population aged 25 years and over were undertaken to assess changes in blood pressure (BP and behavioural CVDRFs (smoking, alcohol consumption, physical inactivity and salty diet in both communes before and after the 3-year intervention. Results Overall 4,650 adults above 25 years old were surveyed, in four randomly independent samples covering both communes at baseline and after the 3-year intervention. Although physical inactivity and obesity increased over time in the intervention commune, there was a significant reduction in systolic and diastolic BP (3.3 and 4.7 mmHg in women versus 3.0 and 4.6 mmHg in men respectively in the general population at the intervention commune. Health promotion reduced levels of salty diets but had insignificant impact on the prevalence of daily smoking or heavy alcohol consumption. Conclusion Community-targeted healthy lifestyle promotion can significantly improve some CVDRFs in the general population in a rural area over a relatively short time span. Limited effects on a context-bound CVDRF like smoking suggested that higher intensity of intervention

  19. Association of Sarcopenic Obesity with Higher Serum High-Sensitivity C-Reactive Protein Levels in Chinese Older Males--A Community-Based Study (Taichung Community Health Study-Elderly, TCHS-E.

    Directory of Open Access Journals (Sweden)

    Chuan-Wei Yang

    Full Text Available The prevalence of obesity and sarcopenia is high among the elderly. The simultaneous occurrence of these two disorders results in sarcopenic obesity. Research suggests that inflammation has an important role in the pathogenesis of obesity and sarcopenia. This study explores the impact of sarcopenic obesity on inflammatory markers, including interleukin-6 (IL-6, high-sensitivity C-reactive protein (hs-CRP, and tumor necrosis factor-alpha (TNF-α. This study is a community-based cross-sectional study. The study sample consisted of 844 community-dwelling people aged 65 years and older (448 men and 396 women. Sarcopenia was characterized by low muscle mass (skeletal muscle index < 6.87 and 5.46 kg/m2 for men and women, respectively, and obesity was characterized by excess body fat (body fat percentage greater than the 60th percentile of the study sample by sex [27.82% in men and 37.61% in women]. Older individuals identified with sarcopenic obesity were those who had both sarcopenia and obesity. Inflammatory markers such as IL-6, hs-CRP, and TNF-α were measured. The prevalence rates of obesity only, sarcopenia only, and sarcopenic obesity were 32.94%, 11.85%, and 7.23%, respectively. No difference was observed in the serum levels of IL-6 and TNF-α among the four groups of combined sarcopenia and obesity status. After multivariate adjustment, the serum hs-CRP levels in the obesity only and in the sarcopenic obesity groups were 0.14 and 0.16 mg/dL among males, respectively, which were significantly higher than that in the normal group (P=0.012 and 0.036. Our results provide evidence that obesity and sarcopenic obesity are associated with increased levels of serum hs-CRP among males.

  20. Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population.

    Science.gov (United States)

    Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K

    2017-06-01

    Given the uncertain cost of delivering community-based cancer screening programs, we developed a Markov simulation model to project the budget impact of implementing a comprehensive colorectal cancer (CRC) prevention program compared with the status quo. The study modeled the impacts on the costs of clinical services, materials, and staff expenditures for recruitment, education, fecal immunochemical testing (FIT), colonoscopy, follow-up, navigation, and initial treatment. We used data from the Against Colorectal Cancer In Our Neighborhoods comprehensive CRC prevention program implemented in El Paso, Texas, since 2012. We projected the 3-year financial consequences of the presence and absence of the CRC prevention program for a hypothetical population cohort of 10,000 Hispanic medically underserved individuals. The intervention cohort experienced a 23.4% higher test completion rate for CRC prevention, 8 additional CRC diagnoses, and 84 adenomas. The incremental 3-year cost was $1.74 million compared with the status quo. The program cost per person was $261 compared with $86 for the status quo. The costs were sensitive to the proportion of high-risk participants and the frequency of colonoscopy screening and diagnostic procedures. The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Incidence of open-angle glaucoma in a general elderly population - The Rotterdam Study

    NARCIS (Netherlands)

    de Voogd, S; Ikram, MK; Wolfs, RCW; Jansonius, NM; Hofman, A; de Jong, PTVM

    Purpose: To determine the incidence of open-angle glaucoma (OAG) in a general elderly white population. Design: Population-based cohort study. Participants: Participants 55 years and older from the Rotterdam Study, The Netherlands. Methods: Participants at risk for incident OAG underwent at baseline

  2. Unhealthy drinking in the Belgian elderly population: prevalence and associated characteristics.

    Science.gov (United States)

    Hoeck, Sarah; Van Hal, Guido

    2013-12-01

    Knowledge about alcohol consumption patterns and alcohol problems among the Belgian elderly population is scarce. The aims of this study were to explore alcohol consumption patterns and alcohol problems among the Belgian elderly population aged ≥ 65 years living at home, and to determine their association with socio-demographic characteristics, health status and socio-economic status. In this cross-sectional study based on a representative sample of 4825 non-institutionalized Belgian elderly people (≥ 65 years) in the Belgian Health Interview Surveys 2001 and 2004, alcohol consumption patterns and alcohol problems were estimated according to age, gender, survey year, living situation, frequency of social contacts, smoking status, and socio-economic status. In all, 50.4% of the sample were non- or occasional drinkers, 29.1% were moderate drinkers, 10.4% at-risk drinkers, 4.6% heavy drinkers and 5.5% problematic drinkers. In total, 20.5% of the Belgian elderly population drank in excess of the National Institute on Alcohol Abuse and Alcoholism guidelines, and 4.7% had an alcohol problem according to the CAGE. In addition, 81.3% of the elderly people who consume alcohol used prescribed medications in the past 2 weeks. After adjustment for risk factors we found that, compared with moderate drinking, unhealthy drinking was significantly associated with age, gender, frequency of social contacts, health status and socio-economic status. Belgian health policy should be aware of the high level of at-risk drinkers in the elderly population and the underdetection and misdiagnosis of alcohol problems in this age group. An increased attention in public health initiatives among the Belgian elderly population is needed.

  3. [Comparative analysis of the migration increase dynamics of the elderly population living in the Samara region].

    Science.gov (United States)

    Gridasov, G N; Zakharova, N O; Balueva, E S

    2011-01-01

    On the large amount of factual material we studied the dynamics of net migration of elderly in urban and rural areas of Samara region for the period from 2002 to 2009. We made a comparative analysis of changes in the structure and settlement characteristics of different groups of migrants (the elderly, children and able-bodied). We came to the conclusion, that the net migration of elderly in Samara region has considerably grown, mainly due to the influx of female population. The vector of net migration of people over working age moved into the countryside and this growth is ensured by older women to a large extent. The research results of one of the main demographic processes, migration, should be considered in the formation of local and regional policies for the elderly.

  4. [Traumatic experiences in elderly Germans. Importance for mental and physical health at a population level].

    Science.gov (United States)

    Glaesmer, H

    2014-04-01

    World War II (WWII) is probably the most distressing and fatal historical event in Europe's recent past. Research on mental and physical health sequelae of these traumatic experiences from WWII has only started recently. An overview on the findings from several population-based studies investigating the mental and physical health outcomes of traumatic experiences in the German elderly (born prior to 1946), especially from WWII, is given. The results presented here are based on several population-based representative studies regarding several aspects of mental and physical health in the elderly. About 40-50 % of the elderly German population report at least one traumatic event, mostly from WWII. Traumatic experiences are related to higher rates of depressive and somatoform disorders, posttraumatic stress disorder, and physical morbidity, which are associated with increased health care utilization. The findings underline that the negative effects on health are long-term, manifold, and serious. Some of the elderly need psychotherapeutic interventions. Thus, a specific internet-based psychotherapeutic approach (ITT) is briefly presented. However, the majority of the elderly generally use other kinds of medical care, such as primary care, inpatient care, and geriatric care. It seems useful and necessary to pay more attention to the historical and biographical backgrounds of the patients to see and understand the current symptoms from this aspect.

  5. The impact of community-based palliative care on acute hospital use in the last year of life is modified by time to death, age and underlying cause of death. A population-based retrospective cohort study.

    Science.gov (United States)

    Spilsbury, Katrina; Rosenwax, Lorna; Arendts, Glenn; Semmens, James B

    2017-01-01

    Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays. Multivariate analyses involved time-to-event and population averaged log-link gamma models. There were 28,939 acute care overnight hospital admissions recorded in the last year of life, an average of 2.3 (SD 2.2) per decedent and a mean length of stay of 9.2 (SD 10.3) days. Overall, the rate of hospital admissions was reduced 34% (95%CI 1-66) and the mean length of stay reduced 6% (95%CI 2-10) during periods of time decedents received community-based palliative care compared to periods of time not receiving this care. Decedents aged community-based palliative care showed a reduced rate of hospital admission around five months before death, whereas for older decedents the reduction in hospital admissions was apparent a year before death. All decedents who were receiving community-based palliative care tended towards shorter hospital stays in the last month of life. Decedents with neoplasms had a mean length of stay three weeks prior to death while not receiving community-based palliative care of 9.6 (95%CI 9.3-9.9) days compared to 8.2 (95% CI 7.9-8.7) days when receiving community-based palliative care. Rates of hospital admission during periods of receiving community-based palliative care were reduced with benefits evident five months before death and even earlier for older decedents. The mean length of hospital stay was also reduced while receiving community-based palliative care, mostly in the last month of life.

  6. Race/Ethnicity and Adoption of a Population Health Management Approach to Colorectal Cancer Screening in a Community-Based Healthcare System.

    Science.gov (United States)

    Mehta, Shivan J; Jensen, Christopher D; Quinn, Virginia P; Schottinger, Joanne E; Zauber, Ann G; Meester, Reinier; Laiyemo, Adeyinka O; Fedewa, Stacey; Goodman, Michael; Fletcher, Robert H; Levin, Theodore R; Corley, Douglas A; Doubeni, Chyke A

    2016-11-01

    Screening outreach programs using population health management principles offer services uniformly to all eligible persons, but racial/ethnic colorectal cancer (CRC) screening patterns in such programs are not well known. To examine the association between race/ethnicity and the receipt of CRC screening and timely follow-up of positive results before and after implementation of a screening program. Retrospective cohort study of screen-eligible individuals at the Kaiser Permanente Northern California community-based integrated healthcare delivery system (2004-2013). A total of 868,934 screen-eligible individuals 51-74 years of age at cohort entry, which included 662,872 persons in the period before program implementation (2004-2006), 654,633 during the first 3 years after implementation (2007-2009), and 665,268 in the period from 4 to 7 years (2010-2013) after program implementation. A comprehensive system-wide long-term effort to increase CRC that included leadership alignment, goal-setting, and quality assurance through a PHM approach, using mailed fecal immunochemical testing (FIT) along with offering screening at office visits. Differences over time and by race/ethnicity in up-to-date CRC screening (overall and by test type) and timely follow-up of a positive screen. Race/ethnicity categories included non-Hispanic white, non-Hispanic black, Hispanic/Latino, Asian/Pacific Islander, Native American, and multiple races. From 2004 to 2013, age/sex-adjusted CRC screening rates increased in all groups, including 35.2 to 81.1 % among whites and 35.6 to 78.0 % among blacks. Screening rates among Hispanics (33.1 to 78.3 %) and Native Americans (29.4 to 74.5 %) remained lower than those for whites both before and after program implementation. Blacks, who had slightly higher rates before program implementation (adjusted rate ratio [RR] = 1.04, 99 % CI: 1.02-1.05), had lower rates after program implementation (RR for period from 4 to 7 years = 0.97, 99 % CI: 0

  7. Cholesterol-overloaded HDL particles are independently associated with progression of carotid atherosclerosis in a cardiovascular disease-free population: a community-based cohort study.

    Science.gov (United States)

    Qi, Yue; Fan, Jie; Liu, Jing; Wang, Wei; Wang, Miao; Sun, Jiayi; Liu, Jun; Xie, Wuxiang; Zhao, Fan; Li, Yan; Zhao, Dong

    2015-02-03

    Cholesterol-overloaded high-density lipoprotein (HDL) particles exert a negative impact on the antiatherogenic function of HDL in experimental studies. However, it remains unclear whether cholesterol-overloaded HDL particle is involved in the development of atherosclerosis in humans. The objective of this study was to explore whether cholesterol-overloaded HDL particles are associated with the progression of carotid atherosclerosis in a cardiovascular disease-free population. Baseline HDL particle number was measured using nuclear magnetic resonance spectroscopy in 930 participants ages 45 to 74 years in a community-based cohort study. An estimate of cholesterol molecules per HDL particle (HDL-C/P ratio) was calculated as the ratio of HDL cholesterol to HDL particles. HDL-C/P ratio was categorized as <41.0 (lowest), 41.0 to 46.9, 47.0 to 52.9, and ≥53.0 (highest) using a fixed increment method. Modified Poisson regression was used to assess the association between HDL-C/P ratio and 5-year progression of carotid atherosclerosis as indicated by progression of carotid plaques and change in total plaque area (TPA). Mean baseline HDL-C/P ratio was 46.4 ± 9.3 (range 23.8 to 86.9). Baseline HDL-C/P ratio was significantly associated with 5-year progression of carotid atherosclerosis. Participants with the highest HDL-C/P ratio had 1.56-fold (95% confidence interval: 1.14 to 2.13; p = 0.006) increased progression compared with those with the lowest level. Among participants without baseline plaque, TPA in re-examination was larger by 9.4 mm(2) in the subgroup with the highest level when compared with the lowest level. Our findings suggest that cholesterol-overloaded HDL particles are independently associated with the progression of carotid atherosclerosis. This may explain why in recent trials raising HDL cholesterol was not beneficial. This study strongly suggests that the combination of cholesterol content and particle number determines the antiatherogenic function of

  8. Demographic transition and population ageing in India: Implications on the elderly of the future

    Directory of Open Access Journals (Sweden)

    Shradha Mathur

    2015-01-01

    Full Text Available Ageing population of India will transform into the elderly in future. The issue of health of the elderly population in India has arrested the attention of health policy makers and the researchers, in the recent past. Demographic structure, quality of life, healthcare services and government planning have serious implications on the ageing population. The objective of the research article is to systematically and critically evaluate the impact of demographic transition, projected demographic indicators and changing population characteristics on the health status of the elderly persons living in India in the coming decades. Analysis and discussions are based on secondary data published by the Ministry of Health and Family Welfare of the Government of India. The results indicate that India will be an ageing nation in the coming years and improvements in health, education and government planning are likely to enhance the life expectancy of the elderly, while the share of children will reduce, suggesting an increase in dependency of the older persons on the adult population. The article provides insights into workable solutions and suggests key recommendations to attain faster demographic dividend. India would be competing with the pressure of a dramatic demographic bulge in future.

  9. America's elderly.

    Science.gov (United States)

    Soldo, B J; Agree, E M

    1988-09-01

    The older population in the US has grown twice as fast as the rest of the population in the last 20 years. This growth is expected to accelerate early in the next century as the large baby boom cohorts move through middle age and become elderly. Today, about 1 in 8 Americans is 65 years of age or older. By 2030, 1 out of every 4 persons will be in older person. Substantial improvements in life expectancy at all ages, particularly at extreme old age, mean that not only will there be a greater proportion of elderly in the population, but the more will be the "oldest-old," over 85. By 2050, they will be more than 1/4 of the population. As people live longer, many are active and healthy well past retirement. However, many individuals living into their 80s have to cope with chronic disabilities affecting their capacity to perform day-to-day activities. Modern medicine has made great inroads against mortality from such illnesses as heart disease and stroke, but has not eliminated all the effects of these diseases. As the population ages, the issues of health care funding and availability, particularly long-term care, increase in importance. Contrary to widespread belief, the elderly are not abandoned by their families to nursing home care. The vast majority--95%--live in the community. Those needing assistance generally receive help from family and friends. This has created a tremendous demand for federal subsidies to support community-based long-term care services. 1/4 of the federal budget is now spent on the elderly--$270 billion in 1986. Medicaid and Medicare are among the government's success stories, but these programs are threatened by their very success. Economists estimate that government expenditures are 3 times greater for the elderly than for children, raising the issue of "intergenerational equity"--how to balance the amount of care society provides to those who have already contributed with what is provided to those who will contribute in the future. The

  10. Effects of a Community-Based Program for Oral Health and Nutrition on Cost-Effectiveness by Preventing Disability in Japanese Frail Elderly: A Quasi-Experimental Study Using Propensity Score Matching.

    Science.gov (United States)

    Tomata, Yasutake; Watanabe, Takashi; Sugiyama, Kemmyo; Zhang, Shu; Sugawara, Yumi; Tsuji, Ichiro

    2017-08-01

    In the Japanese Long-Term Care Insurance (LTCI) system, a community-based program for oral health and nutrition (OHN program) has been implemented with the aim of reducing incident disability and care costs. However, the effectiveness of this program has not been confirmed epidemiologically. The purpose of the present study was to test the hypothesis that the OHN program does reduce incident disability and care costs. A prospective study with a 28-month follow-up period was conducted using data from administrative databases at Tagajo City, Japan. Among frail elderly persons (aged 65 years or more) who were enrolled in the LTCI program in Tagajo, 64 participants in the OHN program and 128 controls (nonparticipants) were selected by propensity score matching. We used 2 types of outcome measure: composite outcome (incident disability and death) and care cost. Data on incident disability were retrieved from the public LTCI database. Care cost was defined as the total amount of LTCI service cost added to medical care cost. The hazard ratio of composite outcome was significantly lower for the intervention group than for the control group (hazard ratio = 0.32, 95% confidence interval 0.12-0.82). Even when we set incident disability as an outcome, the hazard ratio for the intervention group did not change (hazard ratio = 0.33, 95% confidence interval 0.11-0.97). The mean cumulative care cost during the 28 months tended to be lower for the intervention group ($4893) than that for the control group ($5770), but this was not statistically significant by the gamma regression model (cost ratio = 0.85, P = .513). The mean care cost per unit follow-up period (1 month) for the intervention group was significantly lower (cost ratio = 0.54, P = .027). The results of this study suggest that the OHN program is effective for preventing incident disability and, consequently, for saving care costs per unit survival period. Copyright © 2017 AMDA – The Society for Post

  11. Progressive disability in elderly population among tribals of Telangana: a cross sectional study.

    Science.gov (United States)

    Katta, Ajitha; Krishna, Anil Kumar Indira; M, Bagavandas; Anegawa, Tomofumi; Munuswamy, Suresh

    2017-06-19

    The tribal population of Telangana, India, lives in remote and difficult conditions. This study was carried out to find out estimate, the prevalence and progression of disability in elderly population among tribals of Khammam District, Telangana state, India. A population based cross sectional survey was conducted in villages of Tribal Sub Plan area. Elderly people who are 60 years or older were chosen with a two stage sampling procedure: (1) probability proportion to size was used to select clusters and (2) in each selected cluster households were selected by systematic random sampling. The participants were interviewed with the 36 item Telugu version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire. Socio- demographic information, behavioral measurements, health and social benefit indicators were also assessed. Descriptive analytical methods were used for prevalence estimation and logistic regression was used to examine the associations of progressive age over disability among elderly. A total of 506 elderly people from 1349 households in 20 villages across 31mandals of Khammam were interviewed. Majority of elderly population among tribals were illiterate (men 88.94%; women 99.33%), used tobacco (men 81.25%; women 57.72%), consumed alcohol (men 80.77%; women 47.32%) and were hypertensive (men 53.85%; women 63.42%). The prevalence of disability was higher in women. Maximum disability in the interviewed elderly population was seen in domains of performing house hold activities, and mobility. In comparison with men, women expressed more disability for majority of domains. As age progressed, the disability for self-care domain increased to a maximum of 2.6 times in men and 6.6 times in women and for mobility domain increased to a maximum of 9.7 times in men and 7.2 times in women. Although present disability modifying mobility Assistive Devices (AD) can help elderly in overcoming disability, these are primarily designed for

  12. Assessment of frailty in elderly pre-dialysis population using simple tools

    Directory of Open Access Journals (Sweden)

    Hatem Ali

    2017-01-01

    Full Text Available Prevalence of chronic kidney disease (CKD is increasing worldwide principally among the elderly population many of whom will eventually need renal replacement therapy. The relationship between frailty and CKD in the elderly population has been recognized. However, studies concentrating on frailty in pre-dialysis patients are limited. CKD predisposes to frailty through many potential mechanisms; anemia, bone mineral disease, oxidative stress, and malnutrition which in turn lead to progression of CKD culminating in a vicious cycle. Identifying potential causes of frailty in elderly pre-dialysis patients and recognizing individuals at risk should be an area of focus to nephrologists and researchers. Modalities that may improve frailty in elderly pre-dialysis patients such as treatment of anemia and bone mineral disease may improve outcome. However, this has not been established and further research is needed. The aim of this review is to address the importance of recognizing frailty in elderly pre-dialysis patients using simple tools and describing its implications on clinical outcome.

  13. RSV vaccine in development : Assessing the potential cost-effectiveness in the Dutch elderly population

    NARCIS (Netherlands)

    Meijboom, M J; Pouwels, K B; Luytjes, W; Postma, Maarten; Hak, E

    2013-01-01

    OBJECTIVES: Respiratory syncytial virus (RSV) is increasingly recognized as an important cause of morbidity, mortality and health-care utilization in the elderly population. A theoretical model was built to assess the levels of vaccine effectiveness and vaccine costs for which a hypothetical

  14. RETINOPATHY, GLUCOSE, AND INSULIN IN AN ELDERLY POPULATION - THE ROTTERDAM STUDY

    NARCIS (Netherlands)

    STOLK, RP; VINGERLING, [No Value; DEJONG, PTVM; DIELEMANS, Hubertus J.A.; HOFMAN, A; LAMBERTS, SWJ; POLS, HAP; GROBBEE, DE

    We studied the association between retinopathy and glucose metabolism in a population-based study of elderly men and women, Glucose metabolism was assessed by serum fructosamine and a nonfasting oral glucose tolerance test, and retinopathy was evaluated by fundus photography, Retinopathy was present

  15. Hyperinsulinemia and bone mineral density in an elderly population : The Rotterdam study

    NARCIS (Netherlands)

    Stolk, RP; VanDaele, PLA; Pols, HAP; Burger, H; Hofman, A; Birkenhager, JC; Lamberts, SWJ; Grobbee, DE

    We studied the association between insulin and glucose levels and bone mineral density (BMD) in a population based study of 5931 elderly men and women, Serum insulin was measured 2 h after a nonfasting oral glucose load in subjects not using antidiabetes medication, BMD was measured by dual-energy

  16. Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons

    NARCIS (Netherlands)

    Berg, J.F. van den; Miedema, H.M.E.; Tulen, J.H.M.; Hofman, A.; Neven, A.K.; Tiemeier, H.

    2009-01-01

    Study Objectives: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Design: Cross-sectional study. Setting: The study was embedded in the Rotterdam Study, a population-based study. Participants: Nine hundred fifty-six

  17. Elder Self-neglect and Suicidal Ideation in an U.S. Chinese Aging Population: Findings From the PINE Study.

    Science.gov (United States)

    Dong, XinQi; Xu, Ying; Ding, Ding

    2017-07-01

    Self-neglect and suicidal ideations are important public health issues among the aging population. This study aims to examine the association between self-neglect, its phenotypes, and suicidal ideation among U.S. Chinese older adults. Guided by a community-based participatory research approach, the Population Study of Chinese Elderly in Chicago (PINE) study is a population-based epidemiological study conducted from 2011 to 2013 among 3,159 Chinese older adults aged 60 years and older in the Greater Chicago area. Self-neglect was assessed by a 27-item instrument, describing five phenotypes with hoarding, poor personal hygiene, unsanitary condition, lack of utilities, and need of home repair. Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Logistic regression is utilized to analyze the association. Higher level of self-neglect was found significantly associated with increased risk of self-reported suicidal ideation within 2 weeks (odds ratio 2.97 [1.54-5.72]); 12 months (odds ratio 2.82 [1.77-4.51]); and lifetime (odds ratio 2.74 [1.89-3.95]). For phenotypes, the study found that poorer personal hygiene and severer level of unsanitary conditions were associated with increased risk of suicidal ideation at all three time periods. This study suggests that self-neglect and its phenotypes are significantly associated with suicidal ideation among Chinese older adults. Longitudinal studies are needed to explore the mechanisms through which self-neglect links with suicidal ideation.

  18. Chronic morbidity and health care seeking behaviour amongst elderly population in rural areas of Uttarakhand

    Directory of Open Access Journals (Sweden)

    Surekha Kishore

    2015-06-01

    Full Text Available Background: Ageing is a natural process, always associated with physiological and biological decline. Global population is ageing; the proportion of older persons has been rising steadily, from 7% in 1950 to 11% in 2007, with an expected rise to reach 22 % in 2050. With improving knowledge and awareness the health care seeking behavior has shown an increasingly positive trend. With increasing age, morbidity,   especially those arising from chronic diseases also increases. On the contrary, health care delivered at household level has definitely   gone down due to financial constraints and increasing cost of living, thus posing a problem for the elderly.  Aims & Objective: To find out the prevalence of chronic morbidity and health care seeking behaviour amongst the elderly in rural areas of Uttarakhand. Material and Methods: A cross-sectional study was carried out in rural areas of Uttarakhand to assess the chronic morbidity amongst elderly population. All the persons above the age group of 60 years of the eight villages were interviewed using a pre-defined, pre-tested, semi-structured and indigenously developed questionnaire. Results: The study group suffered from various chronic morbidities like hypertension, diabetes, cardiovascular diseases. Men were greater in number (158, 62.2%. Participants belonging mostly to nuclear families (156, 61.9%. Below the poverty line were (98, 38.9%. Half of the study population had one or the other chronic morbid condition. Majority of the elderly men contacted the health care facility whereas majority of the elderly women chose to use remedies. Conclusion: There is definitely a need of   provision of health care services for poor geriatric population. In addition to this government should take up some program for social security of this population along with creating an awareness about the same.

  19. Risk factors for falls in the institutionalized elder population

    Directory of Open Access Journals (Sweden)

    Camilo Romero

    2004-12-01

    Full Text Available The objective is to determine the risk factorspredictors of falls in institutionalized elderlypeople. Methodology: Analysis of data from alongitudinal cohort study. Subjects: Institutionalizedelderly volunteers residents of a nursinghome in Arbelaez, Colombia enrolled andfollowed for six months (N= 116; mean age: 78years. Main outcome measures: Falls detected via nurses reports and medical records. Independentvariables: Baseline measures of demographics,medical history, drug intake, depression, mentalstate, visual acuity, orthostatic hypotension,body mass index, cardiovascular state, limbdeformities, limb strength, tone, trophism, rageof motion, Romberg, one leg balance test, GetUp and Go test and timed Get Up and Go test.Evaluation of home facilities by the TESS-NHand SCUEQS scales. Results: Over the six monthfollow-up 36% experienced a fall. All noneinjurious falls. The independent significantpredictors of all falls using logistic regression were female gender, history of dizziness and anabnormal one leg balance test. With coefficientB values of 1.029, 2.024 and 1.712, respectively.Conclusion: The female gender, the history ofdizziness and abnormal one-leg balance testappear to be the main and significant predictorsof falls in institutionalized elderly persons.However, no single factor seems to be accurateenough to be relied on as a sole predictor of fallrisk because so many diverse factors are involvedin falling

  20. Sleep correlates of depression and anxiety in an elderly Asian population.

    Science.gov (United States)

    Yu, Junhong; Rawtaer, Iris; Fam, Johnson; Jiang, Min-Jun; Feng, Lei; Kua, Ee Heok; Mahendran, Rathi

    2016-05-01

    Research looking at the association between sleep and psychiatric symptoms in elderly Asian populations is lacking. The present study examines the sleep correlates of depression and anxiety in a sample of cognitively healthy older adults. The Geriatric Depression Scale, Geriatric Anxiety Inventory, and the Pittsburgh Sleep Quality Index were administered to a community sample of elderly participants (n = 107; 81 women; Mage = 71.3 years, SD = 5.7) RESULTS: Geriatric Depression Scale and Geriatric Anxiety Inventory scores are both significantly correlated with sleep disturbance. Geriatric Depression Scale scores are uniquely associated with daytime dysfunction, and Geriatric Anxiety Inventory scores are uniquely associated with perceived sleep quality, sleep latency, and global Pittsburgh Sleep Quality Index scores. Depression and anxiety in a cohort of elderly Asian subjects are associated with a number of sleep-related issues; both are related to a somewhat different profile of sleep problems. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  1. The prevalence of chronic kidney disease and its relation to socioeconomic conditions in an elderly Polish population: results from the national population-based study PolSenior.

    Science.gov (United States)

    Chudek, Jerzy; Wieczorowska-Tobis, Katarzyna; Zejda, Jan; Broczek, Katarzyna; Skalska, Anna; Zdrojewski, Tomasz; Wiecek, Andrzej

    2014-05-01

    Rapidly progressing ageing of worldwide populations is likely to increase the occurrence of chronic kidney disease (CKD) in the next decades. However, until now little is known about the prevalence of CKD in the Polish elderly population. The aim of this study was to assess the prevalence of CKD and its relation to socioeconomic conditions in the Polish elderly population. A glomerular filtration rate estimated (eGFR) according to the CKD-EPI formula and urine albumin/creatinine ratio were determined in 3797 out of 4979 randomly selected elderly subjects from the national survey study PolSenior. Additionally, some socioeconomic factors related to the prevalence of CKD were also analysed. The prevalence of CKD in the Polish elderly population was 29.4%. Only 3.2% of elderly subjects with CKD were aware of the disease. CKD was more frequent among urban dwellers, non-smokers, alcohol abstinents and those with low physical activity. Decreased eGFR was more frequent among less educated women, better educated men, blue collar female workers and white collar male workers. Increased albuminuria was associated with low physical activity. (i) CKD affects almost one-third of the elderly Polish population. (ii) In Poland elderly subjects with CKD are usually unaware of their kidney disease. (iii) In Polish elderly population, CKD is more frequently present among urban residents, non-smokers, abstainers and less physically active people. (iv) Only in women is higher educational status related to the lower risk of CKD.

  2. Robot-assisted surgery in elderly and very elderly population: our experience in oncologic and general surgery with literature review.

    Science.gov (United States)

    Ceccarelli, Graziano; Andolfi, Enrico; Biancafarina, Alessia; Rocca, Aldo; Amato, Maurizio; Milone, Marco; Scricciolo, Marta; Frezza, Barbara; Miranda, Egidio; De Prizio, Marco; Fontani, Andrea

    2017-02-01

    Although there is no agreement on a definition of elderly, commonly an age cutoff of ≥65 or 75 years is used. Nowadays most of malignancies requiring surgical treatment are diagnosed in old population. Comorbidities and frailty represent well-known problems during and after surgery in elderly patients. Minimally invasive surgery offers earlier postoperative mobilization, less blood loss, lower morbidity as well as reduction in hospital stay and as such represents an interesting and validated option for elderly population. Robot-assisted surgery is a recent improvement of conventional minimally invasive surgery. We provided a complete review of old and very old patients undergoing robot-assisted surgery for oncologic and general surgery interventions. A retrospective review of all patients undergoing robot-assisted surgery in our General Surgery Unit from September 2012 to June 2016 was conducted. Analysis was performed for the entire cohort and in particular for three of the most performed surgeries (gastric resections, right colectomy, and liver resections) classifying patients into three age groups: ≤64, 65-79, and ≥80. Data from these three different age groups were compared and examined in respect of different outcomes: ASA score, comorbidities, oncologic outcomes, conversion rate, estimated blood loss, hospital stay, geriatric events, mortality, etc. Using our in-patient robotic surgery database, we retrospectively examined 363 patients, who underwent robot-assisted surgery for different diseases (402 different robotic procedures): colorectal surgery, upper GI, HPB, etc.; the oncologic procedures were 81%. Male were 56%. The mean age was 65.63 years (18-89). Patients aged ≥65 years represented 61% and ≥80 years 13%. Overall conversion rate was of 6%, most in the group 65-79 years (59% of all conversions). The more frequent diseases treated were colorectal surgery 43%, followed by hepatobilopancreatic surgery 23.4%, upper gastro-intestinal 23

  3. Relationship of Lifestyle and Social Support With Marital Satisfaction of Elderly Population

    Directory of Open Access Journals (Sweden)

    Soosan Rafiee

    2016-07-01

    Full Text Available Objectives: Given the improvement in the personal and social health level of elderly people, the present study aimed to investigate the relationship of factors like lifestyle and social support with marital satisfaction in elderly people in Iran. Methods & Materials: The present study employed a cross-sectional descriptive correlation method. The study population included 381 elderly people aged 60 years and above. They were selected from health care centers using random cluster sampling technique. The subjects were asked to complete the Erich’s marital satisfaction questionnaire, lifestyle questionnaire, and social support questionnaire. The data collected was analyzed through descriptive and inferential statistics (Pearson Correlation Coefficient and Stepwise regression using SPSS 21 software. Results: The outcomes of stepwise regression analysis indicated that lifestyle and social support serve as significant predictors of marital satisfaction among the elderly people in Iran (R2=0.46. However, there was no significant difference (P>0.05 between the contribution of lifestyle and social support towards marital satisfaction. Conclusion: Our findings suggested that social support and lifestyle are the key elements in maintaining the stability of marital satisfaction in the elderly people.

  4. Dietary intakes and biochemical indicators of nutritional status in an elderly, institutionalized population.

    Science.gov (United States)

    Sahyoun, N R; Otradovec, C L; Hartz, S C; Jacob, R A; Peters, H; Russell, R M; McGandy, R B

    1988-03-01

    A dietary and biochemical assessment of the nutritional status of 260 elderly men and women, 60-101 y (average 80.5 y), was conducted in 15 long-term-care facilities in the Boston area. Subjects were free of clinically apparent terminal or wasting illness. Nutrient intakes were comparable to those in a simultaneously studied free-living population as were most biochemical markers of nutrient status. Although no specific nutrient deficiencies were identified, blood levels of vitamin A and retinol-binding protein in males and of zinc in both sexes were lower in this institutionalized group than in the free-living subjects. Hematologic indices, albumin, prealbumin, and transferrin levels were also lower than in noninstitutionalized elderly populations. These differences may reflect the greater prevalence of chronic diseases and medication use in a long-term-care population. However, there is no evidence that institutionalization in itself leads to impairment of nutritional status.

  5. Development of a cognitive screening instrument for tribal elderly population of Himalayan region in northern India

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Raina

    2013-01-01

    Full Text Available Introduction: Cognitive impairment, characteristic of dementia, is measured objectively by standard neuropsychological (cognitive tests. Given the diversity of culture and language in India, it is difficult to use a single modified version of MMSE uniformly to Indian population. In this article, we report methods on the development of a cognitive screening instrument suitable for the tribal (Bharmour elderly (60 years and above population of Himachal Pradesh, India. Materials and Methods: We used a systematic, item-by-item, process for development of a modified version of MMSE suitable for elderly tribal population. Results: The modifications made in the English version of MMSE and the pretesting and pilot testing thereof resulted in the development of Bharmouri version of cognitive scale. Discussion: The study shows that effective modifications can be made to existing tests that require reading and writing; and that culturally sensitive modifications can be made to render the test meaningful and relevant, while still tapping the appropriate cognitive domains.

  6. Elder Mistreatment and Emotional Symptoms among Older Adults in a Largely Rural Population: The South Carolina Elder Mistreatment Study

    Science.gov (United States)

    Begle, Angela M.; Strachan, Martha; Cisler, Joshua M.; Amstadter, Ananda B.; Hernandez, Melba; Acierno, Ron

    2011-01-01

    Although two recent major studies provide some insight into the prevalence and correlates of elder mistreatment, the relationship between elder mistreatment and mental health remains unclear. This study begins to address this issue by examining the relationship between elder mistreatment (i.e., a recent history of emotional and physical abuse) and…

  7. Chronic kidney disease in Polish elderly population aged 75+: results of the WOBASZ Senior Survey.

    Science.gov (United States)

    Zdrojewski, Łukasz; Król, Ewa; Rutkowski, Bolesław; Piotrowski, Walerian; Pająk, Andrzej; Drygas, Wojciech; Zdrojewski, Tomasz

    2017-04-01

    Kidney filtration decreases with age, which results in an increased frequency of chronic kidney disease (CKD) in the elderly population. The purpose of the study was to assess the prevalence and epidemiology of CKD in the Polish elderly population. A representative sample of the Polish elderly population, composed of 918 people (F 452, M 466) in the age of ≥75 years, was chosen. All participants had their history, anthropometric measures and biochemical parameters (creatinine, fasting glucose, complete cholesterol) evaluated. CKD was diagnosed when eGFR was population was 26.9% (F 32.0%, M 15.8%), which gives an estimated number of 495,590 (95% CI 396,363-594,817) patients in the study subpopulation. The majority of these people were in the G3A category-70.1%, while the remaining fell under the G3B-25.7%, G4-3.1% and G5-1.1% categories. Disease awareness among the participants was found to be at 17%. Arterial hypertension (AH) was more frequent in people with CKD (91.0 vs. 80.3%, P increased the chances of developing CKD (OR 1.87, P population was 26.9%. 2. Awareness of CKD is low. 3. DM, increasing age and AH did not increase the risk of CKD. 4. Coexistence of cardiovascular diseases increased the risk of having CKD.

  8. Medical and economic burden of influenza in the elderly population in central and eastern European countries.

    Science.gov (United States)

    Kovács, Gábor; Kaló, Zoltán; Jahnz-Rozyk, Karina; Kyncl, Jan; Csohan, Agnes; Pistol, Adriana; Leleka, Mariya; Kipshakbaev, Rafail; Durand, Laure; Macabeo, Bérengère

    2014-01-01

    Influenza affects 5-15% of the population during an epidemic. In Western Europe, vaccination of at-risk groups forms the cornerstone of influenza prevention. However, vaccination coverage of the elderly (> 65 y) is often low in Central and Eastern Europe (CEE); potentially because a paucity of country-specific data limits evidence-based policy making. Therefore the medical and economic burden of influenza were estimated in elderly populations in the Czech Republic, Hungary, Kazakhstan, Poland, Romania, and Ukraine. Data covering national influenza vaccination policies, surveillance and reporting, healthcare costs, populations, and epidemiology were obtained via literature review, open-access websites and databases, and interviews with experts. A simplified model of patient treatment flow incorporating cost, population, and incidence/prevalence data was used to calculate the influenza burden per country. In the elderly, influenza represented a large burden on the assessed healthcare systems, with yearly excess hospitalization rates of ~30/100,000. Burden varied between countries and was likely influenced by population size, surveillance system, healthcare provision, and vaccine coverage. The greatest burden was found in Poland, where direct costs were over EUR 5 million. Substantial differences in data availability and quality were identified, and to fully quantify the burden of influenza in CEE, influenza reporting systems should be standardized. This study most probably underestimates the real burden of influenza, however the public health problem is recognized worldwide, and will further increase with population aging. Extending influenza vaccination of the elderly may be a cost-effective way to reduce the burden of influenza in CEE.

  9. Bone-conduction hearing aids in an elderly population: complications and quality of life assessment.

    Science.gov (United States)

    Carr, Simon D; Moraleda, Javier; Baldwin, Alice; Ray, Jaydip

    2016-03-01

    To determine whether an elderly population with hearing impairment can be adequately rehabilitated with a bone-conduction hearing aid and whether the putative relationship between the elderly and an increased complication rate is justified. The study design was a retrospective case note review with a postal and telephone questionnaire, which was carried out in a tertiary centre. All patients aged 60 or over underwent implantation with a bone-conduction aid between 2009 and 2013 for conductive, SSD or mixed hearing loss. Outcome measures were complication rates and quality of life assessment using the Glasgow Benefit Inventory. The influence of patient and surgical factors on the complication rate was assessed. Fifty-one patients were implanted. Mean age was 67 years (range 60-89 years). The mean benefit, satisfaction and global GBI scores were 70 % (range 0-100 %), 70 % (0-100 %) and 82 % (83-100 %), respectively. The residual disability was 18 % (0-25 %). The adverse skin reaction rate was 16 % and the fixture loss rate was 2 %. There was a demonstrable increase in the complication rate with the dermatome (45 %; 5 patients) compared to the Sheffield 'S' (13 %; 2 patients) or linear incision techniques (29 %; 7 patients). The bone-conduction hearing aids are ideal method of hearing rehabilitation in the elderly for all forms of hearing loss. It provides significant benefit with no increased complication rate, which is imperative if social isolation is to be avoided and cognition preserved in this growing elderly population.

  10. Cognitive assessment in an elderly population with metabolic syndrome in Brazil

    Directory of Open Access Journals (Sweden)

    Nadia Shigaeff

    Full Text Available ABSTRACT Chronic degenerative conditions are very common in the elderly. According to medical literature, there is a correlation between cognitive impairment among elders and arterial hypertension/hyperglycemia which in turn are common diseases among the elderly population worldwide. Nonetheless, data on the association between cognitive impairment and Metabolic Syndrome (MetS remains controversial. Objective: To compare the cognitive status of Brazilian elderly outpatients with and without MetS. Methods: A cross-sectional case-control study with 49 subjects (25 MetS and 24 controls who underwent a global geriatric and neuropsychological assessment was carried out. The scores for cognitive abilities (sustained attention, alternating attention, immediate memory, working memory, memory - immediate recall, memory - delayed recall, memory - recognition, executive function, ideomotor praxis, constructive praxis, naming ability, verbal fluency were compared with the data for the normal population and differences between case and control groups were analyzed using Student's t-test or the Mann-Whitney test. Results: Forty-five patients (91.8% were female, with a mean age of 73.9±5.9 years, and 3.0±1.0 years of schooling. A significant difference (p<0.01 was found between case and control groups regarding the MetS components. For cognitive abilities, no statistically significant difference was detected between the groups and all subjects presented low cognitive scores. Conclusion: The results obtained in the present study showed that MetS was not associated with cognitive impairment in this population. Further prospective studies are necessary to investigate the influence of well-controlled MetS on cognitive performance among elders.

  11. The health status of the elderly population of Iran in 2012.

    Science.gov (United States)

    Tanjani, Parisa Taheri; Motlagh, Mohammad Esmaeil; Nazar, Mehdi Moradi; Najafi, Farid

    2015-01-01

    With advancing age comes dramatic increase in the incidence of chronic diseases, disabilities, and mental problems. This study was conducted to epidemiologically describe the health status of the elderly population of Iran. People aged ≥60 were selected. Mini-nutritional assessment, activity of daily living, geriatric depression scale questionnaires were administered. Physical diseases and risk factors were also investigated. For the purpose of this study, 1350 elderly individuals were randomly selected. The mean age of sample was 69.1±7.3 and 65.9% were illiterate. From total, 727 (53.8%) had vision problems. The most common problem was cataracts with a prevalence of 305 (22.6%) patients who were either suffering from cataracts or had undergone a surgery for it. From 634 individuals who used dentures, 446 (70.3%) wore the same first denture for over 10 years, without being examined. 524 (38.8%) of our seniors spent their free time alone at home. 13.2% of women and 12.6% of men were dependent on others for at least one daily activity. In terms of nutrition, 70 (5.5%) of the elderly (46 women and 24 men) were severely malnourished with 554 (41.3%) (243 men and 311 women) at risk of malnutrition. The health status of the elderly in Iran was similar to other countries in the world. However there continues to be room for improvement. Taking into account the rapidly aging population of Iran, health providers, and policy makers are required to take steps at a national level and direct more resources into supporting the elderly population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Health care utilization in the elderly Mexican population: Expenditures and determinants

    Directory of Open Access Journals (Sweden)

    García-Peña Carmen

    2011-03-01

    Full Text Available Abstract Background Worldwide population aging has been considered one of the most important demographic phenomena, and is frequently referred as a determinant of health costs and expenditures. These costs are an effect either of the aging process itself (social or because of the increase that comes with older age (individual. Objective To analyze health expenditures and its determinants in a sample of Mexican population, for three dimensions acute morbidity, ambulatory care and hospitalization focusing on different age groups, particularly the elderly. Methods A secondary analysis of the Mexican National Health and Nutrition Survey (ENSANUT, 2006 was conducted. A descriptive analysis was performed to establish a health profile by socio-demographic characteristics. Logistic regression models were estimated to determine the relation between acute morbidity, ambulatory care, hospitalization and age group; to establish the determinants of hospitalization among the population 60 years and older; and to determine hospitalization expenditures by age. Results Higher proportion of elderly reporting health problems was found. Average expenditures of hospitalization in households were $240.6 am dlls, whereas in households exclusively with elderly the expenditure was $308.9 am dlls, the highest among the considered age groups. The multivariate analysis showed higher probability of being hospitalized among the elderly, but not for risks for acute morbidity and ambulatory care. Among the elderly, older age, being male or living in a city or in a metro area implied a higher probability of hospitalization during the last year, with chronic diseases playing a key role in hospitalization. Conclusions The conditions associated with age, such as chronic diseases, have higher weight than age itself; therefore, they are responsible for the higher expenditures reported. Conclusions point towards a differentiated use and intensity of health services depending on age

  13. Screening for Depression among a Well Elderly Population.

    Science.gov (United States)

    Dorfman, Rachelle A.; And Others

    1995-01-01

    Describes a geriatric wellness program in which social work practitioners played a major role. Compared results of a telephone screening test to detect depression with the clinical judgment of social workers. The screening instrument proved effective in assessing a population with a high rate of major depression. (RJM)

  14. Physical Function Decline and the Risk of Elder Self-Neglect in a Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Fulmer, Terry; de Leon, Carlos F. Mendes; Rajan, Bharat; Evans, Denis A.

    2010-01-01

    Purpose: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population. Design and Methods: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The…

  15. The assessment of cognitive impairment suspected of dementia in Polish elderly people: results of the population-based PolSenior Study.

    Science.gov (United States)

    Klich-Rączka, Alicja; Piotrowicz, Karolina; Mossakowska, Małgorzata; Skalska, Anna; Wizner, Barbara; Broczek, Katarzyna; Wieczorowska-Tobis, Katarzyna; Grodzicki, Tomasz

    2014-09-01

    was no significant difference in the prevalence of cognitive impairment according to gender in the general population (raw MMSE); however in analyses including MMSEadj results, the suspicion of dementia was made more often among men. Suspicion of dementia based on raw MMSE and MMSEadj results was made significantly more often among men than women at the age of 65-69years, and significantly more often among the oldest women, aged 90years and more. Suspicion of dementia was diagnosed more often in respondents living in rural communities (based on raw MMSE, but not on MMSEadj), which might be related to the differences in their educational status. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Mental status testing in elderly Hispanic populations: special concerns.

    Science.gov (United States)

    Mahurin, R K; Espino, D V; Holifield, E B

    1992-01-01

    The rapid growth of the older Hispanic population highlights the importance of accurately assessing the mental status of these individuals. Although several community surveys have reported relatively higher rates of cognitive impairment among older Hispanics, closer analysis has revealed excessive false positives and the underestimation of cognitive functioning. Problems inherent in the mental status testing of this group include the lack of appropriately translated and culturally sensitive instrumentation, the diversity of the population, differences in their educational experiences, and bias in the test-taking situation. Commonly used neuropsychological test batteries have generally been neither translated nor normed for Hispanic subjects. To minimize cultural differences, cross-cultural tests have used nonverbal content; however, nonverbal testing does not, in itself, remove cultural bias. Alternative methods of testing that may reduce bias include performance-based assessment of everyday living skills and measurement of basic psychophysiological responses.

  17. A method for analyzing changing prison populations: explaining the growth of the elderly in prison.

    Science.gov (United States)

    Luallen, Jeremy; Kling, Ryan

    2014-12-01

    For the past several decades, the U.S. prison system has witnessed a steady and persistent increase in the ages of prison populations. Given the additional costs and burdens placed on prisons as they house older inmates, this aging trend has generated intense interest among policy makers and academics who seek to understand why prison populations are getting older. This article presents a method for evaluating drivers influencing the change in age distributions among prisoners. We define a methodological approach and demonstrate its application using prison data from four states reporting to the Bureau of Justice Statistics' National Corrections Reporting Program. We find that since 2000, the primary driver of overall growth in the elderly populations in prison (defined as inmates over 50) is the increasing admission age of offenders entering prison. Moreover, changes in offense mix and sentence length/time served over the last decade have had significantly less influence on the age composition of prison populations. We also find that the impact of explanatory factors varies across states and offense types. For example, prison admission and exit rates explain much of the change in elderly drug offenders in New York, but not elderly violent offenders, where admission age plays a much stronger explanatory role. Our analysis offers an effective demonstration that supports the use of this method as an important and informative first step toward understanding components of change that affect the problem of prison aging. © The Author(s) 2014.

  18. [EPIDEMIOLOGY OF FALLS IN THE NON-INSTITUTIONALIZED SPANISH ELDERLY POPULATION, SYSTEMATIC REVIEW 2014].

    Science.gov (United States)

    Pellicer García, Begoña; Juarez Vela, Raúl; Gracia Carrasco, Elías; Guerrero Portillo, Sandra; García Moyano, Loreto María; Azón Belarre, José Carlos

    2015-11-01

    OBJECTIVE To identify scientific publications about falls among non-institutionalized Spanish elderly population and to summarize the study findings which analysed the incidence, the risk factors and the consequences of the falls in the geriatric spanish population aged 65 years and over who lives institutionalized in our country. Systematic review of the epidemiological observational studies in Spain, with recording of falls, with temporary retrospective and published as scientific articles between the years 2003 and 2014 included. The articles search took place in July 2014, with the limit of language and publication year, in the electronic databases PubMed, Dialnet, RedALyC, SciELO, Enfispo and Google Scholar. The percentage of people who suffered falls depending on the publication year. The frequency of falls recorded varied from 14.9 % to 66.2 %. The mean intake of daily drugs was between 2.7 to 4.5 drugs per day. The fear of falling that had the elderly population non-institutionalized was between 44.7 % and 49.4 %. The vast majority of falls occurred at home, with percentages between 55.1 % and 61 %. Between 30 % and 55.1 % of people who suffered falls maintained health care contact immediately and the fractures prevalence was between 0 % and 26.1 %. CONCLUSTON: It can be confirmed that the falls prevalence in the spanish elderly population is high, so the need ofnew researches are appreciated.

  19. [Incidence of senile dementia and depression in elderly population in Xicheng District, Beijing, an epidemiologic study].

    Science.gov (United States)

    Yan, Fang; Li, Shuran; Liu, Jin; Zhang, Weii; Chen, Changhui; Liu, Mian; Xu, Liang; Li, Shuo; Shao, Jun; Wu, Hong; Wang, Yulan; Liang, Kouhua; Zhao, Changqi; Lei, Xiaxing

    2002-08-10

    To investigate the incidence of senile dementia and depression in the elderly and the factors correlative with these disorders. All the non-case subjects investigated in a survey of prevalence of senile dementia and depression conducted among the elderly population in Xicheng District, Beijing in 1997 were followed up in 1999. The investigation procedure, instruments and diagnostic criteria were identical with those used in 1997 survey. The annual incidence rates of senile dementia was 0.89% in those aged 60 and over. The incidence rate of old males and that of the old females were not significantly different. The annual incidence rate of senile dementia in groups aged 60 approximately 64, 64 approximately 69, 70 approximately 74 75 approximately 79 80 approximately 84 85 approximately 89, and 90 and over were 0.15% 0.68 % 0.44% 1.32% 2.41% 5.72% and 5.13% respectively. The incidence rate in the elderly over 90 was lower than that in the group aged 85 approximately 89. The minimum annual incidence rate of depression in the elderly aged 60 and over was 1.28%. The incidence rate of depression was higher in the group with poorer health than in the group with better health. The incidence rates of moderate and severe dementia were not significantly different from those in 1989. The incidence rate of senile dementia in the elderly remains rather stable during this period of 10 years in Beijing city. The incidence rate of senile dementia is closely correlated with age. The incidence rate of depression in the elderly is remarkably correlated with health status. Senile dementia and depression may coexist in the same person.

  20. The significance of frailty in the relationship between socioeconomic status and health-related quality of life in the Korean community-dwelling elderly population: mediation analysis with bootstrapping.

    Science.gov (United States)

    Kim, Ho-Joong; Park, Saejong; Park, Soo-Hyun; Heo, Young Woo; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

    2017-12-01

    Firstly, to investigate the prevalence of frailty and impact on health-related quality of life (HRQOL) in a Korean community-dwelling elderly population using the Fried frailty criteria; secondly, to investigate the associations among frailty, socioeconomic status (SES), and HRQOL of the Korean community-based population; and thirdly, to analyze the relationship between education, income, and frailty. Nine hundred and sixty-four apparently heathy subjects from the Korean community-based population were enrolled in this prospective cross-sectional study. Using self-reported questionnaires, demographic data, SES, and HRQOL were evaluated. Frailty status was determined according to the Fried frailty criteria. After adjustment of covariates including age, sex, and BMI, multivariate linear regression analyses were conducted to assess each component of the proposed mediation models, and mediation was also verified by the bootstrapping technique. Among the 964 participants, 530 (55.0%), 399 (41.4%), and 35 (3.6%) participants were classified into the robust, pre-frailty, and frailty group, respectively. The frail group demonstrated significantly lower HRQOL. Participants with lower income or education level had significantly higher chances of being frail. Frailty acted as a mediator in this association between low SES (education and income) and low HRQOL. Furthermore, income contributed most to the explanation of educational differences in frailty, suggesting full mediation. Frailty has a significant negative influence on HRQOL in the community-based elderly population, and acts as a mediator between SES and HRQOL. As a mediator, income can explain educational difference related with the frailty.

  1. Elderly Suicide

    Science.gov (United States)

    Elderly Suicide Fact Sheet Based on 2012 Data (2014) Overview • The elderly (ages 65 and older) made up 13. ... population; they accounted for 16.37% of all suicides in the US. • The rate of suicides for ...

  2. Population ageing, retirement policy and living conditions of the elderly in China.

    Science.gov (United States)

    Chesnais, J; Wang, S

    1990-01-01

    The authors discuss economic and social aspects of the predicted rapid aging of China's population. They conclude that "its economic impact will depend on the outcome of the birth control campaign in rural areas...and on the pace of transition towards the nuclear family. In view of the very primitive nature of the retirement and health insurance systems, a rapid breakdown of family structures would constitute a major threat to the welfare of the elderly. Excepting certain middle- or upper-class pensioners in large cities, the standard of living of the elderly population remains very low and, due to the co-residence of generations, it is closely linked to trends in average income." excerpt

  3. Association between vitamin D status and asymmetric dimethylarginine (ADMA) concentration in the Korean elderly population.

    Science.gov (United States)

    Choi, Hye Rin; Lee, Seung Won; Yeom, Hyungseon; Jeon, Da-Hye; Kim, Hyeon Chang; Youm, Yoosik

    2017-08-01

    Vitamin D deficiency has been reported to be associated with the risk of cardiovascular disease. We investigated the relationship between vitamin D status and asymmetric dimethylarginine (ADMA) concentration, a marker of endothelial dysfunction, in the Korean elderly population. A cross-sectional study was conducted on 269 men and 382 women (mean age, 71.6 years) enrolled in the Korean Social Life, Health, and Aging Project (KSHAP), a population-based longitudinal study of health determinants in elderly Koreans. We stratified patients by vitamin D status into three groups according to serum 25-hydroxyvitamin D [25(OH)D] level: sufficient (≥30ng/mL, n=25), insufficient (10-smoking status, and drinking status, ADMA concentrations were higher in the insufficient group (β=0.0742μmol/L, p=0.001) and the deficient group (β=0.1417μmol/L, pKorean people. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Performance on the Benton Visual Retention Test in an educationally diverse elderly population.

    Science.gov (United States)

    Seo, Eun Hyun; Lee, Dong Young; Choo, Il Han; Youn, Jong Choul; Kim, Ki Woong; Jhoo, Jin Hyeong; Suh, Kwan Woo; Paek, Yong Su; Jun, Yong Ho; Woo, Jong Inn

    2007-05-01

    In this study, we investigated the effects of demographic variables on the performances of Administrations A and C of the Benton Visual Retention Test (BVRT) in a geriatric population with a wide range of educational achievement. We administered the test to 554 nondemented elders aged 60-90 years with an educational history of from zero to 25 years. Age and education significantly influenced Administrations A and C, although gender had no main effect. We observed significant Education x Gender interactions for Administrations A and C, Age x Gender interactions for Administration A, and Age x Education interactions for Administration C. Our results suggest that both nonverbal memory and constructional ability are influenced by age and education. Although there is no overall gender effect, men seem to outperform women in a poorly educated (for Administrations A and C) or relatively older (for Administration A) elderly population.

  5. Predicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricans

    Directory of Open Access Journals (Sweden)

    Rosero-Bixby Luis

    2012-06-01

    Full Text Available Abstract Background Little is known about adult health and mortality relationships outside high-income nations, partly because few datasets have contained biomarker data in representative populations. Our objective is to determine the prognostic value of biomarkers with respect to total and cardiovascular mortality in an elderly population of a middle-income country, as well as the extent to which they mediate the effects of age and sex on mortality. Methods This is a prospective population-based study in a nationally representative sample of elderly Costa Ricans. Baseline interviews occurred mostly in 2005 and mortality follow-up went through December 2010. Sample size after excluding observations with missing values: 2,313 individuals and 564 deaths. Main outcome: prospective death rate ratios for 22 baseline biomarkers, which were estimated with hazard regression models. Results Biomarkers significantly predict future death above and beyond demographic and self-reported health conditions. The studied biomarkers account for almost half of the effect of age on mortality. However, the sex gap in mortality became several times wider after controlling for biomarkers. The most powerful predictors were simple physical tests: handgrip strength, pulmonary peak flow, and walking speed. Three blood tests also predicted prospective mortality: C-reactive protein (CRP, glycated hemoglobin (HbA1c, and dehydroepiandrosterone sulfate (DHEAS. Strikingly, high blood pressure (BP and high total cholesterol showed little or no predictive power. Anthropometric measures also failed to show significant mortality effects. Conclusions This study adds to the growing evidence that blood markers for CRP, HbA1c, and DHEAS, along with organ-specific functional reserve indicators (handgrip, walking speed, and pulmonary peak flow, are valuable tools for identifying vulnerable elderly. The results also highlight the need to better understand an anomaly noted previously in

  6. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders.

    Science.gov (United States)

    Gros, Auriane; Bensamoun, David; Manera, Valeria; Fabre, Roxane; Zacconi-Cauvin, Anne-Marie; Thummler, Susanne; Benoit, Michel; Robert, Philippe; David, Renaud

    2016-01-01

    Objective : Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods : A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results : The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia.

  7. Recommendations for the use of ICT in elderly populations with affective disorders

    Directory of Open Access Journals (Sweden)

    Auriane Gros

    2016-11-01

    Full Text Available Objective: Affective disorders are frequently encountered among elderly populations, and the use of Information and Communication Technologies (ICT could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia.Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to better explain to current and coming practitioners the utility of ICT especially for AD patients.

  8. Diabetes, impaired fasting glucose, and cognitive decline in a population of elderly community residents.

    Science.gov (United States)

    Rouch, Isabelle; Roche, Frédéric; Dauphinot, Virginie; Laurent, Bernard; Antérion, Catherine Thomas; Celle, Sébastien; Krolak-Salmon, Pierre; Barthélémy, Jean-Claude

    2012-08-01

    Diabetes and impaired fasting glucose, as well as cognitive impairment, are common in the elderly. Although several cross-sectional studies have demonstrated the influence of diabetes on cognitive impairment, only a few longitudinal studies have assessed the relationship between diabetes, impaired fasting glucose and cognitive decline in non-demented elderly community dwellers, by means of extensive neuropsychological batteries. The present study assesses the relationship between baseline diabetes, impaired fasting glucose (IFG) and 2- year evolution of memory, attention and executive performance in a sample of non-demented elderly subjects. Population-based cohort study [(PROgnostic indicator OF cardiovascular and cerebrovascular events (PROOF)]. One hundred and sixty-three community dwellers aged 65 years without dementia at recruitment. Memory, attention and executive performance. A significant association was observed between baseline diabetes mellitus and a higher 2-year decline in the Trial Making Test B and Stroop test exploring attention and executive function. This effect remained significant after adjusting for age, gender, education, anxiety and depressive symptoms, as well as other cardiovascular risk factors (F=2.41; p=0.007). Instead, no relationship was observed between IFG and cognitive decline. Our study showed that, in a sample of elderly non-demented community dwellers, diabetes mellitus (but not IFG) is associated with a higher decline in selective attention and executive functioning. These results emphasize the importance of detecting and man- aging diabetes and impaired fasting glucose, in order to prevent cognitive impairment and dementia.

  9. Healthy habits: what kind of guidance the elderly population is receiving from health professionals?

    Science.gov (United States)

    Flores, Thaynã Ramos; Nunes, Bruno Pereira; Assunção, Maria Cecília Formoso; Bertoldi, Andréa Dâmaso

    2016-03-01

    To describe the prevalence of guidance on healthy habits received from health professionals by elderly and its relation to socioeconomic demographic, behavioral and health indicators, and the type of services. Cross sectional population based study including individuals aged 60 years or more in the urban area of Pelotas, Rio Grande do Sul, Brazil. Seven guidance on healthy habits were evaluated: weight control, reduction in salt, sugar and fat intake, physical activity practice, not smoking and not drinking alcohol. Among the 1,451 elderly interviewed, 1,281 (88.3%) consulted in the last year. The orientations more refereed were to fat (61.7%) and salt (61.5%) intake reduction and physical activity (58.2%). Elderly who consulted three times or more and in services financed by the Unified Health System received more guidance. Those elderly from the socioeconomic classes A/B were more likely to receive guidance for weight control (RP = 1.27; 95%CI 1.06 - 1.70) and physical activity (RP = 1.34; 95%CI 1.06 - 1.69). The orientation from health professionals were uncommon and, in some cases, unfocused.

  10. Health-related behavior and quality of life among the elderly: a population-based study

    Directory of Open Access Journals (Sweden)

    Margareth Guimarães Lima

    2011-06-01

    Full Text Available OBJECTIVE: To assess the association between health-related behaviors and quality of life among the elderly. METHODS: A population-based cross-sectional study was carried out including 1,958 elderly living in four areas in the state of São Paulo, southeastern Brazil, 2001/2002. Quality of life was assessed using the Medical Outcomes Study SF-36-Item Short Form Health Survey instrument. This instrument's eight subscales and two components were the dependent variables. Independent variables were physical activity, weekly frequency of alcohol consumption and smoking. Multiple linear regression models were used to control for the effect of gender, age, schooling, work, area of residence and number of chronic conditions. RESULTS: Physical activity was positively associated with the eight SF-36 subscales. The stronger associations were found for role-physical (β=11.9, physical functioning (β=11.3 and physical component. Elderly individuals who consumed alcohol at least once a week showed a better quality of life than those did not consume alcohol. Compared to non-smokers, smokers had a poorer quality of life for the mental component (β=-2.4. CONCLUSIONS: The study results showed that physical activity, moderate alcohol consumption and no smoking are positively associated with a better quality of life in the elderly.

  11. Evaluation of a Community-Based Aging Intervention Program

    Science.gov (United States)

    Hsu, Hui-Chuan; Wang, Chun-Hou; Chen, Yi-Chun; Chang, Ming-Chen; Wang, Jean

    2010-01-01

    This study evaluated the outcome and process of a community-based aging intervention program for the elderly in Taiwan. The program included education on nutrition and dietary behavior and on physical activities. Outcome and process evaluations were conducted. The program may have had some effects on decreasing some dietary behavioral problems and…

  12. Cognitive impairment in rural elderly population in ecuador

    Directory of Open Access Journals (Sweden)

    Xavier Wong-Achi

    2017-01-01

    Full Text Available Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48, and 63% (CI: 62.1–63.94 of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3 and 47.2% (95% CI: 45.2–49.2 in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

  13. Falls among the elderly: risk factors in a population-based study

    Directory of Open Access Journals (Sweden)

    Iara Guimarães Rodrigues

    2014-09-01

    Full Text Available Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008. Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI 1.47 - 3.87, elderly adults (80 years old and older (PR = 2.50; 95%CI 1.61 - 3.88, widowed (PR = 1.74; 95%CI 1.04 - 2.89 and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48, osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49, asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74, headache (PR = 1.59; 95%CI 1.07 - 2.38, mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64, dizziness (PR = 2.82; 95%CI 1.98 - 4.02, insomnia (PR = 1.75; 95%CI 1.16 - 2.65, use of multiple medications (five or more (PR = 2.50; 95%CI 1.12 - 5.56 and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93. Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

  14. [Study on hearing impairment among elderly population in the community of Taiyuan city, Shanxi province].

    Science.gov (United States)

    Ma, Fei; Qu, Cheng-Yi; Wang, Ting; Yin, Jiong; Zhang, Xiao-Dong; Meng, Jun; Zhang, Cai-Ping

    2009-03-01

    To study the characteristics and influencing factors on hearing impairment among elderly population in the community of Taiyuan city. 384 ageing people above 60 years old were selected from Chaoyang and Guandi community in Taiyuan city by multi-stage sampling. Data on influencing factors of hearing impairment were collected by questionnaire. 5 ml fasting blood samples were drawn to detect the level of glucose, triglyceride and cholesterin in the blood samples. All the objects were tested with binaural hearing. The level of binaural hearing threshold at 0.5 kHz, 1 kHz, 2 kHz, 3 kHz, 4 kHz, 8 kHz were measured by GVSLN-TC-GK2000 hearing-assistant evaluative apparatus. The level of 3 kHz, 4 kHz, average hearing threshold from ear with better audition was chosen as dependent variable. Socio-demographic data, environmental factors and biochemical indicator were chosen as independent variables, t test, ANOVA and accumulative logistic regression were performed to analyze the influencing factors on hearing impairment by software SPSS 13.0. The prevalence of hearing impairment among elderly population was 90.9%. The hearing disorder was 78.6% with 1.3% of them using hearing-assistant apparatus. Results from single factor analysis showed that the average levels of 3 kHz, 4 kHz, 8 kHz hearing thresholds were significantly different among elderly with different age, sex, education background and the levels of glucose and cholesterin (P cholesterin in blood were risk factors causing hearing impairment. Higher education level seemed to be a preventive factor. Hearing impairment appeared in higher prevalence among the elderly population, suggesting that proper measures should be taken. It is beneficial for abating hearing impairment to decrease the level of glucose and cholesterin in blood.

  15. [Analysis of cancer incidence and mortality in elderly population in China, 2013].

    Science.gov (United States)

    Chen, W Q; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; He, J

    2017-01-23

    Objective: To estimate the cancer incidence and mortality in elderly Chinese population in 2013 based on the data from local cancer registries submitted to National Central Cancer Registry (NCCR). Methods: Data from 255 cancer registries submitted to NCCR with qualified data after checked and evaluated, were selected for this estimation. Cancer incidence and mortality were stratified by areas, sex, age groups and cancer site, combined with population data of the year 2013 to estimate cancer epidemiology in older people in China. Chinese population census in 2000 and Segi's population were used for the estimation of age-standardized incidence/mortality rates. Results: All the 255 cancer registries (88 in urban and 167 in rural areas) were selected for this estimation, covered 37 407 728 elderly subjects, accounting for 17.73% of the entire national elderly population. It was estimated about 2 171.0 thousand new cancer cases in older people in China, accounting for 58.96% of all cancer incidence, with the crude incidence rate of 1 029.16/100 000 (1 297.96 per 100 000 in male, 777.18 per 100 000 in female), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 1 019.25 per 100 000. It was estimated about 1 600.5 thousand deaths in older people in China, accounting for 67.70% of all cancer deaths, with the crude mortality of 758.72/100 000 (988.37 per 100 000 in males, 543.44 per 100 000 in females), and the age-standardized incidence rate by Chinese standard population (ASIRC, 2000) was 730.78 per 100 000. Lung cancer, stomach cancer, colorectal cancer, liver cancer and esophageal cancer were the most common cancers, accounting for about 67.70% of all cancer cases in China. Those cancers are also the most common cancers in China, accounting for about 73.45% of all cancer deaths. Conclusions: The cancer burden of elderly population in China is very serious. The major cancer incidence and mortality in urban and rural areas are similar

  16. Association between advanced oxidation protein products and 5-year mortality risk among amazon riparian elderly population.

    Science.gov (United States)

    Silva, T O; Jung, I E C; Moresco, R N; Barbisan, F; Ribeiro, E E; Ribeiro, E A M; Motta, K; Britto, E; Tasch, E; Bochi, G; Duarte, M M F; Oliveira, A R; Marcon, M; Belló, C; dos Santos Montagner, G F; da Cruz, I B M

    2015-02-01

    Proteins are important targets of several modifications caused by oxidative stress, leading to structural changes and consequently partial or total loss of their functions. The oxidized proteins include advanced oxidation protein products (AOPP) derived from oxidation-modified albumin, as well as fibrinogen and lipoproteins. An increase in AOPP levels indicates an oxidative stress state and the presence of coexisting inflammation. Several investigations have also suggested an association between high AOPP levels and aging-related diseases. However, the link between elevated AOPP levels and elderly mortality risk has not yet been investigated. Here, we report on a 5-year longitudinal study that investigated the potential association between AOPP levels and mortality using a population-based representative sample of riparian elders living in Brazilian Amazon region (Maués-AM). Age, sex, socioeconomic and cultural conditions, chronic morbidities, polypharmacy, and previous morbidities were also tested as potential confounders. The AOPP levels were measured in 540 (84.78%) individuals, all of whom were followed over a 5-year period in order to establish the mortality rate. Within this study period, 74 (13.7%) elders died and 466 (86.3%) survived. The AOPP levels were higher among the elders who died within the 5-year period (46.27 ± 40.6 mmol/L) compared with those who survived (36.79 ± 20.84 mmol/L) (p = 0.002). The analysis confirmed the link between high AOPP levels and mortality risk, independent of other intervenient factors. These results suggest that elevated AOPP levels could be used to predict mortality risk in elderly patients.

  17. Individualized prevention against hypertension based on Traditional Chinese Medicine Constitution Theory: A large community-based retrospective, STROBE-compliant study among Chinese population.

    Science.gov (United States)

    Li, Ying; Li, Xiao-Hui; Huang, Xin; Yin, Lu; Guo, Cheng-Xian; Liu, Chang; He, Yong-Mei; Liu, Xing; Yuan, Hong

    2017-11-01

    Traditional Chinese Medicine Constitution (TCMC) theory states that individuals with a biased TCMC are more likely to suffer from specific diseases. However, little is known regarding the influence of TCMC on susceptibility to hypertension. The aim of this study is to examine the possible relationship between TCMC and hypertension. Retrospective evaluation and observation were performed using the STROBE guidelines checklist. A large community-based cross-sectional study was conducted between 2009 and 2013 in Changsha, China. TCMC was assessed using a questionnaire that included 68 items. TCMC distributions and the associations of different TCMCs with hypertension risk were analyzed. In total, 144,439 subjects underwent evaluations of TCMC and blood pressure (BP). There were significant differences in the hypertension prevalence among the various TCMC groups (P medicine criteria; for example, phlegm wetness with hypertension was similar to obesity-related hypertension. Our results suggest that phlegm wetness, yin deficiency, blood stasis, and qi deficiency have different effects on the prevalence of hypertension. More attention should be paid to TCMCs associated with susceptibility to hypertension, and corresponding preventive and therapeutic treatments should be developed according to different TCMCs.

  18. Tubular proteinuria is the dominant type of proteinuria in an elderly community population in China.

    Science.gov (United States)

    Wang, Hua-Bin; Yang, Qing-Hong; Jiang, Xu; Cui, Xiao-Fan; Liu, Rui

    2015-09-01

    To explore the types of proteinuria in the elderly population in China. Seven hundred and fourteen elderly people (≥ 60 years old) from Tianjin, China, were selected for the study. The albumin-to-creatinine ratio and α1-microglobulin-to-creatinine ratio from morning urine samples were used as indicators of proteinuria. The prevalence of proteinuria was evaluated and the proportion of three different types of proteinuria (mixed, glomerular, and tubular) was assessed in the subjects by analyzing these indicators. Of the 714 subjects, 29.13 % had elevated ACR and 46.36 % had elevated MCR. The proportion of subjects with either elevated ACR or MCR was 53.78 %. The correlation between MCR and ACR was moderate (r = 0.58, R (2) = 0.34, P proteinuria was dominant (45.83 %), followed by mixed glomerular and tubular proteinuria (35.68 %), and significantly higher than glomerular proteinuria. A diet high in salt was the independent risk factor for tubular proteinuria; physical activity was the independent risk factor for glomerular proteinuria. The risk of glomerular proteinuria was lower in males than in females, but the risk of tubular proteinuria was higher in males. The prevalence of tubular proteinuria was higher than that of glomerular proteinuria, and the risk factors are different, in the elderly in China; therefore, tubular damage markers should get more attention in the overall population.

  19. The prevalence of refractive errors and its determinants in the elderly population of Mashhad, Iran.

    Science.gov (United States)

    Yekta, Abbas Ali; Fotouhi, Akbar; Khabazkhoob, Mehdi; Hashemi, Hassan; Ostadimoghaddam, Hadi; Heravian, Javad; Mehravaran, Shiva

    2009-01-01

    To determine the prevalence rates of refractive errors in elderly people in Mashhad, Iran. In a cross-sectional study with a cluster sampling method, the sample population was selected proportionate to the total population of Mashhad. The selected citizens were then invited for eye examinations at the clinic. After an interview, refractive data were collected using objective and subjective refractions. Refractive error data were converted into spherical equivalent (SE), and myopia was defined as an SE worse than -0.50 diopters (D) and hyperopia worse than +0.50 D. Of the 1540 selected samples, 93.5% participated in the study. Data were analyzed for 1367 adults without previous cataract surgery who had right eye refraction data; 35.4% were women, and 64.6% were men. The mean age was 63.7 +/- 7.1 years. The prevalence of myopia was 27.2% (95% confidence interval (CI) 24.8-29.5); 29.6% in men and 22.5% in women (P prevalence of hyperopia was 51.6% (95% CI, 48.9% to 54.3%); 57.6% in women and 48.3% in men (P prevalence of astigmatism in the studied sample was 37.5% (95% CI, 34.9% to 40.0%). Refractive errors are a major issue among the elderly and their prevalence rates vary greatly depending on age and gender. The present study was able to examine this public health issue among the elderly in Mashhad.

  20. Pattern of Ocular Morbidity in the Elderly Population of Northern India

    Science.gov (United States)

    Chopra, Rupali; Batra, Nitin; Singh, Shavinder

    2017-01-01

    Introduction The frequency of eye diseases has been suggested to start increasing around 40 years of age, with an even steeper increase beginning around 60 years of age. Health promotions and curative and rehabilitative services for the visually impaired elderly population should therefore be a priority in the coming years especially in low and middle income countries. Aim To examine the changing pattern of ocular morbidity in the elderly population of Northern India and to determine the socioeconomic status in relation to ocular morbidities. Materials and Methods A team from the Department of Ophthalmology and Department of Community Medicine, conducted house visits and did a complete eye examination of 450 elderly subjects. They were selected by systematic random sampling from the data base available in the Department of Community Medicine. Results A total of 900 eyes were examined. Visual impairment and blindness was seen in 135 (30%) and 36 (8%) individuals respectively. The most common cause of blindness was cataract, followed by corneal opacity, glaucoma, refractive error, diabetic retinopathy, macular scar, age related macular degeneration, retinal detachment, retinitis pigmentosa. Visual impairment was more in individuals with low socioeconomic status. Conclusion The results of this study suggest that though cataract remains the main cause of blindness, there is an increase in blindness and visual impairment due to corneal diseases and glaucoma which was not seen earlier. The availability and accessibility to eye care facilities particularly for corneal diseases and glaucoma should be increased to reduce blindness in Northern India. PMID:28969173

  1. Short-term practice effects and variability in cognitive testing in a healthy elderly population

    DEFF Research Database (Denmark)

    Krenk, L.; Rasmussen, L.S.; Siersma, V.

    2012-01-01

    and variability in test performance. The aim of this study was to collect cognitive test results with repeated testing in an elderly healthy population. METHODS: 161 healthy controls =60years were included. Cognitive testing was performed upon entry into the study, at 1week and 3months. Practice effect......BACKGROUND: Cognitive decline in the elderly is a subject of intense focus. However, there is a lack of consensus regarding definition of significant decline in connection with repeated testing and the interpretation of cognitive tests results must take into account the practice effect...... was evaluated on 7 neuropsychological measures and reference values of clinically important changes were calculated according to z-scores above 1.96. RESULTS: Test scores improved significantly (p...

  2. QT interval prolongation in users of selective serotonin reuptake inhibitors in an elderly surgical population

    DEFF Research Database (Denmark)

    van Haelst, Ingrid M M; van Klei, Wilton A; Doodeman, Hieronymus J

    2014-01-01

    OBJECTIVE: To investigate the association between the use of a selective serotonin reuptake inhibitor (SSRI) and the occurrence of QT interval prolongation in an elderly surgical population. METHOD: A cross-sectional study was conducted among patients (> 60 years) scheduled for outpatient...... preanesthesia evaluation in the period 2007 until 2012. The index group included elderly users of an SSRI. The reference group of nonusers of antidepressants was matched to the index group on sex and year of scheduled surgery (ratio, 1:1). The primary outcome was the occurrence of QT interval prolongation shown...... on electrocardiogram. The QT interval was corrected for heart rate (QTc interval). The secondary outcome was the duration of the QTc interval. The outcomes were adjusted for confounding by using regression techniques. RESULTS: The index and reference groups included 397 users of an SSRI and 397 nonusers, respectively...

  3. Attitudes of Drug use of an Elderly Population Living in Ankara

    Directory of Open Access Journals (Sweden)

    Fatma Arpaci

    2008-12-01

    Full Text Available AIM: Dramatic changes in fertility and mortality rates during the 20 th century ensured that the world would aging rapidly during the 21 st century. If the decline in the physiological functions in elderly and its reflections on the pharmacokinetics and the pharmacodynamics of the drugs are taken into consideration, it is clearly predicted that irrational prescribing of drugs will lead to severe problems in this population. METHOD: This study designed as a descriptive study, the research population is elderly people who live in Ankara, Kecioren. We used quota sampling and evaluate 300 elderly people. Data analysed by SPSS for Windows package programme. We used number and percentages for nominal variables ,and mean+standart deviation for scale variables as descriptive statistics. Chi square and t tests were used for statistical comparison. RESULTS: 56.3% of all group was male, 43.7% was female. The mean age of group was 67.7+5.5. The persantage of lower education then primary school was 4.3%. The drug use behaviours, which signed as “ever do” are “I signed my drugs in a schedule”, “I take some pills without doctors prescription” and “I take pills which were beneficial form y firends”. The drug use behaviours, which signed as “never do” are, “I dislike take pills”, “I preserve drugs in drug cabinet” and “I believe benefits of drugs”. CONCLUSION: Polifarmacie is frequent problem in our group. Therefore, the physicians and the other health professionals working in this chain should pay great attention for safe use of drugs in the elderly group. [TAF Prev Med Bull 2008; 7(6.000: 515-522

  4. The prevalence and causes of bilateral and unilateral blindness in an elderly urban Danish population. The Copenhagen City Eye Study

    DEFF Research Database (Denmark)

    Buch, Helena; Vinding, T; La Cour, M

    2001-01-01

    PURPOSE: To study the prevalence and causes of bilateral and unilateral blindness in an elderly urban Danish population. METHODS: Data originated from a Danish epidemiologic cross-sectional random sample population eye survey conducted during the years 1986-1988. The population consisted of 1...

  5. Chronic kidney disease and end-stage renal disease in the elderly population: current prevalence, future projections, and clinical significance.

    Science.gov (United States)

    Stevens, Lesley A; Viswanathan, Gautham; Weiner, Daniel E

    2010-07-01

    The world's population is aging, with the number of older adults projected to increase dramatically over the next 2 decades. This trend poses major challenges to health care systems, reflecting the greater health care use and more comorbid conditions among elderly adults. Chronic kidney disease (CKD) is a substantial concern in the elderly population, with both an increasing incidence of treated kidney failure with dialysis as well as a high prevalence of earlier stages of CKD. Given the high burden of risk factors for CKD, the high prevalence of CKD in the elderly population is not surprising, with the rise in obesity, diabetes, and hypertension in middle-aged adults likely foreshadowing further increases in CKD prevalence among the elderly population. It is now commonly agreed that the presence of CKD identifies a higher risk state in the elderly population, with increased risk for multiple adverse outcomes, including kidney failure, cardiovascular disease, cognitive impairment, and death. Accordingly, CKD in older adults is worthy of attention by both health care providers and patients, with the presence of a reduced glomerular filtration rate or albuminuria in the elderly potentially informing therapeutic and diagnostic decisions for these individuals. 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Hyperuricemia Is an Independent Risk Factor for New Onset Micro-Albuminuria in a Middle-Aged and Elderly Population: A Prospective Cohort Study in Taiwan

    Science.gov (United States)

    Chang, Hung-Yu; Lee, Pei-Hsien; Lei, Chen-Chou; Tung, Chun-Wu; Hsu, Yung-Chien; Huang, Tung-Jung

    2013-01-01

    Background Hyperuricemia is now regarded as a risk factor for cardiovascular disease. Micro-albuminuria is associated with increased risk for cardiovascular disease and chronic kidney disease. We hypothesized that elevated serum uric acid (UA) is associated with development of micro-albuminuria in the general population. Methodology/Principal Findings We conducted a community-based prospective cohort study. A total of 1862 subjects from southern Taiwan, all older than 40 years, were screened and 993 of these participants without micro-albuminuria were followed for 4 years. Urinary albumin-to-creatinine ratio was measured two times per year. A multiple linear regression model indicated that serum UA was independently associated with ln(ACR) after adjustment for 8 factors (age, sex, and 6 metabolic metrics) (β = 0.194, palbuminuria after adjustment for the same 8 factors (OR = 1.42, 95% CI: 1.27–1.59, palbuminuria in middle-aged and elderly males and females from a general population in Taiwan. Elevated serum UA is an independent predictor for development of micro-albuminuria in this population. PMID:23637835

  7. Quality of life among elderly population residing in urban field practice area of a tertiary care institute of Ahmedabad city, Gujarat.

    Science.gov (United States)

    Shah, Venu R; Christian, Donald S; Prajapati, Arpit C; Patel, Mansi M; Sonaliya, K N

    2017-01-01

    Overall improvement in the living standards of country's population is leading to longer life expectancy. To emphasize the medical and psychological difficulties faced by geriatric people is essential to know status of their quality of life (QOL). A community-based cross-sectional study was carried out at urban field practice area of one of the teaching institutes of Ahmedabad, Gujarat. Considering the prevalence of about 7.5% of 60 years and above people sample size of 250 was calculated. A predesigned questionnaire related to the QOL of elderly people devised by the World Health Organization-QOL was used. Mean age of the study population was 65.8 years with standard deviation of 5 years. Almost two-thirds of geriatrics were currently married and having spouse alive. List of common morbidities observed among study population was joint pain (42.8%), cataract (32.8%), hypertension (22.4%), diabetes mellitus (17.2%), and dental problems (12.4%). Scoring of QOL profile revealed that none of the geriatric had poor QOL, whereas 56% fall into category "good" and 50.8% had "excellent" QOL. QOL as per four different domains was significantly better among males as compared to females. Physical, environmental, and psychological domains were better in those who were educated and married individuals living with their spouse. Overall QOL was good to excellent. Social characteristics, such as education, marital status, and gender, all play role for the perceived QOL among the respondents.

  8. Injury in an elderly population before and after initiating a skeletal muscle relaxant.

    Science.gov (United States)

    Billups, Sarah J; Delate, Thomas; Hoover, Barbara

    2011-04-01

    Quality guidelines recommend avoidance of skeletal muscle relaxants in patients 65 years and older, but this recommendation is based on expert opinion, not evidence. To describe an elderly population using skeletal muscle relaxants and compare the incidence of physical injury among these patients before and after initiation of the medication. This was a retrospective, pre-post cohort analysis, with each patient serving as his/her own control. In a population of elderly patients who purchased a prescription for a skeletal muscle relaxant, the primary outcome was to compare the proportion of patients experiencing an injury in a 60-day period prior to initiating the drug to the proportion experiencing an injury in the 60 days immediately following the purchase date. Of the 11,875 patients included in the study, 108 (0.9%) experienced an injury during the baseline period and 144 (1.2%) experienced an injury in the 60-day follow-up period (unadjusted OR 1.35; 95% CI 1.05 to 1.75; adjusted OR 1.35; 95% CI 1.01 to 1.81). A total of 333 patients needed to be treated with a skeletal muscle relaxant to result in 1 additional injury. Independent predictors of an injury included a history of an injury in the previous 6 months (OR 3.01; 95% CI 1.54 to 5.88) and older age (OR 1.06; 95% CI 1.04 to 1.09). The absolute increase in risk of injury in this population using a skeletal muscle relaxant was small but statistically significant. Cautionary use of these medications in the elderly continues to be advisable, but their use in selected patients 65 years and older could be considered if the expected benefits outweigh the small increased risk of injury. More study is needed to quantify the benefits versus risks of these medications in this population.

  9. Accuracy of Nearly Extinct Cohort Methods for Estimating Very Elderly Subnational Populations

    Directory of Open Access Journals (Sweden)

    Wilma Terblanche

    2015-01-01

    Full Text Available Increasing very elderly populations (ages 85+ have potentially major implications for the cost of income support, aged care, and healthcare. The availability of accurate estimates for this population age group, not only at a national level but also at a state or regional scale, is vital for policy development, budgeting, and planning for services. At the highest ages census-based population estimates are well known to be problematic and previous studies have demonstrated that more accurate estimates can be obtained indirectly from death data. This paper assesses indirect estimation methods for estimating state-level very elderly populations from death counts. A method for incorporating internal migration is also proposed. The results confirm that the accuracy of official estimates deteriorates rapidly with increasing age from 95 and that the survivor ratio method can be successfully applied at subnational level and internal migration is minor. It is shown that the simpler alternative of applying the survivor ratio method at a national level and apportioning the estimates between the states produces very accurate estimates for most states and years. This is the recommended method. While the methods are applied at a state level in Australia, the principles are generic and are applicable to other subnational geographies.

  10. A community-based study of childhood morbidity in

    African Journals Online (AJOL)

    Denmark in urban settings (3). Since 85% of the country's population live in rural areas, information from rural community-based morbidity surveillance is essential for health planners. A one-year community based study of under-fives in rural Butajira in 1991 showed. ARI and acute diarrhea to be the most common diseases ...

  11. Analysis of gender based differences in auditory evoked potentials among healthy elderly population

    Directory of Open Access Journals (Sweden)

    Sharat Gupta

    2014-01-01

    Full Text Available Background: Influence of gender on auditory evoked potentials is contentious. Although there are quite a few studies documenting the gender as an influencing factor on auditory evoked potentials in younger subjects, but there is a lack of similar studies among elderly population. The present study was conducted to find out the pattern of gender based differences in auditory evoked potentials among healthy elderly subjects. Materials and Methods: A cross-sectional study was conducted on age matched, healthy males (n = 35 and females (n = 34, aged 50-70 years. The measures included latencies of waves I-V and interpeak latencies (IPL I-III, III-V and I-V separately for both ears. Data was analyzed statistically using Students unpaired t-test, using Statistical Package for Social Sciences software v13.0. Results: The values of all the latencies and IPL for both the ears were non-significantly higher (P > 0.05 in males as compared to females. These results may be attributed to the differences in head circumference between both the genders and to the changed hormonal milieu of sex hormones after menopause. Conclusions: Statistical insignificance of latencies among male and female elderly subjects excludes gender as an influencing factor on auditory evoked potentials in this age group.

  12. Knowledge about mammography and associated factors: population surveys with female adults and elderly

    Directory of Open Access Journals (Sweden)

    Ione Jayce Ceola Schneider

    2013-12-01

    Full Text Available The purpose of this paper is to describe the knowledge about mammography and to identify associated factors in female adults and elderly. Data were obtained from two population surveys, one with female adults and another with elderly women from Florianópolis (SC in 2009 - 2010. A descriptive analysis of the variables was carried out, the appropriate mean of responses about mammography was estimated and crude and adjusted Poisson regression was conducted to identify associated factors. Among adults, 23.1% answered all of the questions appropriately and the appropriate average responses was 7.2 (95%CI 7.1 - 7.3 in a total of 9. In the adjusted model, older age, higher education and income were associated with knowledge about mammography. For the elderly, 15.3% answered all questions appropriately and the average of appropriate responses was 6.4 (95%CI 5.2 - 6.5 and the factors associated with knowledge about mammography in the adjusted model were younger age groups, increased education and income, and identification of mammography as the main diagnostic method for breast cancer. Information about mammography can neither be transmitted in a clear way nor be easily understood; there are also demographic and socioeconomic differences concerning the knowledge about the exam.

  13. Assessment of kidney function in the elderly: a population-based study.

    Science.gov (United States)

    Dutra, Marina Constante; Uliano, Estevão José Muller; Machado, Danúbia Felippe Grassi de Paula; Martins, Tatiana; Schuelter-Trevisol, Fabiana; Trevisol, Daisson José

    2014-01-01

    Chronic kidney disease (CKD) affects all age groups, and its prevalence has increased during recent years. CKD is divided into six stages, according to the renal function of patients: 1. Normal renal function without kidney damage; 2. Kidney damage with normal renal function; 3. Mild renal insufficiency; 4. Moderate renal insufficiency or lab tests failure; 5. Severe renal insufficiency or clinical failure; 6. End stage of chronic renal failure. This study was intended to assess renal function in elderly patients and identifying the presence of factors associated with those changes. A cross-sectional population-based study was performed. Elderly patients were surveyed between September 2010 and May 2011. Kidney function was assessed by determining of serum creatinine, and estimation of the glomerular filtration rate by the CKD-EPI equation. In all, 822 elderly were surveyed; 61.6% were women; 92.2% were Caucasian; and most (61.0%) were aged between 60 and 69 years. With regard to the glomerular filtration rate, 26.2% had a normal rate; 60.2% showed a slight decrease; 13.0% a moderate decrease; 0.5% severe kidney function decline; and 0.1% extreme fall. Increasing age was associated with kidney damage by decreased glomerular filtration rate (p kidney damage, and 13.6% showed moderate to severe dysfunction.

  14. Anemia and iron deficiency in Mexican elderly population. Results from the Ensanut 2012

    Directory of Open Access Journals (Sweden)

    Alejandra Contreras-Manzano

    2015-09-01

    Full Text Available Objective. To describe de prevalence of iron deficiency (ID and anemia in a sample of Mexican elderly population from the National Health and Nutrition Survey (Ensanut 2012. Materials and methods. 1 920 subjects ≥60 years of age were included. Hemoglobin, serum concentrations of ferritin and CRP were measured. The risk for ID and anemia adjusted for potential confounders was assessed in logistic regression models. Results. The overall prevalence of anemia was 13.9%, 15.2% in males and 12.8% females. For ID,overall it was 4.2%, males 4.0% and females 4.3%. The greatest prevalence of ID was found in males and females over 80 years old (6.9 and 7.0%, respectively. ID was present in 1.5 of 10 Mexican elders with anemia. Conclusion. The prevalence of anemia was high in the elderly, however the prevalence of ID was low; there is a need to further investigate the causes of anemia in this age group.

  15. Race/Ethnicity and Adoption of a Population Health Management Approach to Colorectal Cancer Screening in a Community-Based Healthcare System

    NARCIS (Netherlands)

    Mehta, S.J. (Shivan J.); C.D. Jensen (Christopher D.); V.P. Quinn (Virginia P.); J.E. Schottinger (Joanne E.); A. Zauber (Ann); R.G.S. Meester (Reinier); Laiyemo, A.O. (Adeyinka O.); S. Fedewa (Stacey); Goodman, M. (Michael); Fletcher, R.H. (Robert H.); T.R. Levin (Theodore R.); D.A. Corley (Douglas); C.A. Doubeni (Chyke A.)

    2016-01-01

    textabstractBackground: Screening outreach programs using population health management principles offer services uniformly to all eligible persons, but racial/ethnic colorectal cancer (CRC) screening patterns in such programs are not well known. Objective: To examine the association between

  16. Estimated Glomerular Filtration Rate, Proteinuria, and Risk of Cardiovascular Diseases and All-cause Mortality in Diabetic Population: a Community-based Cohort Study

    OpenAIRE

    Wang, Anxin; Chen, Guojuan; Cao, Yibin; Liu, Xiaoxue; Su, Zhaoping; Luo, Yanxia; Zhao, Zhan; Li, Xia; Chen, Shuohua; Wu, Shouling; Guo, Xiuhua

    2017-01-01

    Data about associations between estimated glomerular filtration rate (eGFR) and proteinuria with cardiovascular diseases (CVDs) and all-cause mortality among diabetic population is less described. We aimed to describe these associations in Chinese diabetic population, and investigate the difference between sexes. The study was based on 8,301 diabetic participants in the Kailuan study, who was free of CVDs at baseline. We used Cox proportional hazard models to examine the associations of eGFR ...

  17. Population Aging in the European Information Societies: Towards a Comprehensive Research Agenda in eHealth Innovations for Elderly.

    Science.gov (United States)

    Vancea, Mihaela; Solé-Casals, Jordi

    2016-08-01

    Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people's daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis.

  18. Metabolically Healthy Obesity and the Risk of Cardiovascular Disease in the Elderly Population.

    Science.gov (United States)

    Dhana, Klodian; Koolhaas, Chantal M; van Rossum, Elisabeth F C; Ikram, M Arfan; Hofman, Albert; Kavousi, Maryam; Franco, Oscar H

    2016-01-01

    Whether being metabolically healthy obese (MHO)-defined by the presence of obesity in the absence of metabolic syndrome-is associated with subsequent cardiovascular disease (CVD) remains unclear and may depend on the participants' age. We examined the association of being MHO with CVD risk in the elderly. This study included 5,314 individuals (mean age 68 years) from the prospective population-based Rotterdam Study. We categorized our population in groups according to body mass index (BMI) and presence and absence of metabolic syndrome, and estimated the hazard ratio (HR) and 95% confidence interval (95%CI) for every group by using Cox proportional hazard models. Among 1048 (19.7%) obese individuals we identified 260 (24.8%) MHO subjects. Over 14 years of follow-up there were 861 incident CVD cases. In the multivariable adjusted analysis, we did not observe an increased CVD risk in MHO individuals (HR 1.07, 95%CI 0.75-1.53), compared to normal weight individuals without metabolic syndrome. CVD risk was increased by the presence of metabolic syndrome in normal weight (HR 1.35, 95%CI 1.02-1.80), overweight (HR 1.32, 95%CI 1.09-1.60) and obese (HR 1.33, 95%CI 1.07-1.66) individuals, compared to those with normal weight without metabolic syndrome. In a mediation analysis, 71.3% of the association between BMI and CVD was explained by the presence of metabolic syndrome. In our elderly population, we found that the presence of obesity without metabolic syndrome did not confer a higher CVD risk. However, metabolic syndrome was strongly associated with CVD risk, and was associated with an increased risk in all BMI categories. Therefore, preventive interventions targeting cardiometabolic risk factors could be considered in elderly, regardless of weight status.

  19. Incidence and risk factors for cognitive impairment in rural elderly populations in Costa Rica

    Directory of Open Access Journals (Sweden)

    Jeffrey L. Nadel

    2014-09-01

    Full Text Available Risk factors for the onset of cognitive impairment in Costa Rica are not well understood, despite a substantial elderly population stemming from a higher than average life expectancy for the western hemisphere. To investigate the risk factors that predict the onset of cognitive impairment in the rural elderly of Costa Rica, a modified version of the Mini Mental State Exam-designed for illiterate populations-was administered to 90 elderly inhabitants of San Carlos, Alajuela, Costa Rica between April and May of 2011. Subsequently, each participant took a structured interview assessing viability of risk factors and behaviors potentially contributing to a diagnosis of cognitive impairment. Results showed strong dependencies between age (p=0.0001, education level (p=0.0095, the ability to read (p=0.0001 and write (p=0.0153, frequency of reading (p=0.0011, use of puzzles and mind games (p<0.0001, vocation (p=0.0225, area of residence (p<0.0001, comorbid mental diseases (p=0.0005, history of stroke or brain trauma (p=0.0104, urinary or renal problems (p=0.0443, consistent cooking practices (p=0.0262 and number of living companions (p=0.0299 in susceptibility for developing cognitive impairment. The study concluded that high intellectual use, or lack thereof, during the lifetime of a person was a predictor for cognitive status later in life. In addition, comorbid mental disorders, including neurological trauma due to stroke, impeded normal cognitive function. Future research should examine incidence and risk factors of cognitive impairment in urban, more educated populations. Rev. Biol. Trop. 62 (3: 869-876. Epub 2014 September 01.

  20. Sexual disorders among elderly: An epidemiological study in south Indian rural population.

    Science.gov (United States)

    Sathyanarayana Rao, T S; Ismail, Shajahan; Darshan, M S; Tandon, Abhinav

    2015-01-01

    Realizing a dearth of data on this topic, especially in the Indian context, an epidemiological study was conducted in a south Indian rural population to identify the sexual activity patterns and sexual problems among the population above 60 years of age. (1) Assessment of sexual activity patterns among individuals above 60 years. (2) Assessment of the prevalence of sexual disorders among individuals above 60 years. The study sample consisted of 259 participants, which included both males and females above 60 years of age. Subjects who were sexually active and fulfilled the study criteria were administered Arizona Sexual Experience Scale as a screening tool, for the presence of sexual problems. Those who were found to have sexual problems were interviewed further using appropriate questionnaires. Only 27.4% of the individuals above 60 years were sexually active, and it progressively dropped as age advanced and none were sexually active after 75 years of age. Among the sexually active males, erectile dysfunction (ED) was prevalent in 43.5%, premature ejaculation in 10.9%, hypoactive sexual desire disorder (HSSD) in 0.77% and anorgasmia in 0.38% of the subjects. Among females, arousal disorder was prevalent in 28%, HSSD in 16%, anorgasmia in 20% and dyspareunia in 8% of the subjects. The study gives us an insight into the sexual problems of the elderly and brings home the point that sexual problems are very much common among both men and women in the older population. Among elderly males, ED is the most common sexual disorder whereas in elderly females, arousal disorder is the most prevalent female sexual dysfunction, implicating biology plays an important role in men, whereas psychology plays an important role in women sexual functioning.

  1. [Counseling and preventive action in elderly population in hospitals and residences in Spain].

    Science.gov (United States)

    Maestre-Miquel, Clara; Figueroa, Carmen; Santos, Juana; Astasio, Paloma; Gil, Pedro

    2016-10-01

    To establish the profile of elderly patients, and to assess current preventive actions in hospitals, geriatric residences, and different health-care centres in Spain. Cross-sectional descriptive study, based on a questionnaire to be answered by doctors who treat the elderly population in Spain (2013). Health-care centres from different regions of Spain. A total of 420 practitioners from hospitals, residences and other community centres, with data from 840 geriatric clinics. Main outcome variables are: dependence, reason for assistance, comorbidity, professional consultation, and life style recommendations. Association factor, type of institution where patients have been attended. Analysis of prevalence and association using Chi-squared test. Two-thirds (66.7%) of the study population were shown to be dependent, with a higher percentage among women than men: 68.9% vs. 62.4% (P=.055). It was also found that among the population aged 85 or more, 88.6% of the women and 85.2% of the men suffered comorbidity. In spite of these results, only 6.6% of the patients suffering comorbidity received additional advice concerning healthy-lifestyle. A large majority (79.6%) of the patients treated in hospitals received advice concerning healthy lifestyle, while 59.62% of those treated in nursing homes received it (P<.001). It was observed that there is a lack of preventive action related to health promotion among the elderly, with differences between hospitals and geriatric residences. This suggests that it is time to put forward new specialised programs addressed to health professionals, in order to reinforce health promotion attitudes and preventive interventions in gerontology clinical practice. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Effects of food groups and dietary nutrients on bone loss in elderly Chinese population.

    Science.gov (United States)

    Chan, R; Woo, J; Leung, J

    2011-04-01

    To examine the effects of food groups and dietary nutrients on bone loss in elderly Chinese population. Prospective cohort study. A longitudinal study started at 2001 in Hong Kong. 1225 Chinese men and 992 women aged 65 years and over in the community. Daily intake of food groups and dietary nutrients at baseline was assessed by a food frequency questionnaire. Nutrient intake was adjusted for energy intake by residual method. Linear regression was used to examine the association of BMD change and food group or energy-adjusted nutrient intake with adjustment for demographic, anthropometric, lifestyle factors, and daily energy intake (for food group only). Higher fish intake was associated with smaller bone loss in hip (B=-0.611, p=0.004) and femoral neck (B=-0.724, p=0.040) in men. None of the food groups were associated with bone loss in both measured sites in women. For men, lower intake of protein (B=-0.012, p=0.003), phosphorus (B=-0.0008, p=0.001), sodium (B=-0.0002, p=0.023) and isoflavone (B=-1.084, p=0.030) was associated with greater BMD loss in hip, whereas lower intake of protein (B=-0.018, p=0.006) and sodium (B=-0.0004, p=0.018) was associated with greater BMD loss in femoral neck. However, these significant associations disappeared after further adjustment for energy-adjusted calcium and vitamin D intakes. None of the nutrients were associated with BMD loss in both measured sites in women. Greater fish intake may help to reduce bone loss in this sample of elderly Chinese men. The significant association between various nutrients and bone loss in elderly Chinese men was likely due to the influence of dietary calcium and vitamin D intakes. The role of food groups and dietary nutrients on bone health in this sample of elderly Chinese women seems to be minimal.

  3. Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore.

    Science.gov (United States)

    Malhotra, Rahul; Chan, Angelique; Malhotra, Chetna; Østbye, Truls

    2010-12-01

    A comprehensive picture of the management of hypertension in the increasing elderly population in Singapore is lacking. In this study, we assess the prevalence and correlates of hypertension and of awareness, treatment and control of hypertension among 4494 elderly Singaporeans (≥60 years) participating in a recent representative survey. The weighted prevalences of hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or current use of antihypertension medication) and of awareness, treatment and control of hypertension were assessed. We assessed the extent of association of these outcomes with socio-demographic (age, gender, ethnicity, education, housing type, living arrangement and social participation) and health (body mass, diabetes and cognitive status) variables using multivariable logistic regression. Nearly three-fourths (73.9%) of participants were found to have hypertension. Of this number, 30.8% were unaware that they had hypertension, 32.0% were not being treated for the disease and 75.9% had suboptimal control of their blood pressure. Among those aware of their hypertension, only 1.9% were untreated. However, nearly two-thirds (64.5%) of treated hypertensives had suboptimal control. Age, gender, ethnicity, education, housing type, body mass and diabetes were significantly correlated with lack of awareness, treatment and control of hypertension. Although the specific 'at-risk' subgroups varied by the outcome, men and Malays had consistently higher odds for all three unfavorable outcomes. There is a need to improve awareness, treatment and especially control of hypertension among elderly Singaporeans. Primary and secondary prevention efforts targeting the elderly and their primary health-care providers are called for, as are regular data collection efforts based on representative samples.

  4. Social Security Measures for Elderly Population in Delhi, India: Awareness, Utilization and Barriers.

    Science.gov (United States)

    Kohli, Charu; Gupta, Kalika; Banerjee, Bratati; Ingle, Gopal Krishna

    2017-05-01

    World population of elderly is increasing at a fast pace. The number of elderly in India has increased by 54.77% in the last 15 years. A number of social security measures have been taken by Indian government. To assess awareness, utilization and barriers faced while utilizing social security schemes by elderly in a secondary care hospital situated in a rural area in Delhi, India. A cross-sectional study was conducted among 360 individuals aged 60 years and above in a secondary care hospital situated in a rural area in Delhi. A pre-tested, semi-structured schedule prepared in local language was used. Data was analysed using SPSS software (version 17.0). Chi-square test was used to observe any statistical association between categorical variables. The results were considered statistically significant if p-value was less than 0.05. A majority of study subjects were females (54.2%), Hindu (89.7%), married (60.3%) and were not engaged in any occupation (82.8%). Awareness about Indira Gandhi National Old Age Pension Scheme (IGNOAPS) was present among 286 (79.4%) and Annapurna scheme in 193 (53.6%) subjects. Among 223 subjects who were below poverty line, 179 (80.3%) were aware of IGNOAPS; while, 112 (50.2%) were utilizing the scheme. There was no association of awareness with education status, occupation, religion, family type, marital status and caste (p>0.05). Corruption and tedious administrative formalities were major barriers reported. Awareness generation, provision of information on how to approach the concerned authority for utilizing the scheme and ease of administrative procedures should be an integral part of any social security scheme or measure. In the present study, about 79.4% of elderly were aware and 45% of the eligible subjects were utilizing pension scheme. Major barriers reported in utilization of schemes were corruption and tedious administrative procedures.

  5. Does cadmium exposure contribute to depressive symptoms in the elderly population?

    Science.gov (United States)

    Han, Changwoo; Lim, Youn-Hee; Hong, Yun-Chul

    2016-04-01

    To date, the association of the neurotoxic agent cadmium (Cd) with depression in elderly people has been poorly evaluated. By investigating the relationship between blood cadmium levels and scores on a depression screening test, we aimed to investigate the impact of cadmium exposure on elderly depression. From 2008 to 2010, a total of 395 elderly participants residing in Seoul, Korea, were evaluated 3 times. Demographic data and lifestyle information were obtained via a systemised questionnaire, and blood samples were collected for analysis. Participants underwent the Korean Version of the Short Form Generic Depression Scale test (SGDS-K) for screening depression and associations were estimated using logistic regression models adjusted for potential confounders. Blood cadmium levels were associated with depressive symptoms in the first visit data analysis. By analysing the first visit data, the highest quartile blood cadmium group (Q4) showed increased risk for depressive symptoms compared to the lowest quartile group (Q1) (OR 3.50, 95% CI 1.22 to 10.00). However, the data of the second and third visits suggested that blood cadmium may be protective against depressive symptoms (second visit data, Q4 vs Q1, OR 0.78, 95% CI 0.19 to 3.14; third visit data, Q4 vs Q1, OR 0.58, 95% CI 0.04 to 8.77). Owing to inconsistent results in analyses between blood cadmium levels and depressive symptoms, we cannot conclude any solid association between blood cadmium levels and depressive symptoms in the elderly population. To clarify the relationship, other prospective studies are needed in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Potentially inappropriate prescribing in an Irish elderly population in primary care.

    LENUS (Irish Health Repository)

    Ryan, Cristín

    2009-12-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * Potentially inappropriate prescribing in older people is a well-documented problem and has been associated with adverse drug reactions and hospitalization. * Beers\\' criteria, Screening Tool of Older Persons\\' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) are screening tools that have been formulated to help physicians and pharmacists identify potentially inappropriate prescribing and potential prescribing omissions. * The prevalence of potentially inappropriate prescribing and prescribing omissions in the elderly population presenting to hospital with acute illness is high according to STOPP and START criteria.

  7. Anemia and iron deficiency in Mexican elderly population. Results from the Ensanut 2012

    OpenAIRE

    Alejandra Contreras-Manzano; Vanessa de la Cruz; Salvador Villalpando; Rosario Rebollar; Teresa Shamah-Levy

    2015-01-01

    Objective. To describe de prevalence of iron deficiency (ID) and anemia in a sample of Mexican elderly population from the National Health and Nutrition Survey (Ensanut) 2012. Materials and methods. 1 920 subjects ≥60 years of age were included. Hemoglobin, serum concentrations of ferritin and CRP were measured. The risk for ID and anemia adjusted for potential confounders was assessed in logistic regression models. Results. The overall prevalence of anemia was 13.9%, 15.2% in males and 12.8%...

  8. Risk Factors for Dementia in a Senegalese Elderly Population Aged 65 Years and Over

    Directory of Open Access Journals (Sweden)

    K. Toure

    2012-04-01

    Full Text Available Background: With the aging of the population, dementia is increasing worldwide. The objective of this study was to identify risk factors for dementia in an elderly population utilizing a primary health care service in Dakar, Senegal. Methods: Through a cross-sectional study conducted from March 2004 to December 31, 2005, 507 elderly patients aged ≥65 years who came to the Social and Medical Center of IPRES, Dakar, Senegal, were first screened with the screening interview questionnaire ‘Aging in Senegal’. Those who were cognitively impaired underwent a clinical examination to detect dementia. Univariate, bivariate, and multivariate logistic regression analyses were done. Results: The whole population had a mean age of 72.4 years (±5.2 and was mostly male, married, and non-educated. Hypertension, arthritis, and gastrointestinal diseases were the main health conditions reported in the past medical history. Smoking was important while alcohol consumption was rare. Social network was high. Forty-five patients (8.87% had dementia. In the multivariate model, only advanced age, education, epilepsy, and family history of dementia were independently associated with dementia. Conclusion: The risk factors identified are also found in developed countries confirming their role in dementia. It is important to take dementia into consideration in Senegal and to sensitize the community for prevention.

  9. An Investigation into Body Mass Index and\\ud Lifestyle Characteristics within an Elderly\\ud Population

    OpenAIRE

    Mills, Claire D; Hayward, Jessica

    2016-01-01

    Understanding and detecting patterns of body composition change and lifestyle factors that influence the development of effective strategies to optimise the health and well-being of the elderly are important. Therefore current research aimed to discover the strength of the correlation\\ud between an elderly populations Body Mass Index (BMI) and lifestyle characteristics including diet, physical activity, mobility, balance, sleep, smoking, alcohol consumption and well-being and whether there we...

  10. Randomised controlled trial of the effect of long-term selenium supplementation on plasma cholesterol in an elderly Danish population

    DEFF Research Database (Denmark)

    Cold, Frederik; Winther, Kristian H; Pastor-Barriuso, Roberto

    2015-01-01

    Although cross-sectional studies have shown a positive association between Se and cholesterol concentrations, a recent randomised controlled trial in 501 elderly UK individuals of relatively low-Se status found that Se supplementation for 6 months lowered total plasma cholesterol. The Danish......:HDL-cholesterol ratio between intervention and placebo groups. The effect of long-term supplementation with Se on plasma cholesterol concentrations or its sub-fractions did not differ significantly from placebo in this elderly population....

  11. Qualitative Evaluation of Baduanjin (Traditional Chinese Qigong on Health Promotion among an Elderly Community Population at Risk for Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Guohua Zheng

    2015-01-01

    Full Text Available Background. Baduanjin is a traditional Chinese qigong that has been practiced for a long time in China as a mind-body exercise in community elderly populations. The objective of this study was to qualitatively evaluate the perceived benefit of regular Baduanjin qigong in community elders. Methods. A total of 20 participants who had completed the 12-week Baduanjin qigong training were interviewed regarding their perceived effect on physical and psychological health and whether Baduanjin qigong was suitable for the elderly. Results. Almost all participants agreed that Baduanjin qigong could promote their multisystem or organ functions (e.g., digestive and circulatory systems, increase their immunity, make their bodies relax, and improve their mood and confidence. Most of the participants also agreed that Baduanjin qigong was appropriate for elderly individuals. Few individuals felt bored because of an hour Baduanjin training each day. Conclusions. The findings suggest that regular Baduanjin qigong may be potentially helpful to promote the overall physical and psychological health of elderly community populations and may be useful and feasible as a body-mind exercise in the health promotion in the elderly community populations.

  12. An apocalyptic vision of ageing in China: Old age care for the largest elderly population in the world.

    Science.gov (United States)

    Liu, Tao; Sun, Li

    2015-06-01

    According to the National Bureau of Statistics of China, by 2010 the number of people aged 60 or over had reached 178 million in China or 13% of its population. With the largest elderly population in the world in absolute numbers, China faces a challenge of providing care for the elderly both in the present and the future. Unlike old age pensions and health protection for the elderly, in Chinese society elderly care had never been considered to be a social problem but rather the individual family's responsibility. After the turn of the millennium, as the repercussions of increasingly ageing demographics, the results of the One-Child Policy and drastic changes in traditional family structures gradually became more apparent, this issue of elderly care has increasingly become one of the most pressing concerns for the ageing society. As there is little existing research on this particular topic, this article aims to shed light on elderly care in China, focusing on the care of elderly needing assistance with activities of daily living, since this group of elderly are most in need of care, their numbers having risen to 33 million in 2010. This article argues it is urgent for China to switch from informal family-based elderly care to the state's formal long-term care, illustrates that a model of social insurance (e.g. as in Germany) is advocated by many Chinese scholars and points out the ways in which it is different from both the commercialized models (e.g. as in the USA) and state organized "Beveridge" models (e.g. as in Sweden).

  13. Management of stage III colon cancer in the elderly: Practice patterns and outcomes in the general population.

    Science.gov (United States)

    Merchant, Shaila J; Nanji, Sulaiman; Brennan, Kelly; Karim, Safiya; Patel, Sunil V; Biagi, James J; Booth, Christopher M

    2017-08-01

    Clinical trials have established surgical resection and adjuvant chemotherapy (ACT) as the standard management for stage III colon cancer; however, the extent to which these results apply to elderly patients in routine practice is unclear. This article describes the management and outcomes of elderly patients with stage III colon cancer. All cases of surgically resected colon cancer from 2002 to 2008 were identified with the population-based Ontario Cancer Registry. Pathology reports were obtained for a random sample (25% of all cases); those with stage III disease constituted the study population. The utilization of ACT, cancer-specific survival (CSS), and overall survival (OS) in elderly patients (≥70 years) and nonelderly patients (elderly. The 30- and 90-day mortality rates increased with advanced age: elderly patients and to 81% of younger patients (P elderly were a younger age (P elderly patients, ACT was associated with improved CSS (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.88) and OS (HR, 0.71; 95% CI, 0.60-0.83); however, the magnitude of the benefit was smaller for elderly patients than younger patients (HR for CSS, 0.53; 95% CI, 0.42-0.67; HR for OS 0.56; 95% CI, 0.45-0.69). Half of elderly patients with stage III colon cancer do not receive ACT. Although the effect size is smaller than that in younger patients, ACT is associated with improved long-term survival. Cancer 2017;123:2840-49. © 2017 American Cancer Society. © 2017 American Cancer Society.

  14. Increase of Elderly Population in the Rainstorm Hazard Areas of China.

    Science.gov (United States)

    Liang, Pujun; Xu, Wei; Ma, Yunjia; Zhao, Xiujuan; Qin, Lianjie

    2017-08-26

    In light of global warming, increased extreme precipitation events have enlarged the population exposed to floods to some extent. Extreme precipitation risk assessments are of great significance in China and allow for the response to climate change and mitigation of risks to the population. China is one of the countries most influenced by climate change and has unique national population conditions. The influence of extreme precipitation depends on the degree of exposure and vulnerability of the population. Accurate assessments of the population exposed to rising rainstorm trends are crucial to mapping extreme precipitation risks. Studying the population exposed to rainstorm hazard areas (RSHA) at the microscale is extremely urgent, due to the local characteristics of extreme precipitation events and regional diversity of the population. The spatial distribution of population density was mapped based on the national population census data from China in 1990, 2000 and 2010. RSHA were also identified using precipitation data from 1975-2015 in China, and the rainstorm tendency values were mapped using GIS in this paper. The spatial characteristics of the rainstorm tendencies were then analyzed. Finally, changes in the population in the RSHA are discussed. The results show that the extreme precipitation trends are increasing in southeastern China. From 1990 to 2010, the population in RSHA increased by 110 million, at a rate of 14.6%. The elderly in the region increased by 38 million at a rate of 86.4%. Studying the size of the population exposed to rainstorm hazards at the county scale can provide scientific evidence for developing disaster prevention and mitigation strategies from the bottom up.

  15. Lumbar Lordosis Minus Thoracic Kyphosis: A Novel Regional Predictor for Sagittal Balance in Elderly Populations.

    Science.gov (United States)

    Yang, Changwei; Yang, Mingyuan; Wei, Xianzhao; Shao, Jie; Chen, Yuanyuan; Zhao, Jian; Zhu, Xiaodong; He, Dawei; Li, Ming

    2016-03-01

    A retrospective study. The aim of this study is to introduce a novel regional predictor for sagittal balance in elderly populations and explore its effectiveness of evaluating sagittal balance. Sagittal balance is getting increasing recognition of importance due to its significant association of health-related quality of life. However, no regional parameters could well reflect and predict the whole sagittal balance. Medical records of elderly patients in our outpatient clinic from January 2012 to January 2014 were reviewed with standing full-spine lateral radiograph. Radiological parameters were evaluated, including max thoracic kyphosis (maxTK), max lumbar lordosis (maxLL), LL minus TK(LL-TK), PI minus LL (PI-LL), sacrum slope (SS), pelvic tilt (PT), pelvic incidence (PI), and SVA (sagittal vertical axis). Correlation analysis between SVA, LL-TK, and other radiological spinopelvic parameters and was pursued. Patients were divided into two groups according to whether patients were well-aligned in sagittal plane: Group A (well-aligned, SVA ≤50  mm) and Group B (poorly aligned, SVA >50  mm), and demographic and sagittal parameters were compared. LL-TK ≥0° and PI-LL ≤13° were used as a threshold value to evaluate their effectiveness of prediction for sagittal balance. A total of 129 patients (M: 25 and F: 104) were included in this study. SVA was significantly correlated with NRS (numeric rating scales), age, maxLL, PT, LL-TK, and PI-LL (all, P 13°, 34 patients were poorly aligned (34/39, 87%). LL-TK was a good regional predictor for sagittal balance in elderly population, especially combined with PI-LL. 4.

  16. Helicobacter pylori infection and metabolic parameters: Is there an association in elderly population?

    Directory of Open Access Journals (Sweden)

    Narges Sotuneh

    2014-01-01

    Full Text Available Background: The association between Helicobacter pylori (HP, as one of the most prevalent infections, and serum glucose level was inconsistent with previous studies. Moreover, there are contradictory reports about the relationship between HP infection and lipid profile. The purpose of this study was to determine the relationship between HP infection with glycemic and lipid profiles in elderly people. Methods: This cross-sectional study was conducted on 1,300 subjects over 60 years in Amirkola Health and Ageing Project. After using a standard questionnaire, the venous sampling was done to determine FBS, triglyceride (TG, cholesterol, low density lipoprotein (LDL, high-density lipoprotein (HDL and IgG anti-HP after a 12-h overnight fast. The information about the individuals was analyzed using SPSS-17. The P < 0.05 was considered statistically significant. Results: The prevalence of HP infection in diabetic and nondiabetic subjects was 77.5% and 75.7%, respectively, which had no statistically significant difference. Also, there was no significant difference between the serum lipid level including TG, LDL and HDL cholesterol with levels of anti-HP antibodies. The rate of HP infection in patients with hypertension was 75% and 78.3% in healthy patients, in which the difference was not statistically significant. In terms of body mass index (BMI, the prevalence of infection in the group with normal BMI was 77.3% and for the overweight and obese elderly population, it was 74.7%, and 77.5%, respectively (P = 0.445. Conclusions: The findings revealed that in a large population of elderly in the northern part of Iran, HP infection is not associated with BMI, serum glucose and lipid profile as well as blood pressure.

  17. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

    Directory of Open Access Journals (Sweden)

    Yaegashi Nobuo

    2010-06-01

    Full Text Available Abstract Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ, from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI and energy intake. Results Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94 after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90 after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. Conclusions The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.

  18. Increasing Prevalence of Metabolic Syndrome in a Chinese Elderly Population: 2001–2010

    Science.gov (United States)

    Jiang, Bin; Sun, Dongling; Wu, Lei; Yang, Shanshan; Wang, Yiyan; Li, Xiaoying; He, Yao

    2013-01-01

    Objective The information on the changes of prevalence of MetS in China is limited. Our objective was to assess a 10-year’s change of the prevalence of MetS in a Chinese elderly population between 2001 and 2010. Methods We conducted two cross-sectional surveys in a representative sample of elderly population aged 60 to 95 years in Beijing in 2001 and 2010 respectively. MetS was defined according to the 2009 harmonizing definition. Results A total of 2,334 participants (943 male, 1,391 female) in 2001 and 2,102 participants (848 male, 1,254 female) in 2010 completed the survey. The prevalence of MetS was 50.4% (95%CI: 48.4%–52.4%) in 2001 and 58.1% (95%CI: 56.0%–60.2%) in 2010. The absolute change of prevalence of MetS was 7.7% over the 10-year’s period (pdislipidemia. PMID:23824753

  19. Prevalence and correlates of valvular heart diseases in the elderly population in Hubei, China.

    Science.gov (United States)

    Shu, Chang; Chen, Si; Qin, Tingting; Fu, Zhen; Sun, Tucheng; Xie, Mingxing; Zhang, Li; Dong, Nianguo; Yin, Ping

    2016-06-02

    We sought to determine the prevalence and correlates of valvular heart diseases (VHD) in the elderly population. The participants' personal information, medical history, behavioral habits and clinical status were assessed by questionnaire, while the left ventricular dimensions, function and the presence and severity of VHD were evaluated by transthoracic echocardiography. This study analyzed the data of 3948 participants who were older than 60 years. Significant VHD was present in 1.93% of participants; the standardized prevalence of VHD among the elderly population in Hubei was 2.05% (95% CI: 1.61-2.49). The most frequent VHD was aortic regurgitation, followed by tricuspid regurgitation, mitral regurgitation and multiple valve diseases. Univariate analysis results indicated that compared with participants without VHD, those with VHD were older (p < 0.001), with a higher body mass index (BMI) (p < 0.001), were more likely to smoke (p = 0.04), and had higher rates of coronary artery disease (CAD) (p < 0.001) and arrhythmia (p < 0.001). The results of multinomial regression analysis of complex sampling indicated that combined mitral and aortic valve diseases were related to older age, male sex and smoking; CAD was associated with single left-sided VHD.

  20. Is ethnicity an important determinant of high blood pressure in Nepalese population? A community-based cross sectional study in Duwakot, Nepal.

    Science.gov (United States)

    Vaidya, A

    2012-01-01

    Background Hypertension is a rising public health problem in Nepal. Most of the upsurge is attributed to the behavioural and lifestyle transitions. However, the hereditary component such as ethnicity, which may also be an important determinant, has not been studied. Objective This study aims to investigate if ethnicity is a key determinant of having a high blood pressure in the Nepalese population. Methods A population-based cross sectional study was conducted in the Duwakot village of Bhaktapur District, Nepal. Systematic random sampling of the adults was done in all the nine wards. A total of 641 adults of both sexes, of age 35 years or more were included in the analysis. Results Most of the life-style related risk factors were comparable in the broad two ethnic groups- Tibeto-Burmans and Indo-Aryans. The prevalence of hypertension was 25.3% in the Tibeto-Burmans compared to the 14.0% in the Indo-Aryans. Crude odds ratio (95% CI) of being hypertensive for the Tibeto-Burmans compared to the Indo-Aryans was 2.07 (1.36-3.15) (p=0.01). After adjusting for the different factors the adjusted odds ratio (95% CI) for the same was found to be 1.78 (1.12-2.81) (p=0.014). Conclusion There is an ethnic variation in the blood pressure distribution in the Nepalese population, which might be acting independent of the different life-style factors. More elaborate studies, including longitudinal and migration studies, and probably genetic analyses, can provide a more definite answer.

  1. Gender differences in nighttime plasma arginine vasopressin and delayed compensatory urine output in the elderly population after desmopressin.

    Science.gov (United States)

    Hvistendahl, Gitte M; Frøkiaer, Jørgen; Nielsen, Søren; Djurhuus, Jens Christian

    2007-12-01

    Monosymptomatic polyuric nocturia is a consequence of aging. We investigated physiological differences between nonpolyuric and polyuric nocturia in the elderly population in relation to urine production regulation in young volunteers with special reference to gender. We performed a study in 37 elderly healthy volunteers 65 years or older and 30 young healthy volunteers 20 to 40 years old who were hospitalized for 48 hours. Before admittance and during hospitalization fluid intake was standardized. The first 24 hours were at baseline conditions. On night 2 participants were given a single oral dose of desmopressin (0.4 mg). During 48 hours urine and blood samples were taken at predetermined time points to measure urine output and plasma arginine vasopressin levels. Elderly individuals with nocturnal polyuria had an inverted rhythm in urine output, which was restored after a single dose of desmopressin. There was an age related change in the circadian rhythm of arginine vasopressin secretion, which was associated with the presence or absence of nocturnal polyuria. A novel and unexpected finding was a decreased circadian rhythm of arginine vasopressin secretion in young women, similar to the pattern observed in elderly women but with a preserved decrease in nighttime urine production. Compensatory diuresis following the induction of temporary antidiuresis was markedly postponed in elderly participants. Age and gender related decreased arginine vasopressin secretion at night underscores the fact that other factors modulate urine production. The pharmacodynamics of desmopressin as an antidiuretic in the elderly population are different from those in young individuals.

  2. The effect of visual biofeedback on balance in elderly population: a systematic review

    Directory of Open Access Journals (Sweden)

    Alhasan H

    2017-03-01

    Full Text Available Hammad Alhasan,1 Victoria Hood,2 Frederick Mainwaring2 1Physiotherapy Department, Faculty of Applied Medical Science, Umm al-Qura University, Mecca, Kingdom of Saudi Arabia; 2School of Health Science, University of Nottingham, Nottingham, Nottinghamshire, UK Background: Balance is commonly affected by multiple factors, especially among the elderly population. Visual biofeedback (VBF is an intervention tool that can be used in balance rehabilitation.Aim: This study aimed to systematically review randomized controlled trials that examine whether VBF training is effective in improving balance in an elderly population.Data sources: Three databases were searched: CIAHL, EMBASE, and MEDLINE. The searches were limited to the period from 2010 to 2016.Eligibility criteria: Healthy adults, aged ≥65 years, with no specific disorders were included. Interventions were any VBF intervention with the aim of improving balance and were compared to no intervention, traditional exercises, placebo, or standard care. The outcome measures were balance as measured by any validated outcome measure.Studies appraisal method: The Physiotherapy Evidence Database quality assessment tool and The Cochrane Collaboration tool for assessing risk of bias were used by two independent authors (HA and FM in order to appraise the included studies.Results: The database search resulted in 879 articles, of which five papers were included. VBF was compared to no intervention, a placebo, and traditional exercise. The total number of participants in all the five included studies was 181, with a mean age of 74.3 years (standard deviation 6.7. Two studies were rated as high-quality studies, and three were rated as fair quality.Conclusion: Engaging elderly people living in the community in VBF training was found to be effective and could improve their balance ability. However, the variation between studies in methodology, intervention protocol, and outcomes utilized made it difficult to

  3. Quality of life determinants and hearing function in an elderly population: Osservatorio Geriatrico Campano Study Group.

    Science.gov (United States)

    Cacciatore, F; Napoli, C; Abete, P; Marciano, E; Triassi, M; Rengo, F

    1999-01-01

    Hearing impairment (HI) is a very common condition in elderly people and the epidemiology together with hearing-related problems is still poorly investigated. Moreover, the cognitive status may be impaired in relation to hearing function. The goal of the study was to evaluate: (a) the prevalence of HI in a random sample of elderly people aged 65 and over (n = 1,750) living in Campania, a region of southern Italy; (b) the cross-sectional relationship between hearing function and cognitive status and also depressive symptomatology and disability, and (c) to assess the role of hearing aids on depressive symptomatology. Cross-sectional study on a random sample of elderly population. The overall participation rate in the study was 74.8% (n = 1,332, mean age was 74.2 +/- 6.4 years). The prevalence rate of HI (evaluated by questionnaire) was 27.2%, cognitive impairment prevalence (evaluated by the Mini-Mental State Examination (MMSE)) was 27.9%, mean depressive symptomatology score (evaluated by Geriatric Depression Scale (GDS)) was 11.4 +/- 6.6, while disability assessed by Activity of Daily Living (ADL) was present in 7.0% of the whole population. A strong relationship was found between both decreasing hearing function and MMSE decline, independently by the effect of age and education (r = 0.97; p < 0.01). A positive relationship (r = 0.85; p < 0.01) between GDS score and hearing function was also found. Moreover, at an increased level of hearing loss, a lower ADL score was recorded (r = 0.98; p < 0.01). Finally, the use of hearing aids reduced GDS score. In logistic regression analysis, gender, age and educational level indicate that hearing loss risk increased with age (odds ratio 1.60; 95% confidence interval 1.53-1.71), whereas education plays a protective role (odds ratio 0.75; 95% confidence interval 0.72-0.80). HI is very prevalent among elderly people and is associated with either cognitive impairment and/or depression and reduction of functional status. This

  4. Enhancing resiliency for elderly populations : Shelter-in-place planning and training at facilities serving elderly populations through the Rhode Island Senior Resiliency Project.

    Science.gov (United States)

    Smith, Richard; Mozzer, Michael; Albanese, Joseph; Paturas, James; Gold, Julia

    2017-06-01

    Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters. Based on this, the Rhode Island Department of Health established the Senior Resiliency Project to bolster the level of resiliency for the types of living facilities housing older adults. The project involves performing onsite assessments of energy resources, developing site-specific sheltering-inplace and energy resiliency plans, and educating and training facility employees and residents on these plans and steps they can take to be better prepared. Based on the feasibility of conducting these activities within a variety of facilities housing older adults, the project is segmented into three phases. This paper describes survey findings, outcomes of interventions, challenges and recommendations for bridging gaps observed in phases 1 and 2 of the project.

  5. Subclinical cardiovascular disease assessment and its relationship with cardiovascular risk SCORE in a healthy adult population: A cross-sectional community-based study.

    Science.gov (United States)

    Mitu, Ovidiu; Roca, Mihai; Floria, Mariana; Petris, Antoniu Octavian; Graur, Mariana; Mitu, Florin

    The aim of this study is to evaluate the relationship and the accuracy of SCORE (Systematic Coronary Risk Evaluation Project) risk correlated to multiple methods for determining subclinical cardiovascular disease (CVD) in a healthy population. This cross-sectional study included 120 completely asymptomatic subjects, with an age range 35-75 years, and randomly selected from the general population. The individuals were evaluated clinically and biochemical, and the SCORE risk was computed. Subclinical atherosclerosis was assessed by various methods: carotid ultrasound for intima-media thickness (cIMT) and plaque detection; aortic pulse wave velocity (aPWV); echocardiography - left ventricular mass index (LVMI) and aortic atheromatosis (AA); ankle-brachial index (ABI). SCORE mean value was 2.95±2.71, with 76% of subjects having SCORE <5. Sixty-four percent of all subjects have had increased subclinical CVD changes, and SCORE risk score was correlated positively with all markers, except for ABI. In the multivariate analysis, increased cIMT and aPWV were significantly associated with high value of SCORE risk (OR 4.14, 95% CI: 1.42-12.15, p=0.009; respectively OR 1.41, 95% CI: 1.01-1.96, p=0.039). A positive linear relationship was observed between 3 territories of subclinical CVD (cIMT, LVMI, aPWV) and SCORE risk (p<0.0001). There was evidence of subclinical CVD in 60% of subjects with a SCORE value <5. As most subjects with a SCORE value <5 have subclinical CVD abnormalities, a more tailored subclinical CVD primary prevention program should be encouraged. Copyright © 2016 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Social participation and perceived depression among elderly population in South Africa

    Directory of Open Access Journals (Sweden)

    Hao G

    2017-06-01

    . The study concludes that addressing the barriers to engaging in community activities may help minimize burden of depression among the elderly population in South Africa. Furthermore, large-scale studies are warranted to explore the social and structural barriers which constrain community participation among the elderly population. Keywords: depression, elderly population, social participation, South Africa, well-being of older people study 

  7. Community-based preventive activities in the Public Dental Service in Norway.

    Science.gov (United States)

    Widström, E; Tillberg, A; Byrkjeflot, L I; Stein, L; Skudutyte-Rysstad, R

    2017-12-13

    The purpose of this study was to describe community-based preventive interventions undertaken by the dental team outside the dental clinics in Norway, from the dental hygienists' and the dentists' perspective, with the main focus on target groups and existing guidelines and routines for these activities. A secondary aim was to identify the personnel responsible for developing the local guidelines and the knowledge sources for the guidelines. With the assistance of the Chief Dental Officers in 15 Public Dental Service (PDS) regions, questionnaires were emailed to the local clinics (n = 421). In each, the most experienced dental hygienist and dentist were asked to respond; 215 dentists and 166 and dental hygienists responded (60%). Almost 40% of the respondents reported that their clinic had guidelines on community-based activities conducted outside the clinics. Dental hygienists and local chief dentists were responsible for planning them. The main target groups were young children and the dependent elderly; the majority of the activities were carried out at child welfare centres and for personnel at nursing homes or for home care nurses. At the regional and local level, a more strategic and coordinated approach to the provision of community-based activities is needed, including assessment of oral health needs among population groups. Continuous documentation and evaluation of results are necessary for optimal use of available resources and to facilitate an evidence-based approach. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Outcome of traumatic brain injury in elderly population: A tertiary centre experience from a developing country.

    Science.gov (United States)

    Prasad, G Lakshmi; Anmol, N; Menon, Girish R

    2017-12-16

    The increasing ratio of elderly population has contributed to increased incidence of TBI in this cohort. Authors put forward their institutional experience in the management of elderly TBI. A 3-year retrospective analysis of 73 consecutive patients aged ≥ 65 years admitted with TBI at our university hospital was performed. The following were excluded-concussion injuries, chronic subdural hematomas (SDH), patients discharged against medical advice (DAMA) and declared dead soon after arrival (within 6 hours). Mode of injury, clinico-radiological features, management and outcomes were analysed. Glasgow outcome scale (GOS) was used to assess outcome. Males predominated (82%). Mean age was 72.1 years (range 65-97 years) and 20 were aged≥75 years. There were 37 mild, 18 moderate and 18 severe head injuries (HI). Contusions constituted the majority. Fifty-five(75%) cases were managed conservatively while 18(25%) underwent surgery. There were 7 deaths(9.5%). Overall, poor outcome was 26%, while being 45% in patients aged ≥75years. Poor outcome in severe HI for the entire cohort was 83% (15/18) but was 100% (7/7) for the very elderly patients. On univariate analysis, age≥75 years, severe HI, acute SDH and surgical management were significantly associated with poor outcome while acute SDH and surgical management were significant on multilogistic regression analysis. Age ≥75 years, severe HI and acute SDH are poor prognostic factors. Benefit of surgery in such conditions is unlikely and surgery needs to be judiciously considered keeping in mind the economics involved and fate of caregivers, especially in developing countries. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. High prevalence of sarcopenia among binge drinking elderly women: a nationwide population-based study.

    Science.gov (United States)

    Yoo, Jun-Il; Ha, Yong-Chan; Lee, Young-Kyun; Hana-Choi; Yoo, Moon-Jib; Koo, Kyung-Hoi

    2017-05-30

    Alcohol consumption is considered a risk factor for sarcopenia, but the association between alcohol consumption and the prevalence of sarcopenia has not been evaluated in detail. This study was to identify the relationship between alcohol drinking patterns and the prevalence of sarcopenia in the elderly Korean population. The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Participants were excluded if they were under the age of 65, or if data was not available regarding skeletal muscle mass or dietary intake. After these exclusions, a total of 4020 participants (men: 1698; women: 2322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS). Binge drinking was defined as consuming ≥5 standard alcoholic drinks (≥4 drinks for women) consecutively on one occasion. This data was subcategorized into two groups based on presence of binge drinking: Social drinking (≤1 time/month) and binge drinking (>1 time/month). Women binge drinkers with weekly or daily consumption had 2.8 times higher prevalence of sarcopenia than social drinkers (Odds Ratio [OR] = 2.84; 95% Confidence Interval [CI] = 1.12-7.29). However, there were no associations between binge drinkers and sarcopenia in men. After adjusting for age, body mass index (BMI), energy intake, moderate physical activity, and energy intake, women binge drinkers with weekly or daily alcohol consumption had 3.9 times higher prevalence of sarcopenia than social drinkers (OR = 3.88; 95% CI = 1.33-11.36). The prevalence of sarcopenia in elderly women was related to binge drinking frequency and amounts of drinking after adjusting for covariates. Elderly Korean women who binge drink once or more per week may be associated with sarcopenia, as seen with the observed 3.9 times higher prevalence compared to social drinkers.

  10. Prevalence and complications of chronic kidney disease in a representative elderly population in Iceland.

    Science.gov (United States)

    Okparavero, Aghogho; Foster, Meredith C; Tighiouart, Hocine; Gudnason, Vilmundur; Indridason, Olafur; Gudmundsdottir, Hrefna; Eiriksdottir, Gudny; Gudmundsson, Elias F; Inker, Lesley A; Levey, Andrew S

    2016-03-01

    Chronic kidney disease (CKD) is common in the elderly, but data are limited on the distribution of glomerular filtration rate (GFR) and albuminuria and the prevalence of CKD and related complications in this population. A cross-sectional study of 3173 older Icelandic adults [42% men; mean (standard deviation, SD) age of 80 (5) years] was performed to examine the distribution of estimated glomerular filtration rate (eGFR) from creatinine and cystatin C, the albumin-to-creatinine ratio (ACR), and CKD-related metabolic complications (hyperparathyroidism, anemia, hypoalbuminemia, increased anion gap, acidosis, hyperphosphatemia and hyperkalemia). There was substantial variability in eGFR [mean (SD) 64 (18) mL/min/1.73 m(2)] and ACR [median (interquartile range) 8 (5, 17) mg/g]. The prevalence (95% confidence interval) of reduced eGFR (30 mg/g) and CKD (either reduced eGFR or albuminuria) was 40% (38-41), 14% (12-15) and 45% (43-47), respectively. The prevalence of complications was higher among those with versus without CKD: hyperparathyroidism (38 versus 15%), anemia (26 versus 14%), hypoalbuminemia (19 versus 13%), increased anion gap (9 versus 5%), acidosis (5 versus 1%); (P ≤ 0.02 for all), except hyperphosphatemia (1 versus 1%) and hyperkalemia (0% overall). The burden of CKD and CKD-related complications is high among community dwelling elderly Icelandic adults. The wide range of eGFR and ACR suggests heterogeneity in processes leading to CKD and that factors beyond aging contribute to the development of CKD in the elderly. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  11. Nutritional status, physical performance and functional capacity in an elderly population in southern Brazil

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Danielewicz

    2014-06-01

    Full Text Available Objective: to investigate the association between nutritional status and functional limitation and disability in an elderly population in southern Brazil. Methods: epidemiological, cross-sectional household-based study carried out with 477 elderly of both sexes (60 to 100 years. Body mass index (BMI served to assess the nutritional status: underweight (BMI 27 kg/m2. The sum score (0-5 obtained in three tests: "chair stand" and "pick up a pen" (measured by time and standing balance (four static measurements assessed the functional limitation. The disability was evaluated by the difficulty in performing one or more self-reported tasks related to basic activities of daily living (ADLs and instrumental activities of daily living (IADLs. Crude and adjusted analyzes (3 models were carried out using Poisson regression; prevalence ratios (PR and 95% confidence intervals (CI were calculated. Results: crude analyzes showed a positive association between underweight and functional limitation (PR = 2.71, 95% CI = 1.63 to 4.51; overweight and disability in ADLs (PR = 2.20, CI 95% = 1.44 to 3.35; overweight and disability in IADLs (PR = 1.56, CI 95% = 1.20 to 2.03. The additional adjustments for gender, age, level of education, living arrangements, current work, cognitive function and number of morbidities reduced the strength of the associations, without changing the statistical strength. Conclusion: nutritional status is a factor that is independently and positively associated with functional limitation and disability. We recommend the use of this indicator to monitor the health of the elderly.

  12. Survival Trends in Elderly Patients with Glioblastoma in the United States: a Population-based Study.

    Science.gov (United States)

    Shah, Binay Kumar; Bista, Amir; Sharma, Sandhya

    2016-09-01

    Concomitant and adjuvant temozolomide along with radiotherapy following surgery (the Stupp regimen) is the preferred therapy for young patients with glioblastoma as well as for elderly (>70 years) ones with favorable risk factors. This study investigated the survival trend since the introduction of the use of the Stupp regimen in elderly patients in a population-based setting. Surveillance, Epidemiology, and End Results 18 database was used to identify patients aged ≥70 years with glioblastoma as the first primary cancer diagnosed from 1999 to 2010. Chi-square test, Kaplan-Meier analysis with log-rank test and Cox proportional hazard method were used for analysis. A total of 5,575 patients were included in the survival analysis. Survival in Stupp era (year of diagnosis ≥2005) was significantly better compared to the pre-Stupp era with p<0.001 by log-rank test, with 1-, 2- and 3-year overall survival of 18.8% vs. 12.9%, 6.5% vs. 2.1% and 3.1% vs. 0.9% respectively, and hazard ratio for death in 3 years in the Stupp era was 0.87 (95% confidence interval=0.82-0.92; p<0.001) when compared with the pre-Stupp era. Factors such as younger age (<85 years), female sex, married status, Caucasian race and total resection favored better survival compared to their counterparts. This study shows that the survival of elderly patients with glioblastoma has improved since the introduction of the Stupp regimen. However, there are significant differences in survival rates among various cohorts. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  13. Nutritional status, physical performance and functional capacity in an elderly population in southern Brazil.

    Science.gov (United States)

    Danielewicz, Ana Lúcia; Barbosa, Aline Rodrigues; Del Duca, Giovâni Firpo

    2014-01-01

    To investigate the association between nutritional status and functional limitation and disability in an elderly population in southern Brazil. Epidemiological, cross-sectional household-based study carried out with 477 elderly of both sexes (60 to 100 years). Body mass index (BMI) served to assess the nutritional status: underweight (BMI 27 kg/m2). The sum score (0-5) obtained in three tests: "chair stand" and "pick up a pen" (measured by time) and standing balance (four static measurements) assessed the functional limitation. The disability was evaluated by the difficulty in performing one or more self-reported tasks related to basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Crude and adjusted analyzes (3 models) were carried out using Poisson regression; prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. Crude analyzes showed a positive association between underweight and functional limitation (PR = 2.71, 95% CI = 1.63 to 4.51); overweight and disability in ADLs (PR = 2.20, CI 95% = 1.44 to 3.35); overweight and disability in IADLs (PR = 1.56, CI 95% = 1.20 to 2.03). The additional adjustments for gender, age, level of education, living arrangements, current work, cognitive function and number of morbidities reduced the strength of the associations, without changing the statistical strength. Nutritional status is a factor that is independently and positively associated with functional limitation and disability. We recommend the use of this indicator to monitor the health of the elderly.

  14. Community-Based Family Health History Education: The Role of State Health Agencies in Engaging Medically Underserved Populations in Understanding Genomics and Risk of Chronic Disease

    Directory of Open Access Journals (Sweden)

    Laura Senier

    2015-10-01

    Full Text Available Although family health history (FHH collection has been recognized as an influential method for assessing a person’s risk of chronic disease, studies have shown that people who are low-income, from racial and ethnic minorities, and poorly educated are less likely to collect their FHH or share it with a medical professional. Programs to raise public awareness about the importance of FHH have conventionally targeted patients in primary care clinics or in the general community, but few efforts have been made to coordinate educational efforts across settings. This paper describes a project by the Connecticut Department of Public Health’s Genomics Office to disseminate training materials about FHH as broadly as possible, by engaging partners in multiple settings: a local health department, a community health center, and two advocacy organizations that serve minority and immigrant populations. We used a mixed methods program evaluation to examine the efficacy of the FHH program and to assess barriers in integrating it into the groups’ regular programming. Our findings highlight how a state health department can promote FHH education among underserved communities.

  15. Prevalence and socioeconomic correlates of chronic morbidity among elderly people in Kosovo: a population-based survey.

    Science.gov (United States)

    Jerliu, Naim; Toçi, Ervin; Burazeri, Genc; Ramadani, Naser; Brand, Helmut

    2013-03-01

    Our aim was to assess the prevalence and demographic and socioeconomic correlates of chronic morbidity in the elderly population of transitional Kosovo. A cross-sectional study was conducted in Kosovo in 2011 including a representative sample of 1890 individuals aged ≥ 65 years (949 men, mean age 73 ± 6 years; 941 women, mean age 74 ± 7 years; response rate: 83%). A structured questionnaire inquired about the presence and the number of self-reported chronic diseases among elderly people, and their access to medical care. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of demographic and socioeconomic characteristics with chronic conditions. In this nationwide population-based sample in Kosovo, 42% of elderly people were unable to access medical care, of whom 88% due to unaffordable costs. About 83% of the elderly people reported at least one chronic condition (63% cardiovascular diseases), and 45% had at least two chronic diseases. In multivariable-adjusted models, factors associated with the presence of chronic conditions and/or multimorbidity were female sex, older age, self-perceived poverty and the inability to access medical care. This study provides important evidence on the magnitude and distribution of chronic conditions among the elderly population of Kosovo. Our findings suggest that, in this sample of elderly people from Kosovo, the oldest-old (especially women) and the poor endure the vast majority of chronic conditions. These findings point to the urgent need to establish a social health insurance scheme including the marginalized segments of elderly people in this transitional country.

  16. Frequency of Werner helicase 1367 polymorphism and age-related morbidity in an elderly Brazilian population

    Directory of Open Access Journals (Sweden)

    M.A.C. Smith

    2005-07-01

    Full Text Available Werner syndrome (WS is a premature aging disease caused by a mutation in the WRN gene. The gene was identified in 1996 and its product acts as a DNA helicase and exonuclease. Some specific WRN polymorphic variants were associated with increased risk for cardiovascular diseases. The identification of genetic polymorphisms as risk factors for complex diseases affecting older people can improve their prevention, diagnosis and prognosis. We investigated WRN codon 1367 polymorphism in 383 residents in a district of the city of São Paulo, who were enrolled in an Elderly Brazilian Longitudinal Study. Their mean age was 79.70 ± 5.32 years, ranging from 67 to 97. This population was composed of 262 females (68.4% and 121 males (31.6% of European (89.2%, Japanese (3.3%, Middle Eastern (1.81%, and mixed and/or other origins (5.7%. There are no studies concerning this polymorphism in Brazilian population. These subjects were evaluated clinically every two years. The major health problems and morbidities affecting this cohort were cardiovascular diseases (21.7%, hypertension (83.7%, diabetes (63.3%, obesity (41.23%, dementia (8.0%, depression (20.0%, and neoplasia (10.8%. Their prevalence is similar to some urban elderly Brazilian samples. DNA was isolated from blood cells, amplified by PCR and digested with PmaCI. Allele frequencies were 0.788 for the cysteine and 0.211 for the arginine. Genotype distributions were within that expected for the Hardy-Weinberg equilibrium. Female gender was associated with hypertension and obesity. Logistic regression analysis did not detect significant association between the polymorphism and morbidity. These findings confirm those from Europeans and differ from Japanese population.

  17. Chronic obstructive pulmonary disease and cognitive impairment in the Chinese elderly population: a large national survey.

    Science.gov (United States)

    Yin, Peng; Ma, Qingfeng; Wang, Limin; Lin, Peng; Zhang, Mei; Qi, Shige; Wang, Zhihui

    2016-01-01

    Previous studies suggested an association between chronic obstructive pulmonary disease (COPD) and cognitive impairment, mostly in developed countries. There is no evidence available on the association between these two common chronic disorders in the elderly people in People's Republic of China where the population is aging rapidly. The study population was randomly selected from a nationally representative Disease Surveillance Point System in People's Republic of China. A standardized questionnaire was administered by trained interviewers during a face-to-face interview in the field survey conducted in 2010-2011. Cognitive function was assessed using the Mini-Mental State Examination. COPD was measured by self-report and the Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A multivariate logistic regression model was applied to examine the association between COPD and cognitive impairment with adjustment for potential confounding factors. A total of 16,629 subjects aged over 60 years were included in the study. The prevalence of cognitive impairment was 9.4% (95% confidence interval [CI] 7.7, 11.1). Chronic phlegm was associated with significantly higher prevalence of cognitive impairment in models adjusted for age, sex, marital status, geographic region, urban/rural, education, smoking status, alcohol drinking, and indoor air pollution (odds ratio [OR] 1.46, 95% CI 1.11, 1.93). Chronic respiratory symptoms and self-reported COPD were strongly related to cognitive impairment in urban areas. There were no significant effect modifications for sex, regions, educational level, smoking status, and alcohol drinking. There was strong association between COPD and cognitive impairment in urban Chinese elderly population.

  18. Prevalence of depression and related social and physical factors amongst the Iranian elderly population in 2012.

    Science.gov (United States)

    Taheri Tanjanai, Parisa; Moradinazar, Mahdi; Najafi, Farid

    2017-01-01

    Depression is the most common psychiatric disorder and the second most common cause of disability among older adults. The objective of the present study was to investigate the prevalence of depression and related social and physical factors in the Iranian elderly population in 2012. In this cross-sectional study, 1350 Iranian older adults aged older than 60 years were selected considering the gender proportion of the population of five out of 31 provinces of Iran. To define depression, the short form (15-item) of the Geriatric Depression Scale was administered. To analyze the data, logistic regression was carried out using stata software (version 12.0). From 1350 participants, 642 (47.5%) were men and the rest were women. The mean ± SD age of the sample was 69 ± 7 years. The prevalence of depression was 36.7% (42.5% in women and 30.2% in men). At the bivariate level, sex, educational level, marital status, satisfaction with income, occupation, relationship with the financial provider, leisure time, activities of daily living, and frequency of meeting with friends and relatives were factors determining the odds of depression. However, after multivariate control, marital status and educational level were removed from the final model. In contrast, smoking, which was insignificant at the bivariate level, became significant at the multivariate level. Depression has a high prevalence among the Iranian elderly population. Therefore, it is important that this vulnerable group is provided with access to supportive environments that involve active participation in occupational and social activities, which in turn help reduce the chance of suffering from depression. Geriatr Gerontol Int 2017; 17: 126-131. © 2016 Japan Geriatrics Society.

  19. Measuring the expected increase in cycling in the city of Milan and evaluating the positive effects on the population's health status: a Community-Based Urban Planning experience.

    Science.gov (United States)

    Rebecchi, A; Boati, L; Oppio, A; Buffoli, M; Capolongo, S

    2016-01-01

    It's scientifically known that inactivity is one of the major risk factors for Non-Communicable Diseases. One of the elements affecting the choice of transport mode, regarding circulation in the city, is the cities' urban morphology, i.e. the infrastructural facilities for the slow mobility service. Cyclability, in fact, can help to increase daily physical activity level, therefore becoming a protective factor for individual health. After a literature review about the state of the art regarding the correlation between built environment, active transport and quantification of the physical activity level, we have developed a specific questionnaire to collect information about current and forecast use of bicycle, in case of improvement and implementation of the cycling network. The questionnaire also investigated social and health aspects concerning the anamnesis of the interviewees (age, gender, health status, sport activity performed, etc) and users' opinions about existing infrastructure and planned interventions, designed to promote cycling mobility. Aim of the research was to quantify the increase of physical activity people would have realized in front of an improvement of the specific infrastructures, and the expected positive effects in terms of health. The collected data (343 interviewed in a district of Milan, named "Zona 7") demonstrate that through the implementation of the cycle network, there would be more cyclists to practice the 150 minutes weekly of physical activity recommended by WHO: time spent in cycling, indeed, would increases by 34.4% compared to the current level of cyclability, as detected by our survey. The investigation confirmed that urban interventions, especially those in small-scale, could play a key role in the promotion of healthy lifestyles, inducing therefore important positive effects on the population health. It was also carried out an application of the WHO "Health Economic Assessment Tool" to evaluate the benefits in terms of

  20. Exploring the Non-Linear Relationship between Alcohol Consumption and Depression in an Elderly Population in Gangneung: The Gangneung Health Study

    OpenAIRE

    Kim, Sang-A; Kim, Eunyoung; Morris, Robert G.; Park, Woong-Sub

    2015-01-01

    Purpose The purpose of this study was to examine a J-shaped relationship between alcohol consumption and depression among the elderly in South Korea. Materials and Methods Cross-section data were drawn from a community-based sample of individuals 60 years of age and older (n=1819). Respondents completed the Alcohol Use Disorders Intensification Test (AUDIT) and the Korean Beck Depression Inventory. Using a regression approach, the effect of alcohol consumption as a non-linear effect was asses...

  1. Prediagnostic Helicobacter pylori Antibodies and Colorectal Cancer Risk in an Elderly, Caucasian Population.

    Science.gov (United States)

    Blase, Jennifer L; Campbell, Peter T; Gapstur, Susan M; Pawlita, Michael; Michel, Angelika; Waterboer, Tim; Teras, Lauren R

    2016-12-01

    Study results on overall seroprevalence of Helicobacter pylori and colorectal cancer risk have been inconsistent. However, one study found positive associations with antibodies to specific H. pylori proteins. To follow up on those findings, we assessed associations of 15 H. pylori specific proteins with colorectal cancer incidence in the prospective Cancer Prevention Study-II Nutrition Cohort. Participants in this nested case-control study included 392 cases and 774 controls who were predominantly elderly (median age at blood draw: 71 years) and Caucasian (98%). Seroreactivity against 15 H. pylori proteins was assessed by fluorescent bead-based multiplex serology and associations with colorectal cancer were estimated using conditional logistic regression. Helicobacter pylori serostatus was not associated with colorectal cancer incidence (odds ratio (OR), 1.17, 95% confidence interval (95% CI), 0.91-1.50). Among individual antigens, GroEl serostatus was associated with colorectal cancer risk (OR, 1.32, 95% CI: 1.03-1.70), whereas CagM was associated with colon cancer risk only (OR, 1.35, 95% CI: 1.01-1.80). No dose-response relationships were observed for any of the antigens, including GroEl and CagM. The results of our study do not support an association between H. pylori infection and colorectal cancer risk in this elderly, mostly Caucasian population. © 2016 John Wiley & Sons Ltd.

  2. Social network characteristics and body mass index in an elderly Korean population.

    Science.gov (United States)

    Lee, Won Joon; Youm, Yoosik; Rhee, Yumie; Park, Yeong-Ran; Chu, Sang Hui; Kim, Hyeon Chang

    2013-11-01

    Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m(2)) in an elderly Korean population. This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis. After adjusting for potential confounders, the men with lower density (0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (β=0.885, p=0.049), but not in the men (p=0.140). Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association.

  3. Unnatural Deaths of the Elderly Population of Sri Lanka: A Descriptive Analysis.

    Science.gov (United States)

    Vadysinghe, Amal Nishantha; Senasinghe, Prabath; Sivasubramanium, Murugupillai; Jayasooriya, Pemasiri; Premarathna, Bhatiya G; Rathnayake, Rathnayake Mudiyanselage Isuri Saumya D; Wickramasinghe, Wickramasinghe Mudiyanselage Medhani Hasanthika P

    2018-02-15

    As people age, they may become more vulnerable to injury because of frailty, ill health, or dependency on others. Data from medicolegal death investigation including autopsy and statements from cases reported to 3 medicolegal units in Sri Lanka were analyzed in this study under the strict ethical framework. Of the study population, 265 were male and 75 were female. Mean age was 71.14 years. Commonest manner of death was accidental (62.1%) followed by suicide (32.1%) and homicide (5.6%). Commonest types of incidents were road traffic accidents (26.5%), falls (22.6%), and poisoning (21.2%). Among the road traffic accidents, pedestrians (77.9%) were the majority. Poisoning (59.6%) was the commonest method of suicide. The commonest weapons used in homicides were blunt weapons (47.3%). Association with alcohol was seen in more than 10% of suicidal and accidental deaths. More attention should be given to the elderly people who are using the roads while developing policies by the state. Furthermore, it is high time to think about psychological aspect in the elderly care management specially alcohol abuse and suicidal ideation among them.

  4. Accuracy of electoral registers and Family Practitioner Committee lists for population studies of the very elderly.

    Science.gov (United States)

    Bowling, A; Hart, D; Silman, A

    1989-12-01

    The purpose of the study was to assess the accuracy of Family Practitioner Committee (FPC) lists for identifying very elderly people registered with general practitioners. The accuracy of available FPC lists was checked against the most recent electoral register to determine which recorded individuals were still living at their FPC registered addresses. This was followed by a postal and home visit enquiry to validate the accuracy of the electoral register. The study was carried out in the London borough of Hackney. The investigation was confined to persons aged 85 and over. Of a total of 3018 people listed as being 85 years or over by the FPC, 1183 (39%) were listed on the electoral register. Of these, 751 (63%) were living at their registered address, ie 25% of the people in the original FPC list. A further 154 (5%) of the original list were not recorded on the electoral register but were alive at the FPC recorded address. the use of FPC lists alone to identify the very elderly in an inner city population is too inaccurate to be of value. The combined use of FPC lists and the electoral register is better but one in six persons will still be missed.

  5. The Experience of Counseling Among a Singaporean Elderly Population: A Qualitative Account of What Clients Report as Beneficial.

    Science.gov (United States)

    Mathews, Mathew

    2016-09-01

    Adjustments that accompany ageing pose a challenge to the mental health of the elderly. Psychologically based counseling has been documented in Western societies as an appropriate intervention for elderly persons with depressive episodes. There is however very little research documenting how Asian elderly populations experience and benefit from counseling. This study addresses this research gap through a qualitative study based on post-counseling interviews with a sample of 41 elderly persons who received counseling at a dedicated organisation catering to the elderly in Singapore. The qualitative data revealed that clients benefitted from counseling through better emotional management - they received emotional support, found emotional healing and learnt to deal with the emotions associated with grief and loss. Clients also reported that counseling assisted them in decision making processes - older persons were able to conceive of alternatives to their predicament, obtained insights to embark on change, were enabled to take the perspective of others and found validation for their decisions. While many elderly clients greatly appreciated and benefitted from this service, citing demonstrable changes, among the very old such changes were uncommon. Cultural explanations for these differential reports and possible directions for much needed future research are provided.

  6. Community-based recreational football

    DEFF Research Database (Denmark)

    Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter

    2014-01-01

    is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under...... the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport...

  7. The Characteristics of the Danish population in the Elderly-study

    DEFF Research Database (Denmark)

    Bilberg, Randi Marie; Andersen, Kjeld; Nielsen, Anette Søgaard

    the characteristics of the Danish population in the Elderly-study. Methods The study is a randomized controlled study and has so far enrolled 716 participants from Germany, USA, and Denmark and 341 are from Denmark. Participants are 60+ years old and fulfil the DSM-5 criteria for alcohol use disorder. The exclusions...... criteria are severe dementia, psychosis; illegal drug use, severe depression, bipolar disorder, suicidal thoughts or behaviour, and having received treatment for the last 30 days for their alcohol use disorder. All participants are examined at baseline, and at four follow up points by the means...... of structured interviews. Results The presentation will include baseline characteristics of the Danish participants including demographics, expectations to treatment and the history of drinking in the last 90 days before baseline. Discussion/Conclusion The data will present information about the profile of 60...

  8. Hippocampal shape is predictive for the development of dementia in a normal, elderly population

    DEFF Research Database (Denmark)

    Achterberg, Hakim C.; van der Lijn, Fedde; den Heijer, Tom

    2014-01-01

    clinical symptoms arise, independent of age and gender. Furthermore, the results suggest that hippocampal shape provides additional predictive value over hippocampal volume and that combining shape and volume leads to better prediction. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc....... assessed whether hippocampal shape provides additional predictive value independent of hippocampal volume. Five hundred eleven brain MRI scans from elderly nondemented participants of a prospective population-based imaging study were used. During the 10-year follow-up period, 52 of these subjects developed...... dementia. For training and evaluation independent of age and gender, a subset of 50 cases and 150 matched controls was selected. The hippocampus was segmented using an automated method. From the segmentation, the volume was determined and a statistical shape model was constructed. We trained a classifier...

  9. Active infection with Helicobacter pylori in an asymptomatic population of middle aged to elderly people

    DEFF Research Database (Denmark)

    Rothenbacher, D; Bode, G; Peschke, F

    1998-01-01

    The study objective was to investigate prevalence and determinants of current Helicobacter pylori infection in an asymptomatic population of middle-aged to elderly people. A cross-sectional study was conducted among 337 participants of a general education programme of the University of Ulm aged 50......-85 years. Prevalence of infection as determined by means of the [13C]urea breath test was 34.8% (95% CI 29.6-40.3%); overall, 33.8% (95% CI 23.0-46.0) in the age group 50-59 years, 32.4% (95% CI 25.4-39.9) in the age group 60-69 years and 41.0% (95% CI 30.0-52.7) in the age group 70-85 years. Duration...... subjects may not be as high as seroprevalence studies have suggested. Socioeconomic characteristics of childhood living conditions appear to be important determinants of infection status even at older age....

  10. Epilepsy-associated stigma in Bolivia: a community-based study among the Guarani population: an International League Against Epilepsy/International Bureau for Epilepsy/World Health Organization Global Campaign Against Epilepsy Regional Project.

    Science.gov (United States)

    Bruno, Elisa; Bartoloni, Alessandro; Sofia, Vito; Rafael, Florentina; Magnelli, Donata; Padilla, Sandra; Quattrocchi, Graziella; Bartalesi, Filippo; Segundo, Higinio; Zappia, Mario; Preux, Pierre-Marie; Nicoletti, Alessandra

    2012-09-01

    Epilepsy is associated with a significant burden of social stigma that appears to be influenced by psychosocial and cultural factors. Stigma has a negative effect on the management of people with epilepsy (PWE), representing one of the major factors that contribute to the burden of epilepsy. To assess stigma perception among the Guarani population, one hundred thirty-two people living in Guaraní communities in Bolivia were invited to complete the Stigma Scale of Epilepsy questionnaire. The main determinants of stigma identified were: the fear linked to loss of control, the feelings of sadness and pity toward PWE, the difficulties faced by PWE in the professional and relationship fields, the level of education and type of seizure. Our study pointed out that, in this population, PWE face difficulties in everyday life because of epilepsy-associated stigma and the results attest to the importance of promoting community-based educational programs aimed at reducing the stigmatization process. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Atherosclerotic ischemic renal disease. Diagnosis and prevalence in an hypertensive and/or uremic elderly population

    Directory of Open Access Journals (Sweden)

    Rossi Michele

    2003-02-01

    Full Text Available Abstract Background Atherosclerotic ischemic renal disease is a frequent cause of end-stage renal failure leading to dialysis among the elderly; Its prevalence is inferred from autopsy or retrospective arteriographic studies. This study has been conducted on 269 subjects over 50 with hypertension and/or CRF, unrelated to other known causes of renal disease. Methods All 269 patients were studied either by color-flow duplex sonography (n = 238 or by renal scintigraphy (n = 224, and 199 of the 269 patients were evaluated using both of these techniques. 40 patients, found to have renal artery stenosis (RAS, were subjected to 3D-contrast enhancement Magnetic Resonance Angiography (MRA and/or Selective Angiography (SA. An additional 23 cases, negative both to scintigraphy and to ultrasound study, underwent renal angiography (MRA and/or SA. Results Color-duplex sonography, carried out in 238 patients, revealed 49 cases of RAS. MR or SA was carried out in 35 of these 49 patients, and confirmed the diagnosis in 33. Color-duplex sonography showed a PPV value of 94.3% and NPV of 87.0% while renal scintigraphy, carried out in 224 patients, had a PPV of 72.2% and a NPV of 29.4%. Patients with RAS showed a higher degree of renal insufficiency compared to non stenotic patients while there were no differences in proteinuria. RAS, based on color-duplex sonography studies, was present in 11% of patients in the age group 50–59, 18% in the 60–69 and 23% at age 70 and above. Conclusions A relatively large percentage of the elderly population with renal insufficiency and/or hypertension is affected by RAS and is at risk of developing end-stage renal failure. Color-duplex ultrasonography is a valid routine method of investigation of population at risk for renal artery stenosis.

  12. Clinical Epidemiology of Reduced Kidney Function among Elderly Male Fishing and Agricultural Population in Taipei, Taiwan

    Directory of Open Access Journals (Sweden)

    Chi-Mei Kuo

    2013-01-01

    Full Text Available Purpose. To quantify the prevalence of and associated factors for chronic kidney disease (CKD among male elderly fishing and agricultural population in Taipei, Taiwan. Methods. Subjects (n=2,766 aged 65 years and over voluntarily admitted to a teaching hospital for a physical checkup were collected in 2010. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2. Results. Among these subjects, the over prevalence of chronic kidney disease was 13.6% (95% CI: 12.3–14.9%. The age-specific prevalence of CKD in 65–74 years, 75–84 years, and ≥85 years was 8.2%, 19.1%, and 27.0%, respectively. From the multiple logistic regression, age (OR = 1.05, 95% CI: 1.02–1.09, hyperuricemia (OR = 2.94, 95% CI: 1.90–3.78, central obesity (OR = 1.17, 95% CI: 1.02–1.56, hyperglycemia (OR = 1.23, 95% CI: 1.11–1.67, hypertriglyceridemia (OR = 1.25, 95% CI: 1.08–1.66, and lower HDL-C (OR = 1.61, 95% CI: 1.23–1.92 were statistically significantly related to CKD. The presence of metabolic components (one or two versus none, OR = 1.10, 95% CI: 1.04–1.25; three or more versus none, OR = 2.12, 95% CI: 1.86–2.78 also appeared to be statistically significantly related to CKD after adjustment for other independent factors. Conclusion. Several clinical factors independently affect the development of CKD in the elderly male fishing and agricultural population.

  13. Asymptomatic hyperuricemia is a strong risk factor for resistant hypertension in elderly subjects from general population.

    Science.gov (United States)

    Mazza, Alberto; Lenti, Salvatore; Schiavon, Laura; Monte, Alvise Del; Townsend, Danyelle M; Ramazzina, Emilio; Rubello, Domenico; Casiglia, Edoardo

    2017-02-01

    In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140mmHg (systolic) and 90mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis. The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, phypertension in women (odds ratio 3.11, 95% confidence intervals 1.06-9.1, p=0.03) but not in men. In elderly women from the general population, an SUA value of ≥6.8mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Relationship Between Visual Constructive Abilities and Activity of Daily Living in Home Dwelling Elderly Population

    Directory of Open Access Journals (Sweden)

    Negin Chehrehnegar

    2016-07-01

    Full Text Available Objectives: Increasing life expectancy and decreasing birthrates have significantly contributed to an increased aging population throughout the world. This sudden change is a global phenomenon often resulting in biological changes that may have various consequences, such as reduced life power and coping skills in the elderly population. Cognitive deficits are one of the most severe impairments in the elderly people. Deficits in cognitive abilities, especially visual constructive skills, can have a considerable impact on the independency of the daily living skills of the elderly people. Self-care by individuals to maintain their life and wellbeing is a key element for their independency. The activity of daily living (ADL can support personal life independency, and is considered as a morbidity index. In the present cross-sectional study, we assessed the visual abilities and ADL in older subjects to determine whether cognitive impairment is associated with changes in self-care behavior. Methods & Materials: This study employed random sampling technique to select and recruit forty seven individuals aged between 60 to 80 years from Jahandidegan club in Shiraz, Iran. They were evaluated through "visual constructive ability" sub-scale from Loewenstein Occupational Therapy Cognitive Assessment (LOTCA battery and "Katz Index", which were used to assess their associated skill and ADL, respectively. Data was collected through observation and interviews. Data analysis was performed through Pearson's correlation test using SPSS. Results: The mean age of the participants (9 women and 38 men was 69.94±4.66 years. Lower scores in cognitive domains predicted functional decline in some scales. There was a significant correlation between visual constructive ability and eating; however, no significant correlation was found between this sub-scale with bathing, moving, toileting, and bowel control. Conclusion: In summary, a significant correlation was noted

  15. Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan.

    Science.gov (United States)

    Huang, C-L; Chang, H-W; Chang, J-B; Chen, J-H; Lin, J-D; Wu, C-Z; Pei, D; Hung, Y-J; Lee, C-H; Chen, Y-L; Hsieh, C-H

    2016-08-01

    Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear. To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels. Two stages included cross-sectional (Stage 1) and prospective (Stage 2) cohort study. In Stage 1 18 287 subjects aged  ≥60 years were enrolled; of these, 5039 without T2D and CVD advanced to Stage 2 and a mean follow-up of 3.8 years. MetS components were analysed, and in Stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In Stage 2, subjects without T2D and CVD in Stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated. ROC curve analysis gave an optimal FPG cut-off for MetS of 93 mg/dl and 92 mg/dl for males and females, respectively. The high-FPG group had a 1.599- and 1.353-fold higher chance of developing T2D compared with the low-FPG group for males and females, respectively (95% CI: 1.606-2.721 and 1.000-1.831, P  =  0.015 and 0.05). The high-FPG group had a 1.24-fold higher chance of developing CVD for females (95% CI: 1.015-1.515, P  =  0.035); however, there was no difference for males. Our results suggest that FPG within the normal range was associated with MetS, and elderly subjects with high normal levels have a higher incidence of developing T2D for both sexes, and CVD for females, over the short-term. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Quality of life in elderly Iranian population using leiden-padua questionnaire: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Parvin Cheraghi

    2017-01-01

    Full Text Available The world population is getting old rapidly; the aging population is the new phenomenon in Iran too. The aim of this meta-analysis was to estimate the overall and subscales mean score of quality of life (QOL based on the Leiden-Padua (LEIPAD questionnaire among the elderly population of Iran. The major international and national databases including; Medlin, Scopus, Science Direct, SID, MagIran, IranMedex, and Irandoc was searched. All cross-sectional studies, which measured the QOL among the elderly population in Iran using the LEIPAD questionnaire, were included. Furthermore, we used the following key words, “Quality of life,” “aging,” “aged,” “elderly,” and “Iran.” Of 2155 records, four articles reminded for the meta-analysis, which involved 628 participants with a mean age of 71.73 ± 4.28 years. The mean scores of QOL in each scale were as follows: 10.80 (9.30–12.31 for physical health, 13.51 (6.81–20.21 for self-care scale, 8.60 (5.07–12.14 for depression and anxiety, 12.48 (10.39–14.58 for cognitive functioning scale, 2.19 (0.67–3.72 for sexual functioning scale, 10.98 (5.87–16.09 for life satisfaction scale, and 5.90 (3.64–8.16 for social desirability scale. This study revealed that the total QOL for the elderly population is relatively low in Iranian society. It is appeared to provide social support, and upgrade their QOL seems to be essential for the elderly population.

  17. Factors Influencing Quality of Life for Disabled and Nondisabled Elderly Population: The Results of a Multiple Correspondence Analysis

    Directory of Open Access Journals (Sweden)

    M. Avolio

    2013-01-01

    Full Text Available Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: “demographic structure and social contacts,” “social relationships,” “trust in the Italian National Health Services (INHS.” Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people’s life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network’s nodes, are likely to play an important role in this relationship.

  18. Rationale and Methodology for a Community-Based Study of Diabetic Retinopathy in an Indonesian Population with Type 2 Diabetes Mellitus: The Jogjakarta Eye Diabetic Study in the Community.

    Science.gov (United States)

    Sasongko, Muhammad B; Agni, Angela N; Wardhana, Firman S; Kotha, Satya P; Gupta, Prateek; Widayanti, Tri W; Supanji; Widyaputri, Felicia; Widyaningrum, Rifa; Wong, Tien Y; Kawasaki, Ryo; Wang, Jie Jin; Pawiroranu, Suhardjo

    2017-02-01

    There are no available data about diabetic retinopathy (DR) in the Indonesian population. This report summarizes the rationale and study design of the Jogjakarta Eye Diabetic Study in the Community (JOGED.COM), a community-based study to estimate the prevalence and risk factors of DR in persons with type 2 diabetes in Jogjakarta, Indonesia. The JOGED.COM aimed to examine a cross-sectional sample of 1200 persons with type 2 diabetes aged 30 years and older residing in the study area. We identified 121 community health centers (CHCs) in Jogjakarta and listed 35 CHCs with non-communicable diseases facilities. Multi-stage, clustered random sampling was used to select 22 CHCs randomly. We included CHCs with coverage population >30,000, and excluded those classified as 100% rural. Lists of persons with diabetes confirmed by their family physician were provided from each CHC. Examinations procedures included detailed interviews, general and eye examinations, anthropometry and body composition scan, and dilated fundus photography. We collaborated with local health authorities, family physicians, and local health practitioners in the recruitment phase. A total of 1435 invitations were distributed, and 1184 people (82.5%) with type 2 diabetes participated in this study, of whom 1138 (79.3%) had completed data with gradable retinal images. JOGED.COM is the first epidemiologic study of DR in an Indonesian population. This study will provide key information about the prevalence and risk factors of DR in the community. These data are very important for future health promotion programs to reduce the burden of DR in the population.

  19. Deep analyses of the associations of a series of biomarkers with insulin resistance, metabolic syndrome, and diabetes risk in nondiabetic middle-aged and elderly individuals: results from a Chinese community-based study

    Directory of Open Access Journals (Sweden)

    Fu S

    2016-10-01

    Full Text Available Shihui Fu,1,2,* Ping Ping,3,* Leiming Luo,1 Ping Ye1 1Department of Geriatric Cardiology, 2Department of Cardiology and Hainan Branch, 3Department of Pharmaceutical Care, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Objective: The current study was designed to perform deep analyses of the associations of biomarkers, including high-sensitivity C-reactive protein (hs-CRP, N-terminal prohormone of brain natriuretic peptide (NT-proBNP, and homocysteine (Hcy, with insulin resistance (IR, metabolic syndrome (MetS, and diabetes risk and evaluate the abilities of biomarkers to identify IR, MetS, and diabetes risk in Chinese community-dwelling middle-aged and elderly residents.Participants and methods: A total of 396 participants older than 45 years underwent physical examinations and laboratory analyses following standardized protocol.Results: Serum hs-CRP concentrations were able to identify MetS, Chinese diabetes risk score (CDRS ≥4, high-density lipoprotein-cholesterol (HDL-c <0.9/1.0 mmol/L, and HDL-c <1.0/1.3 mmol/L (P<0.05 for all. Serum NT-proBNP concentrations were able to identify homeostasis model assessment of IR >1.5, CDRS ≥4, overweight, and blood pressure (BP ≥140/90 mmHg (P<0.05 for all. Serum Hcy concentrations were able to identify CDRS ≥4, general obesity, overweight, and BP ≥140/90 mmHg (P<0.05 for all. Serum hs-CRP concentrations were independently associated with MetS as well as HDL-c <1.0/1.3 mmol/L and HDL-c <0.9/1.0 mmol/L (P<0.05 for all. Serum NT-proBNP concentrations were independently associated with BP ≥140/90 mmHg (P<0.05. Serum Hcy concentrations were independently associated with CDRS ≥4 (P<0.05.Conclusion: Serum HDL-c levels were the major determinant of the associations between serum hs-CRP levels and MetS and the key link between inflammation and MetS. There was no other association of these biomarkers

  20. Hyperuricemia is an independent risk factor for new onset micro-albuminuria in a middle-aged and elderly population: a prospective cohort study in taiwan.

    Directory of Open Access Journals (Sweden)

    Hung-Yu Chang

    Full Text Available BACKGROUND: Hyperuricemia is now regarded as a risk factor for cardiovascular disease. Micro-albuminuria is associated with increased risk for cardiovascular disease and chronic kidney disease. We hypothesized that elevated serum uric acid (UA is associated with development of micro-albuminuria in the general population. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a community-based prospective cohort study. A total of 1862 subjects from southern Taiwan, all older than 40 years, were screened and 993 of these participants without micro-albuminuria were followed for 4 years. Urinary albumin-to-creatinine ratio was measured two times per year. A multiple linear regression model indicated that serum UA was independently associated with ln(ACR after adjustment for 8 factors (age, sex, and 6 metabolic metrics (β = 0.194, p<0.01. Logistic regression analysis indicated that each 1 mg/dL increase of UA was associated with a 1.42-fold increased risk of micro-albuminuria after adjustment for the same 8 factors (OR = 1.42, 95% CI: 1.27-1.59, p<0.01. A Cox regression model using subjects with serum UA less than 5 mg/dL as reference group indicated higher hazard ratios (HRs only found in subjects with serum UA more than 7 mg/dL (HR = 3.54, 95% CI: 2.11-5.93, p<0.01 and not in subjects with serum UA of 5 to 7 mg/dL (HR = 1.30, 95% CI: 0.82-2.07, p = 0.15. CONCLUSION: Hyperuricemia is significantly associated with micro-albuminuria in middle-aged and elderly males and females from a general population in Taiwan. Elevated serum UA is an independent predictor for development of micro-albuminuria in this population.

  1. Combining music and reminiscence therapy interventions for wellbeing in elderly populations: A systematic review.

    Science.gov (United States)

    Istvandity, Lauren

    2017-08-01

    Both music therapy and reminiscence therapy are currently being used to increase aspects of wellbeing in older people, including those with memory diseases such as dementia, as alternatives to pharmacological treatments. There is growing evidence that combining these therapies in a focused way would provide unique wellbeing outcomes for this population. This review aims to report on the existing intervention studies that utilize both music and reminiscence activities in equal measure in elderly adult populations. A systematic review of intervention-based studies published between 1996 and 2016 was carried out: five studies were included in this review. Included studies were predominantly carried out in aged care facilities with aged populations affected by a range of conditions; all studies assessed aspects of mental well-being. The review found music reminiscence therapy to have positive effects for participants in four out of five studies. Further research incorporating qualitative methods and mapping of intervention procedures would complement existing findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Long-term drug use and polypharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Marković-Peković Vanda

    2016-01-01

    Full Text Available Background/Aim. Prescription of drugs is a fundamental care component of the elderly. Elderly patients often take multiple drugs, and it is known that polypharmacy may lead to drug interactions and adverse events. The aim of this study was to analyze the long-term drug use and the prevalence of polypharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective study of outpatient drug use in 2005 and 2010 was conducted, analyzing prescriptions for patients aged ≥ 65 years reimbursed by the Health Insurance Fund. The study population was stratified by gender and age. Long-term drug use was defined as continuous drug dispensing for a whole year or at least two thirds of the year. Polypharmacy was defined as the use of 5 or more different reimbursed drugs. Results. Of all insured people aged ≥ 65 years, long-term drug use was identified in 10% (2005 and in 19% (2010, of whom 62% were women. Two to four different drugs were used by almost 49% (2005 and 54% (2010 of the elderly patients. The polypharmacy prevalence increased from 1.4% (2005 to 3.6% (2010; it increased in all the age groups of both genders. The largest increase was observed in the age group 65-74 years. Polypharmacy prevalence increase was higher in women. The most commonly used drugs were those for to treatment of cardiovascular diseases, in particular drugs for hypertension and cardiac treatment. Conclusion. The study findings point out to the increase of elderly population with a long-term drug use. Over a half of elderly patients use 2-4 different drugs on the long-term basis. The polypharmacy prevalence was low. It increased in the period of 5 years in both genders. The increase was more prominent in women of all the age groups. The use of multiple drugs and polypharmacy increased with ageing.

  3. THE STUDY OF CLINICO-AETIOLOGICAL PROFILE OF PANCYTOPENIA IN ELDERLY POPULATION

    Directory of Open Access Journals (Sweden)

    Vijayashree Thyagaraj

    2017-06-01

    deficiency. We found that mean MCV was 88 fL (p=0.2 in all these patients. CONCLUSION Vitamin B12 deficiency is the most common cause of pancytopenia in elderly population. Symptoms of vitamin B12 deficiency maybe vague in elderly. High index of suspicion is required for the diagnosis. Mean corpuscular volume may not be raised in all cases. Hence, all patients in geriatric population presenting with must be tested for vitamin B12 deficiency.

  4. Presbyopic content of a community based Etecare Programme in ...

    African Journals Online (AJOL)

    A community-based eye care programme was carried out in Ikeduru Local Government Area (LGA) of Imo State, Nigeria. This LGA has an estimated population of 150,000. Ocular examinations were carried out on 16,783 (11.19% of total population) mixed population that cut across different ages. The presbyopic content ...

  5. Prevalence and conversion to dementia of Mild Cognitive Impairment in an elderly Italian population.

    Science.gov (United States)

    Limongi, Federica; Siviero, Paola; Noale, Marianna; Gesmundo, Antonella; Crepaldi, Gaetano; Maggi, Stefania

    2017-06-01

    Mild Cognitive Impairment (MCI) represents a significant risk factor for dementia but there are only a few Italian population studies on its prevalence and its rate of conversion to dementia. Aim of this study was to assess the prevalence of MCI, its subtypes, and rates of conversion to dementia 1 year later in an elderly Italian population. The data are based on an Italian multicenter population-based cohort study with both cross-sectional and longitudinal components. Two thousand three hundred thirty-seven individuals over 65 underwent screening, clinical confirmation and 1-year follow-up. The prevalence of MCI was 21.6% and the amnestic multiple domain was the most frequent subtype (63.2%). The conversion rate to dementia was 4.1% and was found only in the amnestic multiple domain and in the unclassifiable subjects, persons with cognitive deficit but neither demented nor with MCI. The prevalence of MCI in this population sample was similar to that found in other population studies using Petersen's modified MCI criteria as well as his original criteria. With regard to conversion to dementia, our results emphasize the importance to better classify the unclassifiable subjects at high risk of progression to dementia and also at risk of being undiagnosed and untreated. MCI is characterized by extreme variability and instability. Data on the prevalence and the rate of conversion from MCI to dementia are difficult to compare given the important differences from study to study especially with regard to the diagnostic criteria utilized and their operationalization.

  6. Loneliness among very old Mexican Americans: Findings from the Hispanic established populations epidemiologic studies of the elderly

    OpenAIRE

    Gerst-Emerson, Kerstin; Shovali, Tamar E.; Markides, Kyriakos S.

    2014-01-01

    Increasing numbers of researchers are finding that loneliness is a significant risk factor for morbidity and mortality, and several of variables have been found to be closely related to the experience of loneliness among elders. However, much of the research has focused on the general older population, with no research to date focusing on minority populations. The objective of this study was to determine the prevalence and the correlates of loneliness among a community-dwelling older Mexican ...

  7. Potential interactions of central nervous system drugs used in the elderly population

    Directory of Open Access Journals (Sweden)

    Fernanda Bueno Morrone

    2009-06-01

    Full Text Available OBJECTIVE: To describe the use of CNS drugs and to identify the most frequently observed potential drug interactions in the elderly living in Southern Brazil. METHODS: A population-based, transversal and observational study was carried out during 2006-2007. Four hundred and eighty elderly individuals of both genders were randomly recruited and interviewed. A validated pharmacotherapeutic questionnaire and the Micromedex® Healthcare Series were utilized to analyze potential drug interactions. A severity rating scale employing the categories of "mild", "moderate" and "severe" was used to describe the interactions. RESULTS: A population of elderly living in Southern Brazil was interviewed and 98 reported using CNS drugs, 74.5% female and 25.5% male. Out of these patients, 32.0% reported severe or moderate pharmacological interactions related to the use of other drugs. Alprazolam and imipramine were reported to potentially interact with tobacco. Twenty potential moderate drug/ethanol interactions were found. The potential drug/caffeine interactions were classified as mild on the severity scale. CONCLUSION: Elderly being prescribed drugs that act on the CNS should be closely monitored, and furthermore, should be warned against potential drug-drug, drug-ethanol, and drug-tobacco interactions.OBJETIVO: Descrever o uso de medicamentos que atuam no sistema nervoso central (SNC e identificar as possíveis interações mais frequentes com esses medicamentos em idosos do sul do Brasil. MÉTODOS: Estudo de base populacional, transversal e observacional, realizado durante 2006-2007. Quatrocentos e oitenta idosos de ambos os sexos foram randomizados e entrevistados. Foram utilizados um questionário farmacoterapêutico validado e o programa Micromedex® Healthcare Series para analisar as potenciais interações com os medicamentos. Foi utilizada uma escala para descrever a gravidade das interações nas categorias de "leve", "moderada" e "grave". RESULTADOS

  8. Predicting hemorrhage and obstruction in the elderly population using thromboelastographic indices

    Directory of Open Access Journals (Sweden)

    Zheng Q

    2013-10-01

    Full Text Available Qiwen Zheng,1,* Shuhong Fu,2,* Dafang Chen,1 Xiaoxia Li,2 Yuru Li,2 Yanyan Li,2 Jihong Yu,2 Meiliang Gong,2 Jie Bai2 1Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; 2Nanlou Clinical Lab, Chinese PLA General Hospital, Beijing, People's Republic of China *These authors contributed equally to this work Objective: To estimate the value of the different thromboelastogram indices for predicting hemorrhage and vascular obstruction in an elderly population. Methods: This was a prospective cohort study of patients 65 years and older without hematologic disorders who received thromboelastography (TEG examination at the Chinese People's Liberation Army General Hospital from January 2007 to December 2010. Detailed information was collected at recruitment including their TEG test results. Subjects were then followed during outpatient visits and hospitalization. The primary outcome measures were hemorrhage and vascular obstruction. Receiver-operating characteristics (ROC curves were used to compare the predictive value of the four TEG indices, reaction time (R, clot formation time (K, maximal amplitude (MA, alpha angle (ANGLE and their combination for predicting hemorrhage and vascular obstruction. The maximal Youden's index was used to estimate optimal cut-off values for the indices. Areas under the ROC curves were used to estimate overall predictive accuracies. Results: A total of 403 elderly patients met inclusion criteria and were included: 373 male and 30 females with mean age 83.0 ± 7.3 years and range of 65–103 years. Hemorrhage occurred in 25 (6.2% patients and vascular obstruction in 78 (19.4% patients during the 2-year follow up. The currently recommended TEG cut-off values were poorly predictive of vascular obstruction and modestly predictive of hemorrhage. Based on maximal Youden's, the optimal cutoffs of the TEG indices for predicting vascular

  9. Prevalence of self-medication and associated factors in an elderly population: a systematic review.

    Science.gov (United States)

    Jerez-Roig, Javier; Medeiros, Lucas F B; Silva, Victor A B; Bezerra, Camila L P A M; Cavalcante, Leandro A R; Piuvezam, Grasiela; Souza, Dyego L B

    2014-12-01

    The aging of the world populat ion together with changes in the epidemiological profile of diseases have led to increases in both the consumption of medicines and health expenses. In this context, self-medication has gained importance as a rapid treatment that bypasses bureaucracy and, in some instances, delays in obtaining medical assistance. Verification of self-medication prevalence and associated factors in the elderly, as well as identification of the main categories of non-prescription drugs utilized. The following databases were utilized: Cochrane, PubMed, Scopus, LILACS, SciELO, PAHO, MedCarib and WHOLIS. Studies on the prevalence of self-medication in community-dwelling elderly were included. Review studies were excluded, as well as MSc dissertations, PhD theses and research with convenience sampling. Community-dwelling individuals aged 60 years or over. A systematic review of population-based articles published up until September 1, 2014, is presented. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement was applied for critical assessment of the articles, and those with a minimum score of 60% were selected for inclusion in the review. Thirty-six articles were selected, of which 28 were included after critical reading. The prevalence of self-medication varied between 4 and 87%, and the majority of studies reported values between 20 and 60%. The mean prevalence reported in the articles was 38%, but several criteria were utilized to measure self-medication. The most commonly utilized non-prescription drugs were analgesics and antipyretics, followed by non-hormonal anti-inflammatories, cardiovascular agents, dietary complements and alternative medicine components. The variables that presented positive associations with self-medication were female sex, visits to pharmacists, depression, functional dependency, recent hospitalization, oral pain, restriction of activities and physical inactivity. The variables with negative

  10. Self-injury and suicide attempt among the elderly population in the city of São Paulo

    Directory of Open Access Journals (Sweden)

    Jane de Eston Armond

    Full Text Available ABSTRACT Objective In this perspective, the present research aims to describe the reports of self-injury and suicide attempt among the elderly population living in the city of São Paulo. Methods This is a descriptive, quantitative approach based on Violence and Accidents Surveillance Information System (SIVVA of the city of São Paulo. In the selection of notifications, it was included the ones related to self-injury and attempted suicide against men and women, with age group between 60 and over, from January to December 2014 in the city of São Paulo, Southeastern Region of Brazil. Results During 2014, 93 cases of self-injury and attempted suicide were reported among elderly people living in the city of São Paulo. The main instruments used by the elderly population in the analyzed period were poisoning (41.9%, other means (34.4%, cold weapon (15.1%, high precipitation places (4.3%, hanging or suffocation (3.2%, and firearm (1.1%. Conclusion From the results of this study it was possible to characterize some specific aspects related to self-injury and suicide attempt among elderly in the evaluated population. Therefore, developing a strategy to promote effective prevention actions and offer specialized services to most risk groups (brown races, people with lower levels of education, and males.

  11. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital.

    Science.gov (United States)

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information.

  12. Metabolic syndrome and physical activity in southern Brazilian community-dwelling elders: a population-based, cross-sectional study

    Directory of Open Access Journals (Sweden)

    Reichert César L

    2009-01-01

    Full Text Available Abstract Background - The association between a sedentary lifestyle and obesity is well documented, and is linked to an increased prevalence of metabolic syndrome (MS. There is some evidence that information regarding the health benefits of physical activity is beginning to impact on the elderly people and is beginning to change their behavior. We aimed to investigate the level of physical activity undertaken by elderly people with MS and those without this condition. Methods - We evaluated 362 community-dwelling elders of Novo Hamburgo, southern Brazil. Diagnosis of MS was based on the International Diabetes Federation criteria and the physical activity (PA level was estimated by the International Physical Activity Questionnaire. Analysis of covariance was carried out to verify associations between MS risk factors and the level of PA. Logistic regression was used to estimate the MS odds ratio for each level of PA. Results - No significant association was found between MS and the level of physical activity, irrespective of sex. The odds ratio for the presence of MS adjusted for sex and age and using insufficiently active elderly people as reference was 1.04 (95% CI, 0.6 to 1.7 in sufficiently active elderly people and 1.15 (95% CI, 0.7 to 2.0 in very active elderly people. Conclusion - The elderly citizens of a southern Brazilian community who were diagnosed with MS presented the same levels of PA as the individuals who did not have this diagnosis. This may imply that information on the importance of physical activity has already reached this higher risk population.

  13. [Falls in the Spanish elderly population: Incidence, consequences and risk factors].

    Science.gov (United States)

    Rodríguez-Molinero, Alejandro; Narvaiza, Leire; Gálvez-Barrón, César; de la Cruz, Juan José; Ruíz, Jorge; Gonzalo, Natalia; Valldosera, Esther; Yuste, Antonio

    2015-01-01

    Falls in the elderly constitute a public health concern. The objective of the present study was to collect updated data on the frequency of falls in the Spanish elderly population, as well as to analyse their consequences and associated risk factors. This prospective study was conducted on a probabilistic sample of 772 Spanish, community dwelling, older adults. During the baseline visit, data were collected on functional capacity, history of falls, disease background, number of medications used, balance impairment, use of walking aids, cognitive capacity and depression symptoms. Participants were followed up for one year by means of quarterly phone calls, where they were asked about the number of falls occurred in that period, as well as their consequences and associated use of healthcare resources. During the one-year follow up period, 28.4% (95%CI 24.9-32.1) of participants suffered one or more falls, while 9.9% (95%CI 7.4-11.4) suffered multiple falls. One-third of the falls were due to accidental extrinsic causes. Among participants who had suffered falls, 9.3% suffered a fracture (3.1% hip fracture), and 55.4% required healthcare services (29% were managed in the hospital emergency room, and 7.3% were admitted to hospital). Risk factors identified through multivariate analysis were: advanced age (>79 years), not having a companion, using more than 2 drugs, dependency in BADLs, impaired strength or balance, and use of walking aids. Falls continue to be a major public health concern in Spain. Given that some of the associated risk factors may be modified, introducing programs aimed at tackling this problem should be regarded as a priority. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  14. Major bleeding risk associated with warfarin and co-medications in the elderly population.

    Science.gov (United States)

    Vitry, Agnes I; Roughead, Elizabeth E; Ramsay, Emmae N; Preiss, Adrian K; Ryan, Philip; Gilbert, Andrew L; Caughey, Gillian E; Shakib, Sepehr; Esterman, Adrian; Zhang, Ying; McDermott, Robyn A

    2011-10-01

    Warfarin management in the elderly population is complex as medicines prescribed for concomitant diseases may further increase the risk of major bleeding associated with warfarin use. We aimed to quantify the excess risk of bleeding-related hospitalisation when warfarin was co-dispensed with potentially interacting medicines. A retrospective cohort study was undertaken over a 4-year period from July 2002 to June 2006 to examine bleeding risk associated with medications co-administered in patients taking warfarin using an administrative claims database from the Australian Department of Veterans' Affairs. All veterans aged 65 years and over who were new users of warfarin were followed until death or study end. Risk of bleeding was assessed using a Poisson GEE model adjusting for age, gender, socioeconomic status, co-morbidity index, previous bleeding related hospitalisations and indicators of health service use. Overall, 17661 veterans who used warfarin at any time during the study period were included. The overall incidence rate of bleeding-related hospitalisations was 4.1 (95% CI 3.7-4.6) per 100 person-years in veterans who were not receiving potentially interacting medicines. Bleeding-related hospitalisation rates were significantly increased when warfarin was co-prescribed with low-dose aspirin (Adjusted rate ratio (AdjRR) 1.44, 95% CI 1.00-2.07), clopidogrel (AdjRR 2.23, 95% CI 1.48–3.36), clopidogrel with aspirin (AdjRR 3.44, 95% CI 1.28-9.23), amiodarone (AdjRR 3.33, 95% CI 1.38–8.00) and antibiotics (AdjRR 2.34, 95% CI 1.55-3.54). Models assessing bleeding risk with warfarin should take account of the range of potentially harmful medicine combinations used in elderly people with comorbid conditions.

  15. The use of guided imagery to manage pain in an elderly orthopaedic population.

    Science.gov (United States)

    Antall, Gloria F; Kresevic, Denise

    2004-01-01

    The management of postoperative pain in elderly orthopaedic patients is critical for advancing patient outcomes and improving the use of healthcare resources. Adequate pain control without adverse side effects, such as confusion and sedation, is crucial to promote comfort and participation in rehabilitation therapies among all patients but particularly among elderly joint replacement patients. Without adequate pain control, physical therapy is delayed and the risk of complications increases. One area of investigation that holds promise for improved treatment outcomes involves the use of complementary therapies, such as guided imagery. The purpose of this pilot study was to test the effects of a guided imagery intervention in the older adult patient who has undergone joint replacement surgery. This pilot study used a two-group experimental repeated measures design. A sample of 13 patients, age 55 years and older, were recruited. The control group received usual care and a music audio tape. The experimental group received usual care and a guided imagery audio tape intervention. Trends in this pilot study demonstrated positive outcomes for pain relief, decreased anxiety, and decreased length of stay. Complementary therapy holds the promise of increasing positive outcomes. Further research is needed to validate these findings with a larger postoperative sample and in other populations as well. There is a critical need to incorporate the use of guided imagery and other complementary therapies into all nursing curricula. Nurses must develop expertise and be ready and able to act as patient educators and advocates in the use of these interventions in programs of care and institutional policy.

  16. Fundic atrophic gastritis in an elderly population. Effect on hemoglobin and several serum nutritional indicators.

    Science.gov (United States)

    Krasinski, S D; Russell, R M; Samloff, I M; Jacob, R A; Dallal, G E; McGandy, R B; Hartz, S C

    1986-11-01

    The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free-living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen I/pepsinogen II ratio less than 2.9, indicating atrophic gastritis, was found in 113 (31.5%) subjects. The prevalence of atrophic gastritis increased significantly with advancing age (P less than .05). Within the atrophic gastritis group, 84 had a pepsinogen I level greater than or equal to 20 micrograms/L, indicating mild to moderate atrophic gastritis, and 29 had a pepsinogen I level less than 20 micrograms/L, indicating severe atrophic gastritis or gastric atrophy. A significant increase in the prevalences of elevated serum gastrin levels (P less than .005), low serum vitamin B12 levels (P less than .005), circulating intrinsic factor antibody (P less than .005), and anemia (P less than .025) was observed with stepwise increases in severity of atrophic gastritis. Subjects with atrophic gastritis exhibited a lower mean serum vitamin B12 level (P less than .05) and a higher mean folate level (P less than .05), but no difference was detected in mean hemoglobin levels or serum levels of iron, ferritin, retinol or alpha-tocopherol. It is concluded that serum pepsinogen I and pepsinogen II levels can be used to determine the prevalence and severity of atrophic gastritis, that atrophic gastritis is common in an elderly population, and that atrophic gastritis is associated with vitamin B12 deficiency and anemia. Further, higher folate levels in atrophic gastritis may be related to an accumulation of 5-methyl tetrahydrofolate in serum due to vitamin B12 deficiency and/or greater folate synthesis by the intestinal flora resulting from bacterial overgrowth secondary to hypo- or achlorhydria.

  17. The role of blood pressure in cognitive impairment in an elderly population. Osservatorio Geriatrico Campano Group.

    Science.gov (United States)

    Cacciatore, F; Abete, P; Ferrara, N; Paolisso, G; Amato, L; Canonico, S; Maggi, S; Varricchio, M; Rengo, F

    1997-02-01

    The aim of this study was to investigate the cross-sectional relationship between arterial blood pressure and cognitive impairment in a group of elderly subjects, controlling for such confounding variables as age, education, depression, drug use and antihypertensive treatment. A cross-sectional survey in Campania, a region in southern Italy. A random sample of 1339 elderly subjects aged 65-95 years (mean 73.9 +/- 6.2 years) selected from the electoral rolls was interviewed by trained physicians. Sociodemographic characteristics, results of Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), blood pressure and whether antihypertensive treatment was being administered were recorded. When subjects with neurological diseases and those under psychotropic therapy were excluded from the analyses, the population numbered 1106. The MMSE score was less than 24 for 27.9% of the subjects and the mean GDS score was 10.8 +/- 6.3. The mean systolic blood pressure (SBP) was 145.3 +/- 19.0 mmHg and the mean diastolic blood pressure (DBP) was 82.0 +/- 9.2 mmHg. Logistic regression analysis showed that female sex, age, GDS score and DBP but not SBP were predictive of cognitive impairment. Educational level and antihypertensive treatment, on the contrary, play a protective role. DBP was associated with cognitive impairment in subjects aged 75 years (odds ratio 1.62, 95% confidence interval 1.16-2.25) and over (odds ratio 5.16, 95% confidence interval 1.50-17.71) but not in those aged 65-74 years. DBP but not SBP is predictive of cognitive impairment in subjects aged 75 years and over without neurological disorders independently from sex, age, education, GDS and antihypertensive treatment

  18. Physical distress is associated with cardiovascular events in a high risk population of elderly men

    Directory of Open Access Journals (Sweden)

    Klemsdal Tor O

    2009-03-01

    Full Text Available Abstract Background Self-reported health perceptions such as physical distress and quality of life are suggested independent predictors of mortality and morbidity in patients with established cardiovascular disease. This study examined the associations between these factors and three years incidence of cardiovascular events in a population of elderly men with long term hyperlipidemia. Methods We studied observational data in a cohort of 433 men aged 64–76 years from a prospective, 2 × 2 factorial designed, three-year interventional trial. Information of classical risk factors was obtained and the following questionnaires were administered at baseline: Hospital Anxiety and Depression Scale, Physical Symptom Distress Index and Life Satisfaction Index. The occurrence of cardiovascular death, myocardial infarction, cerebrovascular incidences and peripheral arterial disease were registered throughout the study period. Continuous data with skewed distribution was split into tertiles. Hazard ratios (HR were calculated from Cox regression analyses to assess the associations between physical distress, quality of life and cardiovascular events. Results After three years, 49 cardiovascular events were registered, with similar incidence among subjects with and without established cardiovascular disease. In multivariate analyses adjusted for age, smoking, systolic blood pressure, serum glucose, HADS-anxiety and treatment-intervention, physical distress was positively associated (HR 3.1, 95% CI 1.2 – 7.9 for 3rd versus 1st tertile and quality of life negatively associated (HR 2.6, 95% CI 1.1–5.8 for 3rd versus 1st tertile with cardiovascular events. The association remained statistically significant only for physical distress (hazard ratio 2.8 95% CI 1.2 – 6.8, p Conclusion Physical distress, but not quality of life, was independently associated with increased risk of cardiovascular events in an observational study of elderly men predominantly

  19. Studies on health in elderly observation centers (abbreviated from Italian: COSA): a multidimensional evaluation (MDE) of an elderly population frequenting a diurnal center in Catania.

    Science.gov (United States)

    Santangelo, Antonino; Testai', Manuela; Castelli, Roberta; Albani, Salvatore; Cappello, Antonella; Primavera, Grazia; Tomarchio, Marcello; Maugeri, Domenico

    2012-01-01

    The worldwide progressive aging of the population forces us to reconsider the strategies of evaluation the effects of the geriatric "tsunami" on the health politics. The present study on the COSA (abbreviated from the Italian name: "Centro Osservazione Salute Anziani") has the aim to investigate the effects of a new form called Specialistic Geriatric Assistance on the already existing geriatric services in our territory, like UVG (Unità Valutazione Geriatrica), ADI (Assistenza Domiciliare Integrata), MMG (Medici di Medicina Generale). The present preliminary studies were carried out a group of elderly people frequenting the elderly day center "Villa Angela" located in Catania. We enrolled 42 subjects, 29 females and 13 males, in the age-range of 65-89 years (mean=73.6 years). An evaluation protocol was used for the participants, having two parts. The first part was a general one performing an accurate anamnestic examination, while the second part evaluated the cognitive and affective spheres, and the levels of autonomy and autosufficiency. The data obtained show that that the elderly population of the daily center "Villa Angela" in Catania is affected by numerous pathologies and comorbidities, which all increase the total risk of disabilities. The subjects use a high number of medicines (sometimes more than 10), which is not always justified by the pathologies found in them. Considering the functional profiles of the patients, the sanitary services offered to them are appropriate, because almost all of the elderly people were autonomous and autosufficient, having still adequate physical performances. The higher cognitive performance seemed to be reduced in more than 50% of the patients, showing almost always a slight or moderate deterioration. The depressive state measured by the GDS seemed to reach the deflection of joy of life 54.8%, while the established depression was detected in 12%. These results emphasize the importance of the functional psychogeriatric

  20. An exploration of beliefs and attitudes regarding healthy lifestyle behaviour in an urban population in The Netherlands: Results from a focus group study in a community-based prevention project.

    Science.gov (United States)

    Kloosterboer, Sanne M; van den Brekel, Karolien; Rengers, Antonia H; Peek, Niels; de Wit, Niek J

    2015-06-01

    The positive effects of lifestyle intervention programmes might be enhanced when targeted to the health-related behaviour of the users. This study explores the beliefs and attitudes regarding a healthy lifestyle, the influences on lifestyle behavioural change and the needs to support a healthy lifestyle in the local community, during an integrated community-based prevention project in newly developed urban area in the Netherlands. Three focus groups were conducted with urban residents aged 45-70 (n = 28). Thematic qualitative analysis was applied to verbatim transcripts to identify emerging themes. The following themes were identified: beliefs to healthy behaviour, responsibility for health, perceived behavioural control, external influences on behavioural change and needs in the local community. Within these themes, personal responsibility for health and the influence of the social and physical environment emerged to be important for health and lifestyle. The participants expressed the need for clearly organized health and lifestyle facilities, a personalized approach and an easily accessible health risk assessment to support lifestyle behavioural change in the community. In our study, urban residents experienced a strong influence of the social and physical environment to their lifestyle behaviour. This finding supports an integrated approach for preventive health services in this population. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  1. Prevalence, incidence and types of mild anemia in the elderly: the “Health and Anemia” population-based study

    Science.gov (United States)

    Tettamanti, Mauro; Lucca, Ugo; Gandini, Francesca; Recchia, Angela; Mosconi, Paola; Apolone, Giovanni; Nobili, Alessandro; Tallone, Maria Vittoria; Detoma, Paolo; Giacomin, Adriano; Clerico, Mario; Tempia, Patrizia; Savoia, Luigi; Fasolo, Gilberto; Ponchio, Luisa; Della Porta, Matteo G.; Riva, Emma

    2010-01-01

    Background Hemoglobin concentrations slightly below the lower limit of normal are a common laboratory finding in the elderly, but scant evidence is available on the actual occurrence of mild anemia despite its potential effect on health. The objectives of this study were to estimate the prevalence and incidence of mild grade anemia and to assess the frequency of anemia types in the elderly. Design and Methods This was a prospective, population-based study in all residents 65 years or older in Biella, Italy. Results Blood test results were available for analysis from 8,744 elderly. Hemoglobin concentration decreased and mild anemia increased steadily with increasing age. Mild anemia (defined as a hemoglobin concentration of 10.0–11.9 g/dL in women and 10.0–12.9 g/dL in men) affected 11.8% of the elderly included in the analysis, while the estimated prevalence in the entire population was 11.1%. Before hemoglobin determination, most mildly anemic individuals perceived themselves as non-anemic. Chronic disease anemia, thalassemia trait, and renal insufficiency were the most frequent types of mild anemia. The underlying cause of mild anemia remained unexplained in 26.4% of the cases, almost one third of which might be accounted for by myelodysplastic syndromes. In a random sample of non-anemic elderly at baseline (n=529), after about 2 years, the annual incidence rate of mild anemia was 22.5 per 1000 person-years and increased with increasing age. Conclusions The prevalence and incidence of mild anemia increase with age and mild anemia affects more than one out of ten elderly individuals. Unexplained anemia is common and may be due to myelodysplastic syndromes in some cases. PMID:20534701

  2. Chronic osteomyelitis increases long-term mortality risk in the elderly: a nationwide population-based cohort study.

    Science.gov (United States)

    Huang, Chien-Cheng; Tsai, Kang-Ting; Weng, Shih-Feng; Lin, Hung-Jung; Huang, Hung-Sheng; Wang, Jhi-Joung; Guo, How-Ran; Hsu, Chien-Chin

    2016-03-31

    The elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue. We identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011. Patients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 % confidence interval (CI): 2.01-2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 % CI: 2.22-4.82) and males (IRR: 2.7; 95 % CI: 2.31-3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 % CI: 2.02-12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 % CI: 1.13-2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 % CI: 1.66-2.15], advanced age (≥85 years; AHR: 2.02; 95 % CI: 1.70-2.41), male (AHR: 1.34; 95 % CI: 1.22-1.48), and chronic comorbidities were independent predictors of mortality. This study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.

  3. Prevalence, incidence and types of mild anemia in the elderly: the "Health and Anemia" population-based study.

    Science.gov (United States)

    Tettamanti, Mauro; Lucca, Ugo; Gandini, Francesca; Recchia, Angela; Mosconi, Paola; Apolone, Giovanni; Nobili, Alessandro; Tallone, Maria Vittoria; Detoma, Paolo; Giacomin, Adriano; Clerico, Mario; Tempia, Patrizia; Savoia, Luigi; Fasolo, Gilberto; Ponchio, Luisa; Della Porta, Matteo G; Riva, Emma

    2010-11-01

    Hemoglobin concentrations slightly below the lower limit of normal are a common laboratory finding in the elderly, but scant evidence is available on the actual occurrence of mild anemia despite its potential effect on health. The objectives of this study were to estimate the prevalence and incidence of mild grade anemia and to assess the frequency of anemia types in the elderly. This was a prospective, population-based study in all residents 65 years or older in Biella, Italy. Blood test results were available for analysis from 8,744 elderly. Hemoglobin concentration decreased and mild anemia increased steadily with increasing age. Mild anemia (defined as a hemoglobin concentration of 10.0-11.9 g/dL in women and 10.0-12.9 g/dL in men) affected 11.8% of the elderly included in the analysis, while the estimated prevalence in the entire population was 11.1%. Before hemoglobin determination, most mildly anemic individuals perceived themselves as non-anemic. Chronic disease anemia, thalassemia trait, and renal insufficiency were the most frequent types of mild anemia. The underlying cause of mild anemia remained unexplained in 26.4% of the cases, almost one third of which might be accounted for by myelodysplastic syndromes. In a random sample of non-anemic elderly at baseline (n=529), after about 2 years, the annual incidence rate of mild anemia was 22.5 per 1000 person-years and increased with increasing age. The prevalence and incidence of mild anemia increase with age and mild anemia affects more than one out of ten elderly individuals. Unexplained anemia is common and may be due to myelodysplastic syndromes in some cases.

  4. Mild parkinsonian signs in a community-dwelling elderly population sample in Japan.

    Science.gov (United States)

    Uemura, Yusuke; Wada-Isoe, Kenji; Nakashita, Satoko; Nakashima, Kenji

    2011-05-15

    Mild parkinsonian signs (MPS) may represent the mild end of a disease spectrum that spans from normal aging to neurodegenerative diseases. We conducted a population-based study in a rural island town in western Japan, Ama-cho. Participants included 1129 subjects, aged 60 years and older, residing in the town. Participants were classified according to a modified Unified Parkinson's Disease Rating Scale (mUPDRS) score. MPS was determined to be present if any of the following conditions were met: (1) two or more mUPDRS ratings=1 [MPS-mild]; (2) one mUPDRS rating≥2; or (3) mUPDRS rest tremor rating≥1; [(2) and (3): MPS-severe]. Subjects wore a uniaxial accelerometer (Actiwatch), resulting in the measurement of actigraphic activity counts (AC). Of the 804 participants with complete data, 178 subjects (22.1%) were classified as demonstrating MPS. AC was significantly lower in the MPS-severe group compared with both the CTL and the MPS-mild groups. Diagnostic sensitivity for MPS-severe became 100% when we adopted a cutoff point of low physical activity, as measured by actigraphy, combined with the presence of subjective depression. We established the prevalence of MPS in a community-dwelling elderly population sample in Japan. Actigraphy may be a useful objective tool for screening MPS-severe. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly.

    Science.gov (United States)

    Ottenbacher, Kenneth J; Graham, James E; Al Snih, Soham; Raji, Mukaila; Samper-Ternent, Rafael; Ostir, Glenn V; Markides, Kyriakos S

    2009-04-01

    We examined the prevalence of frailty among Mexican American older adults and explored the correlates associated with becoming frail to determine their affect on disability and morbidity in this population. We studied the trajectory of frailty over 10 years in 2049 Mexican Americans participating in the Hispanic Established Populations Epidemiologic Studies of the Elderly. We constructed a frailty index based on weight loss, exhaustion, grip strength, walking speed, and physical activity and collected data on sociodemographic and health status, comorbidities, and functional measures of performance. The sample was 58% female, with a mean age of 74.43 years (SD = 6.04) at baseline. Fifty-five percent of participants at baseline and 75% of the surviving sample at follow-up (n = 777) were classified as prefrail or frail. Of persons identified as frail at baseline, 84% died by the end of follow-up. Baseline age, diabetes, arthritis, smoking status, body mass index, cognition, negative affect, and number of comorbid conditions were predictors of frailty at follow-up (R(2) = 0.29; P ways to reduce the number of Mexican American older adults who become frail and disabled and therefore lose their independence is needed. Future studies should continue to examine the trajectory of frailty as a dynamic process that includes psychosocial and cognitive components.

  6. Barriers, Attitudes, and Dietary Behaviors Regarding Sodium Reduction in the Elderly Korean–Chinese Population in Yanbian, China

    Science.gov (United States)

    Lee, Jounghee; Cui, Wenying; Jin, Meixiang

    2017-01-01

    Objectives This research investigated the barriers, attitudes, and dietary behaviors related to sodium reduction among the elderly Korean–Chinese population in Yanbian, China. Methods We conducted this pilot study using both descriptive research and a focus group interview at the elderly community center in Yanbian. Results In total, 21 elderly Korean–Chinese (average age, 71 years) were examined. The findings showed that the top three barriers to sodium reduction were 1) the difficulties associated with having meals with others, 2) a preference for liquid based-dishes, and 3) the lack of taste in low-sodium dishes. Although the participants strongly believed that a reduced-sodium diet would improve their health, they were poorly aware of the amount of sodium in various foods and dishes. In particular, the focus group interviews with eight participants (mean age, 67 years) revealed that salt-preserved foods (e.g., Korean pickled cabbage called ‘kimchi’ and soybean paste) were frequently consumed as part of their food culture, and that very salty dishes were served at restaurants, both of which lead to a high sodium intake. Conclusion This study provides useful preliminary data to help design a nutrition intervention program for sodium reduction that targets the elderly Korean–Chinese population in China. PMID:28781941

  7. Comparing associations of different metabolic syndrome definitions with ischemic stroke in Chinese elderly population.

    Science.gov (United States)

    Liu, Qian; Li, Yan-Xun; Hu, Zhi-Hao; Jiang, Xiao-Yan; Li, Shu-Juan; Wang, Xiao-Feng

    2018-01-01

    Studies have showed the associations between different definitions of metabolic syndrome (MetS) and risk of ischemic stroke were inconsistent. In this study, we compared associations of different MetS definitions with ischemic stroke in Chinese elderly population. A total of 1713 individuals aged 70-84years from Rugao Longevity and Ageing Study were analyzed. The MetS was defined by four different criteria: Chinese Adult Dyslipidemia Prevention Guide, International Diabetes Federation (IDF), Updated ATPIII (Updated ATPIII) by American heart association/American heart, lung and blood institute (AHA/NHLBI), and Joint Interim Statement(JIS) recommended by IDF and the American heart association/American national institutes of health/American heart, lung and blood institute (AHA/NIH/NHLBI). Prevalence of MetS in the whole population was 24.0% (Chinese guide), 32.5% (IDF), 38.8% (Updated ATPIII) and 24.0% (JIS) and in stroke population was 27.1% (Chinese guide), 41.1% (IDF), 48.8% (Updated ATPIII) and 27.1% (JIS), respectively. The agreement between definitions was highest in Updated ATPIII vs. IDF (kappa=0.863). It showed that only definitions of IDF (OR 1.55, 95%CI 1.04-2.31, p=0.031) and Updated ATPIII (OR 1.64, 95%CI 1.11-2.42, p=0.013) were independently associated with risk of ischemic stroke in multivariable logistic regression analysis. The risk of ischemic stroke increased with the increasing of numbers of Mets components in Updated ATPIII (pguide, IDF and JIS for screening high-risk individuals of ischemic stroke, and the additive effects of Mets components might play a greater role than its composition alone in ischemic stroke. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Prolonged Cardiopulmonary Resuscitation Process and Lower Frequency of Medical Staff Visit Predicts Independently In-hospital Resuscitation Success in the Elderly Population

    Directory of Open Access Journals (Sweden)

    Jui-Chen Tsai

    2012-09-01

    Conclusion: Although the initial resuscitation success rate was not affected by age, a longer time interval between the last medical staffs’ visit and the onset of resuscitation did result in a worse success rate in elderly patients. Our data suggest that more frequent staff visits to the elderly population during hospitalization could alter initial resuscitation results.

  9. Fruit and vegetable consumption among community dwelling elderly in an Iranian population

    Directory of Open Access Journals (Sweden)

    Ali M Sabzghabaee

    2010-01-01

    Conclusions: Most elderly people consumed less than the recom-mended levels of fruits and vegetables. From the point of view of prevention of chronic disease, health education programs which targeted elderly people particularly for those at the risk of low consumption are needed and recommended.

  10. Association between obesity and asthma in the elderly population: potential roles of abdominal subcutaneous adiposity and sarcopenia.

    Science.gov (United States)

    Song, Woo-Jung; Kim, Sae-Hoon; Lim, Soo; Park, Young-Joo; Kim, Min-Hye; Lee, Sang-Min; Lee, Seok-Bum; Kim, Ki-Woong; Jang, Hak-Chul; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2012-10-01

    Obesity is a significant risk factor for asthma; however, the association of asthma with obesity has rarely been studied in the elderly population. The role of central obesity has been suggested as a link between the 2 entities but has not been comprehensively studied in elderly populations. To investigate the mechanisms of association between obesity and asthma in the elderly population. This cross-sectional analysis included 994 participants (aged ≥65 years) in the Korean Longitudinal Study on Health and Aging. Asthma was defined by using questionnaires. Spirometry and chest radiography were performed to exclude asthma-mimicking conditions. Measurements of abdominal subcutaneous and visceral fat were calculated by computed tomography of the abdomen, and regional body compositions were measured by dual energy X-ray absorptiometry. Biochemical parameters were also measured. The prevalence of asthma was 5.4%. The study population had a mean body mass index (BMI) of 24.0. Multivariate logistic regression tests revealed that the risk of asthma increased in proportion to an increase in BMI or abdominal subcutaneous adiposity. However, no association was found with visceral adiposity, serum adiponectin levels, or serum vitamin D levels. The dual energy X-ray absorptiometry-measured appendicular fat-free mass index was inversely related to asthma among patients with a BMI of 25.0 or greater. Our findings suggest that the relationships between obesity and asthma in the elderly population may be mediated by factors such as abdominal subcutaneous adiposity and sarcopenia. These associations warrant further investigations to identify their potential roles. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Association between serum β2-microglobulin levels and frailty in an elderly Chinese population: results from RuLAS.

    Science.gov (United States)

    Liu, Zu-Yun; Shen, Yan-Yu; Ji, Li-Juan; Jiang, Xiao-Yan; Wang, Xiao-Feng; Shi, Yan

    2017-01-01

    To examine the association between serum β2-microglobulin (B2M) levels and frailty in an elderly Chinese population. A population-based cohort study. We used data on 1,663 elderly participants (aged 70-84 years) from the aging arm of the Rugao Longevity and Ageing study, a population-based observational two-arm cohort study conducted in Rugao, China. The serum B2M was measured with chemiluminescence immunoassay by a technician in the biochemistry laboratory of the Rugao People's Hospital. Information on the frailty index and phenotype was collected. The mean B2M levels and frailty index were 1.8 mg/L and 0.16, respectively; 188 (11.3%) participants were classified as frail (frailty phenotype). For a standard deviation increase in B2M, the adjusted odds ratio for frailty phenotype was 1.20 (95% CI: 1.05, 1.39; P=0.009) and the standardized coefficient for frailty index was 0.07 (95% CI: 0.02, 0.11; P=0.004). Relative to the lowest quartile, the highest B2M quartile had a greater risk of prevalent frailty with adjusted odds ratios of 1.68 (95% CI: 1.04, 2.71; P=0.034) for frailty phenotype and 1.51 (95% CI: 1.01, 2.27; P=0.044) for frailty index (≥0.25). In addition, estimated glomerular filtration rate (based on B2M) or chronic kidney disease (estimated glomerular filtration rate frailty phenotype and index. B2M was significantly associated with both frailty phenotype and index in elderly Chinese population. The findings underscore the promising kidney relevant biomarkers for identifying vulnerable elderly Chinese population.

  12. Quality of life in elderly patients with an 'ostomy - a study from the population-based PROFILES registry.

    Science.gov (United States)

    Verweij, N M; Bonhof, C S; Schiphorst, A H W; Maas, H A; Mols, F; Pronk, A; Hamaker, M E

    2017-12-15

    'Ostomies are being placed frequently in surgically treated elderly colorectal cancer (CRC) patients. Having insight into the (potential) impact of 'ostomies on their quality of life (QoL) can be useful in patient counselling as well as in the challenging shared treatment decision making. CRC patients diagnosed between 2000-2009 and registered in the population-based Eindhoven Cancer Registry received a QoL questionnaire (EORTC QLQ-C30) in 2010. In addition, QoL were compared with an age- and sex-matched normative population. 2299 CRC patients were included, of whom 494 had an 'ostomy. No differences were found in reported 'ostomy-related problems between patients aged ≤65, 66-75 and ≥76 years. 'Ostomy patients aged 66-75 and ≥76 years reported significantly lower physical functioning compared to those without an 'ostomy. In the elderly, aged ≥76 years, 'ostomates reported a worse physical and social functioning compared to the normative population. All these differences were of small clinical relevance. The impact of an 'ostomy seems to be more prominent in younger (≤75 years old) 'ostomates, as they experience more functional limitations and a decrease in global health status compared to younger non-ostomy patients and the normative population. Although elderly (≥76 years old) patients with an 'ostomy report significantly more limitations in functioning compared to a normative population and elderly CRC-patients without an 'ostomy, the clinical relevance of this finding is limited. In contrast, the impact of an 'ostomy is more prominent in younger patients. Thus, age itself is not a reason for withholding an 'ostomy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Relationship between Urinary Level of Phytate and Valvular Calcification in an Elderly Population: A Cross-Sectional Study

    Science.gov (United States)

    Fernández-Palomeque, Carlos; Grau, Andres; Perelló, Joan; Sanchis, Pilar; Isern, Bernat; Prieto, Rafel M.; Costa-Bauzá, Antonia; Caldés, Onofre J.; Bonnin, Oriol; Garcia-Raja, Ana; Bethencourt, Armando; Grases, Felix

    2015-01-01

    Pathological calcification generally consists of the formation of solid deposits of hydroxyapatite (calcium phosphate) in soft tissues. Supersaturation is the thermodynamic driving force for crystallization, so it is believed that higher blood levels of calcium and phosphate increase the risk of cardiovascular calcification. However several factors can promote or inhibit the natural process of pathological calcification. This cross-sectional study evaluated the relationship between physiological levels of urinary phytate and heart valve calcification in a population of elderly out subjects. A population of 188 elderly subjects (mean age: 68 years) was studied. Valve calcification was measured by echocardiography. Phytate determination was performed from a urine sample and data on blood chemistry, end-systolic volume, concomitant diseases, cardiovascular risk factors, medication usage and food were obtained. The study population was classified in three tertiles according to level of urinary phytate: low (1.21 μM). Subjects with higher levels of urinary phytate had less mitral annulus calcification and were less likely to have diabetes and hypercholesterolemia. In the multivariate analysis, age, serum phosphorous, leukocytes total count and urinary phytate excretion appeared as independent factors predictive of presence of mitral annulus calcification. There was an inverse correlation between urinary phytate content and mitral annulus calcification in our population of elderly out subjects. These results suggest that consumption of phytate-rich foods may help to prevent cardiovascular calcification evolution. PMID:26322979

  14. Relationship between Urinary Level of Phytate and Valvular Calcification in an Elderly Population: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Carlos Fernández-Palomeque

    Full Text Available Pathological calcification generally consists of the formation of solid deposits of hydroxyapatite (calcium phosphate in soft tissues. Supersaturation is the thermodynamic driving force for crystallization, so it is believed that higher blood levels of calcium and phosphate increase the risk of cardiovascular calcification. However several factors can promote or inhibit the natural process of pathological calcification. This cross-sectional study evaluated the relationship between physiological levels of urinary phytate and heart valve calcification in a population of elderly out subjects. A population of 188 elderly subjects (mean age: 68 years was studied. Valve calcification was measured by echocardiography. Phytate determination was performed from a urine sample and data on blood chemistry, end-systolic volume, concomitant diseases, cardiovascular risk factors, medication usage and food were obtained. The study population was classified in three tertiles according to level of urinary phytate: low (1.21 μM. Subjects with higher levels of urinary phytate had less mitral annulus calcification and were less likely to have diabetes and hypercholesterolemia. In the multivariate analysis, age, serum phosphorous, leukocytes total count and urinary phytate excretion appeared as independent factors predictive of presence of mitral annulus calcification. There was an inverse correlation between urinary phytate content and mitral annulus calcification in our population of elderly out subjects. These results suggest that consumption of phytate-rich foods may help to prevent cardiovascular calcification evolution.

  15. Traumatic experiences and post-traumatic stress disorder among elderly Germans: results of a representative population-based survey

    OpenAIRE

    Glaesmer, Heide; Gunzelmann, Thomas; Braehler, Elmar; Forstmeier, Simon; Maercker, Andreas

    2017-01-01

    BACKGROUND: Only a few population-based studies on the epidemiology of post-traumatic stress disorders (PTSDs) are available to date. Most of the existing studies are from the U.S.A. Against the background of World War II, the extent and long-term effects of war-related traumatic experiences in the German elderly population are of special interest. Nevertheless, population-based data on this topic are lacking to date. METHODS: This study examines the occurrence of traumatic experiences an...

  16. Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis.

    Science.gov (United States)

    Salamone, G; Licari, L; Falco, N; Augello, G; Tutino, R; Campanella, S; Guercio, G; Gulotta, G

    2016-01-01

    Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. Retrospective study on 104 patients admitted and operated for "Acute Secondary Peritonitis due to visceral perforation". MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor. Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of 22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005). Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis.

  17. Frequency distribution of apolipoprotein e genotypes in elderly han chinese population and relationship with senile dementia.

    Science.gov (United States)

    Huang, W; Chen, M; Zhang, Y; Zhao, P; Yao, G; Zhou, H

    2014-12-23

    The aim of the study was to determine the relationship between Apo Eε4 genotype and senile dementia (SD) by analyzing the Apo E allelic frequency distributions among the elderly Han Chinese population. For this purpose, a total of 316 Chongqing residents, aged ≥60yrs, were classified as SD or control groups following the criteria of National Institute of Neurological and Communicative Disorders and Stroke--Alzheimer's Disease and Related Disorders Association. Genomic DNA was isolated from the peripheral blood lymphocytes and exon 4 of the ApoE gene with polymorphism sites was amplified by PCR and genotypes determined by restriction fragment length polymorphism (RFLP). We found that the most prevalent genotype was Apo Eε3/3, followed in order by Apo Eε3/4 and Apo Eε2/2. The estimated ApoE allelic frequencies in individuals with SD were 0.095, 0.560, and 0.345 for ε2, ε3, and ε4, respectively. In controls, the corresponding Apo E allelic frequencies were 0.146, 0.699, and 0.155. The percentage of ε4 allele carriers in SD group was significantly higher than that in control group (Psenile dementia.

  18. Diffuse Large B-Cell Lymphoma in the Elderly: Real World Outcomes of Immunochemotherapy in Asian Population.

    Science.gov (United States)

    Byun, Ja Min; Lee, Jeong-Ok; Kang, Beodeul; Kim, Ji-Won; Kim, Se Hyun; Kim, Jin Won; Kim, Yu Jung; Lee, Keun-Wook; Bang, Soo-Mee; Lee, Jong Seok

    2016-09-01

    We evaluated the real-life treatment outcomes of elderly patients with diffuse large B-cell lymphoma from a homogenous Asian population and defined the cutoff age for "elderly." The medical records of 192 DLBCL patients aged > 60 years who had received first-line immunochemotherapy were retrospectively evaluated. The treatment schedule, adverse events, and survival outcomes were analyzed overall and stratified by 4 age groups (> 60-64, 65-69, 70-74, and ≥ 75 years). Patient age of ≥ 75 years was associated with a significantly lower complete remission rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P population, 75 years seems to be a judicious cutoff for predicting treatment outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Saliva DNA quality and genotyping efficiency in a predominantly elderly population.

    Science.gov (United States)

    Gudiseva, Harini V; Hansen, Mark; Gutierrez, Linda; Collins, David W; He, Jie; Verkuil, Lana D; Danford, Ian D; Sagaser, Anna; Bowman, Anita S; Salowe, Rebecca; Sankar, Prithvi S; Miller-Ellis, Eydie; Lehman, Amanda; O'Brien, Joan M

    2016-04-07

    The question of whether DNA obtained from saliva is an acceptable alternative to DNA from blood is a topic of considerable interest for large genetics studies. We compared the yields, quality and performance of DNAs from saliva and blood from a mostly elderly study population. Two thousand nine hundred ten DNAs from primarily elderly subjects (mean age ± standard deviation (SD): 65 ± 12 years), collected for the Primary Open-Angle African-American Glaucoma Genetics (POAAGG) study, were evaluated by fluorometry and/or spectroscopy. These included 566 DNAs from blood and 2344 from saliva. Subsets of these were evaluated by Sanger sequencing (n = 1555), and by microarray SNP genotyping (n = 94) on an Illumina OmniExpress bead chip platform. The mean age of subjects was 65, and 68 % were female in both the blood and saliva groups. The mean ± SD of DNA yield per ml of requested specimen was significantly higher for saliva (17.6 ± 17.8 μg/ml) than blood (13.2 ± 8.5 μg/ml), but the mean ± SD of total DNA yield obtained per saliva specimen (35 ± 36 μg from 2 ml maximum specimen volume) was approximately three-fold lower than from blood (106 ± 68 μg from 8 ml maximum specimen volume). The average genotyping call rates were >99 % for 43 of 44 saliva DNAs and >99 % for 50 of 50 for blood DNAs. For 22 of 23 paired blood and saliva samples from the same individuals, the average genotyping concordance rate was 99.996 %. High quality PCR Sanger sequencing was obtained from ≥ 98 % of blood (n = 297) and saliva (n = 1258) DNAs. DNA concentrations ≥10 ng/μl, corresponding to total yields ≥ 2 μg, were obtained for 94 % of the saliva specimens (n = 2344). In spite of inferior purity, the performance of saliva DNAs for microarray genotyping was excellent. Our results agree with other studies concluding that saliva collection is a viable alternative to blood. The potential to boost study enrollments and reduce subject discomfort is not necessarily offset by a

  20. Prevalence of frontotemporal dementia in community-based studies in Latin America: A systematic review

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    Full Text Available ABSTRACT Latin America (LA is experiencing a rise in the elderly population and a consequent increase in geriatric problems such as dementia. There are few epidemiological studies assessing the magnitude of dementia and dementia subtypes in LA. Objective: To identify published community-based studies on the prevalence of FTD in LA countries. Methods: A database search for door-to-door studies on FTD prevalence in LA was performed. The search was carried out on Medline, Embase, and LILACS databases for research conducted between 1994 and 2012. The main inclusion criteria were: use of any internationally accepted diagnostic criteria and investigation of community samples. Results: Four hundred and ninety two articles were found, of which 26 were initially pre-selected by title or abstract review. Five studies from 3 different countries were included. The FTD prevalence rates in community-dwelling elderly were 1.2 (Venezuela, 1.3 (Peru and 1.7-1.8 (Brazil per thousand persons, depending on age group. Conclusion: The FTD prevalence in LA studies showed values mid-way between those observed in western and in oriental populations. Despite the magnitude of this problem, epidemiological information on FTD remains scarce in LA.

  1. Factors Related to Physical Activity Among the Elderly Population in Rural Thailand.

    Science.gov (United States)

    Ethisan, Plernta; Somrongthong, Ratana; Ahmed, Jamil; Kumar, Ramesh; Chapman, Robert S

    2017-04-01

    Physical activity in later years of life is not only essential to healthy aging and independent functioning, but it also helps prevent chronic diseases. We aimed this cross-sectional study to assess the prevalence of physical activity and associated factors among rural elderly Thais. We conducted this study on a sample of 300 elderly in 2 rural districts of Phranakornsiayutthaya province in Thailand. The mean age of participants were 67.5±6 years and 42% of them did not perform physical activity. Prevalence of vigorous and moderate intensity physical activity was 43.7% and 48.7%, respectively. About 43.7% elderly used any active transport and spent 2.81 hours on sedentary activities, daily. Females and those with enough income were 3.64 and 0.59 times, respectively, less likely to be physically active ( P elderly were physically inactive. Also male and wealthy elderly were less likely to be engaged in physical activity. We recommend for improved efforts to involve rural Thai elderly in physical activity by offering them opportunities for locally relevant recreational and leisure time physical activities, with special focus on males and higher income elderly.

  2. Targeting pediatric versus elderly populations for norovirus vaccines: a model-based analysis of mass vaccination options

    Science.gov (United States)

    Steele, Molly K.; Remais, Justin V.; Gambhir, Manoj; Glasser, John W.; Handel, Andreas; Parashar, Umesh D.; Lopman, Benjamin A.

    2016-01-01

    Background Noroviruses are the leading cause of acute gastroenteritis and foodborne diarrheal disease in the United States. Norovirus vaccine development has progressed in recent years, but critical questions remain regarding which age groups should be vaccinated to maximize population impact. Methods We developed a deterministic, age-structured compartmental model of norovirus transmission and immunity in the U.S. population. The model was fit to age-specific monthly U.S. hospitalizations between 1996 and 2007. We simulated mass immunization of both pediatric and elderly populations assuming realistic coverages of 90% and 65%, respectively. We considered two mechanism of vaccine action, resulting in lower vaccine efficacy (lVE) between 22% and 43% and higher VE (hVE) of 50%. Results Pediatric vaccination was predicted to avert 33% (95% CI: 27%, 40%) and 60% (95% CI: 49%, 71%) of norovirus episodes among children under five years for lVE and hVE, respectively. Vaccinating the elderly averted 17% (95% CI: 12%, 20%) and 38% (95% CI: 34%, 42%) of cases in 65+ year olds for lVE and hVE, respectively. At a population level, pediatric vaccination was predicted to avert 18–21 times more cases and twice as many deaths per vaccinee compared to elderly vaccination. Conclusions The potential benefits are likely greater for a pediatric program, both via direct protection of vaccinated children and indirect protection of unvaccinated individuals, including adults and the elderly. These findings argue for a clinical development plan that will deliver a vaccine with a safety and efficacy profile suitable for use in children. PMID:27821278

  3. Population Ageing and Socially Assistive Robots for Elderly Persons: The Importance of Sociodemographic Factors for User Acceptance

    OpenAIRE

    Priska Flandorfer

    2012-01-01

    Taking care of older adults is among the major challenges currently faced by ageing populations. Researchers, designers, and engineers have proposed socially assistive robots as one way of helping elderly people stay in their homes longer. In a systematic literature review, this paper wants to investigate if and how evaluations of the acceptance of socially assistive robots by older people take into account sociodemographic factors. The results indicate that this only holds true for a few stu...

  4. PA5 Elderly population in bangladesh: coping with society in transition.

    Science.gov (United States)

    Chanda, Sanchoy Kumar; Wara, Kahful; Das, Sankar Narayan

    2015-04-01

    Bangladesh has a long tradition of looking after the elderly by offspring or family. But rapid socio-economic transformations, changing social values have broken down the traditional extended family system. Many elderly people now stay in old age homes, mainly based in Dhaka, run by non-government organisations or as a charity. This paper explores the scenario of the elderly's reasons for living in old age homes, coping with new environments and satisfaction about old age homes, and to sensitise the policy makers for designing and implementing appropriate programs for the elderly in Bangladesh. Elderly (65+ years) living in two old age homes (n = 56) in Dhaka were interviewed. Reasons for staying in home and satisfaction etc. along with socio-demographic information were collected. Almost all came from better off families, 47% male and 53% female. 68% of men and 36% of women were retired mid and high level officials. Reasons for coming to elderly home were problems with kin (63%) or with children (9%), children living in abroad (5%), no one to take care of them at home (67%), burden on the family (24%), properties occupied by others (27%). Children or relatives visit them (87%). 92% are satisfied with overall management of old age home. Elderly people living in old age homes are mainly from better off urban middle-class and rich families. It does not reflect the real situation of the elderly in the society. The old age home is a new idea or one answer of the elderly in a society in transition. It demands further wide ranged research; however findings reflect the indication of the growing rift between generations. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Transition in public knowledge of risk factors of cardiovascular disease in an Iranian general population: A latent transition analysis (LTA) on a longitudinal large community-based educational prevention program

    Science.gov (United States)

    Rafiee Alhossaini, Mahsa; Hassanzadeh, Akbar; Feizi, Awat; Sarrafzadegan, Nizal

    2016-01-01

    BACKGROUND Cardiovascular diseases (CVD) are the second leading cause of death, after accidents, in Iran. This study was performed to assess the change in levels of knowledge about 8 risk factors of CVD and its associated determinants the Iranian general population. METHODS The current repeated cross-sectional study included 3014 people in 2004, 3012 in 2005, and 4719 in 2007, aged older than 19 years. Knowledge about 8 risk factors (high blood pressure, nutrition, physical inactivity, smoking, diabetes, heredity, stress, and obesity) as the major causes of CVD was evaluated using latent transition analysis (LTA). RESULTS The most widely known CVD risk factors were nutrition and physical inactivity followed by stress. In addition, old age, low level of education, male gender and low socioeconomic status (SES) level were the significant determinants of low knowledge levels of CVD risk factors. Besides, individuals’ knowledge of CVD risk factors increased across the time. CONCLUSION Public knowledge of CVD risk factors has increased; however significant gaps continue to exist, particularly among the elderly, less-educated people, people in low socioeconomic status level and men. Future intensified educational efforts by policymakers are necessary for improving knowledge of CVD, particularly among high-risk groups. PMID:28149314

  6. C-Terminal to Intact Fibroblast Growth Factor 23 Ratio in Relation to Estimated Glomerular Filtration Rate in Elderly Population

    Directory of Open Access Journals (Sweden)

    Maria Bożentowicz-Wikarek

    2016-08-01

    Full Text Available Background/Aims: An analytical equivalence between intact fibroblasts growth factor(iFGF23 and C-terminal(cFGF23 assays is logically expected, however, numerous studies demonstrate lack of a strong association between them. Previously, we have demonstrated the increase in cFGF23 slightly precedes the increase of iFGF23 with the impairment of kidney excretory function; without actually analyzing the ratio between both assays, which are postulated to be affected by declining kidney function. Therefore, the aim of this study was to analyze the ratio between C and iFGF23 in relation to the estimated glomerular filtration rate (eGFR in an elderly population. Methods: We analysed the variability of c/iFGF23 ratio in the population of 3264 elderly PolSenior study participants (≥ 65years in the relation to eGFR calculated according full Modification of Diet in Renal Disease, serum levels of C-reactive protein (hs-CRP, and iron. Results: The log10(c/i FGF23 ratio increased in the subsequent CKD stages. Serum iron and CRP levels reduced the log10 and increased it with age in multivariate regression analysis. Conclusions: Our results suggest impairment in the cleavage of the C-terminal FGF23 fragments with the deterioration of kidney excretory function and age in the elderly population. Inflammation and low serum iron level seems to diminish degradation capacity of FGF23 fragments.

  7. Assessing cognitive ability in research: use of MMSE with minority populations and elderly adults with low education levels.

    Science.gov (United States)

    Wood, Robin Y; Giuliano, Karen K; Bignell, Candace U; Pritham, Whitney W

    2006-04-01

    The Mini-Mental State Examination (MMSE), originally designed to screen for dementia, is an instrument currently used extensively to assess cognitive status in clinical and community settings. This descriptive study compares standard MMSE scores to MMSE scores adjusted for age and education in a sample of 414 elderly Black and White women living independently in communities. After scores were adjusted, 14 participants (all Black) were moved from categories of mild cognitive impairment to unimpaired cognitive ability. However, even after scores were adjusted for age and education, White elderly adults still had higher mean scores than Black elderly adults (p = .003), suggesting that racial differences may have an effect on MMSE performance independent of age and education. Further research is needed to better understand the interaction of race and culture on MMSE outcomes. Implications are offered for appropriate use of the MMSE considering factors of age, education, and racial differences to guide evidence-based practice by gerontological nurses engaged in work with elderly populations.

  8. Falls and self-assessment of eyesight among elderly people: a population-based study in a south Brazilian municipality.

    Science.gov (United States)

    Nunes, Bruno Pereira; de Oliveira Saes, Mirelle; Siqueira, Fernando Vinholes; Tomasi, Elaine; Silva, Suele Manjourany; da Silveira, Denise Silva; Soares, Mariangela Uhlmann; Facchini, Luiz Augusto; Thumé, Elaine

    2014-01-01

    This paper seeks to verify the association between falls and self-assessment of visual acuity in elderly people by means of a cross-sectional population-based study involving 1593 elderly people (aged 60 or over) from the urban zone of the municipality of Bagé-RS. Poisson regression was used for association analysis. Fall prevalence in the last year was 28.0% (95%CI: 25.8; 30.2), with 45.0% of these having suffered two or more falls in the same period. Elderly people self-assessing their eyesight as bad/very poor (10.0%) or regular (33.3%) showed a linear increase in fall occurrence when compared to individuals who considered their eyesight to be good/excellent. Self-assessment of eyesight showed itself to be an important factor associated with the occurrence of falls. This results entails the need to make progress with tracing elderly people with eyesight difficulties and its possible impact on actions to prevent the occurrence of falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Prevalence and risk factors of abuse among community dwelling elderly of Guwahati City, Assam

    Directory of Open Access Journals (Sweden)

    Anku Moni Saikia

    2015-01-01

    Full Text Available Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST. Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population.

  10. Higher estimates of daily dietary net endogenous acid production (NEAP) in the elderly as compared to the young in a healthy, free-living elderly population of Pakistan

    National Research Council Canada - National Science Library

    Alam, Iftikhar; Alam, Ibrar; Paracha, Parvez I; Pawelec, Graham

    2012-01-01

    ...) in a sample of otherwise healthy elderly aged 50 years and above; and (2) compare NEAP between the elderly and young to determine the effects of aging, which could contribute to changes in the acid-base balance...

  11. Barriers to dental care in an elderly population resident in an inner city area.

    Science.gov (United States)

    Fiske, J; Gelbier, S; Watson, R M

    1990-10-01

    A sample of 765 elderly people living in London was interviewed and examined. Barriers to dental care stemmed from: elderly people's beliefs that dentures should last a life-time and dental visits are unnecessary for edentulous persons: mobility difficulties; fear; problems with access to NHS care and with access to satisfactory care. The attitudes of general dental practitioners, community dentists and final year dental students towards elderly people were favourable. Sixty per cent of surgeries were on the ground floor, and 46 per cent of premises were unsuitable for wheelchair access. Carers wanted improvement in domiciliary services. The provision of domiciliary care was significantly related to training. There was a paucity of experience in this field amongst dental students. Community dentists recognized a need for retraining before providing care for handicapped elderly people.

  12. Cutaneous problems in elderly diabetics: A population-based comparative cross-sectional survey

    Directory of Open Access Journals (Sweden)

    N Asokan

    2017-01-01

    Conclusions: Numbness, tingling and burning sensation of extremities, prayer sign, finger pebbling, skin tags, stiff joints and acanthosis nigricans were associated with diabetes mellitus among elderly persons in a village in Kerala.

  13. Prevalence of elder self-neglect in a Chicago Chinese population: The role of cognitive physical and mental health.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa

    2016-09-01

    The present study examined the cognitive, physical and psychological characteristics associated with elder self-neglect in a USA Chinese older population. The Population Study of Chinese Elderly in Chicago is a population-based epidemiological study of Chinese older adults in the greater Chicago area. In total, 3159 Chinese older adults aged 60 years and older were interviewed from 2011 to 2013. Personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions and inadequate utility. The prevalence of elder self-neglect of all severities was higher among older adults who were with worsening health status, lower cognitive function, lower physical function and more depressive symptoms. Poorer health status (mild self-neglect OR 1.20, 95% CI 1.06-1.35; moderate/severe self-neglect: OR 1.52, 95% CI 1.30-1.77), lower physical function (activities of daily living moderate/severe self-neglect OR 1.09, 95% CI 1.05-1.13; instrumental activities of daily living mild OR 1.04, 95% CI 1.03-1.06; instrumental activities of dailiy living moderate/severe OR 1.06, 95% CI 1.04-1.07), lower cognitive function (mild self-neglect OR 1.05, 95% CI 1.03-1.07; moderate/severe self-neglect OR 1.07, 95% CI 1.04-1.09) and more depressive symptoms (mild self-neglect OR 1.05, 95% CI 1.02-1.07; moderate/severe self-neglect OR 1.08, 95% CI 1.06-1.11) were significantly associated with increased risk for elder self-neglect of all severities. Older adults with lower levels of cognitive, physical, and psychological health were more likely to report elder self-neglect and its phenotypes. Future research is required to examine risk/protective factors associated with elder self-neglect. Geriatr Gerontol Int 2016; 16: 1051-1062. © 2015 Japan Geriatrics Society.

  14. Measuring reliability and validity of Persian version of spirituality scale among elderly Iranian population

    OpenAIRE

    Hallaj Zahra; Rafiey Hasan; Momtaz Yadollah Abolfathi; Teimori Robab; Haroni Qholamreza Qaed Amini; Sahaf Robab

    2014-01-01

    Objective: The aim of this study was to measure the validity and reliability of Persian version of spirituality scale among elderly Iranian people. Methods: Based on the international quality of life assessment (IQOLA) project approach, Persian version of the spirituality scale was prepared. Data on 200 elderly people (over 60 years old) were entered into SPSS software. Results: The findings of the descriptive results of the current study showed that there was no correlation between the demog...

  15. Exposure and dose assessment to particle components among an elderly population

    Science.gov (United States)

    Almeida-Silva, M.; Almeida, S. M.; Pegas, P. N.; Nunes, T.; Alves, C. A.; Wolterbeek, H. T.

    2015-02-01

    People spend the majority of their time indoors and the composition and toxicity of indoor particles is very complex and present significant differences comparing with outdoor aerosols. Consequently, ambient particles cannot represent a real exposure. The aim of this work was to determine the daily exposure and the daily inhaled dose to particle components of elders living in Elderly Care Centers. A questionnaire was applied to 193 institutionalized elders in order to achieve their daily time pattern and to define the micro-environments where PM10 and its components (carbonaceous components and trace elements) were assessed. Daily exposure was calculated by integrating the elder's time spend in each micro-environment and the concentration of the pollutants for the period of interest. This parameter, together with the inhalation rate and the standard body weight, were used to calculate the daily inhaled dose. PM10 daily exposure and daily inhaled dose ranged between 11 - 16 μg m-3 and 20 × 10-3 - 28 × 10-3 μg kg-1, respectively. This work not only allowed a fully quantification of the magnitude of the elders exposure, but also showed that the assessment of the integrated exposure to PM components is determinant to accomplish the dose inhaled by elders living in ECCs.

  16. Caregiver Abuse of Chicago Chinese Older Adults in a Community-Dwelling Population.

    Science.gov (United States)

    Dong, Xin Qi; Li, Ge

    This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = -0.10, p speaking (r = 0.16, p caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse.

  17. Severity of chronic pain in an elderly population in Sweden--impact on costs and quality of life.

    Science.gov (United States)

    Bernfort, Lars; Gerdle, Björn; Rahmqvist, Mikael; Husberg, Magnus; Levin, Lars-Åke

    2015-03-01

    Chronic pain is associated with large societal costs, but few studies have investigated the total costs of chronic pain with respect to elderly subjects. The elderly usually require informal care, care performed by municipalities, and care for chronic diseases, all factors that can result in extensive financial burdens on elderly patients, their families, and the social services provided by the state. This study aims to quantify the societal cost of chronic pain in people of age 65 years and older and to assess the impact of chronic pain on quality of life. This study collected data from 3 registers concerning health care, drugs, and municipal services and from 2 surveys. A postal questionnaire was used to collect data from a stratified sample of the population 65 years and older in southeastern Sweden. The questionnaire addressed pain intensity and quality of life variables (EQ-5D). A second postal questionnaire was used to collect data from relatives of the elderly patients suffering from chronic pain. A total of 66.5% valid responses of the 10,000 subjects was achieved; 76.9% were categorized as having no or mild chronic pain, 18.9% as having moderate chronic pain, and 4.2% as having severe chronic pain. Consumed resources increased with the severity of chronic pain. Clear differences in EQ-5D were found with respect to the severity of pain. This study found an association between resource use and severity of chronic pain in elderly subjects: the more severe the chronic pain, the more extensive (and expensive) the use of resources.

  18. Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population

    Directory of Open Access Journals (Sweden)

    Kasukawa Y

    2017-02-01

    Full Text Available Yuji Kasukawa, Naohisa Miyakoshi, Michio Hongo, Yoshinori Ishikawa, Daisuke Kudo, Masazumi Suzuki, Takashi Mizutani, Ryouta Kimura, Yuichi Ono, Yoichi Shimada Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan Abstract: Lumbar kyphosis and the decreased mobility of the lumbar spine increase the risk of falls and impair both the quality of life and the ability to perform activities of daily living. However, in the elderly Japanese population, little is known about the age-related changes and sex-related differences in muscle strength, including of the upper and lower extremities and back extensors. An adequate kyphotic or lordotic angle has also not been determined. In this study, we evaluated the age-related changes in muscle strength and spinal kyphosis in 252 males and 320 females ≥50 years of age. Grip, back extensor, hip flexor, and knee extensor strength; thoracic and lumbar kyphosis; and spinal inclination in the neutral standing position were assessed, together with the range of motion of the thoracic and lumbar spine and spinal inclination. Grip strength, back extensor strength, and the strength of the hip flexors and knee extensors decreased significantly with aging, both in males (P<0.0001 and in females (P=0.0015 to P<0.0001. The lumbar but not the thoracic kyphosis angle decreased significantly with aging, only in females (P<0.0001. Spinal inclination increased significantly with aging in both males (P=0.002 and females (P<0.0001. Back extensor strength and the thoracic kyphosis angle were significant variables influencing the lumbar kyphosis angle in both sexes. Spinal inclination correlated significantly with both the lumbar kyphosis angle and hip flexor strength in males, as well as with the lumbar kyphosis angle in females. Keywords: aging, gender, grip strength, back extensor strength, spinal curvature

  19. Dietary patterns in an elderly population and their relation with bone mineral density: the Rotterdam Study.

    Science.gov (United States)

    de Jonge, Ester A L; Rivadeneira, Fernando; Erler, Nicole S; Hofman, Albert; Uitterlinden, André G; Franco, Oscar H; Kiefte-de Jong, Jessica C

    2016-08-24

    Our aim was to identify dietary patterns that are associated with bone mineral density (BMD) against a background of relatively high dairy intake in elderly Dutch subjects. Participants were 55 years of age and older (n = 5144) who were enrolled in The Rotterdam Study, a population-based prospective cohort study. Baseline intake of 28 pre-defined food groups was determined using a validated food frequency questionnaire. Dietary patterns were identified using principal component analysis. BMD was measured using dual-energy X-ray absorptiometry at baseline and at three subsequent visits (between 1993 and 2004). Linear mixed modelling was used to longitudinally analyse associations of adherence to each pattern with repeatedly measured BMD (both in Z scores). After adjustment for confounders, two dietary patterns were associated with high BMD: a "Traditional" pattern, characterized by high intake of potatoes, meat and fat (β = 0.06; 95 % CI 0.03, 0.09) and a "Health conscious" pattern, characterized by high intake of fruits, vegetables, poultry and fish (β = 0.06; 95 % CI 0.04, 0.08). The "Processed" pattern, characterized by high intake of processed meat and alcohol, was associated with low BMD (β = -0.03; 95 % CI -0.06, -0.01). Associations of adherence to the "Health conscious" and "Processed" pattern with BMD were independent of body weight and height, whereas the association between adherence to the "Traditional" pattern with BMD was not. Against a background of high dairy intake and independent of anthropometrics, a "Health conscious" dietary pattern may have benefits for BMD, whereas a "Processed" dietary pattern may pose a risk for low BMD.

  20. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study.

    Science.gov (United States)

    Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

    2014-01-01

    Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher's exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher's exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty.

  1. Dental Implants in the Elderly Population: A Long-Term Follow-up.

    Science.gov (United States)

    Compton, Sharon M; Clark, Danielle; Chan, Stephanie; Kuc, Iris; Wubie, Berhanu A; Levin, Liran

    The objectives of this study were to evaluate implant survival and success in the elderly population and to assess indicators and risk factors for success or failure of dental implants in older adults (aged 60 years and older). This historical prospective study was developed from a cohort of patients born prior to 1950 who received dental implants in a single private dental office. Implant survival and marginal bone levels were recorded and analyzed with regard to different patient- and implant-related factors. The study examined 245 patient charts and 1,256 implants from one dental clinic. The mean age at the time of implant placement was 62.18 ± 8.6 years. Smoking was reported by 9.4% of the cohort studied. The overall survival rate of the implants was 92.9%; 7.1% of the implants had failed. Marginal bone loss depicted by exposed threads was evident in 23.3% of the implants. Presenting with generalized periodontal disease and/or severe periodontal disease negatively influenced the survival probability of the implant. Implants placed in areas where bone augmentation was performed prior to or during implant surgery did not have the same longevity compared with those that did not have augmentation prior to implantation. The overall findings concluded that implants can be successfully placed in older adults. A variety of factors are involved in the long-term success of the implant, and special consideration should be taken prior to placing implants in older adults to limit the influence of those risk factors.

  2. Obesity and impaired cognitive functioning in the elderly: a population-based cross-sectional study (NEDICES).

    Science.gov (United States)

    Benito-León, J; Mitchell, A J; Hernández-Gallego, J; Bermejo-Pareja, F

    2013-06-01

    Studies of high body mass index (BMI) and cognition in the elderly have shown conflicting results. While some studies have shown a detrimental effect of high BMI on cognitive function, others have observed beneficial effects on cognition. Our aim was to assess cognitive function in a large population-based sample of overweight (BMI 25-29.9 kg/m(2) ) and obese (BMI ≥ 30 kg/m(2) ) community-dwelling elderly participants compared with their counterparts with BMI Spain [the Neurological Diseases in Central Spain study (NEDICES)] underwent a neuropsychological assessment, including tests of global cognitive performance [measured with a 37-item version of the Mini-Mental State Examination (37-MMSE)], psychomotor speed, verbal fluency, memory and pre-morbid intelligence. There were 507 with BMI Test-A (number of errors; indeed more errors), verbal fluency, delayed free recall, immediate logical memory and pre-morbid intelligence. In this large population sample, overweight and obese participants performed poorer on formal neuropsychological tests than their counterparts with BMI < 25 kg/m(2) . These results support the hypothesis of a detrimental effect of high BMI on impaired cognition in the elderly. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  3. The prognostic value of the plasma N-terminal pro-brain natriuretic peptide level on all-cause death and major cardiovascular events in a community-based population

    Directory of Open Access Journals (Sweden)

    Zhu Q

    2016-02-01

    Full Text Available Qiwei Zhu,1 Wenkai Xiao,1,* Yongyi Bai,1,* Ping Ye,1 Leiming Luo,1 Peng Gao,1 Hongmei Wu,1 Jie Bai2 1Department of Geriatric Cardiology, 2Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Despite growing evidence that N-terminal pro-brain natriuretic peptide (NT-proBNP has an important prognostic value for patients with cardiovascular disease, chronic kidney disease, etc, the prognostic significance of NT-proBNP levels in the general population has not been established. The aim of this study was to evaluate the clinical significance of NT-proBNP in a community population.Methods: This is a community-based prospective survey of residents from two communities in Beijing conducted for a routine health status checkup. Out of 1,860 individuals who were eligible for inclusion from 2007 to 2009, 1,499 completed a follow-up and were assessed for the prognostic value of NT-proBNP in 2013. A questionnaire was used for end point events. Anthropometry and blood pressure were measured. Plasma NT-proBNP, creatinine, lipids, and glucose were determined.Results: A total of 1,499 subjects with complete data were included in the analysis. Participants were divided into four groups according to baseline NT-proBNP levels (quartile 1, <19.8 pg/mL; quartile 2, 19.8–41.6 pg/mL; quartile 3, 41.7–81.8 pg/mL; quartile 4, ≥81.9 pg/mL. During a median 4.8-year follow-up period, the all-cause mortality rate rose from 0.8% in the lowest concentration NT-proBNP group (<19.8 pg/mL to 7.8% in the highest NT-proBNP group (≥81.9 pg/mL; P<0.001. The incidence of major adverse cardiovascular events (MACEs increased from 3.1% in the lowest NT-proBNP group to 18.9% in the highest group (P<0.001. Individuals in the highest NT-proBNP group (≥81.9 pg/mL were associated with higher risk of all-cause death and MACEs compared with the lowest NT-proBNP group

  4. Cardiovascular risk assessment in elderly adults using SCORE OP model in a Latin American population: The experience from Ecuador.

    Science.gov (United States)

    Sisa, Ivan

    2018-02-09

    Cardiovascular disease (CVD) mortality is predicted to increase in Latin America countries due to their rapidly aging population. However, there is very little information about CVD risk assessment as a primary preventive measure in this high-risk population. We predicted the national risk of developing CVD in Ecuadorian elderly population using the Systematic COronary Risk Evaluation in Older Persons (SCORE OP) High and Low models by risk categories/CVD risk region in 2009. Data on national cardiovascular risk factors were obtained from the Encuesta sobre Salud, Bienestar y Envejecimiento. We computed the predicted 5-year risk of CVD risk and compared the extent of agreement and reclassification in stratifying high-risk individuals between SCORE OP High and Low models. Analyses were done by risk categories, CVD risk region, and sex. In 2009, based on SCORE OP Low model almost 42% of elderly adults living in Ecuador were at high risk of suffering CVD over a 5-year period. The extent of agreement between SCORE OP High and Low risk prediction models was moderate (Cohen's kappa test of 0.5), 34% of individuals approximately were reclassified into different risk categories and a third of the population would benefit from a pharmacologic intervention to reduce the CVD risk. Forty-two percent of elderly Ecuadorians were at high risk of suffering CVD over a 5-year period, indicating an urgent need to tailor primary preventive measures for this vulnerable and high-risk population. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Elder inmates

    Directory of Open Access Journals (Sweden)

    Kostić Miomira

    2014-01-01

    Full Text Available The criminological literature underscores that criminal offences committed by senior citizens are directly related to their age and entering a new stage of life. In elder offenders, we may observe a distinctive pattern in the development of their criminal activities, the structure of crime, gender-specific criminal offences, their previous criminal records and their social status. The former criminological studies on the elderly population have most frequently focused on examining the senior citizens' fear of crime and their victimization within the family; the studies on criminal offences committed by the elderly seem to be rather scarce. The prior research into the criminal activity of elder offenders has largely addressed the needs and difficulties encountered by elderly inmates, particularly in case they were sentenced to long-term imprisonment and subject to strict parole rules. Some researchers have also extended criticism on the lack of special correctional facilities specifically designed for elder inmates. In general, crime rate drops with aging. In developed countries, there is a constant increase of elder population as opposed to the marked decrease of younger population. Yet, the percentage of convicted offenders among the persons over the age of 55 is still significantly lesser as compared to the percentage of younger convicts. Namely, different issues pertaining to 'elder people behind bars' have eventually become the subject matter of interest of criminologists and penologists, public administration authorities and international organizations advocating the observance of human rights. The incarcerated men and women face many physical and psychological problems which are generally encountered by all people at large but usually at a later age, when they are at least 10 years older than the inmates. Violence, anxiety and distress caused by the immediate prison environment, separation from their friends and families, and the awareness

  6. Sleep and Mental Health in the General Population of Elderly Women.

    Science.gov (United States)

    Thomas, Kathryn M; Redd, Lauren A; Wright, Joshua D; Hartos, Jessica L

    2017-10-01

    Sleep and mental health complaints are prevalent in the elderly and share common risk factors. We assessed the relationship between sleep and mental health in three representative samples of elderly women while controlling for multiple risk factors common to both. We performed this cross sectional secondary data analysis in 2015 using 2013 data from the Behavioral Risk Factor Surveillance System (BRFSS) for females ages 65 years and older from California (N = 1912), Florida (N = 9120), and Pennsylvania (N = 2429). We conducted multiple logistic regression analysis to assess the relationship between sleep duration group (short, moderate/reference, or long) and mental health issues in the past 30 days (yes or no) in elderly females, while controlling for multiple covariates. About 25% of the elderly females reported mental health issues and 20% reported short or long sleep durations. In adjusted analysis, compared to the elderly females in the moderate sleep duration group (averaging 6-8 h of sleep per day), those in the short and long sleep duration groups had increased prevalence of mental health issues by 66% and 26%, respectively. Mental health was also related to physical health issues including general health status, activity limitations, and chronic health conditions. Overall, sleep was related to mental health in representative samples of elderly females even after controlling for risk factors common to both. Even though we could not determine the direction of influence, the findings indicate a need for clinicians to screen their elderly female patients for both sleep and mental health issues, especially in those with physical health comorbidities.

  7. Prescribing of psychotropic medications to the elderly population of a Canadian province: a retrospective study using administrative databases

    Directory of Open Access Journals (Sweden)

    Silvia Alessi-Severini

    2013-09-01

    Full Text Available Background. Psychotropic medications, in particular second-generation antipsychotics (SGAs and benzodiazepines, have been associated with harm in elderly populations. Health agencies around the world have issued warnings about the risks of prescribing such medications to frail individuals affected by dementia and current guidelines recommend their use only in cases where the benefits clearly outweigh the risks. This study documents the use of psychotropic medications in the entire elderly population of a Canadian province in the context of current clinical guidelines for the treatment of behavioural disturbances. Methods. Prevalent and incident utilization of antipsychotics, benzodiazepines and related medications (zopiclone and zaleplon were determined in the population of Manitobans over age 65 in the time period 1997/98 to 2008/09 fiscal years. Comparisons between patients living in the community and those living in personal care (nursing homes (PCH were conducted. Influence of sociodemographic characteristics on prescribing was assessed by generalized estimating equations. Non-optimal use was defined as the prescribing of high dose of antipsychotic medications and the use of combination therapy of a benzodiazepine (or zopiclone/zaleplon with an antipsychotic. A decrease in intensity of use over time and lower proportions of patients treated with antipsychotics at high dose or in combination with benzodiazepines (or zopiclone/zaleplon was considered a trend toward better prescribing. Multiple regression analysis determined predictors of non-optimal use in the elderly population. Results. A 20-fold greater prevalent utilization of SGAs was observed in PCH-dwelling elderly persons compared to those living in the community. In 2008/09, 27% of PCH-dwelling individuals received a prescription for an SGA. Patient characteristics, such as younger age, male gender, diagnoses of dementia (or use of an acetylcholinesterase inhibitor or psychosis in the

  8. Prescribing of psychotropic medications to the elderly population of a Canadian province: a retrospective study using administrative databases.

    Science.gov (United States)

    Alessi-Severini, Silvia; Dahl, Matthew; Schultz, Jennifer; Metge, Colleen; Raymond, Colette

    2013-01-01

    Background. Psychotropic medications, in particular second-generation antipsychotics (SGAs) and benzodiazepines, have been associated with harm in elderly populations. Health agencies around the world have issued warnings about the risks of prescribing such medications to frail individuals affected by dementia and current guidelines recommend their use only in cases where the benefits clearly outweigh the risks. This study documents the use of psychotropic medications in the entire elderly population of a Canadian province in the context of current clinical guidelines for the treatment of behavioural disturbances. Methods. Prevalent and incident utilization of antipsychotics, benzodiazepines and related medications (zopiclone and zaleplon) were determined in the population of Manitobans over age 65 in the time period 1997/98 to 2008/09 fiscal years. Comparisons between patients living in the community and those living in personal care (nursing) homes (PCH) were conducted. Influence of sociodemographic characteristics on prescribing was assessed by generalized estimating equations. Non-optimal use was defined as the prescribing of high dose of antipsychotic medications and the use of combination therapy of a benzodiazepine (or zopiclone/zaleplon) with an antipsychotic. A decrease in intensity of use over time and lower proportions of patients treated with antipsychotics at high dose or in combination with benzodiazepines (or zopiclone/zaleplon) was considered a trend toward better prescribing. Multiple regression analysis determined predictors of non-optimal use in the elderly population. Results. A 20-fold greater prevalent utilization of SGAs was observed in PCH-dwelling elderly persons compared to those living in the community. In 2008/09, 27% of PCH-dwelling individuals received a prescription for an SGA. Patient characteristics, such as younger age, male gender, diagnoses of dementia (or use of an acetylcholinesterase inhibitor) or psychosis in the year prior

  9. Individual and social determinants of self-rated health and well-being in the elderly population of Portugal

    Directory of Open Access Journals (Sweden)

    Pedro Alcântara da Silva

    2014-11-01

    Full Text Available This article aims to identify the main determinants of self-rated health and well-being in the elderly Portuguese population, using a set of dimensions including demographic and socioeconomic indicators, characteristics of interpersonal networks and social activities, health, sexual activity, representations of aging, and feeling of happiness. Taking socioeconomic, behavioral, and attitudinal predictors into account to analyze the explanatory value of the interrelated dimensions and weights for each factor, the author argues that social capital, activities associated with active aging, and greater optimism towards aging can contribute greatly to better self-rated health and wellbeing among the elderly, partially offsetting the effect of socioeconomic factors and illness associated with age.

  10. Organization of healthcare and assistance to the elderly indigenous population: synergies and particularities of the professional context

    Directory of Open Access Journals (Sweden)

    Leidyani Karina Rissardo

    2014-02-01

    Full Text Available This study aimed to describe the effects of the organization of primary healthcare on the assistance provided to the elderly Kaingang population, according to the perception of health professionals that work in this area. It is a qualitative and descriptive study, supported by ethnography methodological references, and was conducted with ten healthcare professionals that work in Faxinal, an indigenous territory in the state of Paraná, in Brazil. Data was collected from November 2010 to February 2012 through participant observation and interviews. The results revealed that health professionals strive to meet the health needs of the elderly Kaingang people; however, there are negative effects that hinder the professional care, especially limited human resources, lack of training and material resources, heavy workload and high turnover rates. This study highlights the need to improve work conditions in order to provide better healthcare.

  11. Chronic Sinusitis and Risk of Head and Neck Cancer in the US Elderly Population.

    Science.gov (United States)

    Beachler, Daniel C; Engels, Eric A

    2017-01-01

    Chronic sinusitis may be involved in the etiology of certain head and neck cancers (HNCs), due to immunodeficiency or inflammation. However, the risk of specific HNCs among people with chronic sinusitis is largely unknown. To evaluate the associations of chronic sinusitis with subsequent HNC, including nasopharyngeal cancer (NPC), human papillomavirus-related oropharyngeal cancer (HPV-OPC), and nasal cavity and paranasal sinus cancer (NCPSC), in an elderly US population. We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to conduct a case-cohort study of US individuals aged 65 years or older during 2004 through 2011. The study included 483 546 Medicare beneficiaries from SEER areas in a 5% random subcohort, and 826 436 from the entire source population who developed cancer (including 21 716 with HNC). Incidence of HNCs including NPC, HPV-OPC, and NCPSC. Most individuals were female (57.7%), and the mean (SD) age at entry was 72.6 (8.0) years. Chronic sinusitis was associated with risk of developing HNC (adjusted hazard ratio [aHR], 1.37; 95% CI, 1.27-1.48), particularly NPC (aHR, 3.71; 95% CI, 2.75-5.02), HPV-OPC (aHR, 1.33; 95% CI, 1.13-1.57), and NCPSC (aHR, 5.49; 95% CI, 4.56-6.62). Most of this increased risk was limited to risk within 1 year of the chronic sinusitis diagnosis, as associations were largely attenuated 1 year or more after chronic sinusitis (NPC: aHR, 1.60; 95% CI, 0.96-2.65; HPV-OPC: aHR, 1.07; 95% CI, 0.86-1.32; NCPSC: aHR, 2.47; 95% CI, 1.84-3.31). All 3 HNC subtypes had cumulative incidence of less than 0.07% 8 years after chronic sinusitis diagnosis. Chronic sinusitis is associated with certain HNCs, particularly NPC and NCPSC. These HNCs are rare, and most of the increased HNC risk is limited to within 1 year of chronic sinusitis diagnosis, consistent with surveillance or detection bias. The associations were weaker over longer intervals, suggesting at most a modest role for sinusitis-related inflammation

  12. Potential contribution of the neurodegenerative disorders risk loci to cognitive performance in an elderly male gout population.

    Science.gov (United States)

    Han, Lin; Jia, Zhaotong; Cao, Chunwei; Liu, Zhen; Liu, Fuqiang; Wang, Lin; Ren, Wei; Sun, Mingxia; Wang, Baoping; Li, Changgui; Chen, Li

    2017-09-01

    Cognitive impairment has been described in elderly subjects with high normal concentrations of serum uric acid. However, it remains unclear if gout confers an increased poorer cognition than those in individuals with asymptomatic hyperuricemia. The present study aimed at evaluating cognitive function in patients suffering from gout in an elderly male population, and further investigating the genetic contributions to the risk of cognitive function.This study examined the cognitive function as assessed by Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in 205 male gout patients and 204 controls. The genetic basis of these cognitive measures was evaluated by genome-wide association study (GWAS) data in 102 male gout patients. Furthermore, 7 loci associated with cognition in GWAS were studied for correlation with gout in 1179 male gout patients and 1848 healthy male controls.Compared with controls, gout patients had significantly lower MoCA scores [22.78 ± 3.01 vs 23.42 ± 2.95, P = .023, adjusted by age, body mass index (BMI), education, and emotional disorder]. GWAS revealed 7 single-nucleotide polymorphisms (SNPs) associations with MoCA test at a level of conventional genome-wide significance (P gout in further analysis (all P > .05).Elderly male subjects with gout exhibit accelerated decline in cognition performance. Several neurodegenerative disorders risk loci were identified for genetic contributors to cognitive performance in our Chinese elderly male gout population. Larger prospective studies of the cognitive performance and genetic analysis in gout subjects are recommended.

  13. Comprehensive geriatric functional analysis of elderly populations in four categories of the long-term care insurance system in a rural, depopulated and aging town in Japan.

    Science.gov (United States)

    Chen, Wenling; Fukutomi, Eriko; Wada, Taizo; Ishimoto, Yasuko; Kimura, Yumi; Kasahara, Yoriko; Sakamoto, Ryota; Okumiya, Kiyohito; Matsubayashi, Kozo

    2013-01-01

    The aim of this study was to show which dimensions of functions differ among community-dwelling elderly participants in four different certification levels of the current long-term care insurance system (LTCI) in a rural, depopulated and aging town in Japan, with special consideration for strengths and weaknesses of the LTCI. The study population consisted of 1077 community-dwelling elderly participants aged 65 years and older, with LTCI certification comprising 542 uncertified elderly (Ippan-Koureisya), 437 specified elderly (Tokutei-Koreisha), 57 support-level elderly (Youshien-Koureisha) and 41 care-level elderly (Youkaigo-Ninteisha). Each participant was rated regarding their health status, with question topics including basic activities of daily living (ADL), the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), the 15-item Geriatric Depression Scale (GDS-15), 21-item Fall Risk Index (FRI-21), the quantitative subjective quality of life (QOL), current medical situation, past medical histories and social backgrounds. The scores in basic ADL, each item of the TMIG-IC and five items of the quantitative subjective QOL were significantly lower, and the scores in GDS-15 and in FRI-21 were significantly higher according to certification level, in order of uncertified, specified, support-level and care-level elderly in a dose-response manner. Exercise and drinking habits were significantly less common in support- or care-level elderly than in specified or uncertified elderly. The prevalence of taking antihypertensive, antihyperlipidemia, antidepressant or sleeping medications was significantly higher in the support- or care-level elderly than in uncertified or specified elderly people. Support- or care-level elderly also had a significantly higher prevalence of past medical histories of stroke, bone fractures, osteoarthropathy, heart disease and cancer than uncertified or specified elderly people. Actual standardized quantitative and

  14. Community-Based Indigenous Digital Storytelling with Elders and Youth

    Science.gov (United States)

    Iseke, Judy; Moore, Sylvia

    2011-01-01

    Indigenous digital storytelling and research are as much about the process of community relationships as they are about the development of digital products and research outcomes. Indigenous researchers, digital storytelling producers, and academics work in different communities with research collaborators who are indigenous community members,…

  15. Comorbid Visual and Psychiatric Disabilities Among the Chinese Elderly: A National Population-Based Survey.

    Science.gov (United States)

    Guo, Chao; Wang, Zhenjie; Li, Ning; Chen, Gong; Zheng, Xiaoying

    2017-12-01

    To estimate the prevalence of, and association between, co-morbid visual and psychiatric disabilities among elderly (>65 years-of-age) persons in China. Random representative samples were obtained using multistage, stratified, cluster sampling, with probabilities proportional to size. Standard weighting procedures were used to construct sample weights that reflected this multistage, stratified cluster sampling survey scheme. Logistic regression models were used to elucidate associations between visual and psychiatric disabilities. Among the Chinese elderly, >160,000 persons have co-morbid visual and psychiatric disabilities. The weighted prevalence among this cohort is 123.7 per 100,000 persons. A higher prevalence of co-morbid visual and psychiatric disabilities was found in the oldest-old (pvisual disability was significantly associated with a higher risk of having a psychiatric disability among persons aged ≥80 years-of-age [adjusted odds ratio, 1.24; 95% confidence interval (CI), 1.03-1.54]. A significant number of Chinese elderly persons were living with co-morbid visual and psychiatric disabilities. To address the challenge of these co-morbid disorders among Chinese elders, it is incumbent upon the government to implement additional and more comprehensive prevention and rehabilitation strategies for health-care systems, reinforce health promotion among the elderly, and improve accessibility to health-care services.

  16. Some predictors of cardiovascular mortality among the elderly population of Botucatu (SP

    Directory of Open Access Journals (Sweden)

    Ruiz Tania

    2001-01-01

    Full Text Available OBJECTIVE: To detect factors associated with cardiovascular mortality in the elderly of Botucatu. METHODS: We evaluated 29 variables of interest in a cohort of patients aged ³60 using data from a survey conducted between 1983/84. The elderly cohort was analyzed in 1992 to detect the occurrence of cardiovascular deaths. Survival analysis was performed using the Kaplan-Meier method, the log-rank test, and Cox regression analysis. Three models were adapted for each group of variables, and a final model was chosen from those variables selected from each group. RESULTS: We identified predictor for cardiovascular death according to age for elderly males not supporting the family, not possessing a vehicle, and previous cardiovascular disease. In elderly females, the predictor variables were previous cardiovascular disease and diabetes mellitus. CONCLUSION: Socioeconomic indicators (family heading and vehicle ownerrship may be added to well stabilished medical factors (diabete mellitus and hypertension to select target groups for programs intended to reduce deaths due to cardiovascular diseases in elderly people.

  17. Education for Community-based Family Medicine: A Social Need in the Real World.

    Science.gov (United States)

    Taniguchi, Shin-Ichi; Park, Daeho; Inoue, Kazuoki; Hamada, Toshihiro

    2017-06-01

    One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues. On the other hand, the appropriate supply of medical and welfare resources is also a fundamental problem. The disparity of physician distribution leads to a marked lack of medical services especially in remote and rural areas of Japan. The government has been attempting to recruit physicians into rural areas through a regional quota system. Based on this background, the medical field pays a great amount of attention to community-based family medicine (CBFM). CBFM requires basic knowledge of community health and family medicine. The main people involved in CBFM are expected to be a new type of general practitioner that cares for residents in targeted communities. To improve the performance of CBFM doctors, we need to establish a better CBFM education system and assess it appropriately when needed. Here, we review the background of CBFM development and propose an effective education system.

  18. Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China.

    Science.gov (United States)

    Zhao, Yanrong; Lin, Junfen; Qiu, Yinwei; Yang, Qing; Wang, Xinyi; Shang, Xiaopeng; Xu, Xiaoping

    2017-03-29

    This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP) based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional study was conducted in 16 community health service (CHS) institutions in Zhejiang Province, China. The urban elderly over 60 years of age were enrolled when visiting the sampled CHS. Baseline characteristics were compared between participants using Chi-Square tests for categorical variables. Univariate and multivariable logistic regression analyses were used to identify determinants of the GP contract service demand and signing decisions, respectively. Among the 1440 urban elderly, 56.67% had signed contracts with their GP, and 55.35% had a demand of the GP contract service. The influencing factors of demand were a history of diabetes or cardiovascular disease (OR = 1.33, 95% CI, 1.05-1.68); urban resident basic medical insurance (URBMI) vs. urban employee basic medical insurance (UEBMI) (OR = 1.96, 95% CI, 1.46-2.61); and middle-income vs. low-income (OR = 0.67, 95% CI, 0.50-0.90 for RMB 1001-3000; OR = 0.59, 95% CI, 0.39-0.90 for RMB 3001-5000). Having a demand for the GP contract service was the strongest determinant of signing decisions (OR = 13.20, 95% CI, 10.09-17.27). Other factors also contributed to these decisions, including gender, caregiver, and income. The urban elderly who had signed contracts with GPs were mainly based on their health care needs. Elderly people with a history of diabetes or cardiovascular disease, as well as those with URBMI, were found to have stronger needs of a GP contract service. It is believed that the high-income elderly should be given equal priority to those of low-income.

  19. Exploring the scope of community-based rehabilitation in ensuring ...

    African Journals Online (AJOL)

    Background: Globally, it has been estimated that almost 15% of world's population live with some form of disability, of which the majority are from developing nations. Objectives: To explore the role of community-based rehabilitation (CBR) in the health sector, identify the prevalent challenges, and to suggest measures to ...

  20. How to move towards community based service delivery?

    NARCIS (Netherlands)

    Meuwissen, L.; Voorham, T.; Bakker, D. de

    2007-01-01

    Aim: Community based primary health care offers in potential the opportunity to tailor health service delivery to the needs and demands of the local population. Up to now, there is no clear cut method to do this. In a pilot benchmark for general practices, data were collected on demand and

  1. A community based study on knowledge, attitude and practice (KAP ...

    African Journals Online (AJOL)

    Background: HIV/AIDS is the major public health problem in our country. Studies need to be conducted to assess the behavioral risk factors of its transmission and prevention. Objectives: To assess knowledge, attitude and practice of HIV/AIDS in the study population. Methods: Community based cross-sectional study was ...

  2. Spectacle coverage and spectacles use among elderly population in residential care in the south Indian state of Andhra Pradesh.

    Science.gov (United States)

    Marmamula, Srinivas; Ravuri, L V Chandra Sekhar; Boon, Mei Ying; Khanna, Rohit C

    2013-01-01

    There is limited research conducted on uncorrected refractive errors, presbyopia, and spectacles use among the elderly population in residential care in developing countries such as India. We conducted a cross-sectional study among elderly in residential care to assess the spectacle coverage and spectacles usage in the south Indian state of Andhra Pradesh. All 524 residents in the 26 "homes for aged" institutions in the district were enumerated. Eye examination was performed that included visual acuity (VA) assessment for distant and near vision. A questionnaire was used to collect information on spectacles use. 494/524 individuals were examined, 78% were women, and 72% had no education. The mean age of participants was 70 years. The spectacle coverage for refractive errors was 35.1% and 23.9% for presbyopia. The prevalence of current use and past use of spectacles was 38.5% (95% CI: 34.2-42.8; n = 190) and 17.2% (95% CI: 13.9-42.8), respectively. There is low spectacle coverage for both refractive errors and presbyopia among elderly individuals in residential care in the south Indian state of Andhra Pradesh. Appropriate service delivery systems should be developed to reach out this vulnerable group of seniors on a priority basis.

  3. Association of serum lipid components and obesity with genetic ancestry in an admixed population of elderly women.

    Science.gov (United States)

    Lins, Tulio C; Pires, Alause S; Paula, Roberta S; Moraes, Clayton F; Vieira, Rodrigo G; Vianna, Lucy G; Nobrega, Otávio T; Pereira, Rinaldo W

    2012-07-01

    The prevalence of metabolic disorders varies among ethnic populations and these disorders represent a critical health care issue for elderly women. This study investigated the correlation between genetic ancestry and body composition, metabolic traits and clinical status in a sample of elderly women. Clinical, nutritional and anthropometric data were collected from 176 volunteers. Genetic ancestry was estimated using 23 ancestry-informative markers. Pearsons correlation test was used to examine the relationship between continuous variables and an independent samples t-test was used to compare the means of continuous traits within categorical variables. Overall ancestry was a combination of European (57.49%), Native American (25.78%) and African (16.73%). Significant correlations were found for European ancestry with body mass index (r = 0.165; p = 0.037) and obesity (mean difference (MD) = 5.3%; p = 0.042). African ancestry showed a significant correlation with LDL (r = 0.159, p = 0.035), VLDL (r = -0.185; p = 0.014), hypertriglyceridemia (MD = 6.4%; p = 0.003) and hyperlipidemia (MD = 4.8%; p = 0.026). Amerindian ancestry showed a significant correlation with triglyceride levels (r = 0.150; p = 0.047) and hypertriglyceridemia (MD = 4.5%; p = 0.039). These findings suggest that genetic admixture may influence the etiology of lipid metabolism-related diseases and obesity in elderly women.

  4. Association of serum lipid components and obesity with genetic ancestry in an admixed population of elderly women

    Directory of Open Access Journals (Sweden)

    Tulio C. Lins

    2012-01-01

    Full Text Available The prevalence of metabolic disorders varies among ethnic populations and these disorders represent a critical health care issue for elderly women. This study investigated the correlation between genetic ancestry and body composition, metabolic traits and clinical status in a sample of elderly women. Clinical, nutritional and anthropometric data were collected from 176 volunteers. Genetic ancestry was estimated using 23 ancestry-informative markers. Pearsons correlation test was used to examine the relationship between continuous variables and an independent samples t-test was used to compare the means of continuous traits within categorical variables. Overall ancestry was a combination of European (57.49%, Native American (25.78% and African (16.73%. Significant correlations were found for European ancestry with body mass index (r = 0.165; p = 0.037 and obesity (mean difference (MD = 5.3%; p = 0.042. African ancestry showed a significant correlation with LDL (r = 0.159, p = 0.035, VLDL (r = -0.185; p = 0.014, hypertriglyceridemia (MD = 6.4%; p = 0.003 and hyperlipidemia (MD = 4.8%; p = 0.026. Amerindian ancestry showed a significant correlation with triglyceride levels (r = 0.150; p = 0.047 and hypertriglyceridemia (MD = 4.5%; p = 0.039. These findings suggest that genetic admixture may influence the etiology of lipid metabolism-related diseases and obesity in elderly women.

  5. Social networks and health status in the elderly: the 'ANZIANI IN-RETE' population-based study.

    Science.gov (United States)

    Bianchetti, Luca; Squazzoni, Flaminio; Casnici, Niccolò; Bianchini, Devis; Garrafa, Emirena; Archetti, Claudia; Romano, Valentina; Rozzini, Luca; Melchiori, Michele; Fiorentini, Chiara; Uberti, Daniela; Calza, Stefano; Marengoni, Alessandra

    2017-12-01

    Certain features of the social environment could maintain and even improve not only psychological well-being, but also health and cognition of the elderly. We tested the association between social network characteristics and the number of chronic diseases in the elderly. A randomized sample of the elderly population of Brescia, Italy, was evaluated (N = 200, age ≥65 years). We performed a comprehensive geriatric assessment, including information on socio-demographic variables (family, friendships, and acquaintance contacts). We measured each person's social network, i.e., degree, efficiency, and variety. The sample included 118 women and 82 men, mean age 77.7 years. The mean number of chronic diseases was 3.5. A higher social network degree, i.e., more social connections, was associated with fewer diseases. We also found that having more contacts with people similar to each other or intense relationships with people who do not know each other were associated with fewer diseases. More healthy people tend to share certain characteristics of social networks. Our study indicates that it is important to look at diseases and health as complex phenomena, which requires integrating different levels of analysis.

  6. Spectacle Coverage and Spectacles Use among Elderly Population in Residential Care in the South Indian State of Andhra Pradesh

    Directory of Open Access Journals (Sweden)

    Srinivas Marmamula

    2013-01-01

    Full Text Available Background. There is limited research conducted on uncorrected refractive errors, presbyopia, and spectacles use among the elderly population in residential care in developing countries such as India. We conducted a cross-sectional study among elderly in residential care to assess the spectacle coverage and spectacles usage in the south Indian state of Andhra Pradesh. Methods. All 524 residents in the 26 “homes for aged” institutions in the district were enumerated. Eye examination was performed that included visual acuity (VA assessment for distant and near vision. A questionnaire was used to collect information on spectacles use. Results. 494/524 individuals were examined, 78% were women, and 72% had no education. The mean age of participants was 70 years. The spectacle coverage for refractive errors was 35.1% and 23.9% for presbyopia. The prevalence of current use and past use of spectacles was 38.5% (95% CI: 34.2–42.8; n=190 and 17.2% (95% CI: 13.9–42.8, respectively. Conclusions. There is low spectacle coverage for both refractive errors and presbyopia among elderly individuals in residential care in the south Indian state of Andhra Pradesh. Appropriate service delivery systems should be developed to reach out this vulnerable group of seniors on a priority basis.

  7. YOU ARE RESPONSIBLE FOR YOUR HEALTH! – COMPARING INFORMATION GIVEN TO THE ELDER POPULATION ABOUT LIFE QUALITY AND RELATED RESEARCHES.

    Directory of Open Access Journals (Sweden)

    Nadia Gislene Gomes Carneiro

    2011-01-01

    Full Text Available According to WHO (1994, the quality of life is defined as the individual's perception of the position in life, in the context of culture and of the value systems in which they live, and that in relation to goals, expectations, standards and concerns. Objective: this study is based on a qualitative research, in order to analyze and support the basic information transmitted by a folder provided to this population and the records shown by the scientific literature on aging and quality of life in Brazil. Method: the database Scielo (Scientific Electronic Library Online was used. Only articles relating to education and health promotion for the elderly were selected, and there were 10 articles.There was no need to be approved by an ethics committee. Results: among the issues the folder, thoseRevista Eletrônica Gestão & SaúdeRevista Eletrônica Gestão & Saúde • Vol.02, Nº. 01, Ano 2011 • p. 249-264are reasons in the literature include physical exercise, participate in groups of living, nutrition care, accident prevention and health service demand for vaccination. On the other hand, no articles were found that deal with sexuality among the elderly and practices that keep the brain up to date. Discussion: it appears that the folder used for the development of this work brings a wealth of information relevant with regard to health promotion and education of the elderly.

  8. Cognitive Change in Elderly Populations: "Normal" Aging, Senile Dementia and Depression.

    Science.gov (United States)

    Bach, Paul J.

    Cognitive change in the elderly can be due to several etiological factors which are empirically difficult to separate and clinically problematic to differentiate. Normal aging is accompanied by behavioral slowing. The slowing down of psycho-motor processes results in a lowered intelligence quotient, but cannot be taken as unequivocal evidence for…

  9. Nutritional and oral health status of an elderly population in Nairobi ...

    African Journals Online (AJOL)

    The study established that many of the elderly persons suffered from dental problems, especially periodontitis with 89.9% having dental plaque, calculus 85.6%, gingival recession 82.5% and bleeding gums 77.4%. The decayed index missing and filled teeth, was 7.173 with 19.7% caries free, 51.9% reported tooth mobility ...

  10. White matter hyperintensities and prepulse inhibition in a mixed elderly population

    DEFF Research Database (Denmark)

    Salem, Lise C; Hejl, Anne-Mette; Garde, Ellen

    2011-01-01

    Prepulse inhibition (PPI) of the startle response, a measure for sensorimotor gating, exhibits a relatively high inter-individual variability in elderly subjects. The aim of this study was to investigate whether white matter hyperintensities (WMH), frequently identified on cranial magnetic...

  11. Dependence of the Geriatric Depression on Nutritional Status and Anthropometric Indices in Elderly Population

    Science.gov (United States)

    Ahmadi, Seyed Mehdi; Mohammadi, Mohammad Reza; Mostafavi, Seyed-Ali; Keshavarzi, Sareh; Kooshesh, Seyed-Mohammad-Ali; Sarikhani, Yaser; Peimani, Payam; Heydari, Seyed Taghi; Lankarani, Kamran Bagheri

    2013-01-01

    Objective Malnutrition and depression are highly prevalent in the elderly and can lead to unfavorable outcomes. The aims of the current study were to determine the association between malnutrition and depression and also to find any correlation of depression with some anthropometric indices in free living elderly. Method In this cross-sectional study, 337 elderly subjects (193 females) were selected using cluster sampling. Depressive symptoms and nutritional status were determined by the Geriatric Depression Scale (GDS) and the Mini-Nutritional Assessment (MNA) scores questionnaires, respectively. Anthropometric indices were measured all in standard situations. Chi squared test and t-test were used when necessary. Pearson correlation coefficients were calculated for linear relations between variables. Results Of all the total subjects, 43.62% were depressed; and of whom, 48.01% were malnourished or at risk of malnutrition. GDS had a significant negative dependence with the MNA for the entire sample (r=-0.58, p elderly subjects living in urban areas were more depressed than those living in rural areas (39.46% vs. 3.85% respectively). Conclusion The results of the present study revealed a high prevalence of depression and malnutrition among old subjects. Moreover, depression was associated with worsening of nutritional status. The mechanism of this association needs further study. PMID:24130608

  12. Nutritional and oral health status of an elderly population in Nairobi ...

    African Journals Online (AJOL)

    Objective: To determine the nutrition and oral health status of elderly persons in Nairobi, Kenya. Design: A cross-sectional study. Setting: Households in Dagoretti Division of Nairobi. Subjects: Two hundred and eighty nine persons (29.8% males and 70.2% females) aged 45 years and above were assessed. Results: The ...

  13. Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey.

    Science.gov (United States)

    Asp, M; Simonsson, B; Larm, P; Molarius, A

    2017-06-01

    To examine how physical activity and physical mobility are related to obesity in the elderly. A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Obesity (body mass index ≥30 kg/m2) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Obesity and the burden of health risks among the elderly in Ghana: A population study.

    Science.gov (United States)

    Boateng, Godfred O; Adams, Ellis A; Odei Boateng, Mavis; Luginaah, Isaac N; Taabazuing, Mary-Margaret

    2017-01-01

    The causes and health risks associated with obesity in young people have been extensively documented, but elderly obesity is less well understood, especially in sub-Saharan Africa. This study examines the relationship between obesity and the risk of chronic diseases, cognitive impairment, and functional disability among the elderly in Ghana. It highlights the social and cultural dimensions of elderly obesity and discusses the implications of related health risks using a socio-ecological model. We used data from wave 1 of the Ghana Study on Global Ageing and Adult Health (SAGE) survey-2007/8, with a restricted sample of 2,091 for those 65 years and older. Using random effects multinomial, ordered, and binary logit models, we examined the relationship between obesity and the risk of stage 1 and stage 2 hypertension, arthritis, difficulties with recall and learning new tasks, and deficiencies with activities of daily living and instrumental activities of daily living. Elderly Ghanaians who were overweight and obese had a higher risk of stage 1 and stage 2 hypertension, and were more likely to be diagnosed with arthritis and report severe deficiencies with instrumental activities of daily living. Those who were underweight were 1.71 times more likely to report severe difficulties with activities of daily living. A sub analysis using waist circumference as a measure of body fat showed elderly females with abdominal adiposity were relatively more likely to have stage 2 hypertension. These findings call for urgent policy initiatives geared towards reducing obesity among working adults given the potentially detrimental consequences in late adulthood. Future research should explore the gendered pathways leading to health disadvantages among Ghanaian women in late adulthood.

  15. Obesity and the burden of health risks among the elderly in Ghana: A population study.

    Directory of Open Access Journals (Sweden)

    Godfred O Boateng

    Full Text Available The causes and health risks associated with obesity in young people have been extensively documented, but elderly obesity is less well understood, especially in sub-Saharan Africa. This study examines the relationship between obesity and the risk of chronic diseases, cognitive impairment, and functional disability among the elderly in Ghana. It highlights the social and cultural dimensions of elderly obesity and discusses the implications of related health risks using a socio-ecological model.We used data from wave 1 of the Ghana Study on Global Ageing and Adult Health (SAGE survey-2007/8, with a restricted sample of 2,091 for those 65 years and older. Using random effects multinomial, ordered, and binary logit models, we examined the relationship between obesity and the risk of stage 1 and stage 2 hypertension, arthritis, difficulties with recall and learning new tasks, and deficiencies with activities of daily living and instrumental activities of daily living.Elderly Ghanaians who were overweight and obese had a higher risk of stage 1 and stage 2 hypertension, and were more likely to be diagnosed with arthritis and report severe deficiencies with instrumental activities of daily living. Those who were underweight were 1.71 times more likely to report severe difficulties with activities of daily living. A sub analysis using waist circumference as a measure of body fat showed elderly females with abdominal adiposity were relatively more likely to have stage 2 hypertension.These findings call for urgent policy initiatives geared towards reducing obesity among working adults given the potentially detrimental consequences in late adulthood. Future research should explore the gendered pathways leading to health disadvantages among Ghanaian women in late adulthood.

  16. Informant reports of changes in personality predict dementia in a population-based study of elderly african americans and yoruba.

    Science.gov (United States)

    Smith-Gamble, Valerie; Baiyewu, Olusegun; Perkins, Anthony J; Gureje, Oye; Hall, Kathleen S; Ogunniyi, Adesola; Hui, Siu L; Hendrie, Hugh C

    2002-01-01

    The authors conducted a longitudinal, population-based survey of African Americans in Indianapolis, Indiana, and Yoruba in Ibadan, Nigeria, using the Community Screening Interview for Dementia to assess the predictive value of informant reports of changes in personality on incident dementia and Alzheimer disease. In all, 3,021 subjects had informants' reports of changes in personality and dementia status (2,084 subjects residing in Ibadan and 937 subjects residing in Indianapolis). After adjusting for demographic, cognitive, and functional characteristics in two markedly different populations, socioeconomically and culturally, subjects with changes in personality had approximately twice the odds of having dementia as subjects with no change in personality. The finding that in two markedly different populations, personality change is a significant predictor of future dementia, independent of cognition and functional status, should make clinicians particularly sensitive to these reports when they occur in their elderly patients.

  17. Smoking patterns and predictors of smoking cessation in elderly populations in Lebanon

    Science.gov (United States)

    Chaaya, M.; Mehio-Sibai, A.; El-Chemaly, S.

    2006-01-01

    SUMMARY OBJECTIVE To investigate smoking patterns in an elderly, low-income population and to identify predictors of smoking cessation, in addition to analyzing the importance of smoking in relation to other risk factors for hospitalization. DESIGN The data were part of an urban health study conducted among 740 individuals aged ≥60 years in three suburban communities of low socio-economic status in Beirut, one of them a refugee camp. A detailed interview schedule was administered that included comprehensive social and health information. RESULTS The overall prevalence of current smokers was 28.1%. Almost half of the group were ever smokers, of whom 44% had quit smoking when they experienced negative health effects. Having at least one chronic illness and having a functional disability significantly increased the odds of smoking cessation. In addition, being a former smoker increased the likelihood of hospital admission. CONCLUSIONS This study is of particular importance, as it has implications for similar low-income and refugee communities in the region and elsewhere. There is a need for more concerted efforts by public health officials to target elderly individuals as a group for smoking cessation interventions, particularly now that mortality and health benefits have been well documented. RÉSUMÉ OBJECTIF Investiguer les types de tabagisme dans une population âgée à faibles revenus et identifier les facteurs prédictifs de l’arrêt du tabagisme, tout en analysant l’importance du tabagisme par rapport aux autres facteurs de risque d’hospitalisation. SCHÉMA Les données constituent une fraction de l’étude de santé urbaine menée chez 740 personnes âgées de ≥60 ans à Beyrouth dans trois collectivités suburbaines à faible statut socio-économique dont une des trois se situe dans un camp de réfugiés. Un schéma détaillé d’interview a été utilisé comportant des informations complètes sur le plan social et celui de la santé. R

  18. The impact of education on time use of elderly population in Serbia

    Directory of Open Access Journals (Sweden)

    Šobot Ankica

    2015-01-01

    Full Text Available The active ageing concept, which implies individual and broader social benefits, is defined for mitigating the negative effects of intensive population ageing. It redefines the perception of ageing in accordance with the positive trends in terms of health and life span of older persons' life. One of the factors which has certain impact on some aspects of active ageing is education. The researches confirm its influence on the health and vitality of the elderly, as well as on their economic activity. It is important not only as a dimension of socio-economic status, but also from the perspective of certain behavior, the availability of learning, the possibility of adopting valid information and the use of new technological achievements for the purpose of healthy lifestyle. The top ten countries in 2015 regarding Active Ageing Index have up to four times higher shares of highly educated persons among those aged 50 or over (between 23% and 34%, compared to the countries which are at the back of the AAI list. However, Italy is ranked second, regarding the participation in society despite the fact that less than 10% of persons aged 50 or over are highly educated. By contrast, Estonia has only high index in employment, while in relation to the other spheres is very low ranking, regardless there are 34% of highly educated among persons aged 50 or over. The first example shows that it is possible to achieve partial progress despite low prevalence of high education. Another indicates that the attainment in active ageing can be limited by other factors despite high proportion of highly educated. It is possible to conclude that in either of these two cases high education did not impact, but that these characteristics of active ageing are the consequences of other factors. Participation in society, in addition to volunteering and political engagement, implies caring for children or the elderly. It is possible that the incidence of these activities have more

  19. Traumatic experiences and post-traumatic stress disorder among elderly Germans: results of a representative population-based survey.

    Science.gov (United States)

    Glaesmer, Heide; Gunzelmann, Thomas; Braehler, Elmar; Forstmeier, Simon; Maercker, Andreas

    2010-06-01

    Only a few population-based studies on the epidemiology of post-traumatic stress disorders (PTSDs) are available to date. Most of the existing studies are from the U.S.A. Against the background of World War II, the extent and long-term effects of war-related traumatic experiences in the German elderly population are of special interest. Nevertheless, population-based data on this topic are lacking to date. This study examines the occurrence of traumatic experiences and the prevalence rates of PTSD according to DSM-IV and of partial PTSD in a randomly selected sample of the German general population aged 60 years and over (N = 814) using self-rating instruments. PTSD is apparent in 3.4%; when partial post-traumatic stress syndromes are included, a total of 7.2% of the aged population are involved. The most common individual symptoms resulting from war-induced trauma are avoidance of thoughts and feelings, sleep disturbances, distressing dreams and intrusive thoughts. The most frequently mentioned traumatic experiences of the generation examined in this study were war-related trauma experienced as children or in early adulthood during World War II. As a person's age increases, so does the prevalence of war-related traumatic experiences. There are some gender differences in traumatic experiences, but not in post-traumatic symptoms. The results emphasize the importance of war-related traumatic experiences from World War II in the German elderly population and their impact on the prevalence of PTSD more than 60 years later.

  20. Consistency in Physical Activity and Increase in Mental Health in Elderly over a Decade: Are We Achieving Better Population Health?

    Directory of Open Access Journals (Sweden)

    Tyler C. Smith

    2016-03-01

    Full Text Available Objective: Over the past century, advances in medicine and public health have resulted in an extraordinary increase in life expectancy. As a result, focus has shifted from infectious to chronic diseases. Though current guidelines for healthy behaviors among the elderly exist, it remains unclear whether this growing segment of the population has shifted their behaviors in response to public health campaigns. The objective of this study was to investigate mental health and physical activity trends that may be leading indicators for healthier living and increased life expectancy. Methods: Using nearly a decade of continuous serial cross-sectional data collected in the nationwide Behavioral Risk Factor Surveillance System, this study investigated trends of health behaviors and mental health in a population of nearly 750,000 who were 65 or older from 2003 through 2011. Weighted univariate and multivariable analyses were utilized including investigation of trend analyses over the decade, producing adjusted annual odds of physical activity and mental health. Results: After controlling for demographic and other factors, higher education and income, lower BMI, and current or previous smoking was associated with higher odds of adverse mental health and lower odds of physical activity engagement. Adjusted odds of adverse mental health climbed over the decade of observation whereas the odds of physical activity remained static. Conclusions: These data, encompassing a very large population over a decade of time, suggest that physical activity is stable though mental health challenges are on the rise in this older population. Public health campaigns may face greater barriers in an elderly population due to lifelong habits, dissemination and educational approaches, or decreasing gains. Further research should be conducted to identify more effective approaches towards increasing physical activity in this important and growing subset of the population and

  1. Economic impact of using fesoterodine for the treatment of overactive bladder with urge urinary incontinence in a vulnerable elderly population in the United States.

    Science.gov (United States)

    Qin, Lei; Luo, Xuemei; Zou, Kelly H; Snedecor, Sonya J

    2016-01-01

    To assess the costs of treating overactive bladder (OAB) with fesoterodine compared to no OAB pharmacotherapy among vulnerable elderly from the US payer perspective. A decision analytic cost model was developed to estimate the 52-week costs of a cohort of vulnerable elderly with OAB initiating treatment with fesoterodine or no OAB pharmacotherapy. Vulnerable elderly OAB patients were defined as those aged ≥65 years with self-reported urge urinary incontinence (UUI) symptoms for ≥3 months, 2-15 UUI episodes/day, and at risk of deteriorating health by a score of ≥3 on the Vulnerable Elders Survey (VES)-13. Patients were evaluated for fesoterodine treatment response (defined as no UUI episodes) and persistence at weeks 12, 26, and 52. The model included a hypothetical health plan with 100,000 elderly members. A total of 7096 vulnerable elderly subjects were identified as the model target population based on the percentage of vulnerable elderly and annual prevalence of OAB among vulnerable elderly. OAB-related costs included fesoterodine drug acquisition costs, healthcare resource use (inpatient hospitalization, outpatient visits, and physician office visits), and OAB-related co-morbidities (falls/fractures, urinary tract infections, depression, and nursing home admissions). All costs were inflated to 2013 US$ using the medical care component of the consumer price index (CPI). When 7096 vulnerable elderly OAB patients were treated with fesoterodine, US healthcare payers could save $11,463,981 per year, or $1616 per patient vs no OAB pharmacotherapy. Univariate one-way sensitivity analyses supported the robustness of the findings and showed results were most sensitive to changes in fesoterodine efficacy followed by annual costs of inpatient hospitalization. From a US payer perspective, treating vulnerable elderly OAB patients with fesoterodine was cost-saving compared to no OAB pharmacotherapy.

  2. Movement disorders in elderly users of risperidone and first generation antipsychotic agents: a Canadian population-based study.

    Directory of Open Access Journals (Sweden)

    Irina Vasilyeva

    Full Text Available Despite concerns over the potential for severe adverse events, antipsychotic medications remain the mainstay of treatment of behaviour disorders and psychosis in elderly patients. Second-generation antipsychotic agents (SGAs; e.g., risperidone, olanzapine, quetiapine have generally shown a better safety profile compared to the first-generation agents (FGAs; e.g., haloperidol and phenothiazines, particularly in terms of a lower potential for involuntary movement disorders. Risperidone, the only SGA with an official indication for the management of inappropriate behaviour in dementia, has emerged as the antipsychotic most commonly prescribed to older patients. Most clinical trials evaluating the risk of movement disorders in elderly patients receiving antipsychotic therapy have been of limited sample size and/or of relatively short duration. A few observational studies have produced inconsistent results.A population-based retrospective cohort study of all residents of the Canadian province of Manitoba aged 65 and over, who were dispensed antipsychotic medications for the first time during the time period from April 1, 2000 to March 31, 2007, was conducted using Manitoba's Department of Health's administrative databases. Cox proportional hazards models were used to determine the risk of extrapyramidal symptoms (EPS in new users of risperidone compared to new users of FGAs.After controlling for potential confounders (demographics, comorbidity and medication use, risperidone use was associated with a lower risk of EPS compared to FGAs at 30, 60, 90 and 180 days (adjusted hazard ratios [HR] 0.38, 95% CI: 0.22-0.67; 0.45, 95% CI: 0.28-0.73; 0.50, 95% CI: 0.33-0.77; 0.65, 95% CI: 0.45-0.94, respectively. At 360 days, the strength of the association weakened with an adjusted HR of 0.75, 95% CI: 0.54-1.05.In a large population of elderly patients the use of risperidone was associated with a lower risk of EPS compared to FGAs.

  3. Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study

    Directory of Open Access Journals (Sweden)

    Lilian Varanda Pereira

    2014-08-01

    Full Text Available OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status.METHOD: cross-sectional study with a populational sample (n=934, conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more was measured using a numerical scale (0-10 and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor. For the statistical analysis, the absolute frequency and percentage, CI (95%, Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%.RESULTS: The prevalence of chronic pain was 52.8% [CI (95%:49.4-56.1]; most frequently located in the lower limbs (34.5% and lumbar region (29.5%; with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001 a worse self-perception of health (OR=4.2:2.5-7.0, a greater number of chronic diseases (OR=1.8:1.2-2.7, joint disease (OR=3.5:2.4-5.1 and the female gender (OR=2.3:1.7-3.0. A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001.CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population.

  4. Gender Responsive Community Based Planning and Budgeting ...

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

    Gender Responsive Community Based Planning and Budgeting Tool for Local Governance. During the early 1990s, IDRC supported the development and testing of a reliable and cost-efficient tool for monitoring poverty and facilitating local level budgeting: the community-based (poverty) monitoring system (CBMS).

  5. Community-based Mural: The People's Art.

    Science.gov (United States)

    Chilcoat, George W.

    2000-01-01

    Discusses the history and reasons for community-based mural art in North America. Describes the steps involved in a community-based mural project for students in which they work in groups to develop a mural theme and a sketch of the mural, paint the mural, document the process, and then present the mural to the class. (CMK)

  6. Sustainable Community Based Interventions for Improving ...

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

    Sustainable community based interventions for improving environment and health for communities in slums of Banda, Kampala City, Uganda : final technical report (2007-2011). Rapports. Eco-Health project start-up/methodological workshop , Sports View Hotel, Kireka, 11th-13th July 2007 : sustainable community based ...

  7. Denture acceptance among newly rehabilitated elderly population in old age homes in South India.

    Science.gov (United States)

    Shetty, Mallika S; Panchaml, Ganesh Shenoy; Shenoy, K Kamalakanth

    2015-03-01

    Elders in old age homes are mainly those who have been abandoned by their family and have one or more physical or mental disabilities. It is a major challenge for the dental professional to plan oral health strategy for this group of patients. Aim of the present study is to observe and determine the acceptance of new dental prosthesis among the elderly residing as inmates of 3 old age homes in Mangalore City. This cross-sectional study was conducted using a survey proforma. Information regarding their experience with the new denture, 1-month, 3 months and 6 months after denture insertion was gathered. Statistical analysis of the data was done using the Chi-square test with the P makeup of the patient must be taken into consideration during the entire procedure. We must understand that the success of the prosthesis depends mainly on the patient's confidence in the dentist rather than the quality of the prosthesis.

  8. Functional status and its predictor among elderly population in a hilly state of North India

    OpenAIRE

    Deepak Sharma; Anupam Parashar; Salig Ram Mazta

    2014-01-01

    Background: Functional status can be conceptualized as an individual′s ability to manage activities related to personal self-care and self-maintenance. Functional status assessment is fundamental aspect of geriatric examination. This assessment helps clinicians and policymakers to design and implement interventions that help elderly to live safely and independently. Aims and Objectives: The primary aim was to assess the prevalence of limitation in activities of daily living (ADL) and instrume...

  9. EXIT25 - Executive interview applied to a cognitively healthy elderly population with heterogeneous educational background

    Directory of Open Access Journals (Sweden)

    Maria Niures P.S. Matioli

    Full Text Available Abstract Education interferes with the performance in most cognitive tests, including executive function assessment. Objective: To investigate the effects of education on the performance of healthy elderly on the Brazilian version of the Executive Interview (EXIT25. Methods: The EXIT25 was administered to a sample of 83 healthy elderly. The subjects were also submitted to the Mini-Mental State Examination (MMSE, a delayed recall test, clock drawing and category fluency (animals/min tests in order to rule out cognitive impairment. The Geriatric Depression Scale (GDS was employed to exclude clinically-relevant depressive symptoms. The total sample was divided into three groups according to educational level: G1 (1-4 years, G2 (5-8 years and G3 (>8 years. Results: The mean values for age, educational level, MMSE and EXIT25 scores of all subjects were 72.2, 7.5, 27.6 and 6.9, respectively. The scores on the EXIT25 for each group were: G1=8.3, G2=5.9 and G3=5.8. There was a statistical difference between the performance of G1 and the other two groups on the EXIT25. Conclusions: The Brazilian version of the EXIT25 proved straightforward to administer. The performance of this sample of healthy elderly on the test was significantly influenced by educational level.

  10. Measuring reliability and validity of Persian version of spirituality scale among elderly Iranian population

    Directory of Open Access Journals (Sweden)

    Hallaj Zahra

    2014-01-01

    Full Text Available Objective: The aim of this study was to measure the validity and reliability of Persian version of spirituality scale among elderly Iranian people. Methods: Based on the international quality of life assessment (IQOLA project approach, Persian version of the spirituality scale was prepared. Data on 200 elderly people (over 60 years old were entered into SPSS software. Results: The findings of the descriptive results of the current study showed that there was no correlation between the demographic data collected in this study such as age, religion and marital status with spirituality. On the other hand, after performing the exploratory factor analysis, calculating test-retest and intra-class correlation coefficient and measuring Cronbach's Alpha coefficient for internal consistency, the results showed that respectively the reliability, the face and content validity of the questionnaire were confirmed in high level. Also, through the exploratory factor analysis, the construct validity was confirmed. Conclusions: The Persian version of the spirituality scale in the elderly people with an acceptable reliability and validity can be used in clinical assessment and research.

  11. Subjective memory complaints in an elderly population with poor sleep quality.

    Science.gov (United States)

    Kang, Suk-Hoon; Yoon, In-Young; Lee, Sang Don; Kim, Tae; Lee, Chung Suk; Han, Ji Won; Kim, Ki Woong; Kim, Chan-Hyung

    2017-05-01

    The association between sleep disturbances and cognitive decline in the elderly has been putative and controversial. We evaluated the relation between subjective sleep quality and cognitive function in the Korean elderly. Among 459 community-dwelling subjects, 352 subjects without depression or neurologic disorders (mean age 68.2 ± 6.1) were analyzed in this study. All the participants completed the Korean version of the consortium to establish a registry for Alzheimer's disease neuropsychological battery (CERAD-KN) as an objective cognitive measure and subjective memory complaints questionnaire (SMCQ). Based on the Pittsburgh sleep quality index, two types of sleepers were defined: 'good sleepers' and 'poor sleepers'. There were 192 good sleepers (92 men) and 160 poor sleepers (51 men). Poor sleepers reported more depressive symptoms and more use of sleep medication, and showed higher SMCQ scores than good sleepers, but there was no difference in any assessments of CERAD-KN. In the regression analysis, depressive symptoms and subjective sleep quality were associated with subjective memory complaints (β = 0.312, p poor sleep quality was associated with subjective memory complaints, but not with objective cognitive measures. As subjective memory complaints might develop into cognitive disorders, poor sleep quality in the elderly needs to be adequately controlled.

  12. Description of a mixed ethnic, elderly population. I. Demography, nutrient/energy intakes, and income status.

    Science.gov (United States)

    Prothro, J W; Rosenbloom, C A

    1999-06-01

    Elderly participants in the Title III-C Nutrition Program, 60-103 years of age, were assessed for nutrient/energy intakes, relationship of income status to intakes, and comparison with data from the National Evaluation of the Elderly Nutrition Program (ENP). Nonrandomized volunteers were interviewed in senior centers or in their homes. Chi-square, t test, and ANOVA were used to test for differences in dietary intakes with regard to ethnicity, gender, age, type of meal (congregate dining or home delivered), socialization factor (lived alone or with others), and income status. A new method of looking at diet quality, which conjoins nutrients and energy, was developed for this study. Six percent of the sample had adequate energy and nutrient intakes over a 3-day period; 53% were rated tenuous or marginal, and 41% submarginal or inadequate. The Title III-C noon meal provided 38%-44% of the average daily energy intake and 33%-65% of the average intake of selected nutrients. Diets of men were better than those of women (p Nutrition Programs have been implemented since 1973, and nutrition education is an obligatory component. The high incidence of nutrient/energy inadequacy in this study was surprising, but consistent with previous reports. New ways of implementing better food intakes of senior citizens are needed. In addition, research is needed to establish differences in nutrient profiles of elderly clients below and above the poverty level.

  13. Potentially inappropriate prescribing in elderly population: A study in medicine out-patient department

    Directory of Open Access Journals (Sweden)

    Ajit Kumar Sah

    2017-03-01

    Full Text Available Background & Objectives: Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The study was conducted with objectives to determine the prevalence of potentially inappropriate medicine (PIM prescribing in older Nepalese patients in a medicine outpatient department.Materials & Methods: A prospective observational analysis of drugs prescribed in medicine out-patient department (OPD of a tertiary hospital of central Nepal was conducted during November 2012 to October 2013 among 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM in elderly patients was analysed using Beer’s Criteria updated to 2013. Results: In the 869 patients included, the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%, amlodipine (23.16%, paracetamol (17.6%, salbutamol (15.72% and vitamin B complex (13.26%. The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Conclusion: Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with number of medications prescribed. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

  14. Safety of a tetanus-diphtheria-acellular pertussis vaccine when used off-label in an elderly population.

    Science.gov (United States)

    Tseng, Hung Fu; Sy, Lina S; Qian, Lei; Marcy, S Michael; Jackson, Lisa A; Glanz, Jason; Nordin, Jim; Baxter, Roger; Naleway, Allison; Donahue, James; Weintraub, Eric; Jacobsen, Steven J

    2013-02-01

    Published data on the safety of tetanus-diphtheria-acellular pertussis vaccine (Tdap) in persons aged ≥65 years are limited. This study aims to examine a large cohort of Tdap users ≥65 years for evidence of increased risk of adverse events following vaccination. A matched cohort study design and a self-controlled case series (SCCS) design were used. The study population was adults aged ≥65 years who received the Tdap or tetanus and diphtheria (Td) vaccine during 1 January 2006-31 December 2010 at 7 health maintenance organizations in the United States. Seven major groups of prespecified events were identified electronically by diagnostic codes. The study included 119 573 Tdap vaccinees and the same number of Td vaccinees. The results indicated that the risk of the prespecified events following Tdap was comparable to that following Td vaccination in this elderly population. There was a small increased rate of codes suggesting medically attended inflammatory or allergic events in 1-6 days following Tdap in the SCCS analysis (incidence rate ratio, 1.59 [95% confidence interval, 1.40-1.81]). Although there is a small increased risk of medically attended inflammatory or allergic events in 1-6 days following Tdap compared to other time periods, it is no more common than that following Td. This study provides empirical safety data suggesting that immunizing adults aged ≥65 years with Tdap to reduce the risk of pertussis in the elderly and their contacts should not have untoward safety consequences.

  15. Gender Difference on the Association between Dietary Patterns and Obesity in Chinese Middle-Aged and Elderly Populations.

    Science.gov (United States)

    Yuan, Ya-Qun; Li, Fan; Meng, Pai; You, Jie; Wu, Min; Li, Shu-Guang; Chen, Bo

    2016-07-23

    Dietary patterns are linked to obesity, but the gender difference in the association between dietary patterns and obesity remains unclear. We explored this gender difference in a middle-aged and elderly populations in Shanghai. Residents (n = 2046; aged ≥45 years; 968 men and 1078 women) who participated in the Shanghai Food Consumption Survey were studied. Factor analysis of data from four periods of 24-h dietary recalls (across 2012-2014) identified dietary patterns. Height, body weight, and waist circumference were measured to calculate the body mass index. A log binominal model examined the association between dietary patterns and obesity, stratified by gender. Four dietary patterns were identified for both genders: rice staple, wheat staple, snacks, and prudent patterns. The rice staple pattern was associated positively with abdominal obesity in men (prevalence ratio (PR) = 1.358; 95% confidence interval (CI) 1.132-1.639; p = 0.001), but was associated negatively with general obesity in women (PR = 0.745; 95% CI: 0.673-0.807; p = 0.031). Men in the highest quartile of the wheat staple pattern had significantly greater risk of central obesity (PR = 1.331; 95% CI: 1.094-1.627; p = 0.005). There may be gender differences in the association between dietary patterns and obesity in middle-aged and elderly populations in Shanghai, China.

  16. The effect of patient sex on the incidence of early adverse effects in a population of elderly patients.

    Science.gov (United States)

    Conti, D; Ballo, P; Boccalini, R; Boccherini, A; Cantini, S; Venni, A; Pezzati, S; Gori, S; Franconi, F; Zuppiroli, A; Pedullà, A

    2014-07-01

    Patient sex is known to influence the response to general and regional anaesthesia and recovery after surgery. However, most studies come from analyses carried out on middle-aged patients. As most of the patients admitted to the post-anaesthesia recovery room in our institution are elderly, we took the opportunity to investigate the association between sex and incidence of early adverse events in this older population of patients after major surgery. Consecutive patients undergoing general, orthopaedic, urological and gynaecological surgery, admitted to the recovery room of our institution over a 15-month period, were retrospectively studied. The following adverse events were considered in the analysis: shivering, postoperative nausea and vomiting, hypotension and hypertensive responses, new arrhythmias requiring treatment, acute respiratory failure and desaturation. A total of 1347 patients (mean age 73.3±15.1 years, 61.4% women) were included. Women showed a higher incidence of shivering (relative difference +48%, P=0.0003), postoperative nausea and vomiting (+91%, Pincidence of hypertensive response, arrhythmias and acute respiratory failure were not statistically significantly different. The findings of this exploratory study suggest that women have a higher risk of early postoperative adverse events even in a more elderly population.

  17. Increase of elderly poor in developing nations--the implications of dependency theory and modernization theory for the aging of world population.

    Science.gov (United States)

    Osako, M

    1982-12-01

    Despite the growing number of elderly residents in developing countries, little is known about the impact of economic development policies on the elderly in these countries. In an effort to identify public policies which may have a beneficial impact on the elderly, the impact of development policies and of foreign aid on the elderly in Taiwan was examined. Information on the elderly in developing countries and in Taiwan was derived from reports of various international organizations and from social science literature. Between 1980-2000, the proportion of elderly persons in developing countries will increase from 6.1%-7.1%, and the absolute number of elderly will increase from 200 million to 350 million. In 2000, the proportion of elderly persons in the developed countries will be 18.2%, but the absolute number of elderly will be only 244 million. There is little information on the income of the elderly in developing countries , but the elderly are probably over represented among the poor in developing countries just as they are in most developed countries. A disproportionate number of the elderly live in the rural areas of developing countries. Structural changes which occur in developing countries under conditions of economic development may have a negative impact on the elderly. Little is known about the impact of foreign aid on the general population of poor people in developing countries and even less in known about the impact of foreign aid on the elderly. Neo-classical economic theorists argue that foreign aid has a trickle down effect and that the poor ultimately benefit from foreign aid and investment. Dependency theorists argue that foreign aid and investment slows economic growth, perpetuates a dual economy for the elite and the poor, and increases income differences between the poor and the elite. It is difficult to assess the validity of these theories in the abstract. The impact of foreign aid and other policies must be assessed in reference to

  18. Normative data for a battery of free recall, cued recall and recognition tests in the elderly Italian population.

    Science.gov (United States)

    Coluccia, Emanuele; Gamboz, Nadia; Brandimonte, Maria A

    2011-12-01

    The present study aimed to provide normative data on a large sample of the elderly Italian population (N = 464; range of age = 49-94; range of education = 3-25) on both the word and the picture versions of a battery of free recall, cued recall, and recognition tests of memory. Results from multiple regression analyses showed that both age and education were significant predictors of performance. Therefore, norms were calculated taking into account these demographic variables. The availability of normative data based on a large sample will allow a more reliable use of the battery for clinical assessment in Italian-speaking dementia population.

  19. Prevalence and Outcomes of Frailty in Korean Elderly Population: Comparisons of a Multidimensional Frailty Index with Two Phenotype Models

    Science.gov (United States)

    Jung, Hee-Won; Kim, Sun-Wook; Ahn, Soyeon; Lim, Jae-Young; Han, Ji-Won; Kim, Tae-Hui; Kim, Ki-Woong; Kim, Kwang-il; Kim, Cheol-Ho

    2014-01-01

    Background Frailty is related to adverse outcomes in the elderly. However, current status and clinical significance of frailty have not been evaluated for the Korean elderly population. We aimed to investigate the usefulness of established frailty criteria for community-dwelling Korean elderly. We also tried to develop and validate a new frailty index based on a multidimensional model. Methods We studied 693 participants of the Korean Longitudinal Study on Health and Aging (KLoSHA). We developed a new frailty index (KLoSHA Frailty Index, KFI) and compared predictability of it with the established frailty indexes from the Cardiovascular Health Study (CHS) and Study of Osteoporotic Fracture (SOF). Mortality, hospitalization, and functional decline were evaluated. Results The prevalence of frailty was 9.2% (SOF index), 13.2% (CHS index), and 15.6% (KFI). The criteria from CHS and KFI correlated with each other, but SOF did not correlate with KFI. During the follow-up period (5.6±0.9 years), 97 participants (14.0%) died. Frailty defined by KFI predicted mortality better than CHS index (c-index: 0.713 and 0.596, respectively; p<0.001, better for KFI). In contrast, frailty by SOF index was not related to mortality. The KFI showed better predictability for following functional decline than CHS index (area under the receiver-operating characteristic curve was 0.937 for KFI and 0.704 for CHS index, p = 0.001). However, the SOF index could not predict subsequent functional decline. Frailty by the KFI (OR = 2.13, 95% CI 1.04–4.35) and CHS index (OR = 2.24, 95% CI 1.05–4.76) were associated with hospitalization. In contrast, frailty by the SOF index was not correlated with hospitalization (OR = 1.43, 95% CI 0.68–3.01). Conclusion Prevalence of frailty was higher in Korea compared to previous studies in other countries. A novel frailty index (KFI), which includes domains of comprehensive geriatric assessment, is a valid criterion for the evaluation and

  20. Prevalence and outcomes of frailty in Korean elderly population: comparisons of a multidimensional frailty index with two phenotype models.

    Directory of Open Access Journals (Sweden)

    Hee-Won Jung

    Full Text Available BACKGROUND: Frailty is related to adverse outcomes in the elderly. However, current status and clinical significance of frailty have not been evaluated for the Korean elderly population. We aimed to investigate the usefulness of established frailty criteria for community-dwelling Korean elderly. We also tried to develop and validate a new frailty index based on a multidimensional model. METHODS: We studied 693 participants of the Korean Longitudinal Study on Health and Aging (KLoSHA. We developed a new frailty index (KLoSHA Frailty Index, KFI and compared predictability of it with the established frailty indexes from the Cardiovascular Health Study (CHS and Study of Osteoporotic Fracture (SOF. Mortality, hospitalization, and functional decline were evaluated. RESULTS: The prevalence of frailty was 9.2% (SOF index, 13.2% (CHS index, and 15.6% (KFI. The criteria from CHS and KFI correlated with each other, but SOF did not correlate with KFI. During the follow-up period (5.6 ± 0.9 years, 97 participants (14.0% died. Frailty defined by KFI predicted mortality better than CHS index (c-index: 0.713 and 0.596, respectively; p<0.001, better for KFI. In contrast, frailty by SOF index was not related to mortality. The KFI showed better predictability for following functional decline than CHS index (area under the receiver-operating characteristic curve was 0.937 for KFI and 0.704 for CHS index, p = 0.001. However, the SOF index could not predict subsequent functional decline. Frailty by the KFI (OR = 2.13, 95% CI 1.04-4.35 and CHS index (OR = 2.24, 95% CI 1.05-4.76 were associated with hospitalization. In contrast, frailty by the SOF index was not correlated with hospitalization (OR = 1.43, 95% CI 0.68-3.01. CONCLUSION: Prevalence of frailty was higher in Korea compared to previous studies in other countries. A novel frailty index (KFI, which includes domains of comprehensive geriatric assessment, is a valid criterion for the evaluation and prediction of

  1. Loneliness among very old Mexican Americans: findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly.

    Science.gov (United States)

    Gerst-Emerson, Kerstin; Shovali, Tamar E; Markides, Kyriakos S

    2014-01-01

    Increasing numbers of researchers are finding that loneliness is a significant risk factor for morbidity and mortality, and several variables have been found to be closely related to the experience of loneliness among elders. However, much of the research has focused on the general older population, with no research to date focusing on minority populations. The objective of this study was to determine the prevalence and the correlates of loneliness among a community-dwelling older Mexican American population. This study used a three-item loneliness scale to determine the prevalence of loneliness. Pearson's correlation and linear regression analyses were used to determine the cross-sectional association between sociodemographic, interpersonal relationship and health variables with the scale. Data used came from the most recent wave (2011) of the Hispanic Established Populations for the Epidemiological Study of the Elderly (H-EPESE). A total of 873 Mexican Americans completed the loneliness scale. The age range was from 80 to 102, with a majority (65%) female. The mean score on the scale was 4.05 (range 3-9), indicating relatively low levels of loneliness. Regression results indicate that depressive symptoms, cognitive status, and living alone were significantly associated with higher loneliness scores. Being married and having a confidante were significantly associated with lower loneliness. Age, number of close relatives and frequency of contact were not associated with loneliness. Findings suggest that among community-dwelling Mexican American older adults, loneliness has multiple determinants. Loneliness is a significant public health topic and clinicians should be aware of the various factors that can affect loneliness. Published by Elsevier Ireland Ltd.

  2. Second Morning ACR Could Be the Alternative to First Morning ACR to Assess Albuminuria in Elderly Population.

    Science.gov (United States)

    Wang, Hua-Bin; Li, Rong; Liu, Rui; Cui, Xiao-Fan; Pan, Wen-Jie; Sun, Ao

    2016-03-01

    Albumin/creatinine ratio (ACR) from a first morning urine is recommended as a early indicator for diabetic nephropathy. However, it is not always feasible to collect the first morning urine for outpatients. We aimed to explore whether ACR from a second morning urine had a good consistency with that from a first morning urine to predict albuminuria in Chinese elderly citizens. One hundred and ninety-one elderly citizens (≧60 years old) from Junliangcheng community, Dongli district, Tianjin, China were included. A first and second morning urine was collected from each participants, successfully and detected the urinary albumin and creatinine of each urine sample. Albumin to creatinine ratio from a first morning urine (ACR1) was compared with that from a second morning urine (ACR2), and the ability of ACR1 and ACR2 to predict albuminuria was assessed. ACR1 and ACR2 were highly correlated (r = 0.901), especially in male and hypertension group (r = 0.938 and 0.904). The slope and intercept were 0.93 and 0.11 after log-transformed. And there was no statistical difference between values of ACR1 and ACR2 (P = 0.271). Overall, 26.2% participants were detected with albuminuria when judged by ACR1 and 28.3% by ACR2. A good concordance of ACR category (normal or albuminuria) was found between ACR1 and ACR2 (Kappa value = 0.815 in overall; in male and hypertension group were 0.900 and 0.850). A second morning urine ACR could be the alternative to a first morning urine ACR for albuminuria detection in elderly population. © 2015 Wiley Periodicals, Inc.

  3. Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

    Science.gov (United States)

    Martins, Andréa Maria Eleutério de Barros Lima; Jardim, Lorena Amaral; Souza, João Gabriel Silva; Rodrigues, Carlos Alberto Quintão; Ferreira, Raquel Conceição; Pordeus, Isabela Almeida

    2014-01-01

    This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

  4. Blood mercury concentrations are associated with decline in liver function in an elderly population: a panel study.

    Science.gov (United States)

    Lee, Mee-Ri; Lim, Youn-Hee; Lee, Bo-Eun; Hong, Yun-Chul

    2017-03-04

    Mercury is a toxic heavy metal and is known to affect many diseases. However, few studies have examined the effects of mercury exposure on liver function in the general population. We examined the association between blood mercury concentrations and liver enzyme levels in the elderly. We included 560 elderly participants (60 years or older) who were recruited from 2008 to 2010 and followed up to 2014. Subjects visited a community welfare center and underwent a medical examination and measurement of mercury levels up to five times. Analyses using generalized estimating equations model were performed after adjusting for age, sex, education, overweight, alcohol consumption, smoking, regular exercise, high-density lipoproteins cholesterol, and total calorie intake. Additionally, we estimated interaction effects of alcohol consumption with mercury and mediation effect of oxidative stress in the relationship between mercury levels and liver function. The geometric mean (95% confidence interval (CI)) of blood mercury concentrations was 2.81 μg/L (2.73, 2.89). Significant relationships were observed between blood mercury concentrations and the level of liver enzymes, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT), after adjusting for potential confounders (P mercury quartile compared to those with the lowest quartile. Particularly, regular alcohol drinkers showed greater effect estimates of mercury on the liver function than non-drinkers groups. There was no mediation effect of oxidative stress in the relationship between blood mercury concentrations and liver function. Our results suggest that blood mercury levels are associated with elevated liver enzymes and interact with alcohol consumption for the association in the elderly.

  5. Potentially inappropriate medications (PIMs) and anticholinergic levels in the elderly: a population based study in a French region.

    Science.gov (United States)

    Beuscart, Jean-Baptiste; Dupont, Corinne; Defebvre, Marie-Margueritte; Puisieux, Francois

    2014-01-01

    Prescriptions of PIMs and anticholinergic drugs lead to adverse events and hospitalizations in the elderly. The objective of this study was to determine the prevalence of PIMs and prescriptions with a high anticholinergic effect in a French region. All prescriptions dispensed at community pharmacies in patients aged 75 and older between January 1 and March 31, 2012 were extracted from French Health Insurance information System - Nord-Pas-de-Calais Region for patients affiliated to the Social Security. Prescription of PIMs was defined according to the Laroche list. The anticholinergic score for each prescription was calculated using the Anticholinergic Drug Scale (ADS). 65.6% (n=207,979) of people aged over 75 years, living in the Nord-Pas-de-Calais Region were included, of which 4.5% (n=9284) living in nursing homes. Patients received an average of 8.3 drugs over the 3-month study period. In 32.6% (n=67,863) of patients, at least one PMI was prescribed. According to the ADS, 10.0% (n=20,978) of patients in the general population and 24.0% (n=2231) of patients living in nursing homes was exposed to a prescription with a high or very high anticholinergic score (ADS≥3). Hydroxyzine prescribed in 51.4% (n=10,792) of them ranked first among drugs most often reported. In conclusion, PMIs and anticholinergic drugs were commonly prescribed in elderly living in the Nord-Pas-de-Calais Region. Improving the quality of prescriptions in the elderly appears necessary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

    Directory of Open Access Journals (Sweden)

    Andréa Maria Eleutério de Barros Lima Martins

    2014-03-01

    Full Text Available This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2test and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7% evaluated the provided services negatively (very poor or poor. Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

  7. General knowledge about diabetes in the elderly diabetic population in Slovenia

    Directory of Open Access Journals (Sweden)

    Eva Turk

    2012-08-01

    Results: A total of 225 individuals returned the questionnaire, which represents 75 % response rate. The average score was 8.0 ± 2.4. Not a single subject responded correctly to all 14 questions. The average score achieved by men and women was 8.8 ± 1.9 and 7.6 ± 2.5, respectively. There was no significant difference between the elderly living in urban and rural areas, and the level of education is the most important predictor for better results.

  8. Social and economic correlates of malnutrition in Polish elderly population: the results of PolSenior study.

    Science.gov (United States)

    Krzymińska-Siemaszko, R; Mossakowska, M; Skalska, A; Klich-Rączka, A; Tobis, S; Szybalska, A; Cylkowska-Nowak, M; Olszanecka-Glinianowicz, M; Chudek, J; Wieczorowska-Tobis, K

    2015-04-01

    The aim of this study was to evaluate the prevalence of malnutrition in Polish elderly population and analyse its social and economic correlates based on the data from the PolSenior project, the first large-scale study of a representative group of Polish seniors. A cross-sectional population-based study. All territorial provinces in Poland. 4482 community-dwelling respondents aged 65 years or above (women: n=2142, age=79.0±8.4 years; men: n=2340, age= 78.3±8.6 years). The nutritional status of participants was assessed through the Mini Nutritional Assessment Short Form (the revised MNA-SF). Out of social and economic correlates we evaluated age, sex, level of education, marital status, place of residence, living conditions and economic status. Economic status of the respondents was determined on the basis of questions on how well they could manage their own budgets. Those who could afford only the cheapest food or clothes were considered the group of self-reported poverty. Frequency of malnutrition in the PolSenior population accounted for 7.5% (in 5.0% men and 9.0% women; p<0.001). The risk of malnutrition was present in 38.9% (33.3% men and 42.4% women; p<0.001). In our study female sex, older age, unmarried status, living in a rural area and self-reported poverty were independent correlates of malnutrition. Our data showed high prevalence of malnutrition and the risk of its development among the community-dwelling elderly people in Poland. Screening with MNA-SF should focus in particular on unmarried, poorly educated individuals, in late old age, living in rural areas and self-reporting a poor financial state, especially women.

  9. Relationships of Macular Pigment Optical Density With Plasma Lutein, Zeaxanthin, and Diet in an Elderly Population: The Montrachet Study.

    Science.gov (United States)

    Alassane, Seydou; Binquet, Christine; Cottet, Vanessa; Fleck, Olivier; Acar, Niyazi; Daniel, Sandrine; Delcourt, Cécile; Bretillon, Lionel; Bron, Alain M; Creuzot-Garcher, Catherine

    2016-03-01

    To investigate the association of macular pigment optical density (MPOD) with plasma lutein, zeaxanthin, and diet in an elderly population. We conducted a population-based study, the Montrachet (Maculopathy Optic Nerve, nuTRition neurovAsCular, and HEarT disease) study, in subjects older than 75 years. The MPOD was measured by means of the two-wavelength autofluorescence technique. Plasma lutein and zeaxanthin were measured in fasting blood samples using HPLC. Food frequency consumption was assessed with self-reported food frequency questionnaires. Overall, 433 healthy participants (62.1% females) were included. Mean age was 82.0 ± 3.6 years. Mean MPOD at 0.5° eccentricity was 0.57 ± 0.25 density units (DU) and was higher in women than in men (0.59 ± 0.25 vs. 0.53 ± 0.25, P = 0.017). The MPOD was lower in alcohol consumers than in non-alcohol consumers (0.55 ± 0.25 vs. 0.61 ± 0.25, P = 0.016). Median plasma lutein and zeaxanthin levels were 281.4 μg/L and 20.0 μg/L, respectively, and were higher in women (P = 0.010 and P = 0.003, respectively). The MPOD was positively correlated with plasma lutein and zeaxanthin (r = 0.10, P = 0.030 and r = 0.11, P = 0.027, respectively). A higher consumption of squash was associated with higher plasma lutein and zeaxanthin. Adjusting for confounders and diet revealed that MPOD was weakly associated with plasma lutein in nonsmokers (β = 0.11, P = 0.021). This study suggests that plasma lutein is associated with MPOD after taking into account potential confounding factors in an elderly population.

  10. [Ten-year incidence of fatal and non-fatal myocardial infarction in the elderly population of Madrid].

    Science.gov (United States)

    Novella, Blanca; Alonso, Margarita; Rodriguez-Salvanés, Francisco; Susi, Rosario; Reviriego, Blanca; Escalante, Luisa; Suárez, Carmen; Gabriel, Rafael

    2008-11-01

    To determine the incidence of and mortality due to myocardial infarction and coronary heart disease in the elderly population of Madrid, Spain. The study involved a population-based cohort of 1297 individuals aged over 64 years without cardiovascular disease who were recruited in 1995. All cases of fatal and non-fatal myocardial infarction recorded up until December 2004 were investigated and classified using WHO-MONICA (World Health Organization-Multinational MONItoring of trends and determinants in CArdiovascular disease) criteria. Men had a significantly higher cumulative incidence of ischemic events (P< .001) and sudden death (P< .001), and a non-significantly higher risk of myocardial infarction (6.30%; 95% confidence interval [CI], 4.33%-8.76%) than women (4.90%; 95% CI, 3.54%-6.70%; P=.181). While the risk of myocardial infarction increased with age (P< .05), gender differences tended to narrow. The incidence was higher in men (889/100 000 person-years) than women (610/100,000 person-years; P< .001) and increased with age (P< .01). This increase was progressive in women but not in men. The mortality rate was also higher in men (472/100,000 person-years; 95% CI, 248-697) than women (328/100,000 person-years; 95% CI, 188-469; P< .001), and was six times higher in the 385-year-old age group than in those aged 65-74 years (P< .001). The incidence of fatal and non-fatal myocardial infarction was very high in the elderly population of Madrid. Both incidence and mortality rates increased dramatically with age after 64 years. Rates were higher in men than women at all ages, though gender differences decreased with age.

  11. A systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union.

    Science.gov (United States)

    Shields, Gemma E; Elvidge, Jamie; Davies, Linda M

    2017-06-10

    The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population. The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU. Electronic searches of the NHS Economic Evaluation, Health Technology Assessment, MEDLINE and Embase databases were run to identify full economic evaluations. Two levels of screening were used, with explicit inclusion criteria applied by two independent reviewers at each stage. Prespecified data extraction and critical appraisal were performed on identified studies. Results were summarised qualitatively. Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics. Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Families and elder care in the twenty-first century.

    Science.gov (United States)

    Bookman, Ann; Kimbrel, Delia

    2011-01-01

    Although most Americans know that the U.S. population is aging, they are far less informed about the reality of providing elders with personal care, health care, and social support. Families-particularly women-have always been critical in providing elder care, but the entry of so many women into the paid labor force has made elder care increasingly difficult. Ann Bookman and Delia Kimbrel show how changes in both work and family life are complicating families' efforts to care for elderly relatives. Because almost 60 percent of elder caregivers today are employed, many forms of caregiving must now be "outsourced" to nonfamily members. And because elders are widely diverse by race and socioeconomic status, their families attach differing cultural meanings to care and have widely different resources with which to accomplish their care goals. Although the poorest elders have access to some subsidized services, and the wealthiest can pay for services, many middle-class families cannot afford services that allow elders to age in their homes and avoid even more costly institutional care. Six key groups--health care providers, nongovernmental community-based service providers, employers, government, families, and elders themselves--are engaged in elder care, but their efforts are often fragmented and uncoordinated. All six groups must be able to work in concert and to receive the resources they need. Both employer and government policies must be improved. Although large businesses have taken up the elder care challenge, most small and mid-sized firms still do not offer flexible work arrangements. Social Security and Medicare have provided critical support to families caring for elders, yet both face significant financial shortfalls. The Older American Act and the National Family Caregiver Support Program have broadened access to elder services, but need updating to address the needs of today's employed caregivers and elders who want to "age in place." And just over half of

  13. Higher estimates of daily dietary net endogenous acid production (NEAP) in the elderly as compared to the young in a healthy, free-living elderly population of Pakistan

    Science.gov (United States)

    Alam, Iftikhar; Alam, Ibrar; Paracha, Parvez I; Pawelec, Graham

    2012-01-01

    Dietary intake has been shown to influence the acid–base balance in human subjects; however, this phenomenon is poorly understood and rarely reported for the least well-studied segment of older people in a developing country. The aims of the present study were to: (1) quantify estimates of daily net endogenous acid production (NEAP) (mEq/d) in a sample of otherwise healthy elderly aged 50 years and above; and (2) compare NEAP between the elderly and young to determine the effects of aging, which could contribute to changes in the acid–base balance. Analyses were carried out among 526 elderly and 131 young participants (aged 50–80 and 23–28 years, respectively), all of whom were free of discernible disease, nonsmokers, and not on any chronic medication. Selected anthropometric factors were measured and 24-hour dietary recall was recorded. We used two measures to characterize dietary acid load: (1) NEAP estimated as the dietary potential renal acid load plus organic acid excretion, the latter as a multiple of estimated body surface area; and (2) estimated NEAP based on protein and K. For the young and elderly, the ranges of NEAP were 12.1–67.8 mEq/d and 2.0–78.3 mEq/d, respectively. Regardless of the method used, the mean dietary acid–base balance (NEAP) was significantly higher for the elderly than the young (P = 0.0035 for NEAP [elderly, 44.1 mEq/d versus young 40.1 mEq/d]; and P = 0.0035 for the protein:potassium ratio [elderly, 1.4 mEq/d versus young 1.1 mEq/d]). A positive and significant correlation was found between NEAP and energy, protein, and phosphorus (P elderly. PMID:23271903

  14. Should digoxin be proscribed in elderly subjects in sinus rhythm free from heart failure? A population-based study.

    Science.gov (United States)

    Casiglia, E; Tikhonoff, V; Pizziol, A; Onesto, C; Ginocchio, G; Mazza, A; Pessina, A C

    1998-09-01

    Increased mortality in digoxin-treated subjects has been demonstrated in patients with recent myocardial infarction. Those with congestive heart failure (CHF) due to causes other than myocardial infarction seem to be free from this effect. No information is currently available concerning mortality in elderly people who are frequently prescribed digitalis even in the absence of CHF. The aim of this study was to investigate whether subjects improperly receiving digoxin were worse off than those not receiving this drug. This analysis is a part of CASTEL, a population-based prospective study that has enrolled a cohort of 2,254 subjects aged > or = 65 years. CHF was diagnosed in 187 subjects and atrial fibrillation (AF) in 90. The remaining 1,977 were free from CHF and in sinus rhythm, but 447 were treated with digitalis. Cumulative mortality and morbid events by digitalis treatment were calculated in all these categories. Among subjects free from CHF and AF (improper use), all-cause and cardiovascular mortality was significantly higher among those taking digitalis than in those who did not. Non-fatal events including CHF were also more apparent in the former than in the latter. Cox analysis confirmed digitalis as a predictor of mortality in these subjects. No effect of digitalis on survival was found in patients with CHF or AF (proper use). In elderly subjects without atrial fibrillation or CHF, the use of digitalis worsens morbidity and mortality.

  15. Tolerability in the elderly population of high-dose alpha lipoic acid: a potential antioxidant therapy for the eye

    Directory of Open Access Journals (Sweden)

    Sarezky D

    2016-09-01

    Full Text Available Daniel Sarezky, Aaishah R Raquib, Joshua L Dunaief, Benjamin J Kim Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Purpose: Alpha lipoic acid (ALA is an antioxidant and iron-chelating supplement that has potential benefits for geographic atrophy in dry age-related macular degeneration as well as other eye diseases. The purpose of this study was to determine the tolerability of ALA in the elderly population. Patients and methods: Fifteen subjects, age ≥65 years, took sequential ALA doses of 600, 800, and 1,200 mg. Each dose was taken once daily with a meal for 5 days. After each dose was taken by the subjects for 5 days, the subjects were contacted by phone, a review of systems was performed, and they were asked if they thought they could tolerate taking that dose of ALA for an extended period of time. Results: The 600 mg dose was well tolerated. At the 800 mg dose, one subject had an intolerable flushing sensation. At the 1,200 mg dose, two subjects had intolerable upper gastrointestinal side effects and one subject had an intolerable flushing sensation. Subjects taking gastrointestinal prophylaxis medications had no upper gastrointestinal side effects. Conclusion: High-dose ALA is not completely tolerated by the elderly. These preliminary data suggest that gastrointestinal prophylaxis may improve tolerability. (ClinicalTrials.gov, NCT02613572. Keywords: age-related macular degeneration, geographic atrophy, antioxidant, gastrointestinal, dietary supplements, lipoic acid

  16. High-resolution intracranial vessel wall MRI in an elderly asymptomatic populat