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Sample records for dwelling older adults

  1. Resilience in Rural Community-Dwelling Older Adults

    Science.gov (United States)

    Wells, Margaret

    2009-01-01

    Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…

  2. Psychological and socioeconomic health of community-dwelling older adults.

    Science.gov (United States)

    Chen, Kuei-Min; Lin, Mei-Hui; Wang, Yueh-Chin; Li, Chun-Huw; Huang, Hsin-Ting

    2013-01-01

    Different dimensions of health are intertwined. The purposes of this study were: (1) to investigate the psychological and socioeconomic health status of community-dwelling older adults in Taiwan, and (2) to compare the psychological and socioeconomic health differences among people of different age groups, gender, marital status, and exercise habits. Using stratified random sampling, 384 Taiwanese community-dwelling older adults were recruited for this survey research. Based on the Health Model of Older Adults, seven constructs were measured: (1) psychological health: sleep quality, emotional health, cognitive functioning, and health promotion behaviors; (2) socioeconomic health: social engagement, social support, and financial status. Results showed that most participants were in a good state of psychological and socioeconomic health, except that 38.02% of them suffered from sleep disruptions, and the majority of them were not involved in any social group, nor engaged in any volunteer work. Young-old older adults had better psychological and socioeconomic health than middle-old and old-old older adults. Male older adults had better psychological health than female older adults; however, they had less social engagement and social support than female older adults. Married older adults and exercisers performed better in most of the psychological and socioeconomic health indicators than single/widowed older adults and non-exercisers.

  3. Prevalence of cognitive impairment in community-dwelling older adults.

    Science.gov (United States)

    Rashedi, Vahid; Rezaei, Mohammad; Gharib, Masoud

    2014-01-01

    Mild cognitive impairment can be considered as an intermediate clinical state between normal cognitive aging and mild dementia. Elderly people with this impairment represent an at-risk group for the development of dementia. The aim of this study was to investigate the prevalence of cognitive impairment in community-dwelling older adults by Mini-Mental State Examination (MMSE) and its relationship with socio-demographic variables. In this analytical-descriptive study, 212 subjects admitted to Hamadan's day care centers were selected through simple random sampling method. To gather the data, MMSE was used as well as a questionnaire containing demographic variables. Data analysis was completed through SPSS-16. The sample consisted of 17.9% male, 59.4% of whom were married. According to the results, 96 cases (45.3%) suffered from mild (MMSE≥22), 110 cases (51.9%) from moderate (11≤MMSE≤21) and 6 cases (2.8%) from severe cognitive disorder (MMSE≤10). As findings revealed, factors such as age (Pv = 0.005, r = -0.491) and schooling (Pv cognitive decline in community-dwelling older adults was of normal range. Hence, familial relations and social support can decrease mental status disorder.

  4. Neighborhood Environment and Falls among Community-Dwelling Older Adults.

    Science.gov (United States)

    Nicklett, Emily Joy; Lohman, Matthew C; Smith, Matthew Lee

    2017-02-10

    Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006-2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interval (CI): 0.93-0.99) and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90-0.98). A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93-0.99) and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91-1.00) in adjusted models. Conclusions: The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings.

  5. Macronutrient intake and inadequacies of community-dwelling older adults, a systematic review

    NARCIS (Netherlands)

    Borg, ter S.J.; Verlaan, S.; Mijnarends, D.; Schols, J.M.G.A.; Groot, de C.P.G.M.; Luiking, Y.C.

    2015-01-01

    Background: Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. Summary: This systematic review provides a comprehensive overview of the energy an

  6. Acceptability of wristband activity trackers among community dwelling older adults.

    Science.gov (United States)

    O'Brien, Tara; Troutman-Jordan, Meredith; Hathaway, Donna; Armstrong, Shannon; Moore, Michael

    2015-01-01

    Wristband activity trackers have become widely used among young adults. However, few studies have explored their use for monitoring and improving health outcomes among older adults. The purpose of this study was to evaluate the feasibility and utility of activity tracker use among older adults for monitoring activity, improving self-efficacy, and health outcomes. A 12-week pilot study was conducted to evaluate the feasibility and utility of mobile wristband activity trackers. The sample (N = 34) was 65% women 73.5 ± 9.4 years of age who had a high school diploma or GED (38%) and reported an income ≤$35,000 (58%). Participants completing the study (95%) experienced a decrease in waist circumference (p > 0.009), however no change in self-efficacy. Participants found activity trackers easy to use which contributed to minimal study withdrawals. It was concluded that activity trackers could be useful for monitoring and promoting physical activity and improving older adults' health.

  7. Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

    Science.gov (United States)

    Bandayrel, Kristofer; Wong, Sharon

    2011-01-01

    Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

  8. The Relationship of Sleep Duration with Obesity and Sarcopenia in Community-Dwelling Older Adults.

    Science.gov (United States)

    Chien, Meng-Yueh; Wang, Li-Ying; Chen, Hsi-Chung

    2015-01-01

    Numerous studies have reported the relationship between sleep duration and obesity in elderly adults; however, little is known about the relationship of sleep duration and sarcopenia. We examined the relationship of sleep duration with obesity and sarcopenia in community-dwelling older adults. A total of 488 community-dwelling adults (224 men and 264 women) aged ≥65 years were included in the analysis. Self-reported sleep duration and anthropometric data were collected. Skeletal muscle mass was estimated using the predicted equation from a bioelectrical impedance analysis measurement. Obesity and sarcopenia were defined according to the body mass index and the skeletal muscle mass index, respectively. The association between sleep duration and sarcopenia exhibited a U shape in older adults. Compared to adults with 6-8 h of sleep, adults with adults with ≥8 h of sleep had a nearly 2-fold increased risk of sarcopenia (OR: 1.89, 95% CI: 1.01-3.54). Older adults with a sleep duration obesity (OR: 2.15, 95% CI: 1.08-4.30). After gender stratification, the association between obesity and short sleep duration was more robust in women. There were significant associations of sleep duration with either obesity or sarcopenia in community-dwelling older adults. Gender differences in these associations were also observed.

  9. Improving nursing students' assessment of fall risk in community-dwelling older adults.

    Science.gov (United States)

    Patton, Susan K

    2016-12-09

    Nationally, approximately one third of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence-based protocols by health care providers to identify older adults at risk of falling is limited, and rates of participation by older adults in prevention activities is low. Because of nursing's increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community-dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 undergraduate nursing students and 22 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult. After completing the clinical assignment, students completed a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. Results revealed an increase in knowledge and student self-reporting of efficacy of fall risk assessment skills for the older adult population. This study suggests that nursing students acquired the necessary knowledge and self-efficacy for assessing fall risk of older adults through the combination of an online learning module and participating in actual fall risk assessment of an older adult.

  10. Urinary incontinence, mental health and loneliness among community-dwelling older adults in Ireland

    DEFF Research Database (Denmark)

    Stickley, Andrew; Santini, Ziggi Ivan; Koyanagi, Ai

    2017-01-01

    Background Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland. Methods Data were analyzed from...... frequency of UI and activity limitations due to UI were both significantly associated with loneliness prior to adjustment for mental disorders, neither association remained significant after adjustment for both depression and anxiety. Conclusion UI is associated with higher odds for loneliness among older...... community-dwelling adults but this association is largely explained by comorbid mental health problems, in particular, depression....

  11. Micronutrient intakes and potential inadequacies of community-dwelling older adults: a systematic review

    NARCIS (Netherlands)

    Borg, ter S.; Verlaan, S.; Hemsworth, J.; Mijnarends, D.; Schols, J.M.G.A.; Luiking, Y.C.; Groot, de C.P.G.M.

    2015-01-01

    Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial fo

  12. Micronutrient intakes and potential inadequacies of community-dwelling older adults: a systematic review

    NARCIS (Netherlands)

    Borg, ter S.; Verlaan, S.; Hemsworth, J.; Mijnarends, D.; Schols, J.M.G.A.; Luiking, Y.C.; Groot, de C.P.G.M.

    2015-01-01

    Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial fo

  13. The effectiveness of Pilates on balance and falls in community dwelling older adults.

    Science.gov (United States)

    Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

    2016-10-01

    The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Risk of falling, fear of falling and functionality in community-dwelling older adults

    OpenAIRE

    Fernandes, Beatriz; Tomás, Mª Teresa; Quirino, Diogo

    2016-01-01

    Ageing among Portuguese population is leading to an increase in the proportion of elderly people. Age-related changes are responsible for high levels of disability, balance problems and high risk of falls, Physiotherapy can identify elderly in risk of falling and provide strategies to prevent falls in this population contributing to maintain functionality. The purpose of this study was to characterise the risk of falling in a sample of community-dwelling older adults and investigate the assoc...

  15. Sedentary behavior and sleep efficiency in active community-dwelling older adults

    OpenAIRE

    Madden, Kenneth M.; Ashe, Maureen C; Chris Lockhart; Chase, Jocelyn M.

    2014-01-01

    Objectives: Previous studies have demonstrated that aerobic exercise interventions have a positive impact on sleep efficiency in older adults. However, little work has been done on the impact of sedentary behavior (sitting, watching television, etc.) on sleep efficiency. Methods: 54 Community-dwelling men and women >65 years of age living in Whistler, British Columbia (mean 71.5 years) were enrolled in this cross-sectional observational study. Measures of sleep efficiency as well as averag...

  16. Predicting sarcopenia from functional measures among community-dwelling older adults.

    Science.gov (United States)

    Gray, Michelle; Glenn, Jordan M; Binns, Ashley

    2016-02-01

    Sarcopenia is defined as age-related lean tissue mass (LTM) loss resulting in reduced muscular strength, physical function, and mobility. Up to 33 % of older adults currently are sarcopenic, with likely many more undiagnosed. The purpose of this investigation was to predict sarcopenia status from easily accessible functional measures of community-dwelling older adults. Forty-three community-dwelling older adults (n = 32 females and n = 11 males) participated in the present investigation. Inclusion criteria included ≥65 years of age, mini-mental state examination score ≥24, and no falls within previous 12 months. All subjects completed their appendicular skeletal mass (ASM) assessment via dual-energy X-ray absorptiometry (DXA) and were categorized as either sarcopenic or non-sarcopenic. Physical assessments included 10-m usual walk, hand-grip (HG) strength, 6-min walk, 8-ft up-and-go, 30-s chair stand, 30-s arm curl, and sit-to-stand muscular power. A forward, stepwise multiple regression analysis revealed that age, sex, weight, height, 10-m walk, HG, and sit-to-stand muscular power account for 96.1 % of the variance in ASM. The area under the curve was 0.92 for correctly identifying sarcopenic participants compared to their actual classification. This is the first prediction model used to identify sarcopenia based on parameters of demographic and functional fitness measures in community-dwelling older adults. The ability to accurately identify sarcopenia in older adults is imperative to their quality of life and ability to perform activities of daily living.

  17. Physical performance measures that predict faller status in community-dwelling older adults.

    Science.gov (United States)

    Macrae, P G; Lacourse, M; Moldavon, R

    1992-01-01

    Falls are a leading cause of fatal and nonfatal injuries among the elderly. Accurate determination of risk factors associated with falls in older adults is necessary, not only for individual patient management, but also for the development of fall prevention programs. The purpose of this study was to evaluate the effectiveness of clinical measures, such as the one-legged stance test (OLST), sit-to-stand test (STST), manual muscle tests (MMT), and response speed in predicting faller status in community-dwelling older adults (N = 94, age 60-89 years). The variables assessed were single-leg standing (as measured by OLST), STST, and MMT of 12 different muscle groups (hip flexors, hip abductors, hip adductors, knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors, shoulder flexors, shoulder abductors, elbow flexors, elbow extensors, and finger flexors), and speed of response (as measured by a visual hand reaction and movement time task). Of the 94 older adults assessed, 28 (29.7%) reported at least one fall within the previous year. The discriminant analysis revealed that there were six variables that significantly discriminated between fallers and nonfallers. These variables included MMT of the ankle dorsiflexors, knee flexors, hip abductors, and knee extensors, as well as time on the OLST and the STST. The results indicate that simple clinical measures of musculoskeletal function can discriminate fallers from nonfallers in community-dwelling older adults. J Orthop Sports Phys Ther 1992;16(3):123-128.

  18. Personal factors predictive of health-related lifestyles of community-dwelling older adults.

    Science.gov (United States)

    Peralta-Catipon, Terry; Hwang, Jengliang Eric

    2011-01-01

    We explored personal factors that can predict health-related lifestyles of community-dwelling older adults. A convenience sample of 253 older adults was recruited to complete the Health Enhancement Lifestyle Profile (HELP), a comprehensive measure of health-promoting behaviors. Data were analyzed through univariate correlational/comparative statistics followed by stepwise multiple regression analysis to determine significant predictor variables for different aspects of health-related lifestyle. Personal health conditions, including the number of chronic diseases or impairments and self-rated health, were two strong predictors for the HELP (R2 = .571, p Leisure). When developing individualized plans for older adults in community settings, occupational therapists should consider the clients' strengths and vulnerabilities potentially derived from personal health factors and demographic attributes to yield more effective lifestyle interventions.

  19. Depression and Psychosocial Risk Factors among Community-Dwelling Older Adults in Singapore.

    Science.gov (United States)

    Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

    2015-12-01

    Depression is the most common mental and emotional disorder that emerges in the late stages of life. It is closely associated with poor health, disability, mortality, and suicide. The study examines the risk factors of depression in late life, especially the psychosocial factors, among a sample comprising 162 community-dwelling Singaporean adults aged 65 years and above. An interview-based structured survey was conducted in multiple senior activity centers located in different parts of Singapore. Results from the hierarchical regression analysis show that 32.9% of the variance in geriatric depression can be explained by the three psychosocial factors, among which loneliness, perceived social support, and the emotional regulation component of resilience are significantly associated with depression in older adults. Large-scale studies should be conducted to confirm the findings of the present study, and to further examine the predictive effects of these psychosocial factors on depression among older adults.

  20. Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults.

    Science.gov (United States)

    Tay, L; Ding, Y Y; Leung, B P; Ismail, N H; Yeo, A; Yew, S; Tay, K S; Tan, C H; Chong, M S

    2015-12-01

    With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this cross-sectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, C-reactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR = 5.71, 95% CI 1.13-28.84.44, p = 0.035) while higher but acceptable range serum triglyceride was protective in men (OR = 0.05, 95% CI 0.00-0.52, p = 0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR = 1.11, 95% CI 1.00-1.24, p = 0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1% decline in odds of sarcopenia in women (p = 0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted

  1. [Individual reminiscence therapy improves self-esteem for Japanese community-dwelling older adults].

    Science.gov (United States)

    Nomura, Nobutake

    2009-04-01

    This study examined the effects of individual reminiscence therapy in Japanese community-dwelling older adults without dementia. Participants (twenty three men and fifty seven women, mean age = 82.6 yrs) were recruited from a community day-care center. They were randomly assigned to a reminiscence therapy group or a control group. Participants in the reminiscence group completed five or six weekly sessions (30-60 minutes) of individual reminiscence therapy. Participant's depression, life satisfaction, and self-esteem were assessed before and after the sessions. The results showed that the reminiscence group had a significant improvement in self-esteem. Thus individual reminiscence therapy can be a tool to maintain or improve self-esteem for Japanese older adults without dementia.

  2. Chair yoga: benefits for community-dwelling older adults with osteoarthritis.

    Science.gov (United States)

    Park, Juyoung; McCaffrey, Ruth

    2012-05-01

    The aim of this pilot study was to examine whether chair yoga was effective in reducing pain level and improving physical function and emotional well-being in a sample of community-dwelling older adults with osteoarthritis. One-way repeated measures analysis of variance was performed to examine the effectiveness of chair yoga at baseline, midpoint (4 weeks), and end of the intervention (8 weeks). Although chair yoga was effective in improving physical function and reducing stiffness in older adults with osteoarthritis, it was not effective in reducing pain level or improving depressive symptoms. Future research planned by this team will use rigorous study methods, including larger samples, randomized controlled trials, and follow up for monitoring home practice after the interventions.

  3. Correlates of excessive daytime sleepiness in community-dwelling older adults: an exploratory study.

    Science.gov (United States)

    Lima, Camila Astolphi; Soares, Wuber Jefferson de Souza; Bilton, Tereza Loffredo; Dias, Rosângela Corrêa; Ferrioll, Eduardo; Perracini, Monica Rodrigues

    2015-01-01

    Excessive daytime sleepiness (EDS) imposes a wide range of adverse health-related outcomes in older people, such as disability, which impair everyday activities and may increase the risk of fall. Few studies have explored EDS in Brazilian older people living in the community who are typically cared in primary health services. This study aims to investigate the prevalence of EDS and its sociodemographic, physical and mental health correlates among community-dwelling older adults. This is an exploratory, population-based study derived from Frailty in Brazilian Older Adults (FIBRA) study including adults aged 65 years and older. Participants with a score ≥ 11 points on the Epworth Sleepiness Scale were considered as having excessive daytime sleepiness. A structured, multidimensional questionnaire was used to investigate sociodemographic, physical and mental health, and self-rated health variables. The sample was composed of 776 older adults, of whom 21% (n = 162) presented excessive daytime sleepiness. Multivariate regression analysis revealed that EDS is associated with obesity (OR = 1.50; 95%CI 1.02 - 2.20), urinary incontinence (OR = 1.53; 95%CI 1.01 - 2.31), poor self-rated health (OR = 1.54; 95%CI 1.06 - 2.24), and depression symptoms (OR = 1.49; 95%CI 1.00 - 2.20). Our results suggest that healthcare professionals should identify older adults with EDS and implement intervention strategies to minimize the negative impact of the co-occurrence of this condition with obesity, depression and urinary incontinence over health and quality of life.

  4. Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

    OpenAIRE

    Makino, Keitaro; Ihira, Hikaru; MIZUMOTO, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

    2015-01-01

    [Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older...

  5. Toward a better understanding of loneliness in community-dwelling older adults.

    Science.gov (United States)

    Smith, Judith M

    2012-01-01

    The purpose of this interpretive phenomenological study was to explore the meaning of loneliness in community-dwelling older adults and to understand their daily practices in coping with loneliness. The sample consisted of 8 women and 4 men. Interviews were conducted with the 12 participants utilizing several tools, including 3 separate interview guides and the UCLA Loneliness Scale, Version 3 (Russell, 1996). A critical finding was that many participants experienced loneliness as a result of disrupted meaningful engagement, due to age-related changes, as well as other losses, including death of spouse, retirement, and giving up the car. Two paradigm cases and themes representing the loneliness and coping experience emerged. Participant coping practices with loneliness included reaching out to others, helping those in need, and seeking companionship with pets. Many older adults are at risk for loneliness because of declining health and other age-related losses that prevent them from remaining engaged in meaningful relationships. Health care professionals can screen for loneliness to identify those at risk and can intervene to help older adults maintain connections. Recommendations for those caring for lonely older adults include active listening, vision and hearing screenings, transportation needs, pet therapy, volunteering, and engagement in social activities.

  6. Developing a personal health record for community-dwelling older adults and clinicians: technology and content.

    Science.gov (United States)

    Monsen, Karen A; Westra, Bonnie L; Paitich, Nadine; Ekstrom, Dawn; Mehle, Susan C; Kaeding, Maggie; Abdo, Sajeda; Natarajan, Gowtham; Ruddarraju, Uday Kumar Raju

    2012-07-01

    To empower older consumers and improve health outcomes, a consumer-friendly personal health record (PHR) is needed. The purpose of this article was to evaluate PHR technology and content for older community-dwelling consumers. Specific aims were to: (a) develop a secure, web-based application for a PHR to enable interoperable exchanges of data between consumers and clinicians; (b) develop structured, evidence-based shared care plan content for the PHR using an interface terminology standard; and (c) validate the shared care plans with consumers. An interoperable web-based form was developed. The standardized PHR content was developed by expert panel consensus using the Omaha System problem list and care plans, and validated by consumer interviews. Evidence-based shared care plans for 21 problems common among community-dwelling older adults were developed and encoded with Omaha System terms for data capture in the PHR. An additional problem, Neighborhood-workplace safety, was identified by consumers and will be added to the care plans.

  7. Current status and trends in oral health in community dwelling older adults: a global perspective.

    Science.gov (United States)

    Kossioni, Anastassia E

    2013-01-01

    To record the available current national and regional data on the oral health of community-dwelling (living in their own homes, not institutionalised) older people globally and discuss the future trends considering existing dangers and opportunities. A literature search on tooth loss, dental decay and periodontal disease in the elderly was performed using available databases and electronic sources. The findings revealed that the updated national data are scarce in many parts of the world, particularly in Africa, Asia and South America, and direct comparisons are not always possible due to methodological variations. The available information may indicate that dental disease in older adults worldwide is more prevalent compared to younger age groups, with significant variation between countries and regions. Tooth loss is currently more common in the developed countries, while dental decay and periodontal disease are more widespread globally. There are important threats for further deterioration of the oral status among older adults in many developed and less developed areas due to existing sociodemographic and economic risk factors. National studies should be undertaken to record the specific oral problems of the elderly in each area. It is also necessary to develop gerodontology study programmes globally at the undergraduate, postgraduate and continuing education levels which will enhance dentists' knowledge, skills and attitudes towards oral care in the older population, and will promote opportunities for further research and development of relevant policies.

  8. Tooth loss and dental caries in community-dwelling older adults in northern Manhattan

    Science.gov (United States)

    Northridge, Mary E.; Ue, Frances V.; Borrell, Luisa N.; De La Cruz, Leydis D.; Chakraborty, Bibhas; Bodnar, Stephanie; Marshall, Stephen; Lamster, Ira B.

    2011-01-01

    Objective To examine tooth loss and dental caries by sociodemographic characteristics from community-based oral health examinations conducted by dentists in northern Manhattan. Background The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City. Materials and Methods Self-reported sociodemographic characteristics and health and health care information were provided by community-dwelling ElderSmile participants aged 65 years and older who took part in community-based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%). Results The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non-Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism. Conclusion Provision of oral health screenings in community-based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults. PMID:21718349

  9. Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Tuntl

    2016-09-01

    Full Text Available Hanne Tuntland,1,2 Mona Kristin Aaslund,1 Eva Langeland,2 Birgitte Espehaug,3 Ingvild Kjeken4,5 1Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; 2Centre for Care Research Western Norway, Bergen University College, Bergen, Norway; 3Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; 4National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Bergen, Norway; 5Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences,Oslo, Norway Background: The Canadian Occupational Performance Measure (COPM is an occupational therapy instrument designed to help participants identify, prioritize, and evaluate performance of important occupations.Objective: To investigate the validity, responsiveness, interpretability, and feasibility of the COPM when used by various health professions in home-dwelling older adults receiving reablement. Reablement is a new form of multidisciplinary home-based rehabilitation for older adults experiencing functional decline.Participants and methods: The sample of 225 participants, mean age 80.8 years, who were in need of rehabilitation for various health conditions were included in the study. Data collection was conducted at baseline and at 10 weeks follow-up. The COSMIN guidelines and recommendations for evaluating methodological quality were followed.Results: Content validity, construct validity, and feasibility were found to be adequate. Responsiveness, however, was moderate. Functional mobility was the most frequently prioritized occupational category of all. Regarding interpretability, the minimal important change was 3.0 points and 3.2 points for performance and satisfaction, respectively. The older adults reported that COPM was a useful and manageable instrument. The majority of the occupational therapists

  10. Fitness, Balance Efficacy, and Postural Control in Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Anna Lee

    2016-02-01

    Full Text Available Age-related declines in postural control and physical fitness are strong risk factors for falls in older adults. Balance efficacy has been utilized to identify poor postural control, reduced physical function, and fall risk. However, it is not clear as to whether balance efficacy is truly a better predictor of functional fitness outcomes or postural control. Distinguishing these associations is an important step in the future derivation of physiotherapeutic programming to remediate acute and chronic decline. Therefore, the purpose of this cross-sectional study was to partition which measures are more associated with balance efficacy, fitness, or postural control. One hundred eleven community-dwelling older adults participated and were asked to complete the Balance Efficacy Scale (BES, a functional fitness measure (the Senior Fitness Test [SFT], and a measure of postural control (the Sensory Organization Test [SOT].We found that the SFT was more significantly associated with balance efficacy (R2 = .37 than the SOT (R2 = .08 in older adults. Overall, aerobic endurance, functional mobility in the SFT, and the vestibular score on the SOT were significantly associated with balance efficacy. We concluded that clinicians utilizing the BES as a preliminary screen should recommend physiotherapy follow-up activities that build endurance (walking, lower extremity functional mobility (sit-to-stand, and vestibular function (head movement while walking. Understanding the links between a preliminary screening tool and the physiological needs of the patient will allow for targeted activities to be prescribed.

  11. Frailty in community-dwelling older adults: association with adverse outcomes

    Science.gov (United States)

    Sánchez-García, Sergio; García-Peña, Carmen; Salvà, Antoni; Sánchez-Arenas, Rosalinda; Granados-García, Víctor; Cuadros-Moreno, Juan; Velázquez-Olmedo, Laura Bárbara; Cárdenas-Bahena, Ángel

    2017-01-01

    Background The study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults. Methods A cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (≥60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City. Data were derived from the database of the “Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults” (COSFOMA). Operationalization of the phenotype of frailty was performed using the criteria of Fried et al (weight loss, self-report of exhaustion, low physical activity, slow gait, and weakness). Adverse outcomes studied were limitation in basic activities of daily living (ADLs), falls and admission to emergency services in the previous year, and low quality of life (WHOQOL-OLD). Results Frailty was identified in 20.6% (n=258), pre-frailty in 57.6% (n=721), and not frail in 21.8% (n=273). The association between frailty and limitations in ADL was odds ratio (OR) =2.3 (95% confidence interval [CI] 1.7–3.2) and adjusted OR =1.7 (95% CI 1.2–2.4); falls OR =1.6 (95% CI 1.2–2.1) and adjusted OR =1.4 (95% CI 1.0–1.9); admission to emergency services OR =1.9 (95% CI 1.1–3.1) and adjusted OR =1.9 (95% CI 1.1–3.4); low quality of life OR =3.4 (95% CI 2.6–4.6) and adjusted OR =2.1 (95% CI 1.5–2.9). Conclusion Approximately 2 out of 10 older adults demonstrate frailty. This is associated with limitations in ADL, falls, and admission to emergency rooms during the previous year as well as low quality of life. PMID:28721028

  12. Correlate of self-care and self-neglect among community-dwelling older adults

    Science.gov (United States)

    Mardan, Homa; Hamid, TengkuAizan; Redzuan, Ma’rof; Ibrahim, Rahimah

    2014-01-01

    Background: The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. Materials and Methods: A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. Results: The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. Conclusions: The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being. PMID:25949256

  13. Association between physiological falls risk and physical performance tests among community-dwelling older adults

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    Singh DK

    2015-08-01

    Full Text Available Devinder KA Singh,1 Sharmila GK Pillai,1 Sin Thien Tan,1 Chu Chiau Tai,1 Suzana Shahar2 1Physiotherapy Programme, School of Rehabilitation Sciences, 2Nutrition and Dietetics Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia Background: Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA, a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests.Methods: One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males, aged 60 years and above (65.77±4.61, participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST, short physical performance battery (SPPB, functional reach test (FRT, static balance test (SBT, TUG, dominant hand-grip strength (DHGS, and gait speed test (GST were also performed. Spearman’s rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests with falls risk (dependent variable.Results: Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05 were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01 weak correlation

  14. Personality Traits among Community-Dwelling Chinese Older Adults in the Greater Chicago Area

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    E-Shien Chang

    2014-10-01

    Full Text Available Objectives: Personality traits are important indicators of health and well-being. Neuroticism and conscientiousness in particular, are closely associated with morbidity and mortality in old age. However, little is known regarding the levels of these two key personality traits among U.S. Chinese older adults. This report aimed to examine the levels of personality traits among this population. Methods: Data were from the PINE study, a population-based study of U.S. Chinese older adults aged 60 and above. We measured neuroticism and conscientiousness using modified NEO personality inventory. Results: Of the 3,159 community-dwelling Chinese older adults, 58.9% were female, and mean age was 72.8 years. Compared to neuroticism, conscientiousness trait was endorsed higher among Chinese older adults in our sample. Each conscientiousness item had at least 67.8% of participant endorsement, in comparison to the lowest endorsement rate of 14.3% in the neuroticism measure. Younger age (r-neuroticism = -0.06, r-conscientiousness = -0.14 and fewer children (r-neuroticism = -0.06, r-conscientiousness = -0.06 were correlated with both traits. Female gender (r = 0.11, poorer health status (r = -0.26, poorer quality of life (r = -0.23 and worsened health over the past year (r = -0.15 were correlated with higher levels of neuroticism. In contrast, male gender (r = -0.05, better health status (r = 0.20, higher quality of life (r = 0.17 and improved health over the past year (r = 0.07 were correlated with higher levels of conscientiousness. Education level (r = 0.15 was positively correlated with higher levels of conscientiousness, but not with neuroticism; whereas income level (r = -0.04 was negatively correlated with neuroticism but not with conscientiousness. Conclusion: U.S. Chinese older adults generally possess higher agreement level on conscientiousness traits than neuroticism. Future analysis should be conducted to explore the complex associations between

  15. Predictors of Adult Education Program Satisfaction in Urban Community-Dwelling Older Adults

    Science.gov (United States)

    Yamashita, Takashi; López, Erick B.; Keene, Jennifer R.; Kinney, Jennifer M.

    2015-01-01

    Lifelong learning is receiving greater attention due to population aging in modern societies. Lifelong learning benefits individuals by supporting their physical, psychological, social, and economic well-being. However, older adults generally have lower motivation for learning than younger adults, and facilitating long-term participation in…

  16. The power of power wheelchairs: Mobility choices of community-dwelling, older adults.

    Science.gov (United States)

    Mortenson, William Bennett; Hammell, Karen W; Luts, Anneli; Soles, Chelsea; Miller, William C

    2015-01-01

    Power wheelchairs are purported to have a positive effect on health, occupation, and quality of life. However, there is limited knowledge about what factors shape power wheelchair use decisions. A study was undertaken to understand the mobility choices of community-dwelling, power wheelchair users. A series of semi-structured qualitative interviews was conducted with 13 older adult power wheelchair users. Participants were interviewed at enrollment and four months later. Data analysis was informed by Bourdieu's theoretical constructs of habitus, capital, and field. Three main styles of power wheelchair use were identified: reluctant use, strategic use, and essential use, and each type is illustrated using an aggregate case study. These findings highlight the need to alter the power relationship that exists between prescribers and device users and to effect policy changes that enable people with physical impairments to make as wide a range of mobility choices as possible.

  17. The power of power wheelchairs: Mobility choices of community-dwelling, older adults

    Science.gov (United States)

    Mortenson, WB; Hammell, KW; Luts, A; Soles, C; Miller, WC

    2015-01-01

    Background Power wheelchairs are purported to have a positive effect on health, occupation, and quality of life. However, there is limited knowledge about what factors shape power wheelchair use decisions. Aims/Objectives A study was undertaken to understand the mobility choices of community-dwelling, power wheelchair users. Methods A series of semi-structured qualitative interviews was conducted with 13 older adult power wheelchair users. Participants were interviewed at enrollment and four months later. Data analysis was informed by Bourdieu’s theoretical constructs of habitus, capital, and field. Results Three main styles of power wheelchair use were identified: reluctant use, strategic use and essential use, and each type is illustrated using an aggregate case study. Conclusion/Significance These findings highlight the need to alter the power relationship that exists between prescribers and device users and to effect policy changes that enable people with physical impairments to make as wide a range of mobility choices as possible. PMID:26027749

  18. Social Frailty in Community-Dwelling Older Adults as a Risk Factor for Disability.

    Science.gov (United States)

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

    2015-11-01

    To determine social frailty status using simple questions and to examine the association between social frailty and disability onset among community-dwelling older adults. Prospective cohort study. Japanese community. A total of 4304 adults age ≥65 years living in the community participated in a baseline assessment from 2011 to 2012. They were followed monthly for incident certification of care needs during the 2 years after the baseline assessment. Care-needs certification in the national long-term care insurance system of Japan; a self-reported questionnaire including 7 items to define social frailty status, adjustment for several potential confounders such as demographic characteristics; and Kaplan-Meier survival curves for disability incidence by social frailty. During the 2 years, 144 participants (3.3%) were certified as requiring long-term care insurance in accordance with incident disability. Five of the 7 items in the self-reported questionnaire were significantly associated with disability incidence. In the adjusted model including potential covariates, participants who were defined as having social frailty (≥2/5) (hazard ratio 1.66, 95% confidence interval 1.00-2.74) and prefrailty (=1/5) (hazard ratio 1.53, 95% confidence interval 1.02-2.531), based on 5 items at the baseline assessment, had an increased risk of disability compared with nonfrail participants (=0/5). Social frailty, assessed using simple questions regarding living alone, going out less frequently compared with the prior year, visiting friends sometimes, feeling helpful to friends or family, and talking with someone every day, has a strong impact on the risk of future disability among community-dwelling older people. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. Theory-Driven Intervention Improves Calcium Intake, Osteoporosis Knowledge, and Self-Efficacy in Community-Dwelling Older Black Adults

    Science.gov (United States)

    Babatunde, Oyinlola T.; Himburg, Susan P.; Newman, Frederick L.; Campa, Adriana; Dixon, Zisca

    2011-01-01

    Objective: To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. Design: Randomized repeated measures experimental design. Setting: Churches and community-based organizations. Participants: Men and women (n = 110) 50 years old and older…

  20. Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment

    NARCIS (Netherlands)

    Uffelen, J.G.Z. van; Chinapaw, M.J.M.; Hopman-Rock, M.; Mechelen, W. van

    2009-01-01

    This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty pa

  1. Sleep and Cognition in Community-Dwelling Older Adults: A Review of Literature

    Directory of Open Access Journals (Sweden)

    Glenna S. Brewster

    2015-12-01

    Full Text Available Changes in sleep and cognition occur with advancing age. While both may occur independently of each other, it is possible that alterations in sleep parameters may increase the risk of age-related cognitive changes. This review aimed to understand the relationship between sleep parameters (sleep latency, wake after sleep onset, sleep efficiency, sleep duration, general sleep complaints and cognition in community-dwelling adults aged 60 years and older without sleep disorders. Systematic, computer-aided searches were conducted using multiple sleep and cognition-related search terms in PubMed, PsycINFO, and CINAHL. Twenty-nine manuscripts met the inclusion criteria. Results suggest an inconsistent relationship between sleep parameters and cognition in older adults and modifiers such as depressive symptoms, undiagnosed sleep apnea and other medical conditions may influence their association. Measures of sleep and cognition were heterogeneous. Future studies should aim to further clarify the association between sleep parameters and cognitive domains by simultaneously using both objective and subjective measures of sleep parameters. Identifying which sleep parameters to target may lead to the development of novel targets for interventions and reduce the risk of cognitive changes with aging.

  2. Dietary protein intake is associated with lean body mass in community-dwelling older adults.

    Science.gov (United States)

    Geirsdottir, Olof G; Arnarson, Atli; Ramel, Alfons; Jonsson, Palmi V; Thorsdottir, Inga

    2013-08-01

    Lean body mass (LBM) is important to maintain physical function during aging. We hypothesized that dietary protein intake and leisure-time physical activity are associated with LBM in community-dwelling older adults. To test the hypothesis, participants (n = 237; age, 65-92 years) did 3-day weighed food records and reported physical activity. Body composition was assessed using dual-energy x-ray absorptiometry. Protein intake was 0.98 ± 0.28 and 0.95 ± 0.29 g/kg body weight in male and female participants, respectively. Protein intake (in grams per kilogram of body weight) was associated with LBM (in kilograms); that is, the differences in LBM were 2.3 kg (P protein intake, respectively. Only a minor part of this association was explained by increased energy intake, which follows an increased protein intake. Our study shows that dietary protein intake was positively associated with LBM in older adults with a mean protein intake higher than the current recommended daily allowance of 0.8 g/kg per day. Leisure-time physical activity, predominantly consisting of endurance type exercises, was not related to LBM in this group.

  3. Relation of Late-Life Social Activity With Incident Disability Among Community-Dwelling Older Adults

    Science.gov (United States)

    Boyle, Patricia A.; Buchman, Aron S.; Bennett, David A.

    2011-01-01

    Background. We tested the hypothesis that a higher level of social activity was associated with decreased risk of incident disability in older adults. Methods. Data came from older adults in the Rush Memory and Aging Project, an ongoing longitudinal cohort study of aging. Analyses were restricted to persons without clinical dementia and reporting no need for help performing any task in the particular functional domain assessed. Participants were followed for an average of 5.1 years (SD = 2.5). Social activity, based on 6 items (visiting friends or relatives; going to restaurants, sporting events, or playing games; group meetings; church/religious services; day or overnight trips; unpaid community/volunteer work), was assessed at baseline. Disability in basic activities of daily living, mobility disability, and instrumental activities of daily living was assessed annually. Proportional hazard models adjusted for age, sex, and education were used to examine the association between social activity and incident disability. Fully adjusted models included terms for depression, vascular diseases and risk factors, body mass index, social networks, and self-reported physical activity. Results. In fully adjusted models, among 954 persons without baseline disability, the risk of developing disability in activities of daily living decreased by 43% (hazard ratio = 0.57, 95% confidence interval = 0.46, 0.71) for each additional unit of social activity. Social activity was also associated with decreased risk of developing mobility disability (hazard ratio = 0.69, 95% confidence interval = 0.54, 0.88) and disability in instrumental activities of daily living (hazard ratio = 0.71, 95% confidence interval = 0.55, 0.93). Conclusions. Social activity is associated with a decreased risk of incident disability in activities of daily living, mobility, and instrumental activities of daily living, among community-dwelling older adults. PMID:21300745

  4. Community-Dwelling Adults versus Older Adults: Psychopathology and the Continuum Hypothesis

    Science.gov (United States)

    Lagana, Luciana; Tramutolo, Carmine; Boncori, Lucia; Cruciani, Anna Clara

    2012-01-01

    Little empirical evidence is available on older adults regarding the existence of a continuum between "normal" personality traits and DSM-IV-TR Axes I and II disorders (American Psychiatric Association, 2000). Given the typical complexity of clinical presentations in advanced age, it is feasible to expect a dimensional conceptualization…

  5. Community-Dwelling Adults versus Older Adults: Psychopathology and the Continuum Hypothesis

    Science.gov (United States)

    Lagana, Luciana; Tramutolo, Carmine; Boncori, Lucia; Cruciani, Anna Clara

    2012-01-01

    Little empirical evidence is available on older adults regarding the existence of a continuum between "normal" personality traits and DSM-IV-TR Axes I and II disorders (American Psychiatric Association, 2000). Given the typical complexity of clinical presentations in advanced age, it is feasible to expect a dimensional conceptualization…

  6. Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews

    Science.gov (United States)

    MacGillivray, Stephen; Frost, Helen; Kroll, Thilo; Skelton, Dawn A.; Gavine, Anna; Gray, Nicola M.; Toma, Madalina; Morris, Jacqui

    2017-01-01

    Objectives While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old. Methods Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes. Results Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended). Conclusion The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are

  7. The relation between social network site usage and loneliness and mental health in community-dwelling older adults.

    Science.gov (United States)

    Aarts, S; Peek, S T M; Wouters, E J M

    2015-09-01

    Loneliness is expected to become an even bigger social problem in the upcoming decades, because of the growing number of older adults. It has been argued that the use of social network sites can aid in decreasing loneliness and improving mental health. The purpose of this study was to examine whether and how social network sites usage is related to loneliness and mental health in community-dwelling older adults. The study population included community-dwelling older adults aged 60 and over residing in the Netherlands (n = 626) collected through the LISS panel (www.lissdata.nl). Univariate and multivariate linear regression analyses, adjusted for potentially important confounders, were conducted in order to investigate the relation between social network sites usage and (emotional and social) loneliness and mental health. More than half of the individuals (56.2%) reported to use social network sites at least several times per week. Social network sites usage appeared unrelated to loneliness in general, and to emotional and social loneliness in particular. Social network sites usage also appeared unrelated to mental health. Several significant associations between related factors and the outcomes at hand were detected. In this sample, which was representative for the Dutch population, social network sites usage was unrelated to loneliness and/or mental health. The results indicate that a simple association between social network site usage and loneliness and mental health as such, cannot automatically be assumed in community-dwelling older adults. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Metabolic Syndrome and 16-year Cognitive Decline in Community-Dwelling Older Adults

    Science.gov (United States)

    McEvoy, Linda K.; Laughlin, Gail A.; Barrett-Connor, Elizabeth; Bergstrom, Jaclyn; Kritz-Silverstein, Donna; Der-Martirosian, Claudia; von Mühlen, Denise

    2012-01-01

    PURPOSE To determine whether metabolic syndrome is associated with accelerated cognitive decline in community-dwelling older adults. METHODS Longitudinal study of 993 adults (mean 66.8 ± 8.7 years) from the Rancho Bernardo Study. Metabolic syndrome components, defined by 2001 NCEP-ATP III criteria, were measured in 1984–87. Cognitive function was first assessed in 1988–92. Cognitive assessments were repeated approximately every four years, for a maximum 16-year follow-up. Mixed-effects models examined longitudinal rate of cognitive decline by metabolic syndrome status, controlling for factors plausibly associated with cognitive function (diabetes, inflammation). RESULTS Metabolic syndrome was more common in men than women (14% vs. 9%, p=0.01). In women, metabolic syndrome was associated with greater executive function and long term memory decline. These associations did not differ by inflammatory biomarker levels. Diabetes did not alter the association of metabolic syndrome with long-term recall but modified the association with executive function: metabolic syndrome was associated with accelerated executive function decline in diabetic women only. Metabolic syndrome was not related to rate of decline on any cognitive measure in men. CONCLUSIONS Metabolic syndrome was a risk factor for accelerated cognitive decline, but only in women. Prevention of metabolic syndrome may aid in maintenance of cognitive function with age. PMID:22285865

  9. Amount and type of alcohol consumption and missing teeth among community-dwelling older adults

    DEFF Research Database (Denmark)

    Heegaard, Karen; Avlund, Kirsten; Holm-Pedersen, Poul

    2011-01-01

    Objectives: To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists. Methods: A cross-sectional study including a total of 783 community-dwelling men and women aged 65...

  10. Psychometric properties of the Beck Depression Inventory II (BDI-II) among community-dwelling older adults.

    Science.gov (United States)

    Segal, Daniel L; Coolidge, Frederick L; Cahill, Brian S; O'Riley, Alisa A

    2008-01-01

    The psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-administered screening tool for depressive symptoms were examined in a sample of community-dwelling older and younger adults. Participants completed the BDI-II, the Center for Epidemiologic Studies Depression Scale, the Coolidge Axis II Inventory, the Perceived Stress Scale, and the Short Psychological Well-Being Scale. Internal reliability of the BDI-II was found to be good among older and younger adults. The average BDI-II depression score did not differ between younger and older adults. Solid evidence for convergent and discriminant validity was demonstrated by correlations between the BDI-II with the other measures. The BDI-II appears to have strong psychometric support as a screening measure for depression among older adults in the general population. Implications for using the BDI-II as an assessment instrument in behaviorally based psychotherapy are discussed.

  11. Grey matter correlates of susceptibility to scams in community-dwelling older adults.

    Science.gov (United States)

    Duke Han, S; Boyle, Patricia A; Yu, Lei; Arfanakis, Konstantinos; James, Bryan D; Fleischman, Debra A; Bennett, David A

    2016-06-01

    Susceptibility to scams is a significant issue among older adults, even among those with intact cognition. Age-related changes in brain macrostructure may be associated with susceptibility to scams; however, this has yet to be explored. Based on previous work implicating frontal and temporal lobe functioning as important in decision making, we tested the hypothesis that susceptibility to scams is associated with smaller grey matter volume in frontal and temporal lobe regions in a large community-dwelling cohort of non-demented older adults. Participants (N = 327, mean age = 81.55, mean education = 15.30, 78.9 % female) completed a self-report measure used to assess susceptibility to scams and an MRI brain scan. Results indicated an inverse association between overall grey matter and susceptibility to scams in models adjusted for age, education, and sex; and in models further adjusted for cognitive function. No significant associations were observed for white matter, cerebrospinal fluid, or total brain volume. Models adjusted for age, education, and sex revealed seven clusters showing smaller grey matter in the right parahippocampal/hippocampal/fusiform, left middle temporal, left orbitofrontal, right ventromedial prefrontal, right middle temporal, right precuneus, and right dorsolateral prefrontal regions. In models further adjusted for cognitive function, results revealed three significant clusters showing smaller grey matter in the right parahippocampal/hippocampal/fusiform, right hippocampal, and right middle temporal regions. Lower grey matter concentration in specific brain regions may be associated with susceptibility to scams, even after adjusting for cognitive ability. Future research is needed to determine whether grey matter reductions in these regions may be a biomarker for susceptibility to scams in old age.

  12. Supervision of care networks for frail community dwelling adults aged 75 years and older: protocol of a mixed methods study.

    Science.gov (United States)

    Verver, Didi; Merten, Hanneke; Robben, Paul; Wagner, Cordula

    2015-08-25

    The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation. This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ. The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  13. Effects of Reiki on anxiety, depression, pain, and physiological factors in community-dwelling older adults.

    Science.gov (United States)

    Richeson, Nancy E; Spross, Judith A; Lutz, Katherine; Peng, Cheng

    2010-07-01

    The purpose of this study was to evaluate the effect of Reiki as an alternative and complementary approach to treating community-dwelling older adults who experience pain, depression, and/or anxiety. Participants (N = 20) were randomly assigned to either an experimental or wait list control group. The pre- and posttest measures included the Hamilton Anxiety Scale, Geriatric Depression Scale-Short Form, Faces Pain Scale, and heart rate and blood pressure. The research design included an experimental component to examine changes in these measures and a descriptive component (semi-structured interview) to elicit information about the experience of having Reiki treatments. Significant differences were observed between the experimental and treatment groups on measures of pain, depression, and anxiety; no changes in heart rate and blood pressure were noted. Content analysis of treatment notes and interviews revealed five broad categories of responses: Relaxation; Improved Physical Symptoms, Mood, and Well-Being; Curiosity and a Desire to Learn More; Enhanced Self-Care; and Sensory and Cognitive Responses to Reiki.

  14. Falls in the community-dwelling older adult: A review for primary-care providers

    Directory of Open Access Journals (Sweden)

    Theresa A Soriano

    2008-01-01

    Full Text Available Theresa A Soriano1, Linda V DeCherrie2, David C Thomas11The Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA; 2Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USAAbstract: Falls in the elderly are an important independent marker of frailty. Up to half of elderly people over 65 experience a fall every year. They are associated with high morbidity and mortality and are responsible for greater than 20 billion dollars a year in healthcare costs in the United States. This article presents a review and guide for the primary care provider of the predisposing and situational risk factors for falls; comprehensive assessment for screening and tailored intervention; and discussion of single and multicomponent measures for fall prevention and management in the older person living in the community. Interventions for the cognitively impaired and demented elderly will also be addressed.Keywords: falls, elderly, community-dwelling, review

  15. Predictors of outcomes following reablement in community-dwelling older adults

    Science.gov (United States)

    Tuntland, Hanne; Kjeken, Ingvild; Langeland, Eva; Folkestad, Bjarte; Espehaug, Birgitte; Førland, Oddvar; Aaslund, Mona Kristin

    2017-01-01

    Background Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking. Objective The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up. Methods The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM). Results The results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively. Conclusion The results indicate that diagnosis, functional level

  16. Controlled whole-body vibration training reduces risk of falls among community-dwelling older adults.

    Science.gov (United States)

    Yang, Feng; King, George A; Dillon, Loretta; Su, Xiaogang

    2015-09-18

    The primary purpose of this study was to systematically examine the effects of an 8-week controlled whole-body vibration training on reducing the risk of falls among community-dwelling adults. Eighteen healthy elderlies received vibration training which was delivered on a side alternating vibration platform in an intermittent way: five repetitions of 1 min vibration followed by a 1 min rest. The vibration frequency and amplitude were 20 Hz and 3.0mm respectively. The same training was repeated 3 times a week, and the entire training lasted for 8 weeks for a total of 24 training sessions. Immediately prior to (or pre-training) and following (or post-training) the 8-week training course, all participants' risk of falls were evaluated in terms of body balance, functional mobility, muscle strength and power, bone density, range of motion at lower limb joints, foot cutaneous sensation level, and fear of falling. Our results revealed that the training was able to improve all fall risk factors examined with moderate to large effect sizes ranging between 0.55 and 1.26. The important findings of this study were that an 8-week vibration training could significantly increase the range of motion of ankle joints on the sagittal plane (6.4° at pre-training evaluation vs. 9.6° at post-training evaluation for dorsiflexion and 45.8° vs. 51.9° for plantar-flexion, pvibration training paradigm for fall prevention among older adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults

    DEFF Research Database (Denmark)

    Jørgensen, Martin; Læssøe, Uffe; Hendriksen, Carsten

    2013-01-01

    . METHODS: This randomized controlled trial examined postural balance and muscle strength in community-dwelling older adults (75±6 years) pre- and post-10 weeks of biofeedback-based Nintendo Wii training (WII, n = 28) or daily use of ethylene vinyl acetate copolymer insoles (controls [CON], n = 30). Primary......BACKGROUND: Older adults show increased risk of falling and major risk factors include impaired lower extremity muscle strength and postural balance. However, the potential positive effect of biofeedback-based Nintendo Wii training on muscle strength and postural balance in older adults is unknown...... strength (18%) than the control group at follow up (between-group difference = 269 N, 95% CI = 122; 416, and p = .001). In contrast, the center of pressure velocity moment did not differ (1%) between WII and CON at follow-up (between-group difference = 0.23mm(2)/s, 95% CI = -4.1; 4.6, and p = .92...

  18. Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults.

    Science.gov (United States)

    Pociask, Fredrick D; DiZazzo-Miller, Rosanne; Goldberg, Allon; Adamo, Diane E

    2016-01-01

    Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance.

  19. Development and Validation of the State-Trait Inventory of Cognitive Fatigue in Community-Dwelling Older Adults.

    Science.gov (United States)

    Shuman-Paretsky, Melissa; Zemon, Vance; Foley, Frederick W; Holtzer, Roee

    2017-04-01

    To develop and validate a subjective measure of cognitive fatigue-the State-Trait Inventory of Cognitive Fatigue-in community-dwelling older adults. Scale development and test construction. Community-dwelling older adults enrolled in a longitudinal cohort aging study. Participants (N=175) were healthy, English-speaking, community-dwelling adults, age ≥65 years. Not applicable. State-Trait Inventory of Cognitive Fatigue total, cognitive fatigue, motivation, mental effort, and boredom summation scores for both state and trait forms. Principal component analysis yielded the expected 4 components for both state and trait forms: cognitive fatigue, mental effort, motivation, and boredom. All components had good reliability. There was good convergent validity as measured by the strong positive relation between cognitive fatigue and a subjective measure of general fatigue, even after controlling for depressive symptoms. Greater subjective cognitive fatigue was associated with worse performance on measures thought to be more sensitive to aspects of executive functioning. This study developed and established the psychometric properties of a new instrument for the subjective measurement of cognitive fatigue for use in community-dwelling older adults. The State-Trait Inventory of Cognitive Fatigue's relatively brief administration time (<10min; mean, 5.6±2.9) and strong psychometric properties support its utility in both research and clinical settings. Future studies should establish the psychometric properties of this scale in other populations and examine its predictive utility for relevant clinical outcomes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Exercise and social support are associated with psychological distress outcomes in a population of community-dwelling older adults.

    Science.gov (United States)

    McHugh, Joanna E; Lawlor, Brian A

    2012-09-01

    Exercise reduces the likelihood of psychological distress, but this may be due to incidental socializing. We gathered information on exercise, social support and three aspects of psychological distress from 583 community-dwelling older adults. Exercise and social support from friends were both associated with lower scores of depression, anxiety and perceived stress. For infrequent exercisers, having a low level of social support indicated higher levels of depression, whereas for frequent exercisers, having a low level of social support did not affect depression levels. Both exercise and social support have roles in regulating psychological well-being in older populations and exercisers are less susceptible to effects of low social support on depression.

  1. Factors related to fear of falling among community-dwelling older adults.

    Science.gov (United States)

    Hoang, Oanh Tran Thi; Jullamate, Pornchai; Piphatvanitcha, Naiyana; Rosenberg, Edwin

    2017-01-01

    To investigate the relationship between age, gender, history of falls, balance and gait status, general health perception, activities of daily living and depression to fear of falling in community-dwelling older people in Danang, Vietnam. Fear of falling is a common and consequential psychosocial problem for older people and can lead to decreased quality of life. There is only limited research on fear of falling in Vietnam. This is a cross-sectional descriptive study. One hundred fifty-three community-dwelling older people were recruited from seven communities of different districts in Danang. Data were collected using six instruments: a demographic questionnaire, the Fall Efficacy Scale-International, the General Health Perception questionnaire, the Barthel Activities of Daily Living, the Geriatric Depression Scale and the Timed Up and Go test. Data were analysed using descriptive and correlational statistics. The mean Fall Efficacy Scale-International score was 35, indicating a high level of fear of falling. ADLs, general health perception and Timed Up and Go were significantly and negatively related to fear of falling (rp  = -0·80, rsp  = -0·77 and rp  = -0·75, respectively). Age, depression and history of falls were significantly and positively related to fear of falling (rp  = 0·54, rp  = 0·45 and rs  = 0·39, respectively). Women were significantly more likely than men to have higher fear of falling (rpb  = -0·28). Fear of falling is more common in older people who are female, have a history of falls, have poor balance and gait status, have poor health perception, have greater ADL dependency, are depressed and, within the older people population, are older. Further research could examine additional correlates of fear of falling and develop/evaluate factor-specific intervention strategies to reduce fear of falling among community-dwelling older people. Understanding correlates of fear of falling among older Vietnamese people contributes to

  2. Oily Fish Intake and Cognitive Performance in Community-Dwelling Older Adults: The Atahualpa Project.

    Science.gov (United States)

    Del Brutto, Oscar H; Mera, Robertino M; Gillman, Jennifer; Zambrano, Mauricio; Ha, Jung-eun

    2016-02-01

    Due to their high content of omega-3 polyunsaturated fatty acids, oily fish consumption is likely associated with a better cognitive performance. However, information on this association is controversial, with some studies showing a positive effect while others showing no association. We aimed to assess the effects of oily fish consumption on cognitive performance in a population of frequent fish consumers living in rural coastal Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door survey and evaluated by the use of the Montreal Cognitive Assessment (MoCA). Oily fish servings per week were calculated in all participants. We estimated whether fish intake correlated with MoCA scores in generalized multivariate linear models adjusted for demographics, cardiovascular risk factors, edentulism and symptoms of depression. Out of 330 eligible persons, 307 (93%) were enrolled. Mean MoCA scores were 19 ± 4.8 points, and mean oily fish consumption was 8.6 ± 5.3 servings per week. In multivariate analyses, MoCA scores were related to fish servings (β 0.097, 95% CI 0.005-0.188, p = 0.038). Locally weighted scatterplot smoothing showed an inflection point in the total MoCA score curve at four fish servings per week. However, predictive margins of the MoCA score were similar across groups below and above this point, suggesting a direct linear relationship between oily fish intake and cognitive performance. Simple preventive measures, such as modifying dietary habits might be of value to reduce the rate of cognitive decline in community-dwelling older adults living in underserved populations.

  3. Perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment.

    Science.gov (United States)

    Mattos, Meghan K; Burke, Lora E; Baernholdt, Marianne; Hu, Lu; Nilsen, Marci L; Lingler, Jennifer H

    2017-01-01

    Limited access to resources and delayed detection of subtle cognitive changes may negatively impact the long-term cognitive health of rural-dwelling adults. This study explored perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment. Semi-structured interviews were conducted with older, rural-dwelling adults with early-stage cognitive impairment and their care partners. Thematic content analysis was performed. Participants ( n = 9) were 73.7 ± 6.0 years of age with 14.2 ± 3.1 years of education; care partners ( n = 10) were 70.9 ± 7.4 years of age with 15.6 ± 2.3 years of education. Data analysis revealed six themes: Staying active, Eating well, Living with cognitive changes, Living rural, Connecting with neighbors and community, and Relying on children. Dyads' depictions of perceived social determinants of health focused on the adoption of a healthy lifestyle, description of relationships, and advantages of living in a rural area. Emergent themes may be used to promote adoption of self-management and prevention behaviors, particularly lifestyle changes.

  4. Shifts in Attitudes, Knowledge, and Social Goals in Nursing Students Following Structured Contact With Community-Dwelling Older Adults.

    Science.gov (United States)

    Redfield, Carol S; McGuire, Adam P; Lin, Ting-Chun; Orton, Valorie J; Aust, Melissa; Erickson, Thane M

    2016-10-01

    Traditional nursing pedagogies have not systematically addressed the ageist perspectives students bring into training that threaten competent care for older adults. The current study evaluated nursing students' shifts in attitudes, knowledge about aging, and social goals during a program of repeated and structured social interactions with community-dwelling older adults. Beginning nursing students in pairs met with high-functioning older adults four times over 8 months to provide brief health promotion activities. Students' knowledge and attitudes on aging were assessed at baseline and prior to each visit; social goals were assessed after each visit. Multilevel growth curves revealed increases in students' knowledge about aging and positive views on caring for older adults. Motivation to help older adults (i.e., compassionate goals) did not change, but students' motivation to defend their competence (i.e., self-image goals) declined. A relational contact-based program may shift knowledge, attitudes, and social goals in nursing students, complementing traditional classroom nursing education. [J Nurs Educ. 2016;55(10):569-573.]. Copyright 2016, SLACK Incorporated.

  5. Sarcopenia as a Risk Factor for Cognitive Deterioration in Community-Dwelling Older Adults: A 1-Year Prospective Study.

    Science.gov (United States)

    Nishiguchi, Shu; Yamada, Minoru; Shirooka, Hidehiko; Nozaki, Yuma; Fukutani, Naoto; Tashiro, Yuto; Hirata, Hinako; Yamaguchi, Moe; Tasaka, Seishiro; Matsushita, Tomofumi; Matsubara, Keisuke; Tsuboyama, Tadao; Aoyama, Tomoki

    2016-04-01

    The purpose of this 1-year prospective study was to determine whether sarcopenia is an independent risk factor of cognitive deterioration in community-dwelling older adults. One-year prospective study. Japanese community. A total of 131 community-dwelling older adults aged 65 years and older participated in this study. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia, and the participants were classified into the sarcopenia and normal groups according to this definition. The participants' cognitive functions were assessed using the Mini-Mental State Examination (MMSE) during pre- and postdata collection (after 1 year). The rate of change in pre- and post-MMSE scores during the follow-up term was significantly different between the 2 groups (normal group, -0.32 ± 8.39%; sarcopenia group, -5.86 ± 5.16%; P = .002). The analysis of covariance, adjusted for demographic data and the pre-MMSE scores, showed a significant change in the MMSE scores between the normal and sarcopenia group (F = 9.30, P = .003). Furthermore, in the multivariate logistic regression analysis, the cognitive function was significantly more likely to deteriorate (defined as a loss of at least 2 points of MMSE) in the sarcopenia group during the follow-up term (odds ratio: 7.86, 95% confidence interval: 1.53-40.5). Sarcopenia was identified as an independent risk factor of cognitive deterioration in community-dwelling older adults during the 1-year study period. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Risk Factors of Falls in Community-Dwelling Older Adults: Logistic Regression Tree Analysis

    Science.gov (United States)

    Yamashita, Takashi; Noe, Douglas A.; Bailer, A. John

    2012-01-01

    Purpose of the Study: A novel logistic regression tree-based method was applied to identify fall risk factors and possible interaction effects of those risk factors. Design and Methods: A nationally representative sample of American older adults aged 65 years and older (N = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used.…

  7. Risk Factors of Falls in Community-Dwelling Older Adults: Logistic Regression Tree Analysis

    Science.gov (United States)

    Yamashita, Takashi; Noe, Douglas A.; Bailer, A. John

    2012-01-01

    Purpose of the Study: A novel logistic regression tree-based method was applied to identify fall risk factors and possible interaction effects of those risk factors. Design and Methods: A nationally representative sample of American older adults aged 65 years and older (N = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used.…

  8. Instructions influence response to the Chinese version of the Movement-Specific Reinvestment Scale in community-dwelling older adults.

    Science.gov (United States)

    Wong, Thomson Wl; Abernethy, Bruce; Masters, Rich Sw

    2016-12-01

    To examine whether differences emerged when the Chinese version of the Movement-Specific Reinvestment Scale (MSRS-C) was administered to community-dwelling older adults with instructions to respond in the context of "general" movements, walking, using chopsticks or dressing. Furthermore, the difference between the six-point Likert scale and four-point Likert scale response formats of the MSRS-C was investigated. The study was implemented in the community of Hong Kong with 52 older adults (mean age 77.4 years). Telephone interviews were carried out on two occasions for each participant. Participants provided a verbal response to each of 10 questions from the MSRS-C with different response formats (i.e., six-point or four-point Likert Scales) and different instructions in the response context (i.e. general, walking, using chopsticks, dressing). The sequence of response format and context was randomized for each participant. Older fallers scored significantly higher on the MSRS-C (general) with six-point or four-point response formats than non-fallers. The MSRS-C (general) and MSRS-C (walking) were not statistically different, and showed good discriminative power for previous older fall status (older fallers or older non-fallers). However, MSRS-C (chopsticks) and MSRS-C (dressing) failed to differentiate older fallers from older non-fallers. Both the MSRS-C (general) and MSRS-C (walking) with a six-point or a four-point response format showed good discrimination of older fallers from non-fallers. Older adults might respond to the MSRS-C with respect to the most challenging movements (e.g. fall-related movements) in their daily living. Geriatr Gerontol Int 2016; 16: 1305-1311. © 2015 Japan Geriatrics Society.

  9. Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review.

    Science.gov (United States)

    Fried, Terri R; O'Leary, John; Towle, Virginia; Goldstein, Mary K; Trentalange, Mark; Martin, Deanna K

    2014-12-01

    To summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community-dwelling persons. Systematic review of MEDLINE (OvidSP 1946 to May, Week 3, 2014). Community. Observational studies examining health outcomes according to number of prescription medications taken. Association between number of medications and health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding. Of the 50 studies identified, the majority that were rated good in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls, fall outcomes, fall risk factors, adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of studies rated fair or poor. Data are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes in community-dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more-definitive evidence regarding this relationship than observational studies can provide. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  10. Dual-tasking over an extended walking distance is associated with falls among community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Hirashima K

    2015-04-01

    Full Text Available Kenichi Hirashima,1,2 Yumi Higuchi,1 Masakazu Imaoka,1 Emiko Todo,1 Tomomi Kitagawa,1 Tetsuya Ueda11Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan; 2Faculty of Health and Welfare, Department of Physical Therapy, Tokushima Bunri University, Nishihamaboji, Yamashiro Town, Tokushima City, Tokushima, Japan Aim: Dual-task methods, in which walking is the primary task, are not sufficient for accurately screening for the risk of falls among healthy older adults. Therefore, the goal of this research was to investigate whether using a dual-task method over an extended walking distance can predict falls among community-dwelling older adults.Methods: We enrolled independent community-dwelling adults aged ≥65 years. Physical performance, cognitive function, psychological function, and a dual-task test were assessed at baseline. Our dual-task test required the subjects to walk 60 m while stepping over lines. The intervals between the lines ranged from 50–100 cm and were unequal. Falls and fall-related injuries were measured over a 12-month follow-up period using monthly postal surveys. Results: Ninety-two of 118 subjects (mean age, 75.4±5.5 years completed the 12-month follow-up. Sixteen (17.4% of fallers had injurious falls or fell more than or equal to two times. There were no significant differences between the fallers and non-fallers, except in age and in the number of missteps during the dual-task test when walking ≥40 m. The Kaplan–Meier analysis revealed that those who had more than one misstep while walking ≥40 m had a significantly higher incidence of injurious or multiple falls than those who had no missteps.Conclusion: Our findings suggest that the dual-task method with an extended walking distance may be able to predict falls among community-dwelling older adults. Keywords: cohort study, community-dwelling older adults, dual-task, falls

  11. Cognitive Impairment, Oral Self-care Function and Dental Caries Severity in Community-dwelling Older Adults

    Science.gov (United States)

    Chen, Xi; Clark, Jennifer JJ; Chen, Hong; Naorungroj, Supawadee

    2013-01-01

    Objective To investigate whether oral self-care function mediates the associations between cognitive impairment and caries severity in community-dwelling older adults. Background Cognitive impairment significantly affects activities of daily living and compromises oral health, systemic health and quality of life in older adults. However, the associations among cognitive impairment, oral self-care capacity and caries severity remain unclear. This increases difficulty in developing effective interventions for cognitively impaired patients. Materials and methods Medical, dental, cognitive and functional assessments were abstracted from the dental records of 600 community-dwelling elderly. 230 participants were selected using propensity score matching and categorised into normal, cognitive impairment but no dementia (CIND) and dementia groups based on their cognitive status and a diagnosis of dementia. Multivariable regressions were developed to examine the mediating effect of oral self-care function on the association between cognitive status and number of caries or retained roots. Results Cognitive impairment, oral self-care function and dental caries severity were intercorrelated. Multivariable analysis showed that without adjusting for oral self-care capacity, cognition was significantly associated with the number of caries or retained roots (p = 0.003). However, the association was not significant when oral self-care capacity was adjusted (p = 0.125). In contrast, individuals with impaired oral self-care capacity had a greater risk of having a caries or retained root (RR = 1.67, 95% CI 1.15, 2.44). Conclusion Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults. PMID:23758583

  12. Associations among self-reported diabetes, nutritional status, and socio-demographic variables in community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Maria Clara Moretto

    2014-12-01

    Full Text Available Objective: The aim of this study was to describe relationships between self-reported diabetes mellitus and its treatment, according to demographic and socioeconomic data, as well as indicators of nutritional status in community-dwelling older adults. Methods: This is a population-based and a cross-sectional study derived from the multicentric survey "Frailty in Brazilian Elderly". The random sample consisted of 881 community-dwelling older adults aged 65 years and older from the city of Campinas. The self-reported variables were: age, gender, family income (minimum salaries, education (years of education; and absolute data (yes versus no regarding unintentional weight loss and weight gain, diabetes, and its treatment. Anthropometric variables were collected by trained examiners following classic protocols. Body mass index was classified as: underweight 1.00 and >0.90. Results: The variables most associated with diabetes were obesity (OR=2.19, abdominal adiposity (OR=2.97, and unintentional weight loss (OR=3.38. The lack of diabetes treatment was associated with advanced age (p=0.027, lower educational level (p=0.005, and low metabolic risk (p=0.004. Conclusion: Self-reported diabetes was associated with obesity but mostly with abdominal adiposity and unintentional weight loss. Not being treated for diabetes mellitus was associated with advanced age, lower levels of education, and lower abdominal adiposity.

  13. Performance improvement in managed long-term care: physician communication in managing community-dwelling older adults.

    Science.gov (United States)

    Kogan, Polina; Underwood, Susan; Desmond, Donna; Hayes, Marjorie; Lucien, Gina

    2010-02-01

    This performance improvement initiative focused on the nurse consultant's communication with the physician about care management of community-dwelling older adults. Three defined areas were measured: (1) changes in clinical setting, (2) reporting adverse effects from medications that can contribute to falls, and (3) HbA1c results >9. Physicians were informed of our quality initiative; nurse practitioners led workshops addressing barriers to effective communication; and portable reference cards were created to assist staff in organizing information prior to contacting a physician. The Project Goal of 10% improvement for all three indicators was achieved. Staff identified best practices for communicating with physicians.

  14. Vision and agility training in community dwelling older adults: incorporating visual training into programs for fall prevention.

    Science.gov (United States)

    Reed-Jones, Rebecca J; Dorgo, Sandor; Hitchings, Maija K; Bader, Julia O

    2012-04-01

    This study aimed to examine the effect of visual training on obstacle course performance of independent community dwelling older adults. Agility is the ability to rapidly alter ongoing motor patterns, an important aspect of mobility which is required in obstacle avoidance. However, visual information is also a critical factor in successful obstacle avoidance. We compared obstacle course performance of a group that trained in visually driven body movements and agility drills, to a group that trained only in agility drills. We also included a control group that followed the American College of Sports Medicine exercise recommendations for older adults. Significant gains in fitness, mobility and power were observed across all training groups. Obstacle course performance results revealed that visual training had the greatest improvement on obstacle course performance (22%) following a 12 week training program. These results suggest that visual training may be an important consideration for fall prevention programs.

  15. The Physical Activity Scale for the Elderly (PASE): Validity and Reliability Among Community-Dwelling Older Adults in Malaysia.

    Science.gov (United States)

    Ismail, Norliana; Hairi, Farizah; Choo, Wan Yuen; Hairi, Noran Naqiah; Peramalah, Devi; Bulgiba, Awang

    2015-11-01

    Physical Activity Scale for the Elderly (PASE) is among the frequently used self-reported physical activity assessment for older adults. This study aims to assess the validity and reliability of a Malay version of this scale (PASE-M). A total of 408 community-dwelling older adults were enrolled. Concurrent validity was evaluated by Spearman's rank correlation coefficients between PASE with physical and psychosocial measures. Test-retest reliability was determined by the intraclass correlation coefficient (ICC). The mean PASE-M scores at baseline and follow-up were 94.96 (SD 62.82) and 92.19 (SD 64.02). Fair to moderate correlation were found between PASE-M and physical function scale, IADL (rs = 0.429, P physical activity level of elderly Malaysians.

  16. Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study.

    Science.gov (United States)

    Hu, Xiaoyi; Jiang, Jiaojiao; Wang, Haozhong; Zhang, Lei; Dong, Birong; Yang, Ming

    2017-03-01

    Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.

  17. International classification of function, disability and health framework for fall risk stratification in community dwelling older adults

    Directory of Open Access Journals (Sweden)

    Majumi M. Noohu

    2017-05-01

    Full Text Available Falls is an important cause for mortality and morbidity in older adults. The fall risk assessment is an integral component of fall prevention in older adults. The international classification of function, disability and health (ICF can be an ideal comprehensive model for fall risk assessment. There is lack of information relating ICF and fall risk assessment in community dwelling older adults. In this study we tried to assess the fall risk using different domains of ICF using various clinical tools. A total of 255 subjects were recruited through convenient sampling method from geriatric clinic (OPD of All India Institute of Medical Sciences, New Delhi. The study was single session cross-section design. The body mass index (BMI, grip strength, depression score (Geriatric depression scale:short form; GDS-S and co morbidities were used to assess body function and structure domain, timed up and go (TUG, Berg balance scale (BBS and elderly fall screening test (EFST scores were used for activity domain, selfreported cause of fall, medications and uses of assistive device for environmental factors. Then the association of body function and structure, activity and environmental factors were determined with falls. There was an association of fall in analysis in subjects with no fall and one or more falls for, BMI, grip strength (kg, GDS-S score, no. of co morbidities, chronic pain, TUG, BBS, TUG (s, BBS, EFST, slip/trip, walking cane, hypoglycemic and antihypertensives medications (unadjusted and adjusted odds ratio.The diabetes, and hyper tension showed association for adjusted odds ratio only. In subjects with one fall and more than one fall, TUG, BBS, EFST, GDS-S score, NSAIDS and antidepressants use showed a significant association with fall (unadjusted and adjusted odds ratio. The ICF may be used in routine for fall risk assessment in community dwelling older adults.

  18. Medication Regimen Complexity and Low Adherence in Older Community-Dwelling Adults With Substantiated Self-Neglect.

    Science.gov (United States)

    Abada, Sharon; Clark, Leslie E; Sinha, Arup K; Xia, Rui; Pace-Murphy, Kathleen; Flores, Renee J; Burnett, Jason

    2017-06-01

    Determine whether medication regimen complexity predicts medication adherence levels in a sample of community-dwelling adults 65 years and older with Adult Protective Services-substantiated self-neglect. A cross-sectional analysis of baseline data ( N = 31 participants) from a pilot intervention to increase medication adherence among the target group was performed. The Medication Regimen Complexity Index (MRCI) and the 8-item Morisky Medication Adherence Scale (MMAS-8)™ were the primary independent and dependent measures, respectively. A multivariable linear regression analysis, adjusting for potential confounders, was conducted to estimate the association between complexity and adherence. Regimen complexity was high (mean MRCI = 19.6) and adherence was low (mean MMAS = 5.1). Even after controlling for confounders, increased complexity was significantly associated with lower adherence. Older community-dwelling adults who self-neglect have complex medication regimens that contribute to low medication adherence. Medication regimen complexity may be a modifiable contributor to low adherence that can be targeted by future interventions to reduce self-neglect and its consequences.

  19. Predictors of outcomes following reablement in community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Tuntland H

    2016-12-01

    Full Text Available Hanne Tuntland,1,2 Ingvild Kjeken,3,4 Eva Langeland,2,5 Bjarte Folkestad,2,6 Birgitte Espehaug,7 Oddvar Førland,2,8 Mona Kristin Aaslund1 1Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, 2Centre for Care Research Western Norway, Bergen University College, Bergen, 3National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, 4Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, 5Department of Nursing, Faculty of Health and Social Sciences, Bergen University College, 6Uni Research Rokkan Centre, 7Centre for Evidence-Based Practice, Bergen University College, 8Faculty of Health Studies, VID Specialized University, Campus Bergen, Bergen, Norway Background: Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking. Objective: The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up. Methods: The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P and satisfaction with that performance (COPM-S at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM

  20. Active ageing and quality of life : Community-dwelling older adults in deprived neighbourhoods

    NARCIS (Netherlands)

    Bielderman, Johanne Henrike

    2016-01-01

    Socioeconomic factors may influence health and quality of life. Older adults residing in deprived neighbourhoods are at risk to develop negative health outcomes with adverse consequences for a person’s quality of life. Therefore, it is crucial to determine feasible and effective ways to maintain or

  1. The Efficacy of Self-Taught Memory Training for Community-Dwelling Older Adults.

    Science.gov (United States)

    Scogin, Forrest; Prohaska, Mark

    1992-01-01

    Recall was assessed three times for older adults in three groups: (1) participants in self-taught memory training (n=22); (2) delayed-training control group (n=24); and (3) attention-placebo group (n=23). The self-taught group's recall was superior to the control but equal to the attention-placebo group. Self-teaching resulted in improved…

  2. Differences in perception of gerotranscendence behaviors between college students and community-dwelling older adults.

    Science.gov (United States)

    Buchanan, Jeffrey A; Lai, Duc; Ebel, Donald

    2015-08-01

    Within the field of gerontology, several different theories have attempted to explain common psychological and social changes associated with the aging process. The Theory of Gerotranscendence is one such theory which purports that a shift in meta-perspective from a more materialistic and pragmatic view of the world to a more cosmic and transcendent one occurs as we age. Corresponding with this shift in meta-perspective, the individual exhibits certain behaviors that could be mistaken as signs of psychopathology if viewed based on the assumptions of more culturally-assimilated theories of aging. The purpose of this study was to examine the difference in perception of gerotranscendence behaviors between college students and older adults. Perceptions were quantified using an instrument that described many behaviors indicative of gerotranscendence within the context of a written narrative depicting an older adult living in an assisted living facility. Respondents were then asked to rate these behaviors in terms of how unusual they were and how concerning they were. As hypothesized, results indicated that several behaviors indicative of gerotranscendence were rated as more concerning and unusual by college students compared to older adults. Implications of these findings in terms of interactions between younger and older individuals occurring in the community and within healthcare settings are discussed.

  3. Sarco-Osteoporosis: Prevalence and Association with Frailty in Chinese Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Yan-Jiao Wang

    2015-01-01

    Full Text Available The aim was to apply AWGS criteria to estimate the prevalence of sarco-osteoporosis and investigate its relationship with frailty, in a sample of 316 community-dwelling Chinese older people. Regression analysis was performed using frailty as the dependent variable. The results showed that the prevalence rate of sarco-osteoporosis was 10.4% in older men and 15.1% in older women. ≧80 years old (OR 4.8; 95% CI, 3.05–10.76; P=0.027, women (OR 2.6; 95% CI, 1.18–2.76; P=0.036, and higher level of comorbidity (OR 3.71; 95% CI, 1.61–10.43; P=0.021 were independently associated with the likelihood of being sarco-osteoporosis. In the frail group, sarco-osteoporosis occurred in 26.3% of men, in 38.5% of women, and in lower proportion in the prefrail (13.6% of men; 16.2% of women and nonfrail group (1.6% of men; 1.9% of women (P<0.05, resp.. Furthermore, the likelihood of being frail/prefrail was substantially higher in the presence of sarco-osteoporosis (OR 4.16; 95% CI, 2.17–17.65; P=0.019 in men; and OR 4.67; 95% CI, 2.42–18.86; P=0.007 in women. The results indicate that patients with sarco-osteoporosis are more likely to be ≧80 yrs with higher burden of comorbidities and to have frailty/prefrailty, especially for women.

  4. Does smart home technology prevent falls in community-dwelling older adults: a literature review

    Directory of Open Access Journals (Sweden)

    Eva Pietrzak

    2014-06-01

    Full Text Available Background: Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies.Objective: The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly.Method: Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of ‘snowballing’. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants’ fear of falling and attitudes towards monitoring technology were included.Results: Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1 older adults’ attitudes towards fall detectors and smart home technology are generally positive; (2 privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3 unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology.Conclusion: So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults’ confidence and sense of security, thus possibly enabling aging in place. 

  5. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults.

    Science.gov (United States)

    Vanoh, Divya; Shahar, Suzana; Rosdinom, Razali; Din, Normah Che; Yahya, Hanis Mastura; Omar, Azahadi

    2016-01-01

    Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS). A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose.

  6. The effect of therapeutic horseback riding on balance in community-dwelling older adults: a pilot study.

    Science.gov (United States)

    Homnick, Tamara D; Henning, Kim M; Swain, Charlene V; Homnick, Douglas N

    2015-02-01

    Equine assisted activities (hippotherapy and therapeutic riding) improve balance in patients with disabilities such as cerebral palsy, but have not been systematically studied in older adults, at risk of falls due to balance deficits. We conducted a 10-week, single blind, controlled trial of the effect of a therapeutic horseback riding course on measures of balance in community-dwelling adults 65 years and older. Nine riders and six controls completed the trial. Controls were age matched to riders and all participants were recruited from the local community. Both groups showed improvements in balance during the trial, but did not reach statistical significance. Sample size was small, participants had relatively high initial balance scores, and controls tended to increase their physical activities, likely influencing outcomes. No adverse events occurred and the supervised therapeutic riding program appeared to be a safe and effective form of exercise to improve balance in older adults. A power analysis was performed to estimate numbers of participants needed for a larger study.

  7. Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training

    DEFF Research Database (Denmark)

    Jørgensen, Martin Grønbech

    citizens' centers and/or in the home of the elderly. The results presented in this thesis suggest that strict control of time-of-day is an important methodological aspect when evaluating postural balance in older adults, and an assessment protocol using the Nintendo Wii-Balance Board is reproducible......The overall purpose of this thesis was to examine selected methodological aspects and novel approaches for measuring postural balance older adults, and to examine the effects of biofeedback-based Nintendo Wii training on selected physiological, psychological and functional outcome variables...... in community-dwelling older adults. In Study I balance control was investigated using force plate analysis of Centre of Pressure (COP) excursion during static bilateral standing in 32 community-dwelling older adults at three different time-points (09:00, 12:30, and 16:00) throughout the day. An overall...

  8. Transportation use in community-dwelling older adults: association with participation and leisure activities.

    Science.gov (United States)

    Dahan-Oliel, Noémi; Mazer, Barbara; Gélinas, Isabelle; Dobbs, Bonnie; Lefebvre, Hélène

    2010-12-01

    This article presents a study that compared participation by elderly individuals living in the community according to primary transportation mode used, and estimated the association between transportation, personal factors, and environmental factors. Participants included 90 adults aged 65 and older (M=76.3 years; SD=7.7). They were classified according to their primary transportation mode: driver, passenger, public transport user, walk, or adapted transport/taxi user. Participation was measured with the Craig Handicap Assessment and Reporting Technique (CHART) and the Nottingham Leisure Questionnaire (NLQ). Overall, results indicated that drivers, public transport users, and walkers had higher participation levels compared to passengers and adapted transport/taxi users. This study suggests that clinicians should consider older adults' use of transportation in an attempt to encourage and maximize their participation.

  9. Identifying Care Coordination Interventions Provided to Community-Dwelling Older Adults Using Electronic Health Records.

    Science.gov (United States)

    Kim, Tae Youn; Marek, Karen D; Coenen, Amy

    2016-07-01

    Although care coordination is a popular intervention, there is no standard method of delivery. Also little is known about who benefits most, or characteristics that predict the amount of care coordination needed, especially with chronically ill older adults. The purpose of this study was to identify types and amount of nurse care coordination interventions provided to 231 chronically ill older adults who participated in a 12-month home care medication management program in the Midwest. For each participant, the nurse care coordinator spent an average of 134 min/mo providing in-person home care, 48 min/mo of travel, and 18 min/mo of indirect care occurring outside the home visit. This accounted for 67.2%, 23.8%, and 9.0% of nursing time, respectively, for home visits, travel, and indirect care. Four of 11 nursing interventions focused on medication management were provided to all participants. Seven of the 11 main interventions were individualized according to each person's special needs. Wide variations were observed in time provided with in-person home care and communications with multiple stakeholders. Study findings indicate the importance of individualizing interventions and the variability in the amount of nursing time needed to provide care coordination to chronically ill older adults.

  10. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Zhuang J

    2014-01-01

    Full Text Available Jie Zhuang,1,* Liang Huang,1,2,* Yanqiang Wu,3 Yanxin Zhang2 1School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China; 2Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand; 3Shanghai Municipal Center for Students' Physical Fitness and Health Surveillance, Shanghai, People's Republic of China *These authors contributed equally to this work Abstract: This study aimed to evaluate the effectiveness of an innovative exercise program on muscle strength, balance, and gait kinematics in elderly community-dwellers. The exercise program included strength and balance training and the 8-form Tai Chi Chuan. The measurements were carried out at baseline and 12 weeks, and consisted of four physical performance tests, joint isokinetic strength tests, and three-dimensional gait analysis. Fifty-six community-dwelling older adults aged 60–80 years old were randomly assigned to an intervention or control group. After 12 weeks, the intervention group showed a 17.6% improvement in the timed up and go test, accompanied by a 54.7% increase in the 30-second chair stand test score. Significant increases in the score of star excursion balance tests, and the strength of the extensor and flexor muscles at knee and ankle joints were also observed. In addition, the intervention group walked at a faster speed with a longer step length, shorter support phase, and a greater sagittal plane range of motion at the hip and ankle joints. No statistical improvements were seen in the control group. This study provided an effective, evidence-based falls prevention program that can be implemented in community settings to improve physical fitness and reduce fall risks among community-dwelling older adults. The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people. Keywords: Tai Chi Chuan, resistance training, balance, fall prevention, fall

  11. Sarcopenia: Prevalence and associated factors based on different suggested definitions in community-dwelling older adults.

    Science.gov (United States)

    Kim, Hunkyung; Hirano, Hirohiko; Edahiro, Ayako; Ohara, Yuki; Watanabe, Yutaka; Kojima, Narumi; Kim, Miji; Hosoi, Erika; Yoshida, Yuko; Yoshida, Hideyo; Shinkai, Shoji

    2016-03-01

    The age-related loss of muscle mass and/or strength and performance, sarcopenia, has been associated with geriatric syndromes, morbidity and mortality. Although sarcopenia has been researched for many years, currently there is a lack of consensus on its definition. Some studies define sarcopenia as low muscle mass alone, whereas other studies have recently combined low muscle mass, strength and physical performance suggested by the European Working Group on Sarcopenia in Older People, as well as the Asian Working Group for Sarcopenia. The arbitrary use of various available sarcopenia definitions within the literature can cause discrepancies in the prevalence and associated risk factors. The application of population-specific cut-off values in any sample population can be problematic, particularly among different ethnicities. Using commonly used cut-off points to define sarcopenia, including solely muscle mass and combined definitions, on a community-dwelling elderly Japanese population, the prevalence of sarcopenia ranged from 2.5 to 28.0% in men and 2.3 to 11.7% in women, with muscle mass measured by dual-energy X-ray absorptiometry, and 7.1-98.0% in men and 19.8-88.0% in women measured by bioelectrical impedance analysis. Body mass index was the most prominent related factor for sarcopenia across the definitions in this Japanese sample. However, other associated hematological and chronic condition factors varied depending on the definition. © 2016 Japan Geriatrics Society.

  12. Comparison of consumer derived evidence with an omaha system evidence-based practice guideline for community dwelling older adults.

    Science.gov (United States)

    Pruinelli, Lisiane; Fu, Helen; Monsen, Karen A; Westra, Bonnie L

    2014-01-01

    Consumer involvement in healthcare is critical to support continuity of care for consumers to manage their health while transitioning from one care setting to another. Validation of evidence-based practice (EBP) guideline by consumers is essential to achieving consumer health goals over time that is consistent with their needs and preferences. The purpose of this study was to compare an Omaha System EBP guideline for community dwelling older adults with consumer-derived evidence of their ongoing needs, resources, and strategies after home care discharge. All identified problems were relevant for all patients except for Neglect and Substance use. Ten additional problems were identified from the interviews, five of which affected at least 10% of the participants. Consumer derived evidence both validated and expanded EBP guidelines; thus further emphasizing the importance of consumer involvement in the delivery of home healthcare.

  13. Neighborhood food environment and obesity in community-dwelling older adults: individual and neighborhood effects.

    Science.gov (United States)

    Pruchno, Rachel; Wilson-Genderson, Maureen; Gupta, Adarsh K

    2014-05-01

    We tested hypotheses about the relationship between neighborhood-level food sources and obesity, controlling for individual-level characteristics. Data (collected November 2006-April 2008) derived from a random-digit-dial sample of 5688 community-dwelling adults aged 50 to 74 years residing in 1644 census tracts in New Jersey. Using multilevel structural equation models, we created latent constructs representing density of fast-food establishments and storefronts (convenience stores, bars and pubs, grocery stores) and an observed indicator for supermarkets at the neighborhood level, simultaneously modeling obesity and demographic characteristics (age, gender, race, education, household income) at the individual level. When we controlled for individual-level age, gender, race, education, and household income, densities of fast-food establishments and storefronts were positively associated with obesity. Supermarkets were not associated with obesity. Because people living in neighborhoods with a higher density of fast food and storefronts are more likely to be obese, these neighborhoods may be optimal sites for interventions.

  14. Clinical usefulness of indoor life-space assessment in community-dwelling older adults certified as needing support or care.

    Science.gov (United States)

    Ohnuma, Takeshi; Hashidate, Hiroyuki; Yoshimatsu, Tatsuki; Abe, Tsutomu

    2014-01-01

    This study aimed to develop a questionnaire to evaluate indoor life-space mobility and assess its validity in community-dwelling older adults certified as needing support or care. The participants included 37 community-dwelling older adults undergoing home-visit rehabilitation (mean age: 78.5±7.0 years). We developed a questionnaire to assess the degree of indoor life-space mobility (home-based life-space assessment (Hb-LSA)), evaluating the functional status (life-space assessment (LSA), time spent away from bed, functional independence measure (FIM), bedside mobility scale (BMS)), physical function (hand grip power (HGP), 30-second chair stand (CS-30), one-leg standing (OLS)) and cognitive status (mental status questionnaire (MSQ)). The average Hb-LSA score was 56.3±24.3 (minimum 4 to maximum 102.5). The test-retest reliability was high (intraclass correlation coefficients: (1, 1)=0.986, (1, 2)=0.993). The Hb-LSA scores were significantly associated with the LSA (r=0.897), time spent away from bed (r=0.497), FIM (r=0.786), BMS (r=0.720), HGP (r=0.388), CS-30 (r=0.541) and OLS (r=0.455). There were no significant associations between the Hb-LSA scores and the FIM cognitive subscores (r=0.180) or MSQ scores (r=-0.240). The Hb-LSA scores were significantly higher among the participants able to move independently indoors (75.8±18.8 points) than in those who required help to move (45.7±20.2 points). The Hb-LSA is a useful, reliable and valid tool for assessing the degree of indoor physical mobility in the life-space. The Hb-LSA score is related to the degree of independence of indoor mobility.

  15. Comparison of two balance training programs on balance in community dwelling older adults

    Directory of Open Access Journals (Sweden)

    Shefali Walia

    2016-09-01

    Full Text Available Impaired balance has been associated with an increased risk for falls and a resulting increase in the mortality rate of elder people. Thus, balance-training interventions have an important place in fall prevention. This study was designed with the purpose of identifying the appropriate balance-training program for community dwelling elderly adults with an active lifestyle. A sample of 70 elderly adults were randomly allocated into two groups: group 1 (n=35 received general balance and mobility exercise; group 2 (n=35 received specific balance strategy training. The intervention consisted of 5 sessions/week for 4 weeks. The outcome measures were Timed up and go test (TUGT and Berg balance scale (BBS. An inter-group (2-way mixed model analysis of co-variance and intra-group (repeated measures analysis was done to find the change in balance scores. After the intervention, the TUGT scores in group 1 were, mean=10.38 s, standard deviation (SD=1.59 s and in group 2 were, mean=9.27 s, SD=1.13 s. Post training, BBS scores for group 1 were, mean=54.69, SD=1.13, and for group 2 were, mean=55.57, SD =0.56. There was a significant group × time effect for TUGT and BBS score. All the subjects showed significant changes in balance scores after balance training interventions. The subjects who participated in the specific balance-strategy training significantly improved their functional mobility, as shown on the TUGT, compared to the general training group.

  16. Telephone-delivered psychotherapy for rural-dwelling older adults with generalized anxiety disorder: study protocol of a randomized controlled trial.

    Science.gov (United States)

    Brenes, Gretchen A; Danhauer, Suzanne C; Lyles, Mary F; Miller, Michael E

    2014-02-08

    Generalized Anxiety Disorder (GAD), characterized by excessive and uncontrollable worry, has a negative impact on the health, well-being, and functioning of older adults. Cognitive behavioral therapy has demonstrated efficacy in reducing anxiety and worry in older adults, but the generalizability of these findings to community-dwelling older adults is unknown. The aim of the current study is to examine the efficacy of a cognitive-behavioral intervention delivered by telephone in reducing anxiety and worry in rural community-dwelling older adults with GAD. We propose a randomized controlled trial comparing telephone-delivered cognitive behavioral therapy (CBT-T) with nondirective supportive therapy (NST-T). One hundred seventy six adults 60 years and older diagnosed with GAD will be randomized to one of the two treatment conditions. The primary outcomes are self-report worry and clinician-rated anxiety. Secondary outcomes include depressive symptoms, sleep, quality of life, and functional status. It is hypothesized that CBT-T will be superior to NST-T in reducing anxiety and worry among older adults with GAD. Further, CBT-T is hypothesized to be superior to NST-T in reducing problems with depressive symptoms, sleep, functional status and quality of life. If this program is successful, it could be implemented as a low-cost program to treat late-life anxiety, especially in rural areas or in circumstances where older adults may not have access to qualified mental health providers. clinicaltrials.gov Identifier: NCT01259596.

  17. Activity-monitor accuracy in measuring step number and cadence in community-dwelling older adults.

    Science.gov (United States)

    Grant, P Margaret; Dall, Philippa M; Mitchell, Sarah L; Granat, Malcolm H

    2008-04-01

    The primary purpose of this study was to investigate the accuracy of the activPAL physical activity monitor in measuring step number and cadence in older adults. Two pedometers (New-Lifestyles Digi-Walker SW-200 and New-Lifestyles NL2000) used in clinical practice to count steps were simultaneously evaluated. Observation was the criterion measure. Twenty-one participants (65-87 yr old) recruited from community-based exercise classes walked on a treadmill at 5 speeds (0.67, 0.90, 1.12, 1.33, and 1.56 m/s) and outdoors at 3 self-selected speeds (slow, normal, and fast). The absolute percentage error of the activPAL was <1% for all treadmill and outdoor conditions for measuring steps and cadence. With the exception of the slowest treadmill speed, the NL-2000 error was <2%. The SW-200 was the least accurate device, particularly at slower walking speeds. The activPAL monitor accurately recorded step number and cadence. Combined with its ability to identify primary postures, the activPAL might be a useful and versatile device for measuring activity in older adults.

  18. Morphological and qualitative characteristics of the quadriceps muscle of community-dwelling older adults based on ultrasound imaging: classification using latent class analysis.

    Science.gov (United States)

    Kawai, Hisashi; Kera, Takeshi; Hirayama, Ryo; Hirano, Hirohiko; Fujiwara, Yoshinori; Ihara, Kazushige; Kojima, Motonaga; Obuchi, Shuichi

    2017-06-02

    Muscle thickness and echo intensity measured using ultrasound imaging represent both increased muscle volume and connective tissue accumulation. In combination, these ultrasound measurements can be utilized for assessing sarcopenia in community-dwelling older adults. This study aimed to determine whether morphological and qualitative characteristics classified by quadriceps muscle thickness and echo intensity measured using ultrasound are associated with muscle strength, physical function, and sarcopenia in community-dwelling older adults. Quadriceps muscle thickness and echo intensity were measured using ultrasound imaging in 1239 community-dwelling older adults. Latent class analyses were conducted to classify participants based on similarity in the subcutaneous fat thickness (FT), quadriceps muscle thickness (MT), subcutaneous fat echo intensity (FEI), and muscle echo intensity (MEI), which were assessed using ultrasound imaging. Morphological and qualitative characteristics were classified into four types as follows: (A) normal, (B) sarcopenic obesity, (C) obesity, and (D) sarcopenia type. Knee extension strength was significantly greater in A than in B and D. FT and percent body fat were greater in C than in the other types. The correlation between the ultrasound measures and knee extension strength differed among the classification types. The classification types were significantly associated with sarcopenia prevalence. Classification of the morphological and qualitative characteristics obtained from ultrasound imaging may be useful for assessing sarcopenia in community-dwelling older adults.

  19. Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adults.

    Science.gov (United States)

    Salguero, Alfonso; Martínez-García, Raquel; Molinero, Olga; Márquez, Sara

    2011-01-01

    This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults.

  20. Antihypertensive and Statin Medication Use and Motor Function in Community-Dwelling Older Adults

    Science.gov (United States)

    Perlman, Amichai; Shah, Raj C.; Bennett, David A.; Buchman, Aron S.; Matok, Ilan

    2015-01-01

    Objectives To investigate whether the use of antihypertensive and statin medication in very old adults is associated with the level of motor performance. Design Cross sectional study. Settings A community-based study recruited from over 40 residential facilities across the metropolitan Chicago area. Participants Community dwelling very old adults (n=1520; mean age 80.2; SD 7.7). Measurements Eleven motor performances were summarized using a composite motor score. All prescription and over the counter medications taken by participants were inspected and coded using the Medi-Span Data Base System. Demographic characteristics and medical history were obtained via detailed interview and medical exams. Results In multiple linear regression models, antihypertensive medications were associated with global motor score (β=−0.075, S.E. 0.011, p<0.001). Thus, motor function in an individual with antihypertensive medication, was on average, about 7.5% lower than an age, sex and education matched individual without antihypertensive medication. The number of antihypertensive medications which were being used had an additive effect, such that a reduction in the level of motor function was observed with each additional medication, and receiving three or more antihypertensive medications was associated with about a 15% reduction in the level of motor function. The association between antihypertensive medications and motor function was robust, and remained unchanged after adjusting for confounding by indication using several potentially confounding variables: smoking, hypertension, diabetes, stroke, congestive heart-failure, myocardial infarction, and intermittent claudication (β=−0.05, S.E. 0.015, p=0.001). In contrast, the use of statin medications was not related to motor function (unadjusted: β=0.003, S.E.=0.015, p=0.826; fully adjusted: β=0.018, S.E. 0.014, p=0.216). Conclusion The use of antihypertensive medications is associated with a lower level of motor function in

  1. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Vanoh D

    2016-05-01

    Full Text Available Divya Vanoh,1 Suzana Shahar,1 Razali Rosdinom,2 Normah Che Din,3 Hanis Mastura Yahya,4 Azahadi Omar5 1Dietetic Programme, Centre of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 2Department of Psychiatry, University Kebangsaan Medical Centre, Kuala Lumpur, Malaysia; 3Health Psychology Programme, 4Nutrition Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 5Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia Background and aim: Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS. Methodology: A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results: A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC, sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion: TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic

  2. Effect of meal size reduction and protein enrichment on intake and satiety in vital community-dwelling older adults.

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    Ziylan, Canan; Kremer, Stefanie; Eerens, Jessie; Haveman-Nies, Annemien; de Groot, Lisette C P G M

    2016-10-01

    Undernutrition risk among community-dwelling older adults is partly caused by inadequate protein intake. Enriching readymade meals with protein could be beneficial in increasing protein intake. Moreover, reduced-size meals could suit older adults with diminished appetite. In this single-blind randomized crossover study with 120 participants (age: 70.5 ± 4.5 y, BMI: 27.2 ± 4.4 kg/m(2)), 60 participants consumed four beef meals and another 60 consumed four chicken meals on four different days, once per week. These meals were produced according to a 2 × 2 factorial design: the protein content was either ∼25 g (lower) or ∼30 g (enriched), and the portion size was either 450 g (normal) or of 400 g (reduced). Palatability evaluation, meal intake, and subsequent satiety ratings after 120 min were measured. No significant differences in palatability among meals were found. While absolute intake (g) of the normal-size meals was significantly higher than that of the reduced-size meals, the relative intake (%) of the served meals did not differ between the four meals. Both protein and energy intakes were significantly higher for the enriched meals, regardless of portion size. Protein intakes were 5.4 g and 5.1 g higher in the normal-size and reduced-size enriched beef meals, respectively, and 6.1 g and 7.1 g higher in the enriched chicken meals, respectively. The normal-size enriched beef meal and reduced-size enriched chicken meal led to slightly but significantly higher ratings of satiety than the non-enriched meals. Due to these mixed satiety findings, separate effects of meal-size reduction and protein enrichment could not be distinguished in this study. The intake findings show that palatable protein-enriched meals support higher protein and energy intakes in vital community-dwelling older adults during a single meal.

  3. Psychological predictors of participation in screening for cognitive impairment among community-dwelling older adults.

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    Harada, Kazuhiro; Lee, Sangyoon; Shimada, Hiroyuki; Lee, Sungchul; Bae, Seongryu; Anan, Yuya; Harada, Kenji; Suzuki, Takao

    2017-08-01

    Detecting cognitive impairment in the earlier stages is important for preventing or delaying dementia. To develop intervention strategies that promote screening for cognitive impairment, it is essential to identify the modifiable predictors for participation in screening. The present study examined whether participation in screening for cognitive impairment was predicted by the constructs of the health belief model, dementia worry and behavioral intentions to undergo screening among older adults. The study used a prospective design. After a baseline questionnaire survey, participation in screening for cognitive impairment was followed for 6 months (n = 10 023). Participation in the screening, constructs of the health belief model (perceived susceptibility to dementia, perceived severity of dementia, perceived benefits of screening, perceived barriers to screening), dementia worry, behavioral intentions and demographic factors were measured. A path analysis showed that the behavioral intention to undergo screening (path coefficient = 0.29) directly predicted participation in screening for cognitive impairment, whereas other psychological and demographic factors did not directly predict participation. The behavioral intention was explained by the perceived benefits of screening (path coefficient = 0.51), perceived barriers to screening (path coefficient = -0.19) and perceived susceptibility to dementia (path coefficient = 0.16). Participation in screening for cognitive impairment was positively predicted by higher behavioral intention to undergo screening. In turn, this behavioral intention was mainly predicted by the perceived benefits of screening among older adults. These findings suggest that emphasizing the perceived benefits and encouraging behavioral intentions might promote participation in screening for cognitive impairment. Geriatr Gerontol Int 2017; 17: 1197-1204. © 2016 Japan Geriatrics Society.

  4. What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK.

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    Bloom, Ilse; Lawrence, Wendy; Barker, Mary; Baird, Janis; Dennison, Elaine; Sayer, Avan Aihie; Cooper, Cyrus; Robinson, Sian

    2017-10-01

    To explore influences on diet in a group of community-dwelling older adults in the UK. Data were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically. Hertfordshire, UK. Participants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998-2001 and 2011. Ninety-two adults participated (47 % women; 74-83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about 'keeping going', being motivated to 'not give up', not wanting to be perceived as 'old', as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet. Interventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.

  5. Psychosocial factors and health as determinants of quality of life in community-dwelling older adults.

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    Brett, Caroline E; Gow, Alan J; Corley, Janie; Pattie, Alison; Starr, John M; Deary, Ian J

    2012-04-01

    It is important to understand the determinants of differences in quality of life in old age and to include a wide range of possible predictors. The present study investigated the determinants of quality of life in two groups of older adults for whom there was an unusually informative set of possible predictor variables. Participants were members of the Lothian Birth Cohorts of 1921 (n = 550) or 1936 (n = 1,091). Four facets of quality of life (QoL) and general QoL were measured using the WHOQOL-BREF. Possible determinants included personality traits, measured with the International Personality Item Pool (IPIP) scales; childhood and old age general cognitive ability, measured with the Moray House Test; minor psychological symptoms, measured with the Hospital Anxiety and Depression Scale (HADS); physical health, assessed by grip strength and cardiovascular disease history; and sociodemographic factors, assessed by interview. Linear regression analyses revealed that HADS depression had the greatest influence on quality of life. Personality traits, most notably Emotional Stability, also predicted quality of life to varying degrees, along with factors reflecting current life circumstances. There were differences between the two cohorts in the variables which predicted quality of life. There were different, conceptually relevant, contributions to the different QoL facets. Personality traits and minor depressive symptoms have an important influence on self-reported quality of life in old age. Quality of life may be influenced more by current than past circumstances, and this relationship may change with age.

  6. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies.

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    Feng, Zeyun; Lugtenberg, Marjolein; Franse, Carmen; Fang, Xinye; Hu, Shanlian; Jin, Chunlin; Raat, Hein

    2017-01-01

    Frailty is one of the greatest challenges facing our aging population, as it can lead to adverse outcomes such as institutionalization, hospitalization, and mortality. However, the factors that are associated with frailty are poorly understood. We performed a systematic review of longitudinal studies in order to identify the sociodemographic, physical, biological, lifestyle-related, and psychological risk or protective factors that are associated with frailty among community-dwelling older adults. A systematic literature search was conducted in the following databases in order to identify studies that assessed the factors associated with of frailty among community-dwelling older adults: Embase, Medline Ovid, Web of Science, Cochrane, PsychINFO Ovid, CINAHL EBSCOhost, and Google Scholar. Studies were selected if they included a longitudinal design, focused on community-dwelling older adults aged 60 years and older, and used a tool to assess frailty. The methodological quality of each study was assessed using the Quality of Reporting of Observational Longitudinal Research checklist. Twenty-three studies were included. Significant associations were reported between the following types of factors and frailty: sociodemographic factors (7/7 studies), physical factors (5/6 studies), biological factors (5/7 studies), lifestyle factors (11/13 studies), and psychological factors (7/8 studies). Significant sociodemographic factors included older age, ethnic background, neighborhood, and access to private insurance or Medicare; significant physical factors included obesity and activities of daily living (ADL) functional status; significant biological factors included serum uric acid; significant lifestyle factors included a higher Diet Quality Index International (DQI) score, higher fruit/vegetable consumption and higher tertile of all measures of habitual dietary resveratrol exposure; significant psychological factors included depressive symptoms. A broad range of

  7. Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults

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    Olivares Pedro R

    2011-12-01

    Full Text Available Abstract Background The aim of the present study was to identify the physical fitness (PF tests of a multi-component battery more related to the perception of problems in each dimension of the health-related quality of life (HRQoL assessed by the EuroQol 5 dimensions 3 level questionnaire (EQ-5D-3L in community-dwelling middle-aged and older adults Methods A cross-sectional study was conducted with 7104 participants (6243 females and 861 males aged 50-99 years who were recruited in the framework of the Exercise Looks After You Program, which is a public health program designed to promote physical activity (PA in community-dwelling middle-aged and older adults. Participants were assessed by the EQ-5D-3L questionnaire and a battery of fitness tests. The responses to each EQ-5D-3L dimension were collapsed into a two-tier variable consisting of «perceive problems» and «do not perceive problems». Correlation coefficients for the relationships between the HRQoL variables, between the PF variables, and between the HRQoL and PF variables were obtained. Two logistic regression models, one adjusted and one unadjusted, were developed for each EQ-5D-3L dimension. Results There were significant correlations between all variables except anxiety/depression and the back scratch test. The PF tests that correlated best with the HRQoL dimensions were the Timed Up-and-Go Test (TUG and the 6-min walk; pain/discomfort and anxiety/depression correlated less well. All PF tests correlated, especially the TUG and 6-min walk tests. Unadjusted logistic models showed significant goodness of fit for the mobility and pain/discomfort dimensions only. Adjusted logistic models showed significant goodness of fit for all dimensions when the following potential confounding variables were included: age, gender, weekly level of PA, smoking and alcohol habits, body mass index, and educational level. For all dimensions, the highest odds ratios for the association with PF tests were

  8. Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

    Science.gov (United States)

    Fritz, Stacy; Middleton, Addie; Allison, Leslie; Wingood, Mariana; Phillips, Emma; Criss, Michelle; Verma, Sangita; Osborne, Jackie; Chui, Kevin K.

    2017-01-01

    Background: Falls and their consequences are significant concerns for older adults, caregivers, and health care providers. Identification of fall risk is crucial for appropriate referral to preventive interventions. Falls are multifactorial; no single measure is an accurate diagnostic tool. There is limited information on which history question, self-report measure, or performance-based measure, or combination of measures, best predicts future falls. Purpose: First, to evaluate the predictive ability of history questions, self-report measures, and performance-based measures for assessing fall risk of community-dwelling older adults by calculating and comparing posttest probability (PoTP) values for individual test/measures. Second, to evaluate usefulness of cumulative PoTP for measures in combination. Data Sources: To be included, a study must have used fall status as an outcome or classification variable, have a sample size of at least 30 ambulatory community-living older adults (≥65 years), and track falls occurrence for a minimum of 6 months. Studies in acute or long-term care settings, as well as those including participants with significant cognitive or neuromuscular conditions related to increased fall risk, were excluded. Searches of Medline/PubMED and Cumulative Index of Nursing and Allied Health (CINAHL) from January 1990 through September 2013 identified 2294 abstracts concerned with fall risk assessment in community-dwelling older adults. Study Selection: Because the number of prospective studies of fall risk assessment was limited, retrospective studies that classified participants (faller/nonfallers) were also included. Ninety-five full-text articles met inclusion criteria; 59 contained necessary data for calculation of PoTP. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) was used to assess each study's methodological quality. Data Extraction: Study design and QUADAS score determined the level of evidence. Data for calculation

  9. Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older

    Directory of Open Access Journals (Sweden)

    Colonvega Makasha

    2006-01-01

    Full Text Available Abstract Background Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiropractic research center, and to explore the utility of several widely used balance instruments for future studies of the effect of chiropractic care on balance in older adults. Methods This descriptive study was conducted from September through December 2004. Participants were recruited through a variety of outreach methods, and all were provided with an educational intervention. Data were collected at each of two visits through questionnaires, interviews, and physical examinations. Balance was assessed on both visits using the Activities-specific Balance Confidence Scale (ABCS, the Berg Balance Scale (BBS, and the One Leg Standing Test (OLST. Results A total of 101 participants enrolled in the study. Advertising in the local senior newspaper was the most effective method of recruitment (46%. The majority of our participants were white (86% females (67%. About one third (32% of participants had a baseline BBS score below 46, the cut-off point for predicting risk of falling. A mean improvement in BBS scores of 1.7 points was observed on the second visit. For the subgroup with baseline scores below 46, the mean change was 4.5 points, but the group mean remained below 46 (42.5. Conclusion Recruitment of community-dwelling seniors for fall-related research conducted at a chiropractic research center appears feasible, and the most successful recruitment strategies for this center appeared to be a combination of targeted newspaper ads and personal contact through

  10. Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults.

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    Foong, Hui Foh; Hamid, Tengku Aizan; Ibrahim, Rahimah; Haron, Sharifah Azizah

    2017-01-06

    Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function. The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0). Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics. Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.

  11. Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Kimiko Tomioka

    2016-10-01

    Full Text Available Background: Population-based data examining the relationship between social participation (SP and instrumental activities of daily living (IADL are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Methods: Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%. Data from 14 956 respondents (6935 males and 8021 females without dependency in basic activities of daily living (ADL were analyzed. The number, type, and frequency of participation in social groups (SGs were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens’ clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. Results: After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001. A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens’ clubs among males. Conclusions: Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

  12. Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training.

    Science.gov (United States)

    Jørgensen, Martin Grønbech

    2014-01-01

    The overall purpose of this thesis was to examine selected methodological aspects and novel approaches for measuring postural balance older adults, and to examine the effects of biofeedback-based Nintendo Wii training on selected physiological, psychological and functional outcome variables in community-dwelling older adults. In Study I balance control was investigated using force plate analysis of Centre of Pressure (COP) excursion during static bilateral standing in 32 community-dwelling older adults at three different time-points (09:00, 12:30, and 16:00) throughout the day. An overall significant time-of-day effect was observed for all selected COP variables. The greatest change in all COP variables was observed (on average ~15%) between midday (12:30) and the afternoon (16:00), indicating that a systematic time-of-day influence on static postural balance exists in community-dwelling older adults. Consequently, longitudinal (i.e. pre-to-post training) comparisons of postural balance in in older adults with repeated assessments should be conducted at the same time-of-day. In Study II a novel approach for measuring postural balance (using the Nintendo Wii Stillness and Agility tests) was examined for reproducibility and concurrent validity in 30 community-dwelling older adults. While the Nintendo Wii Stillness test showed a high reproducibility, a systematic learning effect between successive sessions was observed for the Agility test. Moderate-to-excellent concurrent validity was seen for the Stillness test. In contrast, the Agility test revealed a poor concurrent validity. In conclusion, the Wii Stillness test seems to represent a low-cost objective reproducible test of postural balance in community-dwelling older adults and appears feasible in various clinical settings. A habituation (familiarization) period is necessary for the Wii Agility test to avoid a systematic learning effect between successive test sessions. Study III investigated the effect of ten

  13. Relationship between masticatory ability and physical performance in community-dwelling edentulous older adults wearing complete dentures.

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    Moriya, Shingo; Notani, Kenji; Miura, Hiroko; Inoue, Nobuo

    2014-12-01

    This study aimed to elucidate the association between masticatory ability and physical performance in community-dwelling edentulous older adults wearing complete dentures. Physical performance parameters are significant predictors of decreased activities of daily living. Previous studies have shown the relationships between oral conditions and these parameters. Here, we focused on complete denture wearers. Two hundred and ten edentulous adults aged ≥65 years and wearing complete dentures were enrolled. The following oral conditions were examined: masticatory ability measured by colour-changing chewing gum, number of foods considered chewable, pain when using dentures and denture base fit. Handgrip strength (HG) and one-leg standing time with eyes open (OLST) were used to evaluate muscle strength and static balance. Spearman's rank correlation coefficients were calculated to examine the correlations between oral conditions and physical performance. Forward stepwise linear regression models were applied with each physical performance parameters as the dependent variable and oral conditions as the independent variable. The women did not show significant correlations between oral conditions and the physical performance. In men, significant and positive correlations were found between the number of chewable foods and HG, and between the colour scores and OLST. The significant correlation between the colour scores and OLST was still noted in the stepwise liner regression analysis after adjusting for demographic, social and medical conditions, and other oral conditions. In Japanese elderly edentulous men wearing complete dentures, masticatory ability evaluated as the mixing ability may be associated with static balance. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  14. Religiosity and Function Among Community-Dwelling Older Adult Survivors of Cancer

    Science.gov (United States)

    Caplan, Lee S.; Sawyer, Patricia; Holt, Cheryl; Allman, Richard M.

    2013-01-01

    Aspects of religiosity/spirituality are important to health and quality of life of cancer patients. The three components of religiosity of the Duke Religiosity Scale: organizational (religious affiliation and attendance); non-organizational (prayer, meditation, and private study); and intrinsic religiosity (identification with a higher power and integration of spiritual belief into daily life) are used to determine whether religiosity was associated with physical and/or mental functioning among older cancer survivors of the UAB Study of Aging. Church attendance was independently associated with lower ADL and IADL difficulty and fewer depressive symptoms, while intrinsic religiosity was independently associated with lower depression scores. PMID:24436690

  15. Effects of a Behavioral and Exercise Program on Depression and Quality of Life in Community-Dwelling Older Adults: A Controlled, Quasi-Experimental Study.

    Science.gov (United States)

    Azizan, Azilyana; Justine, Maria

    2016-02-01

    Sedentary behavior and low participation in exercise among older adults can lead to depression and low quality of life (QOL). The current study investigated the effects of behavioral and exercise programs on depression severity and QOL among Malaysian community-dwelling older adults. A controlled, quasi-experimental, pre-posttest design was used. A total of 63 participants were divided into three groups: (a) exercise and behavior group (EBG), (b) exercise only group (EG), and (c) control group (CG). Results showed a significant difference in depression among groups (F(2,58) = 33.49, p EG > CG) and mental (F(2,58) = 4.08, p CG > EG) scores of QOL. A combination of behavioral and exercise programs has superior effects on depression and QOL of older adults. [Journal of Gerontological Nursing, 42(2), 45-54.].

  16. Differences in body composition and physical function related to pure sarcopenia and sarcopenic obesity: A study of community-dwelling older adults in Japan.

    Science.gov (United States)

    Kera, Takeshi; Kawai, Hisashi; Hirano, Hirohiko; Kojima, Motonaga; Fujiwara, Yoshinori; Ihara, Kazushige; Obuchi, Shuichi

    2017-06-28

    We compared skeletal muscle mass and physical function between older adults with sarcopenia and those with sarcopenic obesity. Body composition and physical and cognitive function were measured for 1283 community-dwelling older adults. Participants responded to questionnaires about pain and exercise. The pure sarcopenia group (PS) included individuals with sarcopenia only. The sarcopenic obesity group (SO) included individuals with both sarcopenia and obesity. Groups were compared after adjusting for sex, age and height through propensity score matching. The PS and SO included 129 and 105 individuals, respectively. Comorbidities were more frequent in the SO (P obesity decreases the ratio of lower limb muscle mass to weight by increasing weight. It affects physical function in older Japanese adults with low weight. Decreased relative lower limb muscle mass is an important function-limiting factor in sarcopenic obesity. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  17. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association.

    Science.gov (United States)

    Avin, Keith G; Hanke, Timothy A; Kirk-Sanchez, Neva; McDonough, Christine M; Shubert, Tiffany E; Hardage, Jason; Hartley, Greg

    2015-06-01

    Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists. The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. The Subcommittee on Evidence-Based Documents of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized. Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the previous year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. A gap analysis supports the need for the development of a physical therapy-specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models. This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults. © 2015 American Physical Therapy Association.

  18. Cross-cultural validation of the Falls Efficacy Scale-International (FES-I) in Portuguese community-dwelling older adults.

    Science.gov (United States)

    Figueiredo, Daniela; Santos, Sónia

    The Falls Efficacy Scale-International (FES-I) is a highly reliable instrument to assess fear of falling among older population. This study aimed to develop a European Portuguese version of the FES-I (FES-I(P)) and analyse its psychometric properties in terms of internal consistency, test-retest reliability, concurrent and convergent validity. A cross-sectional study was conducted. Data collection integrated a socio-demographic questionnaire which included falls history and presence/absence of fear of falling, the Activities-specific Balance Confidence Scale (ABC), the Hospital Anxiety and Depression Scale (HADS), the Timed Up and Go (TUG) and the Five Times Sit to Stand Test (FTSST). Descriptive and inferential statistical analyses were performed. A total of 100 Portuguese community-dwelling older people (74.27±8.7years old) have participated in the study. From these, 82 have participated in the reliability study. The FES-I(P) had excellent internal consistency (α=0,978) and test-retest reliability (ICC2,1=0,999). A significant negative correlation was found between the FES-I(P) and the ABC (rs=-0.85; pPortuguese community-living older people. Future studies should explore the FES-I(P) responsiveness to change over time and analyse its psychometric properties in samples of both non-community-dwelling and community-dwelling older adults with different health conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Assessment of nutritional risk in community-dwelling older adults (65 to 75 years) in Kolkata, India.

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    Majumder, Mondrita; Saha, Indranil; Chaudhuri, Debnath

    2014-01-01

    This study was conducted to profile nutritional risk factors in a population of community-dwelling older adults in Kolkata, India. We applied the short version of the Mini Nutritional Assessment-Short Form (MNA-SF) questionnaire among 500 participants (65 to 75 years)--263 males and 237 females. The prevalence of undernutrition was 8.8% in females and 4.9% in males; a risk of undernutrition was found in 24.5% females and 17.5% males. All those with undernutrition or at-risk were studied further using the full version of the MNA. Data regarding education, occupation, socioeconomic status, and food intake pattern were also collected. Females had a significantly lower (P < 0.01) education level than males; 73.4% males were financially independent, whereas 72.7% females were financially dependent on others. Moderate appetite loss was commonly found (64.9%), and in 24.3% of the participants appetite loss was severe. Digestive and chewing problems were present in 32.4% and 21.6% of study participants, respectively. The rate of psychological stress and/or acute disease 3 months prior to study was 47%, and 62.2% of the study population were taking 3 or more medicines per day. Weight loss of greater than 3 kg and of 1 to 3 kg during past 3 months of the study period was observed in 27% and 32.5% of the population, respectively. Undernourished individuals were also found to consume fewer protein-rich foods. We hypothesize that low education levels and lack of financial independence were the strongest underlying causes of high undernutrition in this population, particularly, among females.

  20. Factors associated with (risk of) undernutrition in community-dwelling older adults receiving home care: a cross-sectional study in the Netherlands.

    Science.gov (United States)

    van der Pols-Vijlbrief, Rachel; Wijnhoven, Hanneke Ah; Molenaar, Hilde; Visser, Marjolein

    2016-08-01

    It is generally thought that causes of undernutrition are multifactorial, but there are limited quantitative studies performed. We therefore examined a wide range of potential factors associated with undernutrition in community-dwelling older adults. Cross-sectional study. Community-dwelling older adults (≥65 years) receiving home care in the Netherlands. Data on potential factors associated with (risk of) undernutrition were collected among 300 older adults. Nutritional status was assessed by the SNAQ65+ instrument. Undernutrition was defined as mid-upper arm circumference weight loss of ≥4 kg in 6 months. Being at risk of undernutrition was defined as having poor appetite and inability to walk up and down stairs of fifteen steps, without resting. Of all participants, ninety-two (31·7 %) were undernourished and twenty-four (8·0 %) were at risk of undernutrition. Based on multivariate logistic regression analyses, the statistically significant factors associated with (risk of) undernutrition (P<0·05) were: unable to go outside (OR=5·39), intestinal problems (OR=2·88), smoking (OR=2·56), osteoporosis (OR=2·46), eating fewer than three snacks daily (OR=2·61), dependency in activities of daily living (OR=1·21), physical inactivity (OR=2·01), nausea (OR=2·50) and cancer (OR=2·84); a borderline significant factor was depression symptoms (OR=1·83, P=0·053). The study suggests that (risk of) undernutrition is a multifactorial problem and that associated factors can be found in several domains. These findings may support the development of intervention trials for the prevention and treatment of undernutrition in community-dwelling older adults.

  1. Impact of illiteracy on depression symptomatology in community-dwelling older adults.

    Science.gov (United States)

    Kim, Byung-Soo; Lee, Dong-Woo; Bae, Jae Nam; Chang, Sung Man; Kim, Shinkyum; Kim, Ki Woong; Rim, Hyo-Deog; Park, Jee Eun; Cho, Maeng Je

    2014-10-01

    In many countries, illiteracy rates among aged people are quite high. However, only few studies have specifically investigated the impact of illiteracy on depression. Data for 1,890 elderly individuals (aged ≥65 years) were obtained from a nationwide dementia epidemiological study conducted in South Korea. Based on their reading ability, the participants were divided into three groups: totally illiterate, partially illiterate, and literate. The Korean version of the Geriatric Depression Scale - Short Form (SGDS-K) was used to detect depression (cut-off score = 8). Multivariate logistic regression analyses were used to assess the association between illiteracy and depression. To explore clinical features of depression in illiterate people, we performed logistic regression to calculate odds ratios of positive responses (or negative responses to reverse-coded items) for each SGDS-K item using literate individuals as the reference group. Totally illiterate participants had 2.41 times the odds and partially illiterate individuals had 1.59 times the odds of being depressed compared with literate participants after controlling for other variables. Compared with literate individuals, illiterate elderly persons were at increased odds for responding negatively to the majority of SGDS-K items, including "having memory problems," "others are better off than me," and "feeling worthless" even after controlling for various demographic and clinical factors. Illiteracy in elderly individuals was associated with a higher rate and increased severity of depression. Illiteracy negatively affected depression symptomatology, especially factors associated with self-esteem. Therefore, clinicians should carefully monitor for the presence of depression in illiterate elderly adults.

  2. Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Guallar-Castillón Pilar

    2011-06-01

    Full Text Available Abstract Background Evidence on the relation between leisure-time physical activity (LTPA and health-related quality of life (HRQoL in older adults is based primarily on clinical trials of physical exercise programs in institutionalized persons and on cross-sectional studies of community-dwelling persons. Moreover, there is no evidence on whether leisure-time sedentary behavior (LTSB is associated with HRQoL independently of LTPA. This study examined the longitudinal association between LTPA, LTSB, and HRQoL in older community-dwelling adults in Spain. Methods Prospective cohort study of 1,097 persons aged 62 and over. In 2003 LTPA in MET-hr/week was measured with a validated questionnaire, and LTSB was estimated by the number of sitting hours per week. In 2009 HRQoL was measured with the SF-36 questionnaire. Analyses were done with linear regression and adjusted for the main confounders. Results Compared with those who did no LTPA, subjects in the upper quartile of LTPA had better scores on the SF-36 scales of physical functioning (β 5.65; 95% confidence interval [CI] 1.32-9.98; p linear trend Conclusions Greater LTPA and less LTSB were independently associated with better long-term HRQoL in older adults.

  3. Technology Use and Frequency and Self-Rated Skills: A Survey of Community-Dwelling Older Adults.

    Science.gov (United States)

    Scanlon, Lorraine; O'Shea, Emma; O'Caoimh, Rónán; Timmons, Suzanne

    2015-07-01

    Many older adults are using technology regularly, but the vast majority still rate their technology skills as poor or average,reflecting their low usage of less-familiar items such as tablet computers. Despite moves toward increasing the use of ICT in the care, rehabilitation, and monitoring of older adults, baseline use of such devices is low. Further study is required to investigate how people's attitudes toward and experience with ICT influence its utility in clinical practice

  4. Long-term moderate alcohol consumption does not exacerbate age-related cognitive decline in healthy, community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Malaak Nasser Moussa

    2015-01-01

    Full Text Available Recent census data has found that roughly 40% of adults 65 years and older not only consume alcohol but also drink more of it than previous generations. Older drinkers are more vulnerable than younger counterparts to the psychoactive effects of alcohol due to natural biological changes that occur with aging. This study was specifically designed to measure the effect of long-term moderate alcohol consumption on cognitive health in older adult drinkers. An extensive battery of validated tests commonly used in aging and substance use literature was used to measure performance in specific cognitive domains, including working memory and attention. An age (young, old * alcohol consumption (light, moderate factorial study design was used to evaluate the main effects of age and alcohol consumption on cognitive performance. The focus of the study was then limited to light and moderate older drinkers, and whether or not long–term moderate alcohol consumption exacerbated age-related cognitive decline. No evidence was found to support the idea that long-term moderate alcohol consumption in older adults exacerbates age-related cognitive decline. Findings were specific to healthy community dwelling social drinkers in older age and they should not be generalized to individuals with other consumption patterns, like heavy drinkers, binge drinkers or ex-drinkers.

  5. Long-term moderate alcohol consumption does not exacerbate age-related cognitive decline in healthy, community-dwelling older adults.

    Science.gov (United States)

    Moussa, Malaak N; Simpson, Sean L; Mayhugh, Rhiannon E; Grata, Michelle E; Burdette, Jonathan H; Porrino, Linda J; Laurienti, Paul J

    2014-01-01

    Recent census data has found that roughly 40% of adults 65 years and older not only consume alcohol but also drink more of it than previous generations. Older drinkers are more vulnerable than younger counterparts to the psychoactive effects of alcohol due to natural biological changes that occur with aging. This study was specifically designed to measure the effect of long-term moderate alcohol consumption on cognitive health in older adult drinkers. An extensive battery of validated tests commonly used in aging and substance use literature was used to measure performance in specific cognitive domains, including working memory and attention. An age (young, old) (*) alcohol consumption (light, moderate) factorial study design was used to evaluate the main effects of age and alcohol consumption on cognitive performance. The focus of the study was then limited to light and moderate older drinkers, and whether or not long-term moderate alcohol consumption exacerbated age-related cognitive decline. No evidence was found to support the idea that long-term moderate alcohol consumption in older adults exacerbates age-related cognitive decline. Findings were specific to healthy community dwelling social drinkers in older age and they should not be generalized to individuals with other consumption patterns, like heavy drinkers, binge drinkers or ex-drinkers.

  6. Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Middleton, Addie; Fulk, George D; Herter, Troy M; Beets, Michael W; Donley, Jonathan; Fritz, Stacy L

    2016-07-01

    To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults. WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS). SSWS (P risk assessment. Combining SSWS and MWS to calculate an individual's WSR does not provide additional insight into fall status in this population. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure; (2) Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults; and (3) Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions. Advanced : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

  7. Timed Up and Go test, atrophy of medial temporal areas and cognitive functions in community-dwelling older adults with normal cognition and mild cognitive impairment.

    Science.gov (United States)

    Kose, Yujiro; Ikenaga, Masahiro; Yamada, Yosuke; Morimura, Kazuhiro; Takeda, Noriko; Ouma, Shinji; Tsuboi, Yoshio; Yamada, Tatsuo; Kimura, Misaka; Kiyonaga, Akira; Higaki, Yasuki; Tanaka, Hiroaki

    2016-12-01

    This study aimed to ascertain if performance on the Timed Up and Go (TUG) test is associated with indicators of brain volume and cognitive functions among community-dwelling older adults with normal cognition or mild cognitive impairment. Participants were 80 community-dwelling older adults aged 65-89years (44 men, 36 women), including 20 with mild cognitive impairment. Participants completed the TUG and a battery of cognitive assessments, including the Mini-Mental State Examination (MMSE), the Logical Memory I and II (LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and the Trail Making Test A and B (TMT-A, TMT-B). Bilateral, right- and left-side medial temporal area atrophy as well as whole gray and white matter indices were determined with the Voxel-based Specific Regional Analysis System for Alzheimer's Disease. We divided participants into three groups based on TUG performance: "better" (≤6.9s); "normal" (7-10s); and "poor" (≥10.1s). Worse TMT-A and TMT-B performance showed significant independent associations with worse TUG performance (P<0.05, P<0.01 for trend, respectively). After adjusting for covariates, severe atrophy of bilateral, right-, and left-side medial temporal areas were significantly independently associated with worse TUG performance (P<0.05 for trend). However, no significant associations were found between MMSE, LM-I, LM-II, whole gray and white matter indices, and TUG performance. Worse TUG performance is related to poor performance on TMT-A and TMT-B, and is independently associated with severe medial temporal area atrophy in community-dwelling older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Associations Between Resilience, Community Belonging, and Social Participation Among Community-Dwelling Older Adults: Results From the Eastern Townships Population Health Survey.

    Science.gov (United States)

    Levasseur, Mélanie; Roy, Mathieu; Michallet, Bernard; St-Hilaire, France; Maltais, Danielle; Généreux, Mélissa

    2017-04-26

    To examine the associations between resilience, community belonging, and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. Community. A sample (N=4541) of women (n=2485) and men (n=2056) aged ≥60 years was randomly selected according to area. Most participants had resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in 8 community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to the local community. Social participation and sense of belonging questions came from Statistics Canada surveys. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale, capturing the ability to cope with adversity. Controlling for age, education, and psychological distress, greater resilience and community belonging were associated with greater social participation among women (R(2)=.13; Presilience, especially in men. Greater community belonging further enhanced social participation, especially among women (P=.03) and men (Presilience (moderator effect). Resilience moderates the association between community belonging and social participation among community-dwelling older women and, especially, men. Interventions targeting social participation should consider the potential impact of resilience on improving community belonging. Future studies should investigate why resilience moderates associations between community belonging and social participation, and how to enhance resilience among older adults. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  9. Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training

    DEFF Research Database (Denmark)

    Jørgensen, Martin Grønbech

    The overall purpose of this thesis was to examine selected methodological aspects and novel approaches for measuring postural balance older adults, and to examine the effects of biofeedback-based Nintendo Wii training on selected physiological, psychological and functional outcome variables...... (familiarization) period is necessary for the Wii Agility test to avoid a systematic learning effect between successive test sessions. Study III investigated the effect of ten weeks of biofeedback-based Nintendo Wii training on static postural balance, mechanical lower limb muscle function, and functional...... performance in 58 community-dwelling older adults. Additionally, the study investigated the participant motivation for this type of training (Exergaming). Marked improvements in maximal leg muscle strength, rapid force capacity and functional performance were observed following the period of biofeedback...

  10. The effects of an integrated health education and exercise program in community-dwelling older adults with hypertension: a randomized controlled trial.

    Science.gov (United States)

    Park, Yeon-Hwan; Song, Misoon; Cho, Be-Long; Lim, Jae-Young; Song, Wook; Kim, Seon-Ho

    2011-01-01

    the aim of this study was to examine the effectiveness of HAHA (Healthy Aging and Happy Aging) program, which is an integrated health education and exercise program for community-dwelling older adults with hypertension. older adults with hypertension from one senior center were randomly allocated to experimental (n=18) or control group (n=22). Experimental group received health education, individual counseling and tailored exercise program for 12 weeks. the mean ages were 71 years (experimental group) and 69 (control group). After the intervention, systolic blood pressure of experimental group was significantly decreased than that of control group. Scores of exercise self-efficacy, general health, vitality, social functioning, and mental health in SF-36 were statistically higher than those of control group. the HAHA program was effective in control of systolic blood pressure and improving self-efficacy for exercise and health-related quality of life. 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Depression Affects the Scores of All Facets of the WHOQOL-BREF and May Mediate the Effects of Physical Disability among Community-Dwelling Older Adults.

    Directory of Open Access Journals (Sweden)

    Yu-Chen Chang

    Full Text Available Geriatric depression is associated with the overall quality of life (QOL. However, how depressive symptoms affect the different domains and facets of QOL in older adults, and whether depressive symptoms mediate the relationship between physical disability and QOL in older adults are unclear.A total of 490 ambulatory community-dwelling older adults aged 65 years or above were interviewed using the brief version of the World Health Organisation Quality of Life instrument (WHOQOL-BREF, the Modified Barthel Index (MBI, the 15-item Geriatric Depression Scale (GDS-15, and the Mini-Mental State Examination (MMSE. Sequential models for multiple linear regressions were analysed to determine if the MBI, GDS-15 and MMSE scores predict the WHOQOL-BREF scores. The potential mediation effects of depression (as determined by the GDS-15 on the relationship between MBI and WHOQOL-BREF were also analysed.The GDS-15 score was predictive of the scores of the four domains and all 26 facets of the WHOQOL-BREF. The significant predictive effects of the MBI score on 15 of the 26 facets of the WHOQOL-BREF were reduced to three after the adjustment for the GDS-15 score. Depression (as assessed by the GDS-15 is a mediator of the relationship between MBI and the physical, psychological and environmental domains of the WHOQOL-BREF.Depression (assessed by the GDS-15 may affect the scores of every domain and all facets of the WHOQOL-BREF in the elderly. Furthermore, it may mediate the relationship between the MBI and on QOL scores. We recommend taking depressive symptoms into consideration when measuring community-dwelling older adults' QOL and providing active ageing programs.

  12. Association between objectively measured sleep quality and obesity in community-dwelling adults aged 80 years or older: a cross-sectional study.

    Science.gov (United States)

    Kim, Miji

    2015-02-01

    The purpose of this study was to examine the association between objective measures of sleep quality and obesity in older community-dwelling people. This cross-sectional study included 189 community-dwelling adults aged ≥ 80 yr (83.4 ± 2.5 yr [age range, 80-95 yr]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist 24 hr per day for 7 consecutive nights. Sleep parameters measured included total sleep time, sleep efficiency, and wake after sleep onset (WASO) during the night. Associations between sleep parameters and obesity were investigated by using multivariate logistic regression analysis. In multivariate models, those with sleep efficiency lower than 85% had a 2.85-fold increased odds of obesity, compared with those with sleep efficiency of 85% or higher. Similarly, those with WASO of ≥ 60 min (compared with obesity. However, there were no significant associations between total sleep time or self-reported napping duration and obesity. We found that poor sleep quality was an independent risk factor for obesity in community-dwelling Japanese adults aged ≥ 80 yr, even after controlling for potential confounding factors, including daily physical activity.

  13. Association between multiple geriatric syndromes and life satisfaction in community-dwelling older adults: A nationwide study in Taiwan.

    Science.gov (United States)

    Yang, Deng-Chi; Lee, Jenq-Daw; Huang, Chi-Chang; Shih, Hsin-I; Chang, Chia-Ming

    2015-01-01

    Although previous studies have investigated the association between a single geriatric syndrome and life satisfaction in the older adults, the accumulated effects of multiple geriatric syndromes on life satisfaction remain unclear. We conducted a nationwide study by using data from the Taiwan Longitudinal Study on Aging database. A total of 2415 older adults were enrolled. Life satisfaction was evaluated according to the Life Satisfaction Index, and the geriatric syndromes included a depressive disorder, cognitive impairment, functional impairment, urine incontinence, pain, a fall, and polypharmacy. Other characteristics were age, sex, marital status, education level, self-rated health, and chronic diseases. Univariate analysis revealed that the older adults, who were illiterate, did not live with a partner, yet other issues such as stroke, malignancy, osteoarthritis, poor self-rated health, a depressive disorder, functional impairment, urine incontinence, or pain were associated with lower life satisfaction. In the multivariate regression model, the older adults who were male, illiterate, lived without a partner, had poor self-rated health, or had a depressive disorder were more likely to have lower life satisfaction. In addition, life satisfaction was unaffected in the older adults with only 1 geriatric syndrome, but among those with ≥2 geriatric syndromes, an increased number of geriatric syndromes were associated with lower life satisfaction. In addition to socio-demographic factors, cumulative effects of multiple geriatric syndromes might affect life satisfaction in the older adults. Further study of interventions for reducing geriatric syndromes to maintain life satisfaction is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. [Assessment of balance in community dwelling older adults: reliability and validity of the German version of the Fullerton Advanced Balance Scale].

    Science.gov (United States)

    Schott, N

    2011-12-01

    The purpose of this study was to validate the German translation of the originally English Fullerton Advanced Balance Scale (FAB-D). The 10-item test battery is a performance-based measure that addresses the multiple dimensions of balance. The German FAB-D using a forward-backward procedure was examined by a sample of n = 96 community dwelling older adults (71,6 ± 7,5 years of age) who had reported no history of a fall in the previous 6 months (non-fallers) and 66 older adults (age 75,3 ± 7,3 years of age) who reported falling one or more times (recurrent fallers). The following internationally accepted instruments were used for validation: The Berg-Balance-Scale (BBS), the Activities-Specific Balance Confidence (ABC-D) scale, the Short Form Health Survey (SF-36), the Physical Activity Scale for the Elderly (PASE), the Trail-Making-Test (TMT), and motor tests (balance, strength, mobility). Explorative and confirmative factor analysis showed the best fit for a one dimensional solution. Cronbach's alpha of the German version of the FAB-D was 0.988. Test-retest reliability for the total score was 0.965 and ranged from 0.86-0.88 for individual items. The scales correlate with convergent measures assessing postural control and falls-related confidence (BBS, r = 0.685; Timed-Up-and-Go-Test, r = -0.632; ABC-D, r = 0.561). Criterion validity of the FAB-D was established by statistically significant correlations between the total scale, and the subdimensions of the SF-36 (physical 0.52, mental 0.38), the PASE (0.29), the TMT A (-0.30) and B (-0.41), the Chair Rising Test (0.59) and the 10 m walk (normal velocity -0.49; fast velocity -0.56). Significant differences in the FAB-D scores were found in older adults with (30,3 ± 8,6) and without falls (36,1 ± 4,2). Older adults with a recent fall history scored lower on the FAB-D than older adults without a recent fall history. To conclude, the German version of the FAB-D has properties analogous to the original English

  15. Are frailty components associated with disability in specific activities of daily living in community-dwelling older adults? A multicenter Canadian study.

    Science.gov (United States)

    Provencher, Véronique; Béland, François; Demers, Louise; Desrosiers, Johanne; Bier, Nathalie; Ávila-Funes, José Alberto; Galand, Claude; Julien, Dominic; Fletcher, John D; Trottier, Lise; Hami, Benyahia

    2017-11-01

    Current studies show the relevance of geriatric prevention and rehabilitation programs to slow down the development of disability in community-dwelling older adults who are becoming frail. This evidence reveals the importance of improving knowledge on how individual components of frailty and specific disability in basic and instrumental activities of daily living (ADL) are related, to offer early, targeted, and tailored interventions. The objective was to examine the association between each of the five frailty phenotype components (weakness, slowness, exhaustion, low physical activity, weight loss) and disability in specific ADL pertaining to physical aspects (bathing, dressing, cutting toe nails, transportation, shopping, housekeeping, food purchasing, food preparation) and cognitive aspects (finances, telephone, medication). A cross-sectional design involving 1643 community-dwelling older adults (65+) from the longitudinal multi-center FRéLE study was used. Disability was defined as needing help or being unable to perform specific ADL. Multiple logistic regressions were adjusted for socio-demographic characteristics, clinical variables, and for 4 other frailty components. Results showed that low physical activity and slowness were significantly linked to disability in all physical and cognitive aspects of ADL (OR: 1.71-9.42; pdisability in the physical aspects of instrumental ADL (transportation, shopping, housekeeping, food purchasing, food preparation) (OR: 1.73-9.42; pdisability. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Effect of a dual task on quantitative Timed Up and Go performance in community-dwelling older adults: A preliminary study.

    Science.gov (United States)

    Smith, Erin; Walsh, Lorcan; Doyle, Julie; Greene, Barry; Blake, Catherine

    2017-08-01

    The Timed Up and Go test (TUG) is used as a measure of functional ability in older adults; however, the method of measurement does not allow us to determine which aspects of the test deficits occur in. The aim of the present study was to examine the ability of the quantitative TUG (QTUG) to measure performance during the TUG test under three different conditions - single task, motor task and cognitive dual task - and to compare performance between fallers and non-fallers in high-functioning community-dwelling older adults. A total of 37 community-dwelling older adults, 16 with a self-reported falls history in the previous year, were recruited. Participants underwent a falls risk assessment with a physiotherapist including the QTUG under three conditions (single task, motor task, cognitive dual-task). A total of 10 clinical parameters were chosen for analysis using mancova and a series of ancova, with age, sex and body mass index included as covariates. The mancova analysis showed a significant difference across the three task conditions (Wilk's Lambda F20,186  = 3.37, P time in double support. When faller and non-faller differences were explored, cadence and stride velocity was greater, and stride time longer in those with a prior history of falls. In community-dwelling older adults, these preliminary results show that a cognitive dual-task significantly (P time-to-stand observed with a motor task. Although no statistical difference was found between fallers and non-fallers for many of the parameters, cadence, stride time and stride velocity were statistically different (P < 0.05). A larger sample size and more assessment points might lead to more definitive findings. These results highlight the need for further research to examine QTUG performance under dual-task conditions between fallers and non-fallers in this population, and to look at the ability of dual-task QTUG assessment to measure change longitudinally and the effectiveness of therapeutic

  17. Linking Spiritual and Religious Coping With the Quality of Life of Community-Dwelling Older Adults and Nursing Home Residents

    Directory of Open Access Journals (Sweden)

    Luciano Magalhães Vitorino BSN, MSc

    2016-07-01

    Full Text Available Objective: This study examined the effect of Positive and Negative Spiritual and Religious Coping (SRC upon older Brazilian’s quality of life (QOL. Method: A secondary analysis of data collected from 77 nursing home residents (NHRs; M age = 76.56 and 326 community-dwelling residents (CDRs; M age = 67.22 years was conducted. Participants had completed the Brief SRC, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF and World Health Organization Quality of Life-OLD (WHOQOL-OLD. A General Linear Model regression analysis was undertaken to assess the effects of SRC upon 10 aspects of participants’ QOL. Results: Positive (F = 6.714, df = 10, p < .001 as opposed to Negative (F = 1.194, df = 10, p = .294 SRC was significantly associated with QOL. Positive SRC was more strongly associated with NHR’s physical, psychological, and environmental QOL, and their perceived sensory abilities, autonomy, and opportunities for intimacy. Conclusion: Positive SRC behaviors per se were significantly associated with QOL ratings across both study samples. The effect size of Positive SRC was much larger among NHRs across six aspects of QOL. Place of residence (POR in relation to SRC and QOL in older age warrants further study.

  18. Linking Spiritual and Religious Coping With the Quality of Life of Community-Dwelling Older Adults and Nursing Home Residents

    Directory of Open Access Journals (Sweden)

    Luciano Magalhães Vitorino BSN, MSc

    2016-07-01

    Full Text Available Objective: This study examined the effect of Positive and Negative Spiritual and Religious Coping (SRC upon older Brazilian’s quality of life (QOL. Method: A secondary analysis of data collected from 77 nursing home residents (NHRs; M age = 76.56 and 326 community-dwelling residents (CDRs; M age = 67.22 years was conducted. Participants had completed the Brief SRC, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF and World Health Organization Quality of Life-OLD (WHOQOL-OLD. A General Linear Model regression analysis was undertaken to assess the effects of SRC upon 10 aspects of participants’ QOL. Results: Positive ( F = 6.714, df = 10, p < .001 as opposed to Negative ( F = 1.194, df = 10, p = .294 SRC was significantly associated with QOL. Positive SRC was more strongly associated with NHR’s physical, psychological, and environmental QOL, and their perceived sensory abilities, autonomy, and opportunities for intimacy. Conclusion: Positive SRC behaviors per se were significantly associated with QOL ratings across both study samples. The effect size of Positive SRC was much larger among NHRs across six aspects of QOL. Place of residence (POR in relation to SRC and QOL in older age warrants further study.

  19. Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems

    Directory of Open Access Journals (Sweden)

    Kenji Narazaki, Eri Matsuo, Takanori Honda, Yu Nofuji, Koji Yonemoto, Shuzo Kumagai

    2014-09-01

    Full Text Available Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24 were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%. Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001. These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001. The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community

  20. Oral conditions and dysphagia in Japanese, community-dwelling middle- and older- aged adults, independent in daily living

    Science.gov (United States)

    Inui, Akinari; Takahashi, Ippei; Kurauchi, Sizuka; Soma, Yuki; Oyama, Toshiaki; Tamura, Yoshihiro; Noguchi, Takao; Murashita, Kouichi; Nakaji, Shigeyuki; Kobayashi, Wataru

    2017-01-01

    Purpose Prevention, early detection and effective rehabilitation of dysphagia are important issues to be considered in an aging society. Previous studies have shown conflicting findings regarding the association between dysphagia and its potential risk factors, including age, malnutrition, oral conditions, lifestyle and medical history. Herein, we assessed the prevalence and association of dysphagia with potential risk factors in 50- to 79-year-old adults dwelling in a community in Japan. Patients and methods In this study, there were 532 participants (185 males and 347 females). Participants who responded positively to the question “Do you sometimes choke on drinks/food such as tea and soup?” or those who presented with abnormal repetitive saliva swallowing test findings were diagnosed with dysphagia. The data collected from these participants included the following: number of teeth, occurrence of oral dryness, age, body mass index, serum albumin concentration, smoking, drinking and exercise habits, presence of diseases, such as diabetes mellitus and hypertension, and questions from the Mini–Mental State Examination. Results Dysphagia was observed in 33 males (17.8%) and 76 females (21.9%). To explore the effect of the potential risk factors on the prevalence of dysphagia, a model was built by multivariate logistic regression analysis. Using the forced entry method, oral dryness (odds ratio [OR] =3.683 and P=0.003 in males; OR =1.797 and P=0.032 in females) and the number of teeth (OR =0.946 and P=0.038 in males) were found to be significantly related to dysphagia. Conclusion This cross-sectional study demonstrated associations between oral conditions and dysphagia. Factors such as oral dryness and number of teeth may contribute to dysphagia more so than aging, lifestyle and comorbidity in community-dwelling adults over the age of 50. PMID:28352164

  1. The Effects of Pilates Training on Balance Control and Self-Reported Health Status in Community-Dwelling Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Gabizon, Hadas; Press, Yan; Volkov, Ilia; Melzer, Itshak

    2016-07-01

    To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults. A single-blind, randomized, controlled trial. General community. A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44). The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention. Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period. Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status. The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

  2. Older adults' quality of life - Exploring the role of the built environment and social cohesion in community-dwelling seniors on low income.

    Science.gov (United States)

    Engel, L; Chudyk, A M; Ashe, M C; McKay, H A; Whitehurst, D G T; Bryan, S

    2016-09-01

    The built environment and social cohesion are increasingly recognized as being associated with older adults' quality of life (QoL). However, limited research in this area still exists and the relationship has remained unexplored in the area of Metro Vancouver, Canada. This study examined the association between the built environment and social cohesion with QoL of 160 community-dwelling older adults (aged ≥ 65 years) on low income from Metro Vancouver. Cross-sectional data acquired from the Walk the Talk (WTT) study were used. Health-related QoL (HRQoL) and capability wellbeing were assessed using the EQ-5D-5L and the ICECAP-O, respectively. Measures of the environment comprised the NEWS-A (perceived built environment measure), the Street Smart Walk Score (objective built environment measure), and the SC-5PT (a measure of social cohesion). The primary analysis consists of Tobit regression models to explore the associations between environmental features and HRQoL as well as capability wellbeing. Key findings indicate that after adjusting for covariates, older adults' capability wellbeing was associated with street connectivity and social cohesion, while no statistically significant associations were found between environmental factors and HRQoL. Our results should be considered as hypothesis-generating and need confirmation in a larger longitudinal study.

  3. High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect.

    Science.gov (United States)

    Turner, Anisha; Hochschild, Ann; Burnett, Jason; Zulfiqar, Amber; Dyer, Carmel B

    2012-09-01

    Medication non-adherence can exacerbate disease severity, leading to impairments that interfere with self-care activities in older adults, and, ultimately, death. Elder self-neglect is the most common report to Adult Protective Services (APS) across the USA and is a significant risk factor for early mortality. These individuals often suffer from multiple comorbid diseases that require careful management, but for various reasons they are unwilling or unable to provide themselves with the self-care resources necessary for maintaining health and safety. No studies have assessed whether medication adherence is associated with elder self-neglect. The purpose of this study was to assess and describe medication adherence in this population, as well as evaluate associations between medication adherence and cognitive impairment, depression, physical function, and abilities to perform basic and instrumental activities of daily living (BADLs and IADLs). A cross-sectional study of 100 community-dwelling adults 65 years of age and older with APS-substantiated elder self-neglect were assessed. In-home comprehensive geriatric assessments (CGAs) were completed and included medication reviews. Information on each medication, including the amount taken from the date dispensed, was collected and used to determine adherence. The criteria for non-adherence were taking 110 % of at least one medication. The sample was also split into groups of low adherence (≤29 %), moderate adherence (29-86 %) and high adherence (≥86 %). Scores on the CGA measures Mini-Mental State Examination, Geriatric Depression Scale, Physical Performance Test (PPT) and Kohlman Evaluation of Living Skills were assessed to determine whether cognitive impairment, depression, physical function, and/or ability to perform BADLs and IADLs were associated with non-adherence or low, moderate or high levels of adherence. Twenty-five per cent of the sample was taking more than seven medications daily. The average rate of

  4. "We are all one together": peer educators' views about falls prevention education for community-dwelling older adults--a qualitative study.

    Science.gov (United States)

    Khong, Linda; Farringdon, Fiona; Hill, Keith D; Hill, Anne-Marie

    2015-03-20

    Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering the message. The purpose of this study was to explore peer educators' perspective about their role in delivering peer-led falls prevention education for community-dwelling older adults. A two-stage qualitative inductive constant comparative design was used. In stage one (core component) focus group interviews involving a total of eleven participants were conducted. During stage two (supplementary component) semi-structured interviews with two participants were conducted. Data were analysed thematically by two researchers independently. Key themes were identified and findings were displayed in a conceptual framework. Peer educators were motivated to deliver educational presentations and importantly, to reach an optimal peer connection with their audience. Key themes identified included both personal and organisational factors that impact on educators' capacity to facilitate their peers' engagement with the message. Personal factors that facilitated message delivery and engagement included peer-to-peer connection and perceived credibility, while barriers included a reluctance to accept the message that they were at risk of falling by some members in the audience. Organisational factors, including ongoing training for peer educators and formative feedback following

  5. Sex, race and age differences in muscle strength and limitations in community dwelling older adults: Data from the Health and Retirement Survey (HRS).

    Science.gov (United States)

    Germain, Cassandra M; Vasquez, Elizabeth; Batsis, John A; McQuoid, Douglas R

    2016-01-01

    Aging-related muscle weakness is associated with increased risk of functional limitations and disability. This study examined the association between varying degrees of hand grip strength on functional ability in community-dwelling older adults. Cross-sectional analysis of 4289 men and 5860 women ≥60 from 2006 and 2008 waves of the population-based Health and Retirement Study (HRS) were stratified by sex-specific grip strength tertiles (low, mid, high). Prevalence and adjusted odds of physical limitations (PL), and ADL/IADL limitation were calculated by sex, race/ethnicity and age group (60-69, 70-79, 80+). Models were weighted, adjusted for age, sex, race/ethnicity, education, smoking status, BMI, comorbidities and participation in physical activity. Prevalence of PL, ADL and IADL limitations were significantly lower among adults in the highest grip category as compared to those in the lowest grip category. Adjusted odds for PL OR 0.41[0.33,0.52]; ADL OR.51 [0.39,0.67], and IADL OR 0.47 [0.38-0.59] limitations were significantly lower among adults in the highest grip compared to the lowest grip category. However, notable differences were observed in the strength of these associations by gender, race and age group. Demographic characteristics are important factors to consider for risk stratification and the development of effective grip strength training interventions for older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. The reliability of the quantitative timed up and go test (QTUG) measured over five consecutive days under single and dual-task conditions in community dwelling older adults.

    Science.gov (United States)

    Smith, Erin; Walsh, Lorcan; Doyle, Julie; Greene, Barry; Blake, Catherine

    2016-01-01

    The timed up and go (TUG) test is a commonly used assessment in older people with variations including the addition of a motor or cognitive dual-task, however in high functioning older adults it is more difficult to assess change. The quantified TUG (QTUG) uses inertial sensors to detect test and gait parameters during the test. If it is to be used in the longitudinal assessment of older adults, it is important that we know which parameters are reliable and under which conditions. This study aims to examine the relative reliability of the QTUG over five consecutive days under single, motor and cognitive dual-task conditions. Twelve community dwelling older adults (10 females, mean age 74.17 (3.88)) performed the QTUG under three conditions for five consecutive days. The relative reliability of each of the gait parameters was assessed using intra-class correlation coefficient (ICC 3,1) and standard error of measurement (SEM). Five of the measures demonstrated excellent reliability (ICC>0.70) under all three conditions (time to complete test, walk time, number of gait cycles, number of steps and return from turn time). Measures of variability and turn derived parameters demonstrated weak reliability under all three conditions (ICC=0.05-0.49). For the most reliable parameters under single-task conditions, the addition of a cognitive task resulted in a reduction in reliability suggesting caution when interpreting results under these conditions. Certain sensor derived parameters during the QTUG test may provide an additional resource in the longitudinal assessment of older people and earlier identification of falls risk.

  7. Risk prediction in the community: A systematic review of case-finding instruments that predict adverse healthcare outcomes in community-dwelling older adults.

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2015-09-01

    Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n=18, (78%) were derived in North America from secondary analysis of survey data. The majority n=12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n=16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5\\/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community.

  8. Obesity-specific neural cost of maintaining gait performance under complex conditions in community-dwelling older adults.

    Science.gov (United States)

    Osofundiya, Olufunmilola; Benden, Mark E; Dowdy, Diane; Mehta, Ranjana K

    2016-06-01

    Recent evidence of obesity-related changes in the prefrontal cortex during cognitive and seated motor activities has surfaced; however, the impact of obesity on neural activity during ambulation remains unclear. The purpose of this study was to determine obesity-specific neural cost of simple and complex ambulation in older adults. Twenty non-obese and obese individuals, 65years and older, performed three tasks varying in the types of complexity of ambulation (simple walking, walking+cognitive dual-task, and precision walking). Maximum oxygenated hemoglobin, a measure of neural activity, was measured bilaterally using a portable functional near infrared spectroscopy system, and gait speed and performance on the complex tasks were also obtained. Complex ambulatory tasks were associated with ~2-3.5 times greater cerebral oxygenation levels and ~30-40% slower gait speeds when compared to the simple walking task. Additionally, obesity was associated with three times greater oxygenation levels, particularly during the precision gait task, despite obese adults demonstrating similar gait speeds and performances on the complex gait tasks as non-obese adults. Compared to existing studies that focus solely on biomechanical outcomes, the present study is one of the first to examine obesity-related differences in neural activity during ambulation in older adults. In order to maintain gait performance, obesity was associated with higher neural costs, and this was augmented during ambulatory tasks requiring greater precision control. These preliminary findings have clinical implications in identifying individuals who are at greater risk of mobility limitations, particularly when performing complex ambulatory tasks. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems.

    Science.gov (United States)

    Narazaki, Kenji; Matsuo, Eri; Honda, Takanori; Nofuji, Yu; Yonemoto, Koji; Kumagai, Shuzo

    2014-09-01

    Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of dementia. Key pointsThere is a great need for identifying lifestyle-related markers which help detect subtle cognitive impairment in the preclinical or earlier phase of dementia.In the present study, each of the five physical fitness measures

  10. Acceptability of an intelligent wireless sensor system for the rapid detection of health issues: findings among home-dwelling older adults and their informal caregivers

    Directory of Open Access Journals (Sweden)

    Cohen C

    2016-09-01

    Full Text Available Christine Cohen, Thomas Kampel, Henk Verloo Department Ra&D, La Source School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland Background: Aging at home rather than in an institution is now considered the gold standard. Public health figures document an important demographic transition to an increasingly elderly society. At the same time, this is accompanied by the emergence of significant numbers of innovative technologies to help and support home-dwelling older adults in declining health who wish to remain at home.Study aim: To explore the acceptability of intelligent wireless sensor system (IWSS among home-dwelling older adults in rapidly detecting their health issues.Methods: Data were sourced from a pilot 3-month randomized clinical trial that involved 34 older patients in the experimental group (EG using an IWSS to rapidly detect falls and other health issues at home. The effectiveness of the IWSS was assessed by comparing it to participants’ functional and cognitive status, as measured both before and after the trial. The Resident Assessment Instrument for Home Care, Confusion Assessment Method, Cognitive Performance Scale, Geriatric Depression Scale, and Informed Questionnaire on Cognitive Decline in the Elderly were used for the assessments. Acceptability of the IWSS was explored at the end of the study.Results: Both older adults and their informal caregivers considered the performance and usefulness of the IWSS intervention to be low to moderate. A majority of the participants were unsatisfied with its ease of use and found multiple obstacles in using and having an intention to use the IWSS. However, their informal caregivers were more satisfied with the program and gave higher scores for usefulness, ease of use, and intention to use IWSS technology.Conclusion: The IWSS displayed low-to-moderate acceptability among the older participants and their informal caregivers. We

  11. Oral conditions and dysphagia in Japanese, community-dwelling middle- and older- aged adults, independent in daily living

    Directory of Open Access Journals (Sweden)

    Inui A

    2017-03-01

    Full Text Available Akinari Inui,1 Ippei Takahashi,2 Sizuka Kurauchi,2 Yuki Soma,2 Toshiaki Oyama,1 Yoshihiro Tamura,1 Takao Noguchi,1 Kouichi Murashita,3 Shigeyuki Nakaji,2 Wataru Kobayashi1 1Department of Oral and Maxillofacial Surgery, 2Department of Social Medicine, 3COI Research Initiatives Organization, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori Prefecture, Japan Purpose: Prevention, early detection and effective rehabilitation of dysphagia are important issues to be considered in an aging society. Previous studies have shown conflicting findings regarding the association between dysphagia and its potential risk factors, including age, malnutrition, oral conditions, lifestyle and medical history. Herein, we assessed the prevalence and association of dysphagia with potential risk factors in 50- to 79-year-old adults dwelling in a community in Japan. Patients and methods: In this study, there were 532 participants (185 males and 347 females. Participants who responded positively to the question “Do you sometimes choke on drinks/food such as tea and soup?” or those who presented with abnormal repetitive saliva swallowing test findings were diagnosed with dysphagia. The data collected from these participants included the following: number of teeth, occurrence of oral dryness, age, body mass index, serum albumin concentration, smoking, drinking and exercise habits, presence of diseases, such as diabetes mellitus and hypertension, and questions from the Mini–Mental State Examination. Results: Dysphagia was observed in 33 males (17.8% and 76 females (21.9%. To explore the effect of the potential risk factors on the prevalence of dysphagia, a model was built by multivariate logistic regression analysis. Using the forced entry method, oral dryness (odds ratio [OR] =3.683 and P=0.003 in males; OR =1.797 and P=0.032 in females and the number of teeth (OR =0.946 and P=0.038 in males were found to be significantly related to dysphagia

  12. Intra-rater reproducibility and validity of Nintendo Wii Balance Tests in community-dwelling Older Adults

    DEFF Research Database (Denmark)

    Jørgensen, Martin; Læssøe, Uffe; Hendriksen, C

    2014-01-01

    The aims of the current study were to examine the intrarater intersession reproducibility of the Nintendo Wii agility and stillness tests and explore the concurrent validity in relation to gold-standard force-plate analysis. Within-day intersession reproducibility was examined in 30 older adults......% of 17.9%. Likewise for the Wii agility test ICC was .73 (95% CI 0.50-0.86), CV 5.3%, LOA 1.8, and LOA% of 14.6%. Wii stillness scores correlated to force plate measures (r = .65-.82, p

  13. Living Legends: Effectiveness of a Program to Enhance Sense of Purpose and Meaning in Life Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Chippendale, Tracy; Boltz, Marie

    2015-01-01

    We investigated the therapeutic benefits (i.e., sense of purpose and meaning in life) of the Living Legends program, which includes life review writing and an intergenerational exchange, compared with life review writing alone, for community-dwelling older adults. This study was a randomized controlled trial with a connected qualitative component. We analyzed quantitative data using independent-samples t tests and written descriptions of program experiences using Collaizi's qualitative methodology; we then used a triangulation protocol to integrate the qualitative and quantitative data. For participants in the writing workshop plus intergenerational exchange, sense of purpose and meaning in life increased significantly (psense of purpose and meaning in life, a factor known to prevent cognitive loss and disability, compared with life review writing alone. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  14. Relationship Between Head-Turn Gait Speed and Lateral Balance Function in Community-Dwelling Older Adults.

    Science.gov (United States)

    Singh, Harshvardhan; Sanders, Ozell; McCombe Waller, Sandy; Bair, Woei-Nan; Beamer, Brock; Creath, Robert A; Rogers, Mark W

    2017-10-01

    To determine and compare gait speed during head-forward and side-to-side head-turn walking in individuals with lower versus greater lateral balance. Cross-sectional study. University research laboratory. Older adults (N=93; 42 men, 51 women; mean age ± SD, 73 ± 6.08y) who could walk independently. (1) Balance tolerance limit (BTL), defined as the lowest perturbation intensity where a multistep balance recovery pattern was first evoked in response to randomized lateral waist-pull perturbations of standing balance to the left and right sides, at 6 different intensities (range from level 2: 4.5-cm displacement at 180cm/s(2) acceleration, to level 7: 22.5-cm displacement at 900cm/s(2) acceleration); (2) gait speed, determined using an instrumented gait mat; (3) balance, evaluated with the Activities-specific Balance Confidence Scale; and (4) mobility, determined with the Timed Up and Go (TUG). Individuals with low versus high BTL had a slower self-selected head-forward gait speed and head-turn gait speed (P=.002 and Phead-turn gait speed than head-forward gait speed (Cohen's d=1.0 vs 0.6). Head-turn gait speed best predicted BTL. BTL was moderately and positively related (P=.003) to the ABC Scale and negatively related (P=.017) to TUG. Head-turn gait speed is affected to a greater extent than head-forward gait speed in older individuals with poorer lateral balance and at greater risk of falls. Moreover, head-turn gait speed can be used to assess the interactions of limitations in lateral balance function and gait speed in relation to fall risk in older adults. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Effect of single and multi-joint lower extremity muscle strength on the functional capacity and ADL/IADL status in Japanese community-dwelling older adults.

    Science.gov (United States)

    Azegami, Masako; Ohira, Masayoshi; Miyoshi, Kei; Kobayashi, Chise; Hongo, Minoru; Yanagihashi, Ryuya; Sadoyama, Tsugutake

    2007-09-01

    Forty-seven community-dwelling older adults aged >70 years participated in this Japanese cross-sectional study to determine the relationship between the isometric lower extremity muscle strength measured during knee extension (KE) in single-joint and total leg extension (TLE) in multi-joint tasks, physical performance tests, and functional status. The physical performance was determined by KE and TLE muscle strength, walking capacity, and balance performance tests, while the functional status was evaluated by interview using basic activities of daily living (ADL) and instrumental activities of daily living (IADL) tools. The results indicated that the TLE muscle strength was significantly related to all the other performance tests, while the KE muscle strength was not correlated with the balance test. Also, the bilateral TLE muscle strength was significantly associated with IADL status compared with the KE muscle strength. In conclusion, multi-joint muscle strength testing might be superior to single-joint muscle strength testing for the screening of the functional impairments of older adults.

  16. Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia.

    Science.gov (United States)

    Lim, Li Min; McStea, Megan; Chung, Wen Wei; Nor Azmi, Nuruljannah; Abdul Aziz, Siti Azdiah; Alwi, Syireen; Kamarulzaman, Adeeba; Kamaruzzaman, Shahrul Bahyah; Chua, Siew Siang; Rajasuriar, Reena

    2017-01-01

    Polypharmacy has been associated with increased morbidity and mortality in the older population. The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

  17. Using the Technology Acceptance Model to explore community dwelling older adults' perceptions of a 3D interior design application to facilitate pre-discharge home adaptations.

    Science.gov (United States)

    Money, Arthur G; Atwal, Anita; Young, Katherine L; Day, Yasmin; Wilson, Lesley; Money, Kevin G

    2015-08-26

    In the UK occupational therapy pre-discharge home visits are routinely carried out as a means of facilitating safe transfer from the hospital to home. Whilst they are an integral part of practice, there is little evidence to demonstrate they have a positive outcome on the discharge process. Current issues for patients are around the speed of home visits and the lack of shared decision making in the process, resulting in less than 50 % of the specialist equipment installed actually being used by patients on follow-up. To improve practice there is an urgent need to examine other ways of conducting home visits to facilitate safe discharge. We believe that Computerised 3D Interior Design Applications (CIDAs) could be a means to support more efficient, effective and collaborative practice. A previous study explored practitioners perceptions of using CIDAs; however it is important to ascertain older adult's views about the usability of technology and to compare findings. This study explores the perceptions of community dwelling older adults with regards to adopting and using CIDAs as an assistive tool for the home adaptations process. Ten community dwelling older adults participated in individual interactive task-focused usability sessions with a customised CIDA, utilising the think-aloud protocol and individual semi-structured interviews. Template analysis was used to carry out both deductive and inductive analysis of the think-aloud and interview data. Initially, a deductive stance was adopted, using the three pre-determined high-level themes of the technology acceptance model (TAM): Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Actual Use (AU). Inductive template analysis was then carried out on the data within these themes, from which a number of sub-thmes emerged. Regarding PU, participants believed CIDAs served as a useful visual tool and saw clear potential to facilitate shared understanding and partnership in care delivery. For PEOU, participants were

  18. Consumption of fruit and vegetables and risk of frailty: a dose-response analysis of 3 prospective cohorts of community-dwelling older adults.

    Science.gov (United States)

    García-Esquinas, Esther; Rahi, Berna; Peres, Karine; Colpo, Marco; Dartigues, Jean-François; Bandinelli, Stefania; Feart, Catherine; Rodríguez-Artalejo, Fernando

    2016-07-01

    Consuming fruit and vegetables (FVs) may protect against frailty, but to our knowledge no study has yet assessed their prospective dose-response relation. We sought to examine the dose-response association between FV consumption and the risk of frailty in older adults. Data were taken from 3 independent cohorts of community-dwelling older adults: the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk Factors in Spain) cohort (n = 1872), Three-City (3C) Bordeaux cohort (n = 581), and integrated multidisciplinary approach cohort (n = 473). Baseline food consumption was assessed with a validated computerized diet history (Seniors-ENRICA) or with a food-frequency questionnaire (3C Bordeaux and AMI). In all cohorts, incident frailty was assessed with the use of the Fried criteria. Results across cohorts were pooled with the use of a random-effects model. During a mean 2.5-y follow-up, 300 incident frailty cases occurred. Fully adjusted models showed that the pooled ORs (95% CIs) of incident frailty comparing participants who consumed 1, 2, or ≥3 portions of fruit/d to those with no consumption were, respectively, 0.59 (0.27, 0.90), 0.58 (0.29, 0.86), and 0.48 (0.20, 0.75), with a P-trend of 0.04. The corresponding values for vegetables were 0.69 (0.42, 0.97), 0.56 (0.35, 0.77), and 0.52 (0.13, 0.92), with a P-trend fruit and risk of exhaustion, low physical activity, and slow walking speed, whereas the consumption of vegetables was associated with a decreased risk of exhaustion and unintentional weight loss. Among community-dwelling older adults, FV consumption was associated with a lower short-term risk of frailty in a dose-response manner, and the strongest association was obtained with 3 portions of fruit/d and 2 portions of vegetables/d. © 2016 American Society for Nutrition.

  19. Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system

    Directory of Open Access Journals (Sweden)

    Yano Elizabeth M

    2009-11-01

    Full Text Available Abstract Background Implementing quality improvement programs that require behavior change on the part of health care professionals and patients has proven difficult in routine care. Significant randomized trial evidence supports creating fall prevention programs for community-dwelling older adults, but adoption in routine care has been limited. Nationally-collected data indicated that our local facility could improve its performance on fall prevention in community-dwelling older people. We sought to develop a sustainable local fall prevention program, using theory to guide program development. Methods We planned program development to include important stakeholders within our organization. The theory-derived plan consisted of 1 an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2 focus groups with patients and health care professionals to develop ideas for the program, 3 monthly workgroup meetings with representatives from key departments to develop a blueprint for the program, 4 a second leadership meeting to confirm that the blueprint developed by the workgroup was satisfactory, and also to solicit feedback on ideas for program refinement. Results The leadership and workgroup meetings occurred as planned and led to the development of a functional program. The focus groups did not occur as planned, mainly due to the complexity of obtaining research approval for focus groups. The fall prevention program uses an existing telephonic nurse advice line to 1 place outgoing calls to patients at high fall risk, 2 assess these patients' risk factors for falls, and 3 triage these patients to the appropriate services. The workgroup continues to meet monthly to monitor the progress of the program and improve it. Conclusion A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program.

  20. Developing capacities in aging studies in the Middle East: Implementation of an Arabic version of the CANE IV among community-dwelling older adults in Lebanon.

    Science.gov (United States)

    AbiHabib, Laurie E; Chemaitelly, Hiam S; Jaalouk, Lina Y; Karam, Nadim E

    2011-07-01

    To assess the feasibility, reliability, and construct validity of the Camberwell Assessment of Need for the Elderly (CANE) in identifying needs among community-dwelling older adults in South Lebanon with a view towards expanding ageing research in the country. A cross-sectional study was undertaken with 322 individuals, using the CANE, the EQ5d and a socio-demographic questionnaire. Reliability was determined through measuring internal consistency of the CANE. Construct validity was performed through examining CANE inter-item correlations, and comparing correlations with the EQ5d and socio-demographic indicators. A factor analysis was conducted using varimax orthogonal rotation. Cronbach alpha was 0.71. For construct validity, correlations were highest in items measuring needs in looking after the house and food (r = 0.557); company and intimate relationships (r = 0.572); and medication and written/verbal information (r = 0.586). Moderate correlations were found with EQ5d items assessing the same measure, including: EQ5d 'problems taking care of self' and CANE self-care (r = 0.578) and daytime activities (r = 0.523); EQ5d 'problems performing usual activities' and CANE daytime activities (r = 0.553), self-care (r = 0.511) and mobility (r = 0.500); and EQ5d 'problems while walking' and CANE mobility/falls (r = 0.509). Corresponding items of the CANE and EQ-5d were significantly correlated with similar socio-demographic variables. The factor analysis supported results obtained in the CANE inter-item correlations. The Arabic version of the CANE appears acceptable in assessing needs of older adults in South Lebanon. Given that the CANE is an interesting tool that promotes the integration of older persons' perspectives for appropriate interventions, further research is recommended to establish its validity and applicability in other communities in Lebanon and the region.

  1. A Pilot Randomized Controlled Trial of the Effects of Chair Yoga on Pain and Physical Function Among Community-Dwelling Older Adults With Lower Extremity Osteoarthritis.

    Science.gov (United States)

    Park, Juyoung; McCaffrey, Ruth; Newman, David; Liehr, Patricia; Ouslander, Joseph G

    2017-03-01

    To determine effects of Sit 'N' Fit Chair Yoga, compared to a Health Education program (HEP), on pain and physical function in older adults with lower extremity osteoarthritis (OA) who could not participate in standing exercise. Two-arm randomized controlled trial. One HUD senior housing facility and one day senior center in south Florida. Community-dwelling older adults (N = 131) were randomly assigned to chair yoga (n = 66) or HEP (n = 65). Thirteen dropped after assignment but prior to the intervention; six dropped during the intervention; 106 of 112 completed at least 12 of 16 sessions (95% retention rate). Participants attended either chair yoga or HEP. Both interventions consisted of twice-weekly 45-minute sessions for 8 weeks. Primary: pain, pain interference; secondary: balance, gait speed, fatigue, functional ability measured at baseline, after 4 weeks of intervention, at the end of the 8-week intervention, and post-intervention (1 and 3 months). The chair yoga group showed greater reduction in pain interference during the intervention (P = .01), sustained through 3 months (P = .022). WOMAC pain (P = .048), gait speed (P = .024), and fatigue (P = .037) were improved in the yoga group during the intervention (P = .048) but improvements were not sustained post intervention. Chair yoga had no effect on balance. An 8-week chair yoga program was associated with reduction in pain, pain interference, and fatigue, and improvement in gait speed, but only the effects on pain interference were sustained 3 months post intervention. Chair yoga should be further explored as a nonpharmacologic intervention for older people with OA in the lower extremities. ClinicalTrials.gov: NCT02113410. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  2. A propensity-matched study of the association of diabetes mellitus with incident heart failure and mortality among community-dwelling older adults.

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    Roy, Brita; Pawar, Pushkar P; Desai, Ravi V; Fonarow, Gregg C; Mujib, Marjan; Zhang, Yan; Feller, Margaret A; Ovalle, Fernando; Aban, Inmaculada B; Love, Thomas E; Iskandrian, Ami E; Deedwania, Prakash; Ahmed, Ali

    2011-12-15

    Diabetes mellitus (DM) is a risk factor for incident heart failure (HF) in older adults. However, the extent to which this association is independent of other risk factors remains unclear. Of 5,464 community-dwelling adults ≥65 years old in the Cardiovascular Health Study without baseline HF, 862 had DM (fasting plasma glucose levels ≥126 mg/dl or treatment with insulin or oral hypoglycemic agents). Propensity scores for DM were estimated for each of the 5,464 participants and were used to assemble a cohort of 717 pairs of participants with and without DM who were balanced in 65 baseline characteristics. Incident HF occurred in 31% and 26% of matched participants with and without DM, respectively, during >13 years of follow-up (hazard ratio 1.45 for DM vs no DM, 95% confidence interval [CI] 1.14 to 1.86, p = 0.003). Of the 5,464 participants before matching unadjusted and multivariable-adjusted hazard ratios for incident HF associated with DM were 2.22 (95% CI 1.94 to 2.55, p <0.001) and 1.52 (95% CI 1.30 to 1.78, p <0.001), respectively. All-cause mortality occurred in 57% and 47% of matched participants with and without DM, respectively (hazard ratio 1.35, 95% CI 1.13 to 1.61, p = 0.001). Of matched participants DM-associated hazard ratios for incident peripheral arterial disease, incident acute myocardial infarction, and incident stroke were 2.50 (95% CI 1.45 to 4.32, p = 0.001), 1.37 (95% CI 0.97 to 1.93, p = 0.072), and 1.11 (95% CI 0.81 to 1.51, p = 0.527), respectively. In conclusion, the association of DM with incident HF and all-cause mortality in community-dwelling older adults without HF is independent of major baseline cardiovascular risk factors.

  3. Polypharmacy including falls risk-increasing medications and subsequent falls in community-dwelling middle-aged and older adults.

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    Richardson, Kathryn; Bennett, Kathleen; Kenny, Rose Anne

    2015-01-01

    polypharmacy is an important risk factor for falls, but recent studies suggest only when including medications associated with increasing the risk of falls. a prospective, population-based cohort study. 6,666 adults aged ≥50 years from The Irish Longitudinal study on Ageing. participants reported regular medication use at baseline. Any subsequent falls, any injurious falls and the number of falls were reported 2 years later. The association between polypharmacy (>4 medications) or fall risk-increasing medications and subsequent falls or injurious falls was assessed using modified Poisson regression. The association with the number of falls was assessed using negative binomial regression. during follow-up, 231 falls per 1,000 person-years were reported. Polypharmacy including antidepressants was associated with a greater risk of any fall (adjusted relative risk (aRR) 1.28, 95% CI 1.06-1.54), of injurious falls (aRR 1.51, 95% CI 1.10-2.07) and a greater number of falls (adjusted incident rate ratio (aIRR) 1.60, 95% CI 1.19-2.15), but antidepressant use without polypharmacy and polypharmacy without antidepressants were not. The use of benzodiazepines was associated with injurious falls when coupled with polypharmacy (aRR 1.40, 95% CI 1.04-1.87), but was associated with a greater number of falls (aIRR 1.32, 95% CI 1.05-1.65), independent of polypharmacy. Other medications assessed, including antihypertensives, diuretics and antipsychotics, were not associated with outcomes. in middle-aged and older adults, polypharmacy, including antidepressant or benzodiazepine use, was associated with injurious falls and a greater number of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

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    Ling Na PhD

    2017-03-01

    Full Text Available Objectives: Activity of daily living (ADL stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project ( N = 3,002 were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D], only the complete limitation stage (Stage IV showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

  5. Association of psychological, cognitive, and functional variables with self-reported executive functioning in a sample of nondemented community-dwelling older adults.

    Science.gov (United States)

    Meltzer, Erica P; Kapoor, Ashu; Fogel, Joshua; Elbulok-Charcape, Milushka M; Roth, Robert M; Katz, Mindy J; Lipton, Richard B; Rabin, Laura A

    2016-06-09

    Subjective executive functioning (EF) measures provide valuable information about real-world difficulties, although it is unclear what variables actually associate with subjective EF scores. We investigated subjective EF in 245 nondemented, community-dwelling older adults (aged 70 and above) from the Einstein Aging Study. Partial correlational analyses controlling for age were performed between the nine Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) clinical scales and objective EF tests, self-reported mood and personality, and informant-reported activities of daily living. The significance level was set at p depressive symptom scores. The only objective neuropsychological test that significantly correlated with increased EF difficulties (on four BRIEF-A scales) was a measure of practical judgment. Overall, results indicate that interpretation of subjective EF scores must account for self-report of mood and personality. Moreover, the BRIEF-A only minimally taps objective EF as measured by performance-based measures. We discuss the theoretical and practical implications of these findings.

  6. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Barry, Emma; Galvin, Rose; Keogh, Claire; Horgan, Frances; Fahey, Tom

    2014-02-01

    The Timed Up and Go test (TUG) is a commonly used screening tool to assist clinicians to identify patients at risk of falling. The purpose of this systematic review and meta-analysis is to determine the overall predictive value of the TUG in community-dwelling older adults. A literature search was performed to identify all studies that validated the TUG test. The methodological quality of the selected studies was assessed using the QUADAS-2 tool, a validated tool for the quality assessment of diagnostic accuracy studies. A TUG score of ≥13.5 seconds was used to identify individuals at higher risk of falling. All included studies were combined using a bivariate random effects model to generate pooled estimates of sensitivity and specificity at ≥13.5 seconds. Heterogeneity was assessed using the variance of logit transformed sensitivity and specificity. Twenty-five studies were included in the systematic review and 10 studies were included in meta-analysis. The TUG test was found to be more useful at ruling in rather than ruling out falls in individuals classified as high risk (>13.5 sec), with a higher pooled specificity (0.74, 95% CI 0.52-0.88) than sensitivity (0.31, 95% CI 0.13-0.57). Logistic regression analysis indicated that the TUG score is not a significant predictor of falls (OR = 1.01, 95% CI 1.00-1.02, p = 0.05). The Timed Up and Go test has limited ability to predict falls in community dwelling elderly and should not be used in isolation to identify individuals at high risk of falls in this setting.

  7. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Ryu, Mikyung; Jo, Jaeseong; Lee, Yunhwan; Chung, Yoon-Sok; Kim, Kwang-Min; Baek, Weon-Chil

    2013-11-01

    this study examined the association of physical activity with sarcopenia and sarcopenic obesity among the community-dwelling Korean elderly. subjects consisted of 2,264 aged 65 years or older in the 2008-09 Korea National Health and Nutrition Examination Survey. Sarcopenia was defined as 2 SD below the mean of the appendicular skeletal muscle/weight for healthy young adults. Obesity was defined as waist circumference ≥ 90 cm for men and ≥ 85 cm for women. Levels of physical activity were classified using the metabolic equivalent task method. the prevalence of sarcopenia was 12.1% in men and 11.9% in women. Among those with sarcopenia, obesity was prevalent in 68.3% of men and 65.0% of women. Adjusting for all covariates, compared with those with low physical activity, men who engaged in moderate and high activity were 38% and 74%, respectively, less likely to have sarcopenia (Ptrend obesity, men participating in moderate [odds ratio (OR) = 0.47; 95% confidence interval (CI) 0.26-0.87] and high (OR = 0.27; 95% CI: 0.12-0.60) physical activity, compared with low activity, had significantly lower risk (Ptrend = 0.001). In women, high physical activity was associated with a lower risk of sarcopenic obesity (OR = 0.43; 95% CI: 0.22-0.86). physical activity is associated with a reduced risk of sarcopenia and sarcopenic obesity in older Korean adults. There were gender differences in the relationship, with stronger associations observed in men than in women.

  8. Associations of Sarcopenic Obesity and Dynapenic Obesity with Bone Mineral Density and Incident Fractures Over 5-10 Years in Community-Dwelling Older Adults.

    Science.gov (United States)

    Scott, David; Chandrasekara, Sahan D; Laslett, Laura L; Cicuttini, Flavia; Ebeling, Peter R; Jones, Graeme

    2016-07-01

    The purpose of this study is to determine whether low muscle mass (sarcopenia) or strength (dynapenia), in the presence of obesity, are associated with increased risk for osteoporosis and non-vertebral fracture over 5-10 years in community-dwelling older adults. N = 1089 volunteers (mean ± SD age 62 ± 7 years; 51 % female) participated at baseline and 761 attended follow-up clinics (mean 5.1 ± 0.5 years later). Total body, total hip and spine BMD, and appendicular lean and total fat mass were assessed by DXA. Sarcopenic obesity and dynapenic obesity were defined as the lowest sex-specific tertiles for appendicular lean mass or lower-limb strength, respectively, and the highest sex-specific tertile for total fat mass. Fractures were self-reported on three occasions over 10.7 ± 0.7 years in 563 participants. Obese alone participants had significantly higher BMD at all sites compared with non-sarcopenic non-obese. Sarcopenic obese and dynapenic obese men had lower spine and total body BMD, respectively, and sarcopenic obese women had lower total hip BMD, compared with obese alone (all P obese men had higher non-vertebral fracture rates compared to non-sarcopenic non-obese (incidence rate ratio: 3.0; 95 % CI 1.7-5.5), and obese alone (3.6; 1.7-7.4). Sarcopenic obese women had higher fracture rates compared with obese alone (2.8; 1.4-5.6), but this was non-significant after adjustment for total hip BMD. Sarcopenic and dynapenic obese older adults may have increased risk of osteoporosis and non-vertebral fracture relative to obese alone counterparts. Sarcopenic and dynapenic obese individuals potentially represent a subset of the obese older adult population who require closer monitoring of bone health during ageing.

  9. Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

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    Liu C

    2017-07-01

    Full Text Available Chiung-ju Liu,1,2 Huiping Xu,3,4 NiCole R Keith,2,4,5 Daniel O Clark2,4,6 1Department of Occupational Therapy, Indiana University School of Health and Rehabilitation Sciences, 2Indiana University Center for Aging Research, 3Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health, 4Regenstrief Institute, Inc., 5Department of Kinesiology, Indiana University School of Physical Education and Tourism Management, 6Indiana University School of Medicine, Indianapolis, IN, USA Background: Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise would be more beneficial than resistance exercise alone. Methods: A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate, duration (50–60 minutes each time for 10 weeks, and frequency (three times a week. Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.Results: At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02, but the improvement was not greater than

  10. Instrumental activities of daily living among community-dwelling older adults: personality associations with self-report, performance, and awareness of functional difficulties.

    Science.gov (United States)

    Suchy, Yana; Williams, Paula G; Kraybill, Matthew L; Franchow, Emilie; Butner, Jonathan

    2010-09-01

    Self-reports of the ability to engage in instrumental activities of daily living (IADLs) among older adults are known to be related to personality traits. However, self-reports are sometimes discrepant with performance-based IADL assessments, and little is known about personality associations with objective functionality or with poor insight about functional deficits. This study examined the NEO Personality Inventory-Revised profiles associated with (a) self-report of functional problems, (b) functional errors evidenced on performance-based IADL assessment, and (c) discrepancies between self-report and performance. Participants were 65 community-dwelling individuals ranging in age from 60 to 87 years. The results showed that self-report of IADL problems are associated with higher neuroticism and lower conscientiousness, actual IADL difficulties with higher neuroticism and lower agreeableness and openness to experience, underreporting of problems with higher conscientiousness, and overreporting of problems with higher extraversion and neuroticism. These relationships were partly mediated by age, education, and cognitive status. When unique personality associations with self-report and performance were examined, neuroticism and agreeableness, respectively, emerged as the strongest predictors.

  11. The use of step aerobics and the stability ball to improve balance and quality of life in community-dwelling older adults - a randomized exploratory study.

    Science.gov (United States)

    Dunsky, Ayelet; Yahalom, Tal; Arnon, Michal; Lidor, Ronnie

    2017-07-01

    To explore the use of step aerobics (SA) and the stability ball (SB) as tools for balance improvement in community-dwelling older adults. Forty-two women (age: 72.2±5.8 years) who attended a community day center volunteered to participate in the study. Following the first assessment session, 28 women were assigned randomly to one of two experimental groups (the use of either SA or SB). The other 14 participants, who were engaged in a ceramic class, served as the control group. The study design was based on four assessment sessions and eight weeks of intervention. Assessment included four balance tests: Timed Up and Go (TUG), One-Leg Stand, Functional Reach, and the Performance-Oriented Assessment of Mobility (POMA). Quality of life was assessed by the use of the Short Form-36 Health Survey questionnaire. The TUG and POMA intervention improved significantly (d=.83 and d=.95, respectively) following the SA. In addition, general health perception following both the SA and SB interventions improved significantly relative to the control condition (d=.62 and d=.22, respectively). The findings of this study may imply that trainers should consider the inclusion of SA and SB as components of physical activity programs for seniors, aimed at improving balance ability and quality of life. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Performance of an Abbreviated Version of the Lubben Social Network Scale among Three European Community-Dwelling Older Adult Populations

    Science.gov (United States)

    Lubben, James; Blozik, Eva; Gillmann, Gerhard; Iliffe, Steve; von Renteln-Kruse, Wolfgang; Beck, John C.; Stuck, Andreas E.

    2006-01-01

    Purpose: There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. Design and Methods: The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale…

  13. Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults.

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    Kimiko Tomioka

    Full Text Available This study examined the factors related to intellectual activity in community-dwelling elderly persons.Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210. The response rate was 72.2%. Analytical subjects (n = 8,910 were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai, oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness, and dietary variety measured using the dietary variety score (DVS. A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR for poor intellectual activity.Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61-2.24, having neither hobbies nor ikigai (3.13, 2.55-3.84, having neither regular dental visits nor daily brushing (1.70, 1.35-2.14, the poorest oral function (1.61, 1.31-1.98, and the lowest DVS quartile (1.96, 1.70-2.26.These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the elderly.

  14. Use of an electronic administrative database to identify older community dwelling adults at high-risk for hospitalization or emergency department visits: The elders risk assessment index

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    Chaudhry Rajeev

    2010-12-01

    Full Text Available Abstract Background The prevention of recurrent hospitalizations in the frail elderly requires the implementation of high-intensity interventions such as case management. In order to be practically and financially sustainable, these programs require a method of identifying those patients most at risk for hospitalization, and therefore most likely to benefit from an intervention. The goal of this study is to demonstrate the use of an electronic medical record to create an administrative index which is able to risk-stratify this heterogeneous population. Methods We conducted a retrospective cohort study at a single tertiary care facility in Rochester, Minnesota. Patients included all 12,650 community-dwelling adults age 60 and older assigned to a primary care internal medicine provider on January 1, 2005. Patient risk factors over the previous two years, including demographic characteristics, comorbid diseases, and hospitalizations, were evaluated for significance in a logistic regression model. The primary outcome was the total number of emergency room visits and hospitalizations in the subsequent two years. Risk factors were assigned a score based on their regression coefficient estimate and a total risk score created. This score was evaluated for sensitivity and specificity. Results The final model had an AUC of 0.678 for the primary outcome. Patients in the highest 10% of the risk group had a relative risk of 9.5 for either hospitalization or emergency room visits, and a relative risk of 13.3 for hospitalization in the subsequent two year period. Conclusions It is possible to create a screening tool which identifies an elderly population at high risk for hospital and emergency room admission using clinical and administrative data readily available within an electronic medical record.

  15. Incidence of dental caries among susceptible community-dwelling older adults using fluoride toothpaste: 2-year follow-up study.

    Science.gov (United States)

    Wyatt, Chris C L; Wang, Dan; Aleksejuniene, Jolanta

    2014-01-01

    To explore reasons for the underuse of dental services covered by a government-funded program in Alberta. In 2011, a survey questionnaire was sent to 4000 randomly selected clients of the Alberta Child Health Benefit and the Alberta Adult Health Benefit programs. Only respondents with children were included in the analysis. Reasons were explored among those who indicated that their children did not receive any dental services in the year before the survey. Difficulties faced by those who reported receiving at least 1 dental service were also noted. Among 795 respondents, 597 had at least 1 child. A total of 1303 children aged 1-19 years (mean age 11.79 years, standard deviation 4.2) were included in the analysis. Of these children, 443 (34.0%) had not received any covered dental services; the most common reason (50.7%) was no perceived need (interpreted from the replies "my child was too young" or "had no dental problems") followed by perceived insufficient coverage (38.6%). The most common challenge reported by dental care users was also insufficient coverage (44.9%). About 57% of parents were aware that annual fluoride application was covered by the program; however, only 34.3% of their children received fluoride and 14.2% had sealants. Low-income families underuse available dental benefits for children. Perceived need seems to be the primary determinant of use. Parental awareness about the coverage does not seem to promote the use of preventive measures for young children.

  16. Measurement of the severity of disability in community-dwelling adults and older adults: interval-level measures for accurate comparisons in large survey data sets

    Science.gov (United States)

    Buz, José; Cortés-Rodríguez, María

    2016-01-01

    Objectives To (1) create a single metric of disability using Rasch modelling to be used for comparing disability severity levels across groups and countries, (2) test whether the interval-level measures were invariant across countries, sociodemographic and health variables and (3) examine the gains in precision using interval-level measures relative to ordinal scores when discriminating between groups known to differ in disability. Design Cross-sectional, population-based study. Setting/participants Data were drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), including comparable data across 16 countries and involving 58 489 community-dwelling adults aged 50+. Main outcome measures A single metric of disability composed of self-care and instrumental activities of daily living (IADLs) and functional limitations. We examined the construct validity through the fit to the Rasch model and the know-groups method. Reliability was examined using person separation reliability. Results The single metric fulfilled the requirements of a strong hierarchical scale; was able to separate persons with different levels of disability; demonstrated invariance of the item hierarchy across countries; and was unbiased by age, gender and different health conditions. However, we found a blurred hierarchy of ADL and IADL tasks. Rasch-based measures yielded gains in relative precision (11–116%) in discriminating between groups with different medical conditions. Conclusions Equal-interval measures, with person-invariance and item-invariance properties, provide epidemiologists and researchers with the opportunity to gain better insight into the hierarchical structure of functional disability, and yield more reliable and accurate estimates of disability across groups and countries. Interval-level measures of disability allow parametric statistical analysis to confidently examine the relationship between disability and continuous measures so frequent in health sciences

  17. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

    Science.gov (United States)

    Ng, Shamay S. M.; Cheng, Yoyo T. Y.; Yu, Esther Y. T.; Chow, Gary C. C.; Chak, Yvonne T. C.; Chan, Ivy K. Y.; Zhang, Joni; Macfarlane, Duncan

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020

  18. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

    Science.gov (United States)

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  19. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Shirley S. M. Fong

    2016-01-01

    Full Text Available Objectives. To evaluate the effects of Ving Tsun (VT martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5±6.7 years underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice, and 18 (mean age ± SD = 72.0±6.7 years received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P=0.007 in the VT group and the time to reach peak force decreased (9.9% differentially in the VT group compared to the control group (P=0.033. For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P=0.002. Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  20. Feasibility of a Self-Determination Theory-Based Exercise Program in Community-Dwelling South Korean Older Adults: Experiences from a 13-Month Trial.

    Science.gov (United States)

    Lee, Minyoung; Kim, Min Joo; Suh, Dongwon; Kim, Jungjin; Jo, Eunkyoung; Yoon, BumChul

    2016-01-01

    Little is known about the effectiveness of self-determination theory (SDT), a representative motivational theory, on exercise domain in older adults. This feasibility study used quantitative and qualitative approaches to evaluate the effectiveness of a 13-month group exercise program applying SDT-based motivational strategies on exercise adherence, physical fitness, and quality of life, and to explore factors affecting exercise adherence in South Korean older adults (N = 18). Exercise attendance rate was high (82.52%). There were significant differences in aerobic endurance (p < .001), lower body strength (p < .05), dynamic balance (p < .001), and perceived social functioning (p < .05) at 13 months compared with baseline. Factors affecting exercise adherence were related to the SDT-based motivational strategies. These results support the importance of health professionals applying SDT-based motivational strategies to exercise programs to help facilitate motivation for participation and to promote physical fitness and quality of life in older adults.

  1. Effect of exercise on cognitive performance in community-dwelling older adults: review of intervention trials and recommendations for public health practice and research.

    Science.gov (United States)

    Snowden, Mark; Steinman, Lesley; Mochan, Kara; Grodstein, Francine; Prohaska, Thomas R; Thurman, David J; Brown, David R; Laditka, James N; Soares, Jesus; Zweiback, Damita J; Little, Deborah; Anderson, Lynda A

    2011-04-01

    There is evidence from observational studies that increasing physical activity may reduce the risk of cognitive decline in older adults. Exercise intervention trials have found conflicting results. A systematic review of physical activity and exercise intervention trials on cognition in older adults was conducted. Six scientific databases and reference lists of previous reviews were searched. Thirty studies were eligible for inclusion. Articles were grouped into intervention-outcome pairings. Interventions were grouped as cardiorespiratory, strength, and multicomponent exercises. Cognitive outcomes were general cognition, executive function, memory, reaction time, attention, cognitive processing, visuospatial, and language. An eight-member multidisciplinary panel rated the quality and effectiveness of each pairing. Although there were some positive studies, the panel did not find sufficient evidence that physical activity or exercise improved cognition in older adults. Future research should report exercise adherence, use longer study durations, and determine the clinical relevance of measures used.

  2. Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Vries, N.M. de; Staal, J.B.; Teerenstra, S.; Adang, E.M.M.; Olde Rikkert, M.G.; Nijhuis-Van der Sanden, M.W.

    2013-01-01

    BACKGROUND: Older adults can benefit from physical activity in numerous ways. Physical activity is considered to be one of the few ways to influence the level of frailty. Standardized exercise programs do not necessarily lead to more physical activity in daily life, however, and a more personalized

  3. Contribution of Structured Exercise Class Participation and Informal Walking for Exercise to Daily Physical Activity in Community-Dwelling Older Adults.

    Science.gov (United States)

    Tudor-Locke, C.; Jones, G. R.; Myers, A. M.; Paterson, D. H.; Ecclestone, N. A.

    2002-01-01

    Examined the physical activity and exercise habits of independent-living older adults from a structured exercise program, noting the contribution of formal and informal exercise participation relative to total daily physical activity measured using pedometer and daily activity logs. Participation in structured exercise was an important contributor…

  4. Contribution of Structured Exercise Class Participation and Informal Walking for Exercise to Daily Physical Activity in Community-Dwelling Older Adults.

    Science.gov (United States)

    Tudor-Locke, C.; Jones, G. R.; Myers, A. M.; Paterson, D. H.; Ecclestone, N. A.

    2002-01-01

    Examined the physical activity and exercise habits of independent-living older adults from a structured exercise program, noting the contribution of formal and informal exercise participation relative to total daily physical activity measured using pedometer and daily activity logs. Participation in structured exercise was an important contributor…

  5. Feasibility of a Brief Community-Based Train-the-Trainer Lesson to Reduce the Risk of Falls among Community Dwelling Older Adults

    Science.gov (United States)

    Gunter, Katherine B.; John, Deborah H.

    2014-01-01

    The Better Balance, Better Bones, Better Bodies (B-Better©) program was developed to disseminate simple home-based strategies to prevent falls and improve functional health of older adults using a train-the-trainer model. Delivered by Family & Community Education Study Group program volunteers, the lesson stresses the importance of a…

  6. Chronic Health Conditions as a Risk Factor for Falls among the Community-Dwelling US Older Adults: A Zero-Inflated Regression Modeling Approach

    Directory of Open Access Journals (Sweden)

    Yoshita Paliwal

    2017-01-01

    Full Text Available Falls are an important health concern among older adults due to age-related changes in the body. Having a medical history of chronic health condition may pose even higher risk of falling. Only few studies have assessed a number of chronic health conditions as risk factor for falls over a large nationally representative sample of US older adults. In this study, Behavioral Risk Factor Surveillance System (BRFSS 2014 participants aged 65 years and older (n = 159,336 were evaluated. It was found that 29.7% (n=44,550 of the sample experienced at least one fall and 16.3% (n=20,444 experienced more than one fall in the past 12 months. According to the study findings, having a medical history of stroke, CKD, arthritis, depression, and diabetes independently predict the risk of first-time falling as well as the risk of recurrent falling in older adult population while controlling for other factors. On the other hand, having a medical history of the heart attack, angina, asthma, and COPD did not predict the risk of first-time falling, but did predict the risk of recurrent falling after experiencing the first fall in this population.

  7. Participation in Social Activities and the Association with Socio-Demographic and Health-Related Factors among Community-Dwelling Older Adults in Jamaica.

    Science.gov (United States)

    Willie-Tyndale, Douladel; Holder-Nevins, Desmalee; Mitchell-Fearon, Kathryn; James, Kenneth; Laws, Hazel; Waldron, Norman K; Eldemire-Shearer, Denise

    2016-12-01

    Social participation is critical for maintaining independence and facilitating active ageing. The aim of this paper is to describe participation in social activities among older adults in Jamaica and to identify independently associated socio-demographic and health characteristics. We analysed data from a nationally representative, community-based survey of 2943 persons 60 years and older. Sixty-three percent of older adults attended religious services and 60 % were visited by friends at least once per month in the 12 months preceding the survey. Age was not independently associated with social participation. Persons with post-secondary level education were twice as likely as those with primary education or less, to be visited by friends and to attend meetings of formal organisations. Men, persons not in union, and those with less functional independence had reduced odds of attending meetings of formal organisations. These variables were however not independently associated with having visits with friends. Persons with a positive depression screen were between 42 % and 44 % less likely to be visited by friends. Persons who received an income through livestock/farming were more likely to visit or be visited by friends. The variables independently associated with social participation vary depending on the type of social activity considered. Where possible, health and social interventions should focus on prevention, delay and reversal of risk factors associated with reduced social participation. Social participation programmes should be prioritized and be informed by input from older adults. Future research should include other forms of social interactions and clarify older adults' perceptions of their quality.

  8. Gamma-glutamyl transferase is associated with sarcopenia and sarcopenic obesity in community-dwelling older adults: results from the Fifth Korea National Health and Nutrition Examination Survey, 2010-2011.

    Science.gov (United States)

    Hong, Namki; Lee, Eun Young; Kim, Chang Oh

    2015-01-01

    Although elevated serum gamma-glutamyl transferase activity (GGT) has been linked with metabolic risk factors for sarcopenia, including non-alcoholic fatty liver disease, adiposity, and insulin resistance, whether GGT independently associated with sarcopenia and sarcopenic obesity has not yet been investigated. We analyzed cross-sectional data of 3,193 community-dwelling adults (42.2% men, age 63.4 ± 8.7) aged ≥50 years from the Fifth Korean National Health and Nutrition Examination Survey, 2010-2011. Sarcopenia was defined as a calculated value of the appendicular skeletal muscle mass divided by body weight (ASM/Wt, %) adults. Sarcopenic obesity was defined as sarcopenia combined with a waist circumference ≥90 cm for men and ≥85 cm for women. The prevalence of sarcopenia and sarcopenic obesity increased stepwise from the lowest to highest GGT quintiles (sarcopenia, 20.2-39.7%; sarcopenic obesity, 7.5-27.3%; P for trend, obesity versus those in the lowest quintile, whereas each single-unit increase in natural log-GGT associated independently with a 35% increased risk of sarcopenia and 62% increased risk of sarcopenic obesity after adjusting for age, sex, body mass index, and other confounders. Elevated serum GGT activity was independently associated with sarcopenia and sarcopenic obesity in community-dwelling older adults.

  9. Identification of stair climbing ability levels in community-dwelling older adults based on the geometric mean of stair ascent and descent speed: The GeMSS classifier.

    Science.gov (United States)

    Mayagoitia, Ruth E; Harding, John; Kitchen, Sheila

    2017-01-01

    The aim was to develop a quantitative approach to identify three stair-climbing ability levels of older adults: no, somewhat and considerable difficulty. Timed-up-and-go test, six-minute-walk test, and Berg balance scale were used for statistical comparison to a new stair climbing ability classifier based on the geometric mean of stair speeds (GeMSS) in ascent and descent on a flight of eight stairs with a 28° pitch in the housing unit where the participants, 28 (16 women) urban older adults (62-94 years), lived. Ordinal logistic regression revealed the thresholds between the three ability levels for each functional test were more stringent than thresholds found in the literature to classify walking ability levels. Though a small study, the intermediate classifier shows promise of early identification of difficulties with stairs, in order to make timely preventative interventions. Further studies are necessary to obtain scaling factors for stairs with other pitches.

  10. Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial

    OpenAIRE

    Vries, N.M. de; Staal, J.B.; Teerenstra, S.; Adang, E.M.M.; Olde Rikkert, M.G.; Nijhuis-Van der Sanden, M.W.

    2013-01-01

    BACKGROUND: Older adults can benefit from physical activity in numerous ways. Physical activity is considered to be one of the few ways to influence the level of frailty. Standardized exercise programs do not necessarily lead to more physical activity in daily life, however, and a more personalized approach seems appropriate. The main objective of this study is to investigate whether a focused, problem-oriented coaching intervention ('Coach2Move') delivered by a physiotherapist specializing i...

  11. High interleukin-6 plasma levels are associated with low HDL-C levels in community-dwelling older adults: The InChianti study

    Science.gov (United States)

    Zuliani, Giovanni; Volpato, Stefano; Blè, Alessando; Bandinelli, Stefania; Corsi, Anna Maria; Lauretani, Fulvio; Paolisso, Giuseppe; Fellin, Renato; Ferrucci, Luigi

    2009-01-01

    Background Low levels of high density lipoprotein cholesterol (HDL-C) are associated with increased incidence of coronary heart disease (CHD). A better understanding of the mechanisms leading to low HDL-C and CHD is essential for planning treatment strategies. Clinical studies have demonstrated that cytokines might affect both concentration and composition of plasma lipoproteins, including HDLs. Methods We investigated the possible association between low HDL-C levels, defined as ≤10th gender specific percentile, and circulating markers of inflammation (IL-1β, TNF-α, IL-6, IL-10, IL-18, and CRP) in a population of 1044 community dwelling older Italian subjects from the InChianti study. Results Using logistic regression analysis we demonstrated that IL-6 levels (III versus I tertile, OR: 2.10; 1.10–3.75), TG (III versus I tertile OR: 27.45; 8.47–88.93), fasting insulin (III versus I tertile OR: 2.84; 1.50–5.42), and age (OR: 1.038; 1.002–1.075) were associated with low HDL-C independent of smoking, BMI, waist circumference, hypertension, diabetes, physical activity, alcohol intake, oral hypoglycaemics, CRP, IL-18, and TNF-α levels. The adjusted attributable risk of low HDL-C in the exposed group (III tertile of IL-6) was 54%. Conclusions The present study provides the epidemiological evidence that besides triglycerides, fasting insulin, and age, IL-6 is one of the main correlates of low HDL-C levels in older individuals. PMID:16787648

  12. Beyond mean values: Quantifying intraindividual variability in pre-sleep arousal and sleep in younger and older community-dwelling adults

    Directory of Open Access Journals (Sweden)

    Kristy D. Shoji

    2015-01-01

    Full Text Available Intraindividual variability is an often understudied aspect of health outcomes research that may provide additional, complementary information to average values. The current paper aims to further our understanding of intraindividual variability in health research by presenting the results of a daily diary study of sleep and pre-sleep arousal. Pre-sleep arousal is often implicated in poor sleep outcomes, although the arousal–sleep association is not uniform across age groups. The examination of intraindividual variability in different age groups may provide a more complete understanding of these constructs, which, in turn, can inform future research. The overall objectives of the current study are to quantify the amount of intraindividual variability in pre-sleep arousal and sleep and to examine age differences in this variability. A sample of older (n=50 and younger (n=50 adults recruited from North Central Florida and online completed 14-consecutive-day diaries assessing pre-sleep arousal and sleep outcomes. Significant age differences were found for sleep and pre-sleep arousal; older adults displayed poorer, more variable sleep for the majority of sleep outcomes, and higher levels of pre-sleep arousal than younger adults. The high amount of intraindividual variability has implications for the assessment of pre-sleep arousal and sleep across age groups.

  13. Schizophrenia in older adults.

    Science.gov (United States)

    Collier, Elizabeth; Sorrell, Jeanne M

    2011-11-01

    Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.

  14. Age-related changes in physical fall risk factors: results from a 3 year follow-up of community dwelling older adults in Tasmania, Australia.

    Science.gov (United States)

    Bird, Marie-Louise; Pittaway, Jane K; Cuisick, Isobel; Rattray, Megan; Ahuja, Kiran D K

    2013-11-11

    As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, and placing an escalating burden on health care systems. Sixty-nine independent community-dwelling adults (60-85 years, 18 males) had their leg strength, physical activity levels and their annual fall rate assessed at two timepoints over three years, (summer 2010 and summer 2013) monitoring balance. Force platform measures of medio-lateral sway range increased significantly under conditions of eyes open (mean difference MD 2.5 cm; 95% CI 2.2 to 2.8 cm) and eyes closed (MD 3.2 cm; 95% CI 2.8 to 3.6 cm), respectively (all p 0.26). Physical activity reduced significantly (MD -909 Cal/week; 95% CI -347 to -1,470 Cal/week; p = 0.002) during the course of the study. Participants maintained aerobic activities, however resistance and balance exercise levels decreased non-significantly. The likelihood of falling was higher at the end of the study compared to the first timepoint (odds ratio 1.93, 95% CI 0.94 to 3.94; p = 0.07). Results of this study indicate that despite maintenance of leg strength there was an increase in medio-lateral sway over a relatively short time frame, with higher than expected increases in fall rates.

  15. Dancing in time: feasibility and acceptability of a contemporary dance programme to modify risk factors for falling in community dwelling older adults.

    Science.gov (United States)

    Britten, Laura; Addington, Christine; Astill, Sarah

    2017-04-11

    Falls are a common cause of injury in older adults, with the prevention of falls being a priority for public health departments around the world. This study investigated the feasibility, and impact of an 8 week contemporary dance programme on modifiable physical (physical activity status, mobility, sedentary behaviour patterns) and psychosocial (depressive state, fear of falling) risk factors for falls. An uncontrolled 'pre-post' intervention design was used. Three groups of older (60 yrs.+) adults were recruited from local community groups to participate in a 3 separate, 8 week dance programmes. Each programme comprised two, 90 min dance classes per week. Quantitative measures of physical activity, sedentary behaviour, depression, mobility and fear of falling were measured at baseline (T1) and after 8 weeks of dance (T2). Weekly attendance was noted, and post-study qualitative work was conducted with participants in 3 separate focus groups. A combined thematic analysis of these data was conducted. Of the 38 (Mean Age = 77.3 ± 8.4 yrs., 37 females) who attended the dance sessions, 22 (21 females; 1 male; mean age = 74.8, ±8.44) consented to be part of the study. Mean attendance was 14.6 (±2.6) sessions, and mean adherence was 84.3% (±17). Significant increases in moderate and vigorous physical activity were noted, with a significant decrease in sitting time over the weekdays (p dance programme as a means of being active, health Benefits, and dance-related barriers and facilitators. The recruitment of older adults, good adherence and favourability across all three sites indicate that a dance programme is feasible as an intervention, but this may be limited to females only. Contemporary dance has the potential to positively affect the physical activity, sitting behaviour, falls related efficacy, mobility and incidence of depression in older females which could reduce their incidence of falls. An adequately powered study with control groups are

  16. The relationship of physical activity to high-density lipoprotein cholesterol level in a sample of community-dwelling older adults from Amazonas, Brazil.

    Science.gov (United States)

    Gouveia, Élvio R; Ihle, Andreas; Kliegel, Matthias; Freitas, Duarte L; Jurema, Jefferson; Tinôco, Maria A; Odim, Angeany; Machado, Floramara T; Muniz, Bárbara R; Antunes, António A; Ornelas, Rui T; Gouveia, Bruna R

    2017-08-10

    (1) To study the relation of physical activity (PA) to high-density lipoprotein cholesterol (HDL-C) and (2) to investigate if the strength of these associations holds after adjustments for sex, age, and other key correlates. This study included 550 older adults from Amazonas. HDL-C was derived from fasting blood samples. PA at sport and leisure, smoking, alcohol consumption, and socioeconomic status (SES) were interviewed. Waist circumference (WACI) was assessed. HDL-C was positively related to PA sport, PA leisure, and SES (0.22≤r≤0.34; p≤0.001) and negatively related to smoking and WACI (r≤-0.10; p<0.05). Controlling for sex and age did not affect these relationships. Hierarchical multiple regression analyses showed that the relation of HDL-C to PA sport and leisure remained significant when controlling for all other investigated correlates (0.14≤β≤0.24; p≤0.001). In order to prevent low HDL-C in older adults, promoting PA seems to be an important additional component besides common recommendations concerning weight reduction. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Multivariate analysis of lifestyle, constitutive and body composition factors influencing bone health in community-dwelling older adults from Madeira, Portugal.

    Science.gov (United States)

    Gouveia, Élvio Rúbio; Blimkie, Cameron Joseph; Maia, José António; Lopes, Carla; Gouveia, Bruna Raquel; Freitas, Duarte Luís

    2014-01-01

    This study describes the association between habitual physical activity (PA), other lifestyle/constitutive factors, body composition, and bone health/strength in a large sample of older adults from Madeira, Portugal. This cross-sectional study included 401 males and 401 females aged 60-79 years old. Femoral strength index (FSI) and bone mineral density (BMD) of the whole body, lumbar spine (LS), femoral neck (FN), and total lean tissue mass (TLTM) and total fat mass (TFM) were determined by dual-energy X-ray absorptiometry-DXA. PA was assessed during face-to-face interviews using the Baecke questionnaire and for a sub-sample by Tritrac accelerometer. Demographic and health history information were obtained by telephone interview through questionnaire. The relationship between habitual PA variables and bone health/strength indicators (whole body BMD, FNBMD, LSBMD, and FSI) investigated using Pearson product-moment correlation coefficient was similar for females (0.098≤r≤0.189) and males (0.104≤r≤0.105). Results from standard multiple regression analysis indicated that the primary and most significant predictors for FNBMD in both sexes were age, TLTM, and TFM. For LSBMD, the most significant predictor was TFM in men and TFM, age, and TLTM in females. Our regression model explained 8.3-14.2% and 14.8-29.6% of the total variance in LSBMD and FNBMD for males and females, respectively. This study suggests that habitual PA is minimally but positively associated with BMD and FSI among older adult males and females and that body composition factors like TLTM and TFM are the strongest determinants of BMD and FSI in this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Association of dietary patterns and weight change in rural older adults 75 years and older

    Science.gov (United States)

    Little is known about the relationship between weight change and dietary patterns (DP) in older adults, especially in those of advanced age (_75 years). We examined the association of DP with obesity and five-year weight change in community-dwelling older adults (n=270; mean±SD age: 78.6±3.9 years)....

  19. Factors Contributing to Single- and Dual-Task Timed "Up & Go" Test Performance in Middle-Aged and Older Adults Who Are Active and Dwell in the Community.

    Science.gov (United States)

    Chen, Hui-Ya; Tang, Pei-Fang

    2016-03-01

    Dual-task Timed "Up & Go" (TUG) tests are likely to have applications different from those of a single-task TUG test and may have different contributing factors. The purpose of this study was to compare factors contributing to performance on single- and dual-task TUG tests. This investigation was a cross-sectional study. Sixty-four adults who were more than 50 years of age and dwelled in the community were recruited. Interviews and physical examinations were performed to identify potential contributors to TUG test performance. The time to complete the single-task TUG test (TUGsingle) or the dual-task TUG test, which consisted of completing the TUG test while performing a serial subtraction task (TUGcognitive) or while carrying water (TUGmanual), was measured. Age, hip extensor strength, walking speed, general mental function, and Stroop scores for word and color were significantly associated with performance on all TUG tests. Hierarchical multiple regression models, without the input of walking speed, revealed different independent factors contributing to TUGsingle performance (Mini-Mental Status Examination score, β=-0.32), TUGmanual performance (age, β=0.35), and TUGcognitive performance (Stroop word score, β=-0.40; Mini-Mental Status Examination score, β=-0.31). At least 40% of the variance in the performance on the 3 TUG tests was not explained by common clinical measures, even when the factor of walking speed was considered. However, this study successfully identified some important factors contributing to performance on different TUG tests, and other studies have reported similar findings for single-task TUG test and dual-task gait performance. Although the TUGsingle and the TUGcognitive shared general mental function as a common factor, the TUGmanual was uniquely influenced by age and the TUGcognitive was uniquely influenced by focused attention. These results suggest that both common and unique factors contribute to performance on single- and dual

  20. Older Adults and Alcohol

    Science.gov (United States)

    ... Problems Certain health problems are common in older adults. Heavy drinking can make these problems worse, including: Diabetes High blood pressure Congestive heart failure Liver problems Osteoporosis Memory problems Mood disorders Bad Interactions with Medications ...

  1. Older Adults and Depression

    Science.gov (United States)

    ... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...

  2. Falls and Older Adults

    Science.gov (United States)

    ... version of this page please turn Javascript on. Falls and Older Adults About Falls Risk Increases With Age Many people have a ... problems -- rises with age. Click for more information Falls Lead to Fractures, Trauma Each year, more than ...

  3. Older Adults (and Oral Health)

    Science.gov (United States)

    ... Health Information Sorted by ... > OlderAdults Older Adults and Oral Health Main Content ​ Is dry mouth a natural part ... from fiction by reading this web page about oral health and growing older. Having the right information can ...

  4. Associação entre déficit visual e aspectos clínico-funcionais em idosos da comunidade Association between visual deficit and clinical-functional characteristics among community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Lívia C. Luiz

    2009-10-01

    Full Text Available OBJETIVO: Identificar os fatores funcionais associados com o déficit visual em idosos da comunidade. MÉTODOS: Foram avaliados 96 idosos quanto à acuidade visual por meio da tabela direcional de Snellen e categorizados em relação à baixa visão (acuidade visual 0,3. Os fatores funcionais analisados foram: número de quedas, presença de doenças visuais, saúde mental, pela Geriatric Depression Scale (GDS, funcionalidade nas atividades diárias pelo Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ e a mobilidade funcional pelo Timed Up & Go Test (TUG. A análise inferencial foi realizada por meio dos testes Qui-Quadrado, Mann-Whitney e Coeficiente de Correlação de Spearman, considerando α=0,05. RESULTADOS: Apresentaram baixa visão 17,7% (n=17 dos idosos. Em relação aos idosos com visão normal, os idosos com baixa visão apresentaram idade mais avançada (pOBJECTIVE: To identify functional factors associated with visual deficits among community-dwelling older adults. METHODS: Ninety-six older adults were assessed for visual acuity by means of the Snellen Eye Chart and categorized as low vision (visual acuity 0.3. The functional factors analyzed were the number of falls, presence of eye diseases, mental health according to the Geriatric Depression Scale (GDS, functional status in daily activities according to the Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ and functional mobility according to the Timed Up & Go Test (TUG. Inferential analysis was performed using the chi-square test, Mann-Whitney test and Spearman correlation coefficient, taking α=0.05. RESULTS: Low vision was found in 17.7% (n=17 of the older adults. Compared to the older adults with normal vision, those with low vision had more advanced age (p<0.001 and more eye and adnexa diseases (p=0.023, higher scores for depressed mood (p=0.002, worse balance in the TUG (p=0.003 and higher numbers of impaired instrumental

  5. The role of individual characteristics and physical frailty on health related quality of life (HRQOL): a cross sectional study of Italian community-dwelling older adults.

    Science.gov (United States)

    Mulasso, Anna; Roppolo, Mattia; Rabaglietti, Emanuela

    2014-01-01

    The aims of this study were to investigate the relationship between individual characteristics and HRQOL, and to identify which components of physical frailty measured according to Fried's criteria provided a better explanation of HRQOL. Two hundred and fifty-nine older adults (age 74±6 years; 69% were women) living in Piemonte Region were enrolled in this cross-sectional study. Socio-demographic and medical characteristics were captured by self-reported questionnaires. Physical frailty was assessed using the five criteria of Fried: shrinking, weakness, poor endurance and energy, slowness, and low physical activity level. HRQOL was measured with the 36-item Short-Form Health Survey (SF-36), using both the mental (MCS) and the Physical Component Summary (PCS). Among individual characteristics, gender was the best predictor for SF-36, the MCS, and the PCS, with values of R(2) of 12.7%, 12.1%, and 8.8%, respectively. Among the five Fried's criteria, poor endurance and energy had the largest effect on HRQOL with values of ΔR(2) of 13.9% for SF-36, 13.4% for the MCS, and 9.4% for the PCS. Results highlighted the role of the individual characteristics and the single weight of the five components of physical frailty on HRQOL. This knowledge may give new insights about the relations between individual functioning and self-rated health, allowing the development of individualized and more effective preventive interventions for a healthy aging. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Associations of frailty and psychosocial factors with autonomy in daily activities: a cross-sectional study in Italian community-dwelling older adults

    Science.gov (United States)

    Mulasso, Anna; Roppolo, Mattia; Giannotta, Fabrizia; Rabaglietti, Emanuela

    2016-01-01

    Frailty has been recognized as a risk factor for geriatric adverse events. Little is known of the role of psychosocial factors associated with frailty in explaining negative outcomes of aging. This study was aimed at 1) evaluating the differences in psychosocial factors among robust, prefrail, and frail individuals and 2) investigating whether there was any interaction effect of frailty status with empirically identified clusters of psychosocial factors on autonomy in the activities of daily living (ADLs). Two-hundred and ten older adults (age 73±6 years, 66% women) were involved in this study. Frailty was assessed using an adapted version of the frailty phenotype. The psychosocial factors investigated were depressive symptoms using the 20-item Center for Epidemiologic Studies Depression Scale, social isolation using the Friendship Scale, and loneliness feeling using the eight-item UCLA Loneliness Scale. The autonomy in ADLs was measured with the Groningen Activity Restriction Scale. Thirty-one percent of participants were robust, 55% prefrail, and 14% frail. We performed an analysis of covariance which showed differences between robust, prefrail, and frail individuals for all the psychosocial variables: Center for Epidemiologic Studies Depression Scale, F(2, 205)=18.48, PScale, F(2, 205)=4.59, P=0.011; UCLA Loneliness Scale, F(2, 205)=5.87, P=0.003, controlling for age and sex. Using the same covariates, the two-way analysis of covariance indicated an interaction effect of frailty with psychosocial factors in determining ADLs, F(4, 199)=3.53, P=0.008. This study demonstrates the close relationship between frailty and psychosocial factors, suggesting the need to take into account simultaneously physical and psychosocial components of human functioning. PMID:26811675

  7. Depression in older adults.

    Science.gov (United States)

    Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret

    2009-01-01

    Depression is less prevalent among older adults than among younger adults, but it can have serious consequences. More than half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and are more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are depressed younger adults. Risk factors leading to the development of late-life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late-life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but are too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support.

  8. Associations of frailty and psychosocial factors with autonomy in daily activities: a cross-sectional study in Italian community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Mulasso A

    2016-01-01

    Full Text Available Anna Mulasso,1 Mattia Roppolo,1,2 Fabrizia Giannotta,3 Emanuela Rabaglietti1 1Department of Psychology, University of Torino, Torino, Italy; 2Department of Developmental Psychology, Rijksuniversiteit of Groningen, Groningen, the Netherlands; 3Department of Psychology, University of Uppsala, Uppsala, Sweden Abstract: Frailty has been recognized as a risk factor for geriatric adverse events. Little is known of the role of psychosocial factors associated with frailty in explaining negative outcomes of aging. This study was aimed at 1 evaluating the differences in psychosocial factors among robust, prefrail, and frail individuals and 2 investigating whether there was any interaction effect of frailty status with empirically identified clusters of psychosocial factors on autonomy in the activities of daily living (ADLs. Two-hundred and ten older adults (age 73±6 years, 66% women were involved in this study. Frailty was assessed using an adapted version of the frailty phenotype. The psychosocial factors investigated were depressive symptoms using the 20-item Center for Epidemiologic Studies Depression Scale, social isolation using the Friendship Scale, and loneliness feeling using the eight-item UCLA Loneliness Scale. The autonomy in ADLs was measured with the Groningen Activity Restriction Scale. Thirty-one percent of participants were robust, 55% prefrail, and 14% frail. We performed an analysis of covariance which showed differences between robust, prefrail, and frail individuals for all the psychosocial variables: Center for Epidemiologic Studies Depression Scale, F(2, 205=18.48, P<0.001; Friendship Scale, F(2, 205=4.59, P=0.011; UCLA Loneliness Scale, F(2, 205=5.87, P=0.003, controlling for age and sex. Using the same covariates, the two-way analysis of covariance indicated an interaction effect of frailty with psychosocial factors in determining ADLs, F(4, 199=3.53, P=0.008. This study demonstrates the close relationship between frailty and

  9. Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

    NARCIS (Netherlands)

    Lum, H.D.; Studenski, S.A.; Degenholtz, H.B.; Hardy, S.E.

    2012-01-01

    BACKGROUND: Hospital readmission within thirty days is common among Medicare beneficiaries, but the relationship between rehospitalization and subsequent mortality in older adults is not known. OBJECTIVE: To compare one-year mortality rates among community-dwelling elderly hospitalized Medicare bene

  10. Systematically Controlling for the Influence of Age, Sex, Hertz and Time Post-Whole-Body Vibration Exposure on Four Measures of Physical Performance in Community-Dwelling Older Adults: A Randomized Cross-Over Study

    Directory of Open Access Journals (Sweden)

    Harold L. Merriman

    2011-01-01

    Full Text Available Though popular, there is little agreement on what whole-body vibration (WBV parameters will optimize performance. This study aimed to clarify the effects of age, sex, hertz and time on four physical function indicators in community-dwelling older adults (=32. Participants were exposed to 2 min WBV per session at either 2 Hz or 26 Hz and outcome measures were recorded at 2, 20 and 40 min post-WBV. Timed get up-and-go and chair sit-and-reach performances improved post-WBV for both sexes, were significantly different between 2 Hz and 26 Hz treatments (≤0.05 and showed statistically significant interactions between age and gender (≤0.01. Counter movement jump and timed one-legged stance performances showed a similar but non-significant response to 2 Hz and 26 Hz treatments, though male subjects showed a distinct trended response. Age and gender should be statistically controlled and both 2 Hz and 26 Hz exert a treatment effect.

  11. Obesity in Older Adults.

    Science.gov (United States)

    Kalish, Virginia B

    2016-03-01

    The percentage of older obese adults is on the rise. Many clinicians underestimate the health consequences of obesity in the elderly, citing scarce evidence and concerns that weight loss might be detrimental to the health of older adults. Although overweight and obese elders are not at the same risk for morbidity and mortality as younger individuals, quality of life and function are adversely impacted. Weight loss plans in the elderly should include aerobic activities as well as balance and resistance activities to maintain optimal physical function. Published by Elsevier Inc.

  12. Examining the Disability Model From the International Classification of Functioning, Disability, and Health Using a Large Data Set of Community-Dwelling Malaysian Older Adults.

    Science.gov (United States)

    Loke, Seng Cheong; Lim, Wee Shiong; Someya, Yoshiko; Hamid, Tengku A; Nudin, Siti S H

    2016-06-01

    This study examines the International Classification of Functioning, Disability, and Health model (ICF) using a data set of 2,563 community-dwelling elderly with disease-independent measures of mobility, physical activity, and social networking, to represent ICF constructs. The relationship between chronic disease and disability (independent and dependent variables) was examined using logistic regression. To demonstrate variability in activity performance with functional impairment, graphing was used. The relationship between functional impairment, activity performance, and social participation was examined graphically and using ANOVA. The impact of cognitive deficits was quantified through stratifying by dementia. Disability is strongly related to chronic disease (Wald 25.5, p social participation (F= 43.6, p < .001). With good function, there is considerable variability in activity performance (inter-quartile range [IQR] = 2.00), but diminishes with high impairment (IQR = 0.00) especially with cognitive deficits. Environment modification benefits those with moderate functional impairment, but not with higher grades of functional loss. © The Author(s) 2015.

  13. Smoking and Older Adults

    Centers for Disease Control (CDC) Podcasts

    2008-10-27

    This podcast discusses the importance of older adults quitting smoking and other tobacco products. It is primarily targeted to public health and aging services professionals.  Created: 10/27/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/20/2008.

  14. Dance for Older Adults.

    Science.gov (United States)

    Pruett, Diane Milhan, Ed.; And Others

    1983-01-01

    Dance programs for older adults that encourage exercise and socializing are described in six articles. Program guidelines of the American Alliance Committee on Aging are explained, and other articles emphasize a movement education approach that may involve intergenerational contact. A dance program held in a worship setting is also discussed. (PP)

  15. Urinary Incontinence: Its Assessment and Relationship to Depression among Community-Dwelling Multiethnic Older Women

    Directory of Open Access Journals (Sweden)

    Luciana Laganà

    2014-01-01

    Full Text Available Urinary Incontinence (UI affects many older adults. Some of its deleterious consequences include stress, major depression, diminished quality of life, sexual dysfunction, and familial discord. Of the various mental health problems identified in the literature as being comorbid with UI, the most notable one continues to be depression. Despite a wealth of research contributions on this topic, the available literature is underrepresentative of ethnic minority older women. Culture has been shown to have a significant impact on a woman’s perception of her own UI symptoms; this demonstrates the necessity for the recruitment of ethnically and culturally diverse samples when studying UI. In the present study, we determined the prevalence of UI among 140 community-dwelling, ethnically diverse older women (28.2%, discovered that our new UI screener is reliable, and did not find the UI-depression link to be significant. The clinical and research implications of our findings are discussed.

  16. Recognition and needs of early dementia-related symptoms among community-dwelling non-dementia older adults%社区老年人对痴呆早期症状的识别及需求调查

    Institute of Scientific and Technical Information of China (English)

    王志稳; 邹宝红; 李小卫; 胡慧秀

    2013-01-01

    Objective To investigate the recognition and needs of early dementia-related symptoms among community-dwelling non-dementia older adults.Methods A total of 182 non-dementia community older adults were recruited and were investigated with a self-designed questionnaire about dementia-related symptoms and knowledge needs.Results The mean score of recognition of dementia symptoms was (8.11±3.02).The correct detection rate of ten dementia cases was 52.86% and the error detection rate of five non-dementia cases was 37.80%.About 41.21 % of the older adults would be hesitant to expose the dementia diagnosis and 44.51% thought that dementia patients were discriminated.They expected to obtain information on dementia prevention (96.70%),early symptoms (80.22%) and risk factors of dementia (71.43%) through media (81.32%) and community health lectures (78.02%).Conclusion Dementia education through media and community health lectures has achieved some effects.About 50.00% of the older adults can detect the early symptoms of dementia.It is suggested to further strengthen dementia education to improve the detection of early symptoms of dementia and improve the early diagnosis rate.%目的 调查社区老年人对痴呆早期症状的识别及需求现状.方法 采用自设问卷对182名社区非痴呆老年人进行问卷调查.结果 社区老年人痴呆症状识别得分为(8.11±3.02)分.对痴呆案例的正确识别率平均为52.86%,对非痴呆案例的误判率平均为37.80%.假如自己或家人得了痴呆,41.21%不愿告诉别人;44.51%认为别人会看不起痴呆老年人;社区老年人希望通过媒体宣传(81.32%)和社区健康讲座(78.02%)等方式,获取痴呆预防方法(96.70%)、早期症状(80.22%)、病因及危险因素(71.43%)等相关信息.结论 媒体宣传和社区讲座已取得一定效果,半数社区老年人能正确识别痴呆症状,但仍存在误区和误判问题.应进一步深化痴呆

  17. Attitudes Regarding the Use of Ventilator Support Given a Supposed Terminal Condition among Community-Dwelling Mexican American and Non-Hispanic White Older Adults: A Pilot Study

    Directory of Open Access Journals (Sweden)

    M. Rosina Finley

    2012-01-01

    Full Text Available Purpose. To determine the factors that are associated with Mexican Americans’ preference for ventilator support, given a supposed terminal diagnosis. Methods. 100 Mexican Americans, aged 60–89, were recruited and screened for MMSE scores above 18. Eligible subjects answered a questionnaire in their preferred language (English/Spanish concerning ventilator use during terminal illness. Mediator variables examined included demographics, generation, religiosity, occupation, self-reported depression, self-reported health, and activities of daily living. Results. Being first or second generation American (OR = 0.18, CI = 0.05–0.66 with no IADL disability (OR = 0.11, CI = 0.02–0.59 and having depressive symptoms (OR = 1.43, CI = 1.08–1.89 were associated with preference for ventilator support. Implications. First and second generation older Mexican Americans and those functionally independent are more likely to prefer end-of-life ventilation support. Although depressive symptoms were inversely associated with ventilator use at the end of life, scores may more accurately reflect psychological stress associated with enduring the scenario. Further studies are needed to determine these factors’ generalizability to the larger Mexican American community.

  18. Cognitive Impairment and Disability in Older Japanese Adults

    OpenAIRE

    Hiroyuki Shimada; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Sangyoon Lee; Takao Suzuki

    2016-01-01

    The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total...

  19. Reliability of the Berg Balance Scale as a Clinical Measure of Balance in Community-Dwelling Older Adults with Mild to Moderate Alzheimer Disease: A Pilot Study.

    Science.gov (United States)

    Muir-Hunter, Susan W; Graham, Laura; Montero Odasso, Manuel

    2015-08-01

    Objectif : Mesurer la fiabilité test-retest et interévaluateurs de l'échelle de Berg chez les adultes âgés qui résident dans la collectivité et qui sont atteints de la maladie d'Alzheimer au stade léger à modéré. Méthode : Un échantillon de 15 adultes (âge moyen de 80,20 [ET de 5,03] ans) atteints d'Alzheimer ont effectué trois tests d'équilibre : l'échelle de Berg (Berg Balance Scale), le test de lever et marcher chronométré (timed up-and-go [TUG]) et le test de portée fonctionnelle (Functional Reach Test). La fiabilité relative, à l'aide du coefficient de corrélation intraclasse (CCI) et la fiabilité absolue, à l'aide de l'erreur type de mesure (ETM) et des valeurs de changement détectable minimal (CDM95), ont été calculées; des courbes de Bland et Altman ont été construites pour évaluer la convergence interévaluateurs. L'intervalle de test-retest était d'une semaine. Résultats : En ce qui concerne l'échelle de Berg, les valeurs de fiabilité relative étaient de 0,95 (95% CI, 0,85 à 0,98) pour la fiabilité test-retest et de 0,72 (95% CI, 0,31 à 0,91) pour la fiabilité interévaluateurs; l'ETM était de 6,01 points et le CDM95 était de 16,66 points, tandis que la convergence interévaluateur était de 16,62 points. L'échelle de Berg a obtenu de meilleurs résultats que les tests de lever et marcher chronométré et de portée fonctionnelle, tests ayant une fiabilité établie pour l'Alzheimer en fiabilité test-retest. De 33% à 50% des participants avaient besoin de plus de directives que les instructions normalisées, car ils n'étaient pas capables de se souvenir des instructions de test. Conclusions : L'échelle de Berg a obtenu des valeurs de fiabilité relative qui appuient son utilité clinique, mais les valeurs de CDM95 et de convergence indiquent que cette échelle présente des limites en matière de rendement pour les cas d'Alzheimer. D'autres recherches visant l'optimisation de l'évaluation de l

  20. Quitting Smoking for Older Adults

    Science.gov (United States)

    ... of this page please turn Javascript on. Quitting Smoking for Older Adults Quitting When You’re Older ... may wonder if it’s too late to quit smoking. Or you may ask yourself if it’s even ...

  1. Hip Fractures among Older Adults

    Science.gov (United States)

    ... online training for health care providers. Learn More Hip Fractures Among Older Adults Recommend on Facebook Tweet Share ... get older. What You Can Do to Prevent Hip Fractures You can prevent hip fractures by taking steps ...

  2. Obesity Prevention in Older Adults.

    Science.gov (United States)

    Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

    2016-06-01

    The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.

  3. Perceived Environmental Barriers to Outdoor Mobility and Feelings of Loneliness Among Community-Dwelling Older People.

    OpenAIRE

    Rantakokko, Merja; Iwarsson, Susanne; Vahaluoto, Satu; Portegijs, Erja; Viljanen, Anne; Rantanen, Taina

    2014-01-01

    We examined the association between perceived environmental barriers to outdoor mobility and loneliness among community-dwelling older people. In addition, we studied whether walking difficulties and autonomy in participation outdoors affected this association.

  4. Older Adults with and without Depressive Symptoms

    Directory of Open Access Journals (Sweden)

    Leilani Feliciano

    2011-01-01

    Full Text Available Cognitive impairment represents a common mental health problem in community-dwelling and institutionalized older adults, and the prevalence increases with age. Multidisciplinary teams are often asked to assess cognitive and functional impairment in this population. The Cognitive Assessment of Minnesota was created by occupational therapists for this purpose and is frequently used, but has not been extensively validated. This study examined the performance of the CAM and compared it to the MMSE with 113 outpatient clinic patients over the age of 60. Subgroups were established based on scores on a depression inventory to determine if the presence of depressed mood altered the relationship between the measures. Both measures demonstrated good internal consistency. The overall correlation between the two measures was high, statistically significant and remained high regardless of depression status. We offer recommendations about the utility of each measure in screening cognitive functioning for older adults.

  5. Cognitive Style Predictors of Affect Change in Older Adults

    Science.gov (United States)

    Isaacowitz, Derek M.; Seligman, Martin E. P.

    2002-01-01

    Cognitive styles are the lenses through which individuals habitually process information from their environment. In this study, we evaluated whether different cognitive style individual difference variables, such as explanatory style and dispositional optimism, could predict changes in affective state over time in community-dwelling older adults.…

  6. Alcohol Use and Older Adults

    Science.gov (United States)

    ... version of this page please turn Javascript on. Alcohol Use and Older Adults Alcohol and Aging Adults of any age can have ... Escape (Esc) button on your keyboard.) What Is Alcohol? Alcohol, also known as ethanol, is a chemical ...

  7. Sexuality in older adults

    Directory of Open Access Journals (Sweden)

    Adrián Sapetti

    2015-07-01

    Full Text Available Just as the body and its functions undergo changes with age, in the same way sexuality shares this aging process. However, remember a golden rule that we are sexual since we are born until we die; only possibilities are modified with the passage of the years. This article intends to show the changes that occur in the sexual response of the elderly. If sexual life during youth was pleasant and satisfactory this will condition sexuality in the socalled third age and the elderly seek to maintain it, this is not the case for those who had a dysfunctional past. This article briefly describes the andropause and the SIM, vicissitudes, changes and differences in sexual response and chances to maintain eroticism in the older adult

  8. A randomized controlled trial to promote volunteering in older adults.

    Science.gov (United States)

    Warner, Lisa M; Wolff, Julia K; Ziegelmann, Jochen P; Wurm, Susanne

    2014-12-01

    Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention.

  9. Clinical Interviewing with Older Adults

    Science.gov (United States)

    Mohlman, Jan; Sirota, Karen Gainer; Papp, Laszlo A.; Staples, Alison M.; King, Arlene; Gorenstein, Ethan E.

    2012-01-01

    Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the…

  10. Effective communication with older adults.

    Science.gov (United States)

    Daly, Louise

    2017-06-07

    Communication is an essential aspect of life, yet it can be taken for granted. Its centrality to being in the world and in professional practice often becomes evident when nurses and older adults encounter communication difficulties. The factors that can affect nurses' communication with older adults relate to the older adult, the nurse, sociocultural considerations and the environment, and the interactions between these factors. In adopting a person-centred approach to communicating with older adults, it is necessary to get to know the person as an individual and ensure communication meets their needs and abilities. Effective communication is essential in nursing practice and requires professional competence and engagement. This article can be used by nurses to support effective communication with older adults across the continuum of care.

  11. Feasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients.

    Science.gov (United States)

    Tucker, Paula W; Evans, Dian Dowling; Clevenger, Carolyn K; Ardisson, Michelle; Hwang, Ula

    Gait speed assessment is a rapid, simple and objective measure for predicting risk of unfavorable outcomes which may provide better prognostic and reliable information than existing geriatric ED (Emergency Department) screening tools. This descriptive pilot project was designed to determine feasibility of implementing gait speed screening into routine nursing practice by objectively identifying patients with sub-optimal gait speeds. Participants included community-dwelling adults 65 years and older with plans for discharge following ED treatment. Patients with a gait speed <1.0 m/s were identified as "high-risk" for an adverse event, and referred to the ED social worker for individualized resources prior to discharge. Thirty-five patients were screened and nurse initiated gait speed screens were completed 60% of the time. This project demonstrates ED gait speed screening may be feasible. Implications for practice should consider incorporating gait speed screening into routine nursing assessment to improve provider ED decision-making and disposition planning.

  12. The step length-frequency relationship in physically active community-dwelling older women

    NARCIS (Netherlands)

    Zijlstra, Agnes; de Bruin, Eling D.; Bruins, Nienke; Zijlstra, Wiebren

    2008-01-01

    This study evaluated the step length-frequency relationship in physically active community-dwelling older women in order to investigate whether the relationship between these two spatio-temporal gait parameters changes with increasing age. Forty older women in four age groups, i.e. 64-69, 70-74, 75-

  13. The step length-frequency relationship in physically active community-dwelling older women

    NARCIS (Netherlands)

    Zijlstra, Agnes; de Bruin, Eling D.; Bruins, Nienke; Zijlstra, Wiebren

    2008-01-01

    This study evaluated the step length-frequency relationship in physically active community-dwelling older women in order to investigate whether the relationship between these two spatio-temporal gait parameters changes with increasing age. Forty older women in four age groups, i.e. 64-69, 70-74, 75-

  14. Comprehensive geriatric assessment : recognition of identified geriatric conditions by community-dwelling older persons

    NARCIS (Netherlands)

    van Rijn, Marjon; Suijker, Jacqueline J; Bol, Wietske; Hoff, Eva; Ter Riet, Gerben; de Rooij, Sophia E; Moll van Charante, Eric P; Buurman, Bianca M

    2016-01-01

    OBJECTIVES: to study (i) the prevalence of geriatric conditions in community-dwelling older persons at increased risk of functional decline and (ii) the extent to which older persons recognise comprehensive geriatric assessment (CGA)-identified conditions as relevant problems. METHODS: trained regis

  15. Chronic disease in older adults

    OpenAIRE

    Durán, Adriana; Pontificia Universidad Javeriana; Valderrama, Laura; Pontificia Universidad Javeriana; Uribe, Ana Fernanda; Pontificia Universidad Javeriana; González, Angélica; Pontificia Universidad Javeriana; Máximo Molina, Juan; Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA)

    2016-01-01

    Methodology: A sample of 500 older adults was selected, between 60 and 96 years of age. A questionnaire of psychosocial factors in older adults designed by Baca, Gonzalez, and Uribe was used. Results: Hypertension, diabetes and osteoporosis were the most frequent diseases in older adults, although the greater percentage of this population did not refer any pathology. Married and widowers individuals presented more diseases as compared to unmarried, separated and people who live together.Concl...

  16. Entry correlates and motivations of older adults participating in organized exercise programs

    NARCIS (Netherlands)

    Stiggelbout, M.; Hopman-Rock, M.; Mechelen, W. van

    2008-01-01

    This study reports entry correlates and motivations of older adults participating in organized exercise programs in the Netherlands, as determined in a descriptive explorative study (N = 2,350, response rate 86%). Participants were community-dwelling older adults (50+ years) who enrolled and started

  17. Entry correlates and motivations of older adults participating in organized exercise programs

    NARCIS (Netherlands)

    Stiggelbout, M.; Hopman-Rock, M.; Mechelen, W. van

    2008-01-01

    This study reports entry correlates and motivations of older adults participating in organized exercise programs in the Netherlands, as determined in a descriptive explorative study (N = 2,350, response rate 86%). Participants were community-dwelling older adults (50+ years) who enrolled and started

  18. Undernutrition management and the role of protein-enriched meals for older adults

    NARCIS (Netherlands)

    Ziylan, Canan

    2016-01-01

    Undernutrition is a major health problem in the growing elderly population. It is estimated that one in ten Dutch community-dwelling older adults is suffering from undernutrition, and one in three Dutch older adults who receive home care. Undernutrition may lead to many negative consequences, rangin

  19. Older adults' perceptions of physical activity: a qualitative study.

    Science.gov (United States)

    Janssen, Sclinda L; Stube, Jan E

    2014-06-01

    The purpose of this study was to explore older adults' perceptions of participation in physical activity (PA) as it impacts productive ageing and informs occupational therapy (OT) practice. In this phenomenological study, 15 community-dwelling older adults were recruited using purposive and snowball sampling at community locations. Data collection methods included two interviews and an observation. The primary finding was that older adults continue individual patterns of meaningful PA across their lifespan when they have support to adapt to age-associated limitations, with a gradual decline in intensity during older years. Although this study's qualitative methodology limits broad generalizability, the findings provide applicability when situated in the context of community-living older adults interested in health maintenance through PA participation. OT practitioners have an important role with community-dwelling older adults to impact productive ageing by designing and promoting meaningful PA with adaptations that address unique, age-associated concerns. There is a need for further experimental research taking an occupational performance and health perspective to enhance the contribution of OT for this population's health-related quality of life through meaningful PA. Copyright © 2013 John Wiley & Sons, Ltd.

  20. Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study

    OpenAIRE

    Morone, Natalia E.; Greco, Carol M.; Weiner, Debra K.

    2007-01-01

    The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were ra...

  1. Dementia: Unique to Older Adults

    Science.gov (United States)

    ... lead to complications too. These include malnutrition, falls, osteoporosis (“thinning bones”), bone fractures, frailty, sleep problems, anxiety, agitation, delirium, and disturbed behavior. Caring for an older adult with dementia and other health problems can be ...

  2. Diabetes: Unique to Older Adults

    Science.gov (United States)

    ... Stroke Urinary Incontinence Related Documents PDF Choosing Wisely: Diabetes Tests and Treatments Download Related Video Join our e-newsletter! Aging & Health A to Z Diabetes Unique to Older Adults This section provides information ...

  3. Delirium: Issues for Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Delirium Unique to Older Adults This section provides information ... of life. Overview of this section: Differences between Delirium and Dementia Other Neurologic Disorders Some Important Causes ...

  4. Osteoporosis: Unique to Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Osteoporosis Unique to Older Adults This section provides information ... and widely-prescribed medications for the treatment of osteoporosis. Some serious side effects of these medication have ...

  5. Nutrition: Unique to Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Nutrition Unique to Older Adults This section provides information ... teeth that are needed for grinding up food, nutrition suffers. If you are unable to chew and ...

  6. Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women

    Directory of Open Access Journals (Sweden)

    Laura J. Samuel

    2012-01-01

    Full Text Available This study examined the relationship between financial strain, or difficulty acquiring necessities, and malnutrition risk in a community dwelling sample of frail and nonfrail women aged 70–79 in the Women’s Health and Aging Study (n=679. Malnutrition risk was measured with a modified version of the Mini-Nutritional Assessment Short Form (MNA-SF and defined as a score <11, financial strain was measured by (1 sufficiency of money on a monthly basis and (2 adequacy of income for food, and income was measured by ordinal categories. Mean (SD modified MNA-SF score was 12.2 (1.80, and 14.7% of women had malnutrition risk. Women who usually did not have enough money to make ends meet had more than four-fold increased odds of malnutrition risk (OR=4.54; 95% CI: 2.26, 9.14 compared to their counterparts who had some money left over each month. This was only slightly attenuated after control for income and education, (OR=4.08; 95% CI: 1.95, 8.52 remaining robust. These results show an association between financial strain and malnutrition risk, independent of income, in older women. Self-reported financial strain may be preferable to income as a screener for malnutrition risk in older adults in clinical and research settings.

  7. Dental Care Utilization among North Carolina Rural Older Adults

    Science.gov (United States)

    Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

    2012-01-01

    Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

  8. Weighty concerns: the growing prevalence of obesity among older adults.

    Science.gov (United States)

    Houston, Denise K; Nicklas, Barbara J; Zizza, Claire A

    2009-11-01

    The prevalence of obesity among older adults has increased during the past 20 years and will affect both medical and social services. Along with an increased risk of cardiovascular disease, diabetes, and several cancers, obesity is associated with increased risk of physical and cognitive disability. However, relatively little attention has been given to the issue of weight management among community-dwelling older adults. Intentional weight loss in obese older adults has not been widely advocated by health care providers due to the uncertainty of whether the benefits outweigh the risks. Limited data in older adults show that intentional weight loss is effective in improving diabetes, cardiovascular risk factors, and physical function. This review describes the changes in body composition associated with aging, the consequences of obesity in older adults, and the effect of intentional weight loss on chronic disease risk factors and physical function. Recommendations for weight loss in obese older adults that minimize the likelihood of adverse effects on muscle mass, bone density, or other aspects of nutritional status are reviewed. Specific recommendations for macronutrient intake, in particular protein, and selected micronutrients, vitamin D and B-12, as well as dietary fiber, and fluid intake as part of a hypocaloric diet and recommendations for physical activity are described. As part of the health professionals team, dietetics practitioners need to be able to guide and manage weight loss treatment options on an individual basis by evaluating the potential benefits against the potential risks in obese older adults.

  9. Severe sepsis in older adults.

    Science.gov (United States)

    Umberger, Reba; Callen, Bonnie; Brown, Mary Lynn

    2015-01-01

    Severe sepsis may be underrecognized in older adults. Therefore, the purpose of this article is to review special considerations related to early detection of severe sepsis in older adults. Normal organ changes attributed to aging may delay early detection of sepsis at the time when interventions have the greatest potential to improve patient outcomes. Systems are reviewed for changes. For example, the cardiovascular system may have a limited or absent compensatory response to inflammation after an infectious insult, and the febrile response and recruitment of white blood cells may be blunted because of immunosenescence in aging. Three of the 4 hallmark responses (temperature, heart rate, and white blood cell count) to systemic inflammation may be diminished in older adults as compared with younger adults. It is important to consider that older adults may not always manifest the typical systemic inflammatory response syndrome. Atypical signs such as confusion, decreased appetite, and unsteady gait may occur before sepsis related organ failure. Systemic inflammatory response syndrome criteria and a comparison of organ failure criteria were reviewed. Mortality rates in sepsis and severe sepsis remain high and are often complicated by multiple organ failures. As the numbers of older adults increase, early identification and prompt treatment is crucial in improving patient outcomes.

  10. Risk for falls among community-dwelling older people: systematic literature review.

    Science.gov (United States)

    Sousa, Luís Manuel Mota; Marques-Vieira, Cristina Maria Alves; Caldevilla, Maria Nilza Guimarães Nogueira de; Henriques, Cristina Maria Alves Dias; Severino, Sandy Silva Pedro; Caldeira, Sílvia Maria Alves

    2017-02-23

    To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification. Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.

  11. Cardiac Rehabilitation in Older Adults.

    Science.gov (United States)

    Schopfer, David W; Forman, Daniel E

    2016-09-01

    The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy.

  12. Lay meanings of health among rural older adults in Appalachia.

    Science.gov (United States)

    Goins, R Turner; Spencer, S Melinda; Williams, Kimberly

    2011-01-01

    Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define health. Qualitative methods may help capture these lay meanings of health. The purpose of our study was to use a qualitative approach to examine what perceptions community-dwelling rural older adults have regarding their health. The study involved thirteen 90-minute focus groups and short self-administered surveys with community-dwelling persons aged 60 years or older residing in 6 rural West Virginia communities. A total of 101 participants were asked questions about their personal definitions of health. With professional transcribed tapes from the focus group discussions, we used a systematic text analysis approach. Discussions included 4 themes on the meaning of health: (1) health as a value, (2) dimensions of life, (3) holistic nature of health, and (4) health care use and adherence. Our results expand on previous studies and demonstrate that health is a subjective, multidimensional construct deeply embedded in the everyday experience of rural older adults. We found that older adults' perceptions about health contain components which most medical professionals would not take into account. Health care providers may consider supplementing traditional medical approaches with a more contextually sensitive recognition of rural elders' desired health goals and outcomes. © 2010 National Rural Health Association.

  13. Weight Management in Older Adults

    Science.gov (United States)

    Gill, Lydia E.; Bartels, Stephen J.; Batsis, John A.

    2017-01-01

    As the number of older adults increases rapidly, the national epidemic of obesity is also affecting our aging population. This is particularly concerning given the numerous health risks and increased costs associated with this condition. Weight management is extremely important for older adults given the risks associated with abdominal adiposity, which is a typical fat redistribution during aging, and the prevalence of comorbid conditions in this age group. However, approaches to weight loss must be considered critically given the dangers of sarcopenia (a condition that occurs when muscle mass and quality is lost), the increase risk of hip fracture with weight loss, and the association between reduced mortality and increased BMI in older adults. This overview highlights the challenges and implications of measuring adiposity in older adults, the dangers and benefits of weight loss in this population, and provides an overview of the new Medicare Obesity Benefit. In addition we provide a summary of outcomes from successful weight loss interventions for older adults and discuss implications for advancing clinical practice. PMID:26627496

  14. Parental longevity correlates with offspring's optimism in two cohorts of community-dwelling older subjects

    NARCIS (Netherlands)

    Rius-Ottenheim, N.; Kromhout, D.; Craen, A.J.M.; Geleijnse, J.M.; Mast, van der R.C.; Zitman, F.G.; Westendorp, R.G.; Slagboom, E.; Giltay, E.J.

    2012-01-01

    Dispositional optimism and other positive personality traits have been associated with longevity. Using a familial approach, we investigated the relationship between parental longevity and offspring’s dispositional optimism among community-dwelling older subjects. Parental age of death was assessed

  15. Self-report of healthcare utilization among community-dwelling older persons: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Marlies T van Dalen

    Full Text Available BACKGROUND: Self-reported data are often used for estimates on healthcare utilization in cost-effectiveness studies. OBJECTIVE: To analyze older adults' self-report of healthcare utilization compared to data obtained from the general practitioners' (GP electronic medical record (EMR and to study the differences in healthcare utilization between those who completed the study, those who did not respond, and those lost to follow-up. METHODS: A prospective cohort study was conducted among community-dwelling persons aged 70 years and above, without dementia and not living in a nursing home. Self-reporting questionnaires were compared to healthcare utilization data extracted from the EMR at the GP-office. RESULTS: Overall, 790 persons completed questionnaires at baseline, median age 75 years (IQR 72-80, 55.8% had no disabilities in (instrumental activities of daily living. Correlations between self-report data and EMR data on healthcare utilization were substantial for 'hospitalizations' and 'GP home visits' at 12 months intraclass correlation coefficient 0.63 (95% CI; 0.58-0.68. Compared to the EMR, self-reported healthcare utilization was generally slightly over-reported. Non-respondents received more GP home visits (p<0.05. Of the participants who died or were institutionalized 62.2% received 2 or more home visits (p<0.001 and 18.9% had 2 or more hospital admissions (p<0.001 versus respectively 18.6% and 3.9% of the participants who completed the study. Of the participants lost to follow-up for other reasons 33.0% received 2 or more home visits (p<0.01 versus 18.6 of the participants who completed the study. CONCLUSIONS: Self-report of hospitalizations and GP home visits in a broadly 'healthy' community-dwelling older population seems adequate and efficient. However, as people become older and more functionally impaired, collecting healthcare utilization data from the EMR should be considered to avoid measurement bias, particularly if the data will

  16. Lipid peroxidation and depressed mood in community-dwelling older men and women.

    Directory of Open Access Journals (Sweden)

    Yuri Milaneschi

    Full Text Available It has been hypothesized that cellular damage caused by oxidative stress is associated with late-life depression but epidemiological evidence is limited. In the present study we evaluated the association between urinary 8-iso-prostaglandin F2α (8-iso-PGF2α, a biomarker of lipid peroxidation, and depressed mood in a large sample of community-dwelling older adults. Participants were selected from the Health, Aging and Body Composition study, a community-based longitudinal study of older persons (aged 70-79 years. The present analyses was based on a subsample of 1027 men and 948 women free of mobility disability. Urinary concentration of 8-iso-PGF2α was measured by radioimmunoassay methods and adjusted for urinary creatinine. Depressed mood was defined as a score greater than 5 on the 15-item Geriatric Depression Scale and/or use of antidepressant medications. Depressed mood was present in 3.0% of men and 5.5% of women. Depressed men presented higher urinary concentrations of 8-iso-PGF2α than non-depressed men even after adjustment for multiple sociodemographic, lifestyle and health factors (p = 0.03, Cohen's d = 0.30. This association was not present in women (depressed status-by-sex interaction p = 0.04. Our study showed that oxidative damage may be linked to depression in older men from a large sample of the general population. Further studies are needed to explore whether the modulation of oxidative stress may break down the link between late-life depression and its deleterious health consequences.

  17. Health Literacy and Older Adults

    Directory of Open Access Journals (Sweden)

    Amy K. Chesser PhD

    2016-02-01

    Full Text Available Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults.

  18. Behavioral health coaching for rural-living older adults with diabetes and depression: an open pilot of the HOPE Study

    National Research Council Canada - National Science Library

    Naik, Aanand D; White, Craig D; Robertson, Suzanne M; Armento, Maria E A; Lawrence, Briana; Stelljes, Linda A; Cully, Jeffrey A

    2012-01-01

    .... A small open trial was conducted to test the acceptability, feasibility and preliminary outcomes of a telephone-delivered coaching intervention for rural-dwelling older adults with uncontrolled...

  19. Perspectives on Wellness Self-Monitoring Tools for Older Adults

    Science.gov (United States)

    Huh, Jina; Le, Thai; Reeder, Blaine; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Purpose Our purpose was to understand different stakeholder perceptions about the use of self-monitoring tools, specifically in the area of older adults’ personal wellness. In conjunction with the advent of personal health records, tracking personal health using self-monitoring technologies shows promising patient support opportunities. While clinicians’ tools for monitoring of older adults have been explored, we know little about how older adults may self-monitor their wellness and health and how their health care providers would perceive such use. Methods We conducted three focus groups with health care providers (n=10) and four focus groups with community-dwelling older adults (n=31). Results Older adult participants’ found the concept of self-monitoring unfamiliar and this influenced a narrowed interest in the use of wellness self-monitoring tools. On the other hand, health care provider participants showed open attitudes towards wellness monitoring tools for older adults and brainstormed about various stakeholders’ use cases. The two participant groups showed diverging perceptions in terms of: perceived uses, stakeholder interests, information ownership and control, and sharing of wellness monitoring tools. Conclusions Our paper provides implications and solutions for how older adults’ wellness self-monitoring tools can enhance patient-health care provider interaction, patient education, and improvement in overall wellness. PMID:24041452

  20. Fifteen Dimensions of Health among Community-Dwelling Older Singaporeans

    Directory of Open Access Journals (Sweden)

    Chetna Malhotra

    2011-01-01

    Full Text Available This paper aims to present a broad perspective of health of older Singaporeans spanning 15 health dimensions and study the association between self-rated health (SRH and other health dimensions. Using data from a survey of 5000 Singaporeans (≥60 years, SRH and health in 14 other dimensions were assessed. Generalized logit model was used to assess contribution of these 14 dimensions to positive and negative SRH, compared to average SRH. About 86% reported their health to be average or higher. Prevalence of positive SRH and “health” in most other dimensions was lower in older age groups. Positive and negative SRH were associated with mobility, hearing, vision, major physical illness, pain, personal mastery, depressive symptoms, and perceived financial adequacy. The findings show that a majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions.

  1. Depression - older adults

    Science.gov (United States)

    ... slowly than in younger adults. To better manage depression at home: Exercise regularly, if the provider says it is OK. Surround yourself with caring, positive people and do fun activities. ... signs of depression, and know how to react if these occur. ...

  2. Parenting style, resilience, and mental health of community-dwelling elderly adults in China

    National Research Council Canada - National Science Library

    Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

    2016-01-01

    .... The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China...

  3. Efficacy of Wii-Fit on Static and Dynamic Balance in Community Dwelling Older Veterans: A Randomized Controlled Pilot Trial

    Science.gov (United States)

    Dubbert, Patricia M.

    2017-01-01

    Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7) years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS)) and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life) were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9) compared to the control group (0.5; 95% CI, −0.3–1.3) at 8 weeks (average intergroup difference (95% CI), 5.5 (4.3–6.7), p balance in community dwelling older Veterans. This trial is registered with ClinicalTrials.gov Identifier NCT02190045. PMID:28261500

  4. Sexuality in Older Adults (65+)

    DEFF Research Database (Denmark)

    Træen, Bente; Hald, Gert Martin; Graham, Cynthia A;

    2017-01-01

    Objectives: The aim of the current article was to provide an overview of literature on sexual function and sexual difficulties in older adults. Method: The authors conducted a narrative review of papers published in English between January 2005 and July 2015 based on an extensive search in Psyc......INFO. Results: The review showed that although common biological changes may adversely affect sexual function in old age, sexual experience seems to also be affected by psychological and interpersonal factors. Conclusions: Greater life expectancy and better medical care will result in older individuals...... with chronic diseases living longer. The need for help to cope with changes in sexual health is likely to increase in older adults, as sexuality may be negatively affected through several pathways....

  5. Walking Tips for Older Adults

    Science.gov (United States)

    ... the most ppular form of exercise among older adults and it's a great choice. What can walking do for you? strengthen muscles help prevent weight gain lower risks of heart disease, stroke, diabetes, and osteoporosis improve balance lower the likelihood of falling If ...

  6. Heat Stress in Older Adults

    Science.gov (United States)

    ... Part 3 of 3) Hot Weather Tips Heat Stress in Older Adults FAQs Extreme Heat PSAs Related Links MMWR Bibliography CDC's Program Floods Flood Readiness Personal Hygiene After a Disaster Cleanup of Flood Water After a Flood Worker Safety Educational Materials Floods ...

  7. Health Literacy in Older Adults

    Centers for Disease Control (CDC) Podcasts

    2011-09-20

    In this podcast, Dr. Lynda Anderson, former Director of CDC’s Healthy Aging Program, discusses the importance of improving health literacy among older adults.  Created: 9/20/2011 by Office of the Associate Director for Communication (OADC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/20/2011.

  8. Oral Health and Older Adults

    Centers for Disease Control (CDC) Podcasts

    2008-10-27

    This podcast discusses the importance of older adults maintaing good oral health habits. It is primarily targeted to public health and aging services professionals.  Created: 10/27/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/27/2008.

  9. Visuomotor Binding in Older Adults

    Science.gov (United States)

    Bloesch, Emily K.; Abrams, Richard A.

    2010-01-01

    Action integration is the process through which actions performed on a stimulus and perceptual aspects of the stimulus become bound as a unitary object. This process appears to be controlled by the dopaminergic system in the prefrontal cortex, an area that is known to decrease in volume and dopamine functioning in older adults. Although the…

  10. [Polypharmacy issues in older adults].

    Science.gov (United States)

    Chiang-Hanisko, Lenny; Tan, Jung-Ying; Chiang, Ling-Chun

    2014-06-01

    Polypharmacy is a major concern in the care of older adults. People over 65 years of age frequently have multiple medical conditions and may have cancer, which requires multiple medications for treatment. The use of multiple medications increases the risk of drug-drug interactions, non-adherence, and adverse drug reactions. Polypharmacy is a term that refers to a high number of prescribed medications, usually five and above, or the use of more medications than is clinically justified. Although medications are an important factor in improving and maintaining the quality of life of older adults, polypharmacy increases the risks of morbidity and mortality, loss of functional independence, and a multiplicity of cognitive and physical problems in this population. This article examines issues related to polypharmacy in older adults and identifies nursing strategies and interventions to detect and prevent polypharmacy. Nursing strategies discussed include: (1) increasing patient knowledge of pharmacological issues, (2) increasing patient medication management competency, (3) promoting safe patient medication practices, and (4) enhancing patient education. Nurses must be familiar with medicine regimens, understand the primary factors that affect adherence, and participate in continuing education to enhance their ability to safeguard older adult patients.

  11. Feasibility study of an attention training application for older adults.

    Science.gov (United States)

    Hill, Nikki L; Mogle, Jacqueline; Colancecco, Elise; Dick, Robert; Hannan, John; Lin, Feng Vankee

    2015-09-01

    Technology-based attention training has demonstrated promise in its potential to improve cognitive functioning in older people. Developing mobile applications, with older users specifically in mind, may support future dissemination of these interventions and integration into daily life. The purpose of this pilot study was to test the feasibility of an Attention Training Application (ATA) for community-dwelling older adults using mobile technology. A descriptive, mixed-methods design was used to capture older adults' feedback on the usability and acceptability of the ATA. A convenience sample of older adults (n = 9) from two independent living facilities participated in a 2-hour training and practice session with the ATA. Participants were given personally tailored instructions for using the mobile device and the ATA specifically. Following a practice session, participants provided ratings on multiple components of the ATA and completed an audio-recorded, semi-structured interview to provide detailed descriptions of their experience and perceptions. An iterative process of content analysis was used to characterise the open-ended responses. Participants rated the ATA favourably overall on several 0-10 scales including likeability [8.5 (1.6)], interest [8.8 (2.3)] and satisfaction [8.2 (1.9)]. The qualitative analyses revealed several issues relevant to the feasibility of the ATA among older people including the importance of the technological background of the user, limiting negative feedback, challenges with the touch screen interface, personal preferences for challenge, extending the practice period and the difficulty of the dual-task condition. The use of the ATA is feasible in the older adult population. Future development should specifically consider personal characteristics as well as preferences to maximise usability and acceptability among older people. Older adults enjoyed the ATA. This opens doors to user-friendly technological interventions that may be

  12. Physiological Parameters Database for Older Adults

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Physiological Parameters Database for Older Adults is available for download and contains physiological parameters values for healthy older human adults (age 60...

  13. How Can Older Adults Prevent Falls?

    Science.gov (United States)

    ... Talk to your doctor about whether you have osteoporosis. Read More "Preventing Falls" Articles Preventing Falls / Great Help for Older Adults / How Can Older Adults Prevent Falls? / Home Improvements ...

  14. Screening for Cognitive Impairment in Older Adults

    Science.gov (United States)

    ... evidence to make a recommendation for or against screening all older adults for cognitive impairment. The Task Force recognizes that ... there was not enough evidence to determine whether screening all older adults would be beneficial. It therefore could not recommend ...

  15. Positive and negative associations of individual social capital factors with health among community-dwelling older people.

    Science.gov (United States)

    Kabayama, Mai; Watanabe, Chie; Ryuno, Hirochika; Kamide, Kei

    2017-06-23

    Previous literature has found positive correlations between social capital and health in older adults, fewer studies have investigated the subdimension's effects of social capital on health. We aimed to determine the individual social capital subfactors in community-dwelling older adults in Japan, and to analyze the associations of these factors with physical and mental health. We sent a self-administered questionnaire assessing their perception of social group activity as the individual social capital, and mental and physical health (measured by the Medical Outcomes Study Short Form-36) to 4320 randomly selected older people. There were 1836 valid responses. We clarified that people who participated in any social activity group were in significantly better physical and mental health compared with the people who did not. By the factor analysis of the perception for the social group activity, we identified three components of the individual social capital aspect that we termed harmonious, hierarchic and diversity. Using multiple linear regression, we found the hierarchic aspect was significantly negatively associated with mental health, whereas the harmonious aspect was significantly positively associated with mental and physical health, and diversity was significantly positively associated with mental health. As the previous research literature on social capital has mainly emphasized its positive health consequences, the present findings provide a novel demonstration that some aspects of individual social capital can have negative associations with health outcomes in community-dwelling older people. For the practical application of promoting a healthier society, it is important to consider both the positive and negative sides of social capital. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  16. Sexuality in Older Adults (65+)

    DEFF Research Database (Denmark)

    Træen, Bente; Carvalheira, Ana; Kvalem, Ingela Lundin

    2017-01-01

    Objectives: the aim of the paper is to provide an overview of the literature published 2005-2015 on sexual satisfaction and body image in older adults. Method: A narrative literature search using the PsycINFO database was conducted. Results: Although women in general seem less satisfied with thei......Objectives: the aim of the paper is to provide an overview of the literature published 2005-2015 on sexual satisfaction and body image in older adults. Method: A narrative literature search using the PsycINFO database was conducted. Results: Although women in general seem less satisfied...... with their bodies than men, particularly in sexual contexts, older women appear to be less vulnerable to body-related dissatisfaction than younger women. Despite the age-specific dynamics of sexual satisfaction and sexual well-being, which parallel age-related decrease in the frequency of sexual activity, research...... findings from different countries show that substantial proportions of aging men and women are satisfied with their sex life. There is some limited evidence that this proportion may be increasing across cohorts. Gender differences in factors that influence sexual satisfaction among older adults appear...

  17. Association of day length and weather conditions with physical activity levels in older community dwelling people.

    Directory of Open Access Journals (Sweden)

    Miles D Witham

    Full Text Available BACKGROUND: Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. METHODS: We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain, and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space, psychological variables (anxiety, depression, perceived behavioural control, social variables (number of close contacts and health status measured using the SF-36 questionnaire. RESULTS: 547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity. CONCLUSIONS: In older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables.

  18. Comparison of the Berg Balance Scale and Fullerton Advanced Balance Scale to predict falls in community-dwelling adults.

    Science.gov (United States)

    Jeon, Yong-Jin; Kim, Gyoung-Mo

    2017-02-01

    [Purpose] The purpose of this study was to investigate and compare the predictive properties of Berg Balance Scale and Fullerton Advanced Balance Scales, in a group of independently-functioning community dwelling older adults. [Subjects and Methods] Ninety-seven community-dwelling older adults (male=39, female=58) who were capable of walking independently on assessment were included in this study. A binary logistic regression analysis of the Berg Balance Scale and Fullerton Advanced Balance Scale scores was used to investigate a predictive model for fall risk. A receiver operating characteristic analysis was conducted for each, to determine the cut-off for optimal levels of sensitivity and specificity. [Results] The overall prediction success rate was 89.7%; the total Berg Balance Scale and Fullerton Advanced Balance Scale scores were significant in predicting fall risk. Receiver operating characteristic analysis determined that a cut-off score of 40 out of 56 on the Berg Balance Scale produced the highest sensitivity (0.82) and specificity (0.67), and a cut-off score of 22 out of 40 on the Fullerton Advanced Balance Scale produced the highest sensitivity (0.85) and specificity (0.65) in predicting faller status. [Conclusion] The Berg Balance Scale and Fullerton Advanced Balance Scales can predict fall risk, when used for independently-functioning community-dwelling older adults.

  19. Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition.

    Science.gov (United States)

    Miner, Brienne; Tinetti, Mary E; Van Ness, Peter H; Han, Ling; Leo-Summers, Linda; Newman, Anne B; Lee, Patty J; Vaz Fragoso, Carlos A

    2016-10-01

    To evaluate the associations between a broad array of cardiorespiratory and noncardiorespiratory impairments and dyspnea in older persons. Cross-sectional. Cardiovascular Health Study. Community-dwelling persons (N = 4,413; mean age 72.6, 57.1% female, 4.5% African American, 27.2% score ≥16; aOR = 2.02, 95% CI = 1.26-3.23), and obesity (BMI ≥30; aOR = 2.07, 95% CI = 1.67-2.55). Impairments with modest but still statistically significant associations with moderate to severe dyspnea included respiratory muscle weakness, diastolic cardiac dysfunction, grip weakness, anxiety symptoms, and use of cardiovascular and psychoactive medications (aORs = 1.31-1.71). In community-dwelling older persons, several cardiorespiratory and noncardiorespiratory impairments were significantly associated with moderate to severe dyspnea, akin to a multifactorial geriatric health condition. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  20. Older Adults and Gambling: A Review

    Science.gov (United States)

    Ariyabuddhiphongs, Vanchai

    2012-01-01

    This paper uses the social cognitive theory model to review the literature on older adult gambling, and related personal and environment characteristics. Results show that lottery is the kind of gambling most frequently played by older adults, followed by casino games. Older adults take trips to casinos to socialize, find excitement, and win…

  1. Changing Medical Students' Attitudes toward Older Adults

    Science.gov (United States)

    Gonzales, Ernest; Morrow-Howell, Nancy; Gilbert, Pat

    2010-01-01

    Given the growth in the number of older adults and the ageist attitudes many in the health care profession hold, interventions aimed at improving health professionals' attitudes toward older adults are imperative. Vital Visionaries is an intergenerational art program designed to improve medical students' attitudes toward older adults. Participants…

  2. Empowering the Older Adult through Folklore

    Science.gov (United States)

    Warner, Dorothy Anne

    2006-01-01

    An opportunity exists for those working with older adults in nursing homes to significantly encourage independence in the older adult using a creative approach. The use of folklore is suggested as a means for assisting the older adult toward a reconnection with the individuation process.

  3. Nutritional screening of older home-dwelling Norwegians: a comparison between two instruments

    Directory of Open Access Journals (Sweden)

    Söderhamn U

    2012-09-01

    Full Text Available Ulrika Söderhamn, Bjørg Dale, Kari Sundsli, Olle SöderhamnCentre for Caring Research-Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, NorwayBackground: It is important to obtain knowledge about the prevalence of nutritional risk and associated factors among older home-dwelling people in order to be able to meet nutritional challenges in this group in the future and to plan appropriate interventions. The aim of this survey was to investigate the prevalence of home-dwelling older people at nutritional risk and to identify associated factors using two different nutritional screening instruments as self-report instruments.Methods: This study had a cross-sectional design. A postal questionnaire, including the Norwegian versions of the Nutritional Form for the Elderly (NUFFE-NO and Mini Nutritional Assessment – Short Form (MNA-SF, background variables, and health-related questions was sent to a randomized sample of 6033 home-dwelling older people in southern Norway. A total of 2106 (34.9% subjects were included in the study. Data were analyzed using descriptive statistics and logistic regression analyses.Results: When using the NUFFE-NO and MNA-SF, 426 (22.3% and 258 (13.5% older persons, respectively, were identified to be at nutritional risk. The risk of undernutrition increased with age. Several predictors for being at risk of undernutrition, including chronic disease/handicap and receiving family help, as well as protective factors, including sufficient food intake and having social contacts, were identified.Conclusion: Health professionals must be aware of older people's vulnerability to risk of undernutrition, perform screening, and have a plan for preventing undernutrition. For that purpose, MNA-SF and NUFFE-NO can be suggested for screening older people living at home.Keywords: aged, risk factors, undernutrition, screening

  4. Vision Loss in Older Adults.

    Science.gov (United States)

    Pelletier, Allen L; Rojas-Roldan, Ledy; Coffin, Janis

    2016-08-01

    Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts. Vitamin supplements can delay the progression of age-related macular degeneration. Intravitreal injection of a vascular endothelial growth factor inhibitor can preserve vision in the neovascular form of macular degeneration. Medicated eye drops reduce intraocular pressure and can delay the progression of vision loss in patients with glaucoma, but adherence to treatment is poor. Laser trabeculoplasty also lowers intraocular pressure and preserves vision in patients with primary open-angle glaucoma, but long-term studies are needed to identify who is most likely to benefit from surgery. Tight glycemic control in adults with diabetes slows the progression of diabetic retinopathy, but must be balanced against the risks of hypoglycemia and death in older adults. Fenofibrate also slows progression of diabetic retinopathy. Panretinal photocoagulation is the mainstay of treatment for diabetic retinopathy, whereas vascular endothelial growth factor inhibitors slow vision loss resulting from diabetic macular edema. Preoperative testing before cataract surgery does not improve outcomes and is not recommended.

  5. Journey to Healthy Aging: Impact of Community Based Education Programs on Knowledge and Health Behavior in Older Adults

    Science.gov (United States)

    McLarry, Sue

    2007-01-01

    The objective of this study was to determine if community based health education programs increased knowledge and health behavior in older adults. The study was a pretest-posttest design with a convenience sample of 111 independent community dwelling older adults. Participants received two disease prevention education presentations: type 2…

  6. Perceptions and Beliefs about the Role of Physical Activity and Nutrition on Brain Health in Older Adults

    Science.gov (United States)

    Wilcox, Sara; Sharkey, Joseph R.; Mathews, Anna E.; Laditka, James N.; Laditka, Sarah B.; Logsdon, Rebecca G.; Sahyoun, Nadine; Robare, Joseph F.; Liu, Rui

    2009-01-01

    Purpose: To examine older adults' perceptions of the link between physical activity (PA) and nutrition to the maintenance of cognitive health. Design and Methods: Forty-two focus groups (FGs) were conducted with 396 ethnically diverse (White, African American, American Indian, Chinese, Vietnamese, and Hispanic) community-dwelling older adults. FGs…

  7. Sexuality in Nigerian older adults

    Science.gov (United States)

    Olatayo, Adeoti Adekunle; Kubwa, Ojo Osaze; Adekunle, Ajayi Ebenezer

    2015-01-01

    Introduction Oftentimes the older adults are assumed to be asexual as few studies explore into the sexuality of this age group worldwide and even in Nigeria. It is an important aspect of quality of life which is often neglected by people in this age group, attending physicians and the society as a whole. The study was aimed at determining the perception of older adults about sexuality, identify the factors that could militate against sexuality and fill any void in information in this regard. Methods Descriptive study conducted in one hundred older adults. A semi-structured questionnaire was administered to consenting participants between 1st of September 2013 and 31st of March 2014. Results Mean age of respondents was 66.42± 5.77 years. Seventy-eight percent of the male respondents considered engaging in sexual activity as safe compared to 45.8% of the female respondents. More of the women (33.3%) regarded sexuality in the older adults as a taboo when compared to the men (5.4%). However, the men were more favourably disposed to discussing sexual problems than the women with their spouses (42% vs 20%) and Physicians (23.2% vs 0.0%). Major factors responsible for sexual inactivity were participants’ medical ailments (65%), partners’ failing health (15%) as well as anxiety about sexual performance (25%) in the men and dyspareunia (25%) in women. Conclusion There is an urgent need to correct the misconception about sexuality in this age group especially among the women and for the physicians to explore the sexual history of every patient. PMID:26977224

  8. Sexuality in Nigerian older adults.

    Science.gov (United States)

    Olatayo, Adeoti Adekunle; Kubwa, Ojo Osaze; Adekunle, Ajayi Ebenezer

    2015-01-01

    Oftentimes the older adults are assumed to be asexual as few studies explore into the sexuality of this age group worldwide and even in Nigeria. It is an important aspect of quality of life which is often neglected by people in this age group, attending physicians and the society as a whole. The study was aimed at determining the perception of older adults about sexuality, identify the factors that could militate against sexuality and fill any void in information in this regard. Descriptive study conducted in one hundred older adults. A semi-structured questionnaire was administered to consenting participants between 1(st) of September 2013 and 31(st) of March 2014. Mean age of respondents was 66.42 ± 5.77 years. Seventy-eight percent of the male respondents considered engaging in sexual activity as safe compared to 45.8% of the female respondents. More of the women (33.3%) regarded sexuality in the older adults as a taboo when compared to the men (5.4%). However, the men were more favourably disposed to discussing sexual problems than the women with their spouses (42% vs 20%) and Physicians (23.2% vs 0.0%). Major factors responsible for sexual inactivity were participants' medical ailments (65%), partners' failing health (15%) as well as anxiety about sexual performance (25%) in the men and dyspareunia (25%) in women. There is an urgent need to correct the misconception about sexuality in this age group especially among the women and for the physicians to explore the sexual history of every patient.

  9. Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

    Directory of Open Access Journals (Sweden)

    Shuk Kwan Tang

    2014-01-01

    Full Text Available To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males were in the intervention group and 38 participants (30 females, 8 males were in the control group. The pain scores were 4.75 (SD 2.32 on a 10-point scale for the intervention group and 5.24 (SD 2.14 for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18, 9.64 (SD 7.05, and 12.91 (SD 7.70, respectively. A significant reduction in negative emotions was found in the intervention group (P<0.05. The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

  10. Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons?

    Science.gov (United States)

    Tang, Shuk Kwan; Tse, M Y Mimi

    2014-01-01

    To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (Paromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

  11. Equilíbrio funcional de idosos da comunidade: comparação em relação ao histórico de quedas Functional balance among community-dwelling older adults: a comparison of their history of falls

    Directory of Open Access Journals (Sweden)

    DFF Gonçalves

    2009-08-01

    Full Text Available CONTEXTUALIZAÇÃO: O equilíbrio humano é uma tarefa motora complexa, e a sua manutenção é essencial para a realização das tarefas cotidianas. O processo de envelhecimento e as doenças crônicas que acometem os idosos geram sérios distúrbios de equilíbrio, tornando-os mais suscetíveis às quedas. OBJETIVOS: Avaliar e comparar o equilíbrio funcional de idosos da comunidade sem história de quedas, com uma queda e com quedas recorrentes. MÉTODOS: Estudo de corte transversal com amostra constituída por 96 sujeitos, com idade igual ou superior a 65 anos, residentes na comunidade e divididos igualmente em três grupos de acordo com o histórico de quedas relatado no último ano. Para a avaliação funcional do equilíbrio, foram utilizados como instrumentos a Berg Balance Scale (BBS e o Timed Up and Go Test (TUGT. RESULTADOS: Idosos com histórico de uma queda e quedas recorrentes realizaram o TUGT em um tempo maior do que idosos sem relato de quedas, sendo esta diferença significativa (p=0,002. Na avaliação pela BBS, idosos que apresentaram quedas recorrentes pontuaram significativamente menos do que aqueles sem quedas (p=0,013. Verificou-se moderada associação entre a BBS e o TUGT nos três grupos (pBACKGROUND: Human balance is a complex motor task. Its maintenance is essential to accomplishing daily tasks. The aging process and the chronic diseases that affect older adults lead to serious balance disorders, thus making such individuals more susceptible to falls. OBJECTIVES: To evaluate the functional balance of community-dwelling older adults and to make a comparison between those with no history of falls, those with one fall and those with recurrent falls. METHODS: A cross-sectional study was carried out. The sample was composed of 96 individuals from the community aged 65 years or older. They were divided equally into three groups according to their reported history of falls over the preceding year. Functional balance was

  12. Independence and shared decision making: the role of smart home technology in empowering older adults.

    Science.gov (United States)

    Demiris, George

    2009-01-01

    This study aims to explore the concepts of independence and shared decision making in the context of smart home technologies for older adults. We conducted a Delphi study with three rounds involving smart home designers, and researchers as well as community dwelling older adults. While there were differences in the way different stakeholders define these concepts, the study findings provide clear implications for the design, implementation and evaluation of smart home applications.

  13. Cochlear implantation in older adults.

    Science.gov (United States)

    Lin, Frank R; Chien, Wade W; Li, Lingsheng; Clarrett, Danisa M; Niparko, John K; Francis, Howard W

    2012-09-01

    Cochlear implants allow individuals with severe to profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation (CI) is approximately 150,000 and will continue to increase with the aging of the population. Should CI be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12-year experience with CI in adults aged ≥60 years (n = 445) at Johns Hopkins Medical Institutions to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that CI in adults aged ≥60 years consistently improved speech understanding scores, with a mean increase of 60.0% (SD 24.1) on HINT (Hearing in Noise Test) sentences in quiet. The magnitude of the gain in speech scores was negatively associated with age at implantation, such that for every increasing year of age at CI the gain in speech scores was 1.3 percentage points less (95% confidence interval [95% CI], 0.6-1.9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40% and 60%) had significantly greater post-CI speech scores by a mean of 10.0 percentage points (95% CI, 0.4-19.6) than those with lower pre-CI speech scores (HINT speech scores obtain the highest speech understanding scores after CI, with possible implications for current United States Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into account the broad cognitive, social, and physical functioning outcomes that are likely detrimentally affected by hearing loss and may be mitigated by CI.

  14. Cardiac function and cognition in older community-dwelling cardiac patients.

    Science.gov (United States)

    Eggermont, Laura H P; Aly, Mohamed F A; Vuijk, Pieter J; de Boer, Karin; Kamp, Otto; van Rossum, Albert C; Scherder, Erik J A

    2017-04-17

    Cognitive deficits have been reported in older cardiac patients. An underlying mechanism for these findings may be reduced cardiac function. The relationship between cardiac function as represented by different echocardiographic measures and different cognitive function domains in older cardiac patients remains unknown. An older (≥70 years) heterogeneous group of 117 community-dwelling cardiac patients under medical supervision by a cardiologist underwent thorough echocardiographic assessment including left ventricular ejection fraction, cardiac index, left atrial volume index, left ventricular mass index, left ventricular diastolic function, and valvular calcification. During a home visit, a neuropsychological assessment was performed within 7.1 ± 3.8 months after echocardiographic assessment; the neuropsychological assessment included three subtests of a word-learning test (encoding, recall, recognition) to examine one memory function domain and three executive function tests, including digit span backwards, Trail Making Test B minus A, and the Stroop colour-word test. Regression analyses showed no significant linear or quadratic associations between any of the echocardiographic functions and the cognitive function measures. None of the echocardiographic measures as representative of cardiac function was correlated with memory or executive function in this group of community-dwelling older cardiac patients. These findings contrast with those of previous studies. © 2017 Japanese Psychogeriatric Society.

  15. Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

    Directory of Open Access Journals (Sweden)

    de Moraes Suzana Albuquerque

    2013-01-01

    Full Text Available Abstract Background Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. Methods This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults, with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. Results The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004. The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35, perceived fatigue (OR = 1.93; 95% CI 1.21-3.10, recurring falls (OR = 2.01; 95% CI 1.11-3.62 and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29. The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727 (p Conclusions The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our

  16. Piloting the older adult financial exploitation measure in adult safeguarding services.

    Science.gov (United States)

    Phelan, A; Fealy, G; Downes, C

    2017-01-27

    Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse.

  17. Underactive Bladder in Older Adults.

    Science.gov (United States)

    Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B

    2015-11-01

    Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies.

  18. Effect of a simple and adherent home exercise program on the physical function of community dwelling adults sixty years of age and older with pre-sarcopenia or sarcopenia.

    Science.gov (United States)

    Maruya, Kohei; Asakawa, Yasuyoshi; Ishibashi, Hideaki; Fujita, Hiroaki; Arai, Tomoyuki; Yamaguchi, Haruyasu

    2016-11-01

    [Purpose] To evaluate the effect of a home exercise program on physical function in community dwelling elderly with pre-sarcopenia or sarcopenia. [Subjects and Methods] Fifty-two community-dwelling individuals, over 60 years and meeting the diagnostic criteria for pre-sarcopenia or sarcopenia, were randomly assigned to intervention group (n=34) and control group (n=18). The intervention group completed 6-months home exercise programs, combining walking with lower limb resistance exercises. Body mass index, skeletal mass index, body fat percentage, handgrip strength, single-leg standing, walking speed (comfortable and maximal), and knee extension strength were evaluated at baseline and post-intervention. Activity was assessed using the 25-question Geriatric Locomotive Functional Scale (GLFS-25) and quality of life using the Euro QOL questionnaire. [Results] Pre- and post-training assessments were completed by 76.5% and 77.8% of participants in the intervention and control groups, respectively. The intervention improved single-leg standing (60.5 s to 77.2 s) and knee extension strength (1.38 Nm/kg to 1.69 Nm/kg). In the control group, maximum walking speed (2.02 m/s to 1.86 m/s) and GLFS-25 score (2.9 to 5.1) worsened. Change of pre-sarcopenia/sarcopenia status was comparable for the intervention (15.4%) and control (14.3%) groups. [Conclusion] A 6-month home exercise program improved physical function in community-dwelling individuals with pre-sarcopenia or sarcopenia.

  19. Heart Failure in Older Adults.

    Science.gov (United States)

    Butrous, Hoda; Hummel, Scott L

    2016-09-01

    Heart failure (HF) is a leading cause of morbidity, hospitalization, and mortality in older adults and a growing public health problem placing a huge financial burden on the health care system. Many challenges exist in the assessment and management of HF in geriatric patients, who often have coexisting multimorbidity, polypharmacy, cognitive impairment, and frailty. These complex "geriatric domains" greatly affect physical and functional status as well as long-term clinical outcomes. Geriatric patients have been under-represented in major HF clinical trials. Nonetheless, available data suggest that guideline-based medical and device therapies improve morbidity and mortality. Nonpharmacologic strategies, such as exercise training and dietary interventions, are an active area of research. Targeted geriatric evaluation, including functional and cognitive assessment, can improve risk stratification and guide management in older patients with HF. Clinical trials that enroll older patients with multiple morbidities and HF and evaluate functional status and quality of life in addition to mortality and cardiovascular morbidity should be encouraged to guide management of this age group.

  20. Depressive symptoms as a risk factor for disabling back pain in community-dwelling older persons.

    Science.gov (United States)

    Reid, M Carrington; Williams, Christianna S; Concato, John; Tinetti, Mary E; Gill, Thomas M

    2003-12-01

    To determine whether the presence of depressive symptoms is an independent risk factor for disabling back pain in community-dwelling older persons. Prospective cohort study with a 12-month follow-up period. General community. Seven hundred forty-four members of a large health plan who were aged 70 and older and independent in bathing, walking, dressing, and transferring at baseline. The presence of depressive symptoms, defined as a score of 16 or greater on the Center for Epidemiologic Studies-Depression Scale, was documented during a comprehensive baseline assessment that also included information regarding participants' demographic, medical, and physical/cognitive status. The occurrence of disabling back pain was ascertained during monthly telephone interviews. Depressive symptoms were present in 153 (20.6%) participants at baseline. Over the 12-month follow-up period, 186 participants (25.0%) reported disabling back pain during 1 to 2 months and 91 (12.2%) during 3 or more months. After adjustment for potential confounders, the presence of depressive symptoms was independently associated with the occurrence of disabling back pain (adjusted odds ratio (AOR)=2.3 (95% confidence interval (CI)=1.2-4.4) for 1 to 2 months with disabling back pain; AOR=7.8 (95% CI=3.7-16.4) for 3 or more months with disabling back pain). The presence of depressive symptoms is a strong, independent, and highly prevalent risk factor for the occurrence of disabling back pain in community-dwelling older persons.

  1. Religiousness/Spirituality and anger management in community-dwelling older persons.

    Science.gov (United States)

    Mefford, Linda; Thomas, Sandra P; Callen, Bonnie; Groer, Maureen

    2014-04-01

    Mismanaged anger is associated with adverse health outcomes. This study examined whether dimensions of religiousness/spirituality could predict healthy anger management in a sample of 82 community-dwelling older Americans. A correlational research design was employed using the Deffenbacher Anger Scale and the Brief Multidimensional Measure of Religiousness/Spirituality. Higher scores on Forgiveness, Daily Spiritual Experiences, Religiousness/Spirituality as Coping, and Self-Ranking of Religiousness/Spirituality were correlated with healthier anger management; however forgiveness was the only significant predictor in the regression analysis. Interventions to facilitate forgiveness may promote healthy anger management and minimize the adverse health effects of mismanaged anger.

  2. FIELD NOTES: PEOPLE, PROGRAMS, & POLICIES* Farmers’ Market Produce Delivery Program for Mitigating Nutritional Risk in Older Adults

    OpenAIRE

    DOVER, SALLY E.; Buys, David R.; ALLOCCA, SALLY; Locher, Julie L.

    2013-01-01

    Community-dwelling older adults in disadvantaged neighborhoods may face nutritional risks not mitigated by existing programs. The Senior Market Basket Program, administered by nonprofit organization P.E.E.R., Inc., is a unique approach to serving community-dwelling senior adults and a valuable model for integrating targeted social services into local food systems. The program ensures access to fresh produce during the growing season for a defined target population.

  3. Polypharmacy and Medication Management in Older Adults.

    Science.gov (United States)

    Kim, Jennifer; Parish, Abby Luck

    2017-09-01

    Polypharmacy in older adults is a global problem that has recently worsened. Approximately 30% of adults aged 65 years and older in developed countries take 5 or more medications. Although prescribed and over-the-counter medications may improve a wide range of health problems, they also may cause or contribute to harm, especially in older adults. Polypharmacy in older adults is associated with worsening of geriatric syndromes and adverse drug events. Given the risks and burdens of polypharmacy and potentially inappropriate medications, nurses must use patient-centered approaches and nonpharmacologic strategies to treat common symptoms and to optimize patient function and quality of life. Published by Elsevier Inc.

  4. Dietary screening tool identifies nutritional risk in older adults123

    Science.gov (United States)

    Miller, Paige E; Mitchell, Diane C; Hartman, Terryl J; Lawrence, Frank R; Sempos, Christopher T; Smiciklas-Wright, Helen

    2009-01-01

    Background: No rapid methods exist for screening overall dietary intakes in older adults. Objective: The purpose of this study was to develop and evaluate a scoring system for a diet screening tool to identify nutritional risk in community-dwelling older adults. Design: This cross-sectional study in older adults (n = 204) who reside in rural areas examined nutrition status by using an in-person interview, biochemical measures, and four 24-h recalls that included the use of dietary supplements. Results: The dietary screening tool was able to characterize 3 levels of nutritional risk: at risk, possible risk, and not at risk. Individuals classified as at nutritional risk had significantly lower indicators of diet quality (Healthy Eating Index and Mean Adequacy Ratio) and intakes of protein, most micronutrients, dietary fiber, fruit, and vegetables. The at-risk group had higher intakes of fats and oils and refined grains. The at-risk group also had the lowest serum vitamin B-12, folate, β-cryptoxanthin, lutein, and zeaxanthin concentrations. The not-at-nutritional-risk group had significantly higher lycopene and β-carotene and lower homocysteine and methylmalonic acid concentrations. Conclusion: The dietary screening tool is a simple and practical tool that can help to detect nutritional risk in older adults. PMID:19458013

  5. Relationship between socioeconomic status and quality of life in older adults : a path analysis

    NARCIS (Netherlands)

    Bielderman, A.; de Greef, M. H. G.; Krijnen, W. P.; van der Schans, C. P.

    2015-01-01

    The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults. A cross-sectional design was used to examine the relationships. A

  6. Memory Aging Knowledge and Memory Self-Appraisal in Younger and Older Adults

    Science.gov (United States)

    Cherry, Katie E.; Brigman, Susan; Reese-Melancon, Celinda; Burton-Chase, Allison; Holland, Kayla

    2013-01-01

    The purpose of this study was to examine relationships among memory aging knowledge and memory self-appraisal in college students and community-dwelling older adults. Participants completed the Knowledge of Memory Aging Questionnaire ([KMAQ] Cherry, Brigman, Hawley, & Reese, 2003) and the Memory Functioning Questionnaire ([MFQ] Gilewski,…

  7. Memory Aging Knowledge and Memory Self-Appraisal in Younger and Older Adults

    Science.gov (United States)

    Cherry, Katie E.; Brigman, Susan; Reese-Melancon, Celinda; Burton-Chase, Allison; Holland, Kayla

    2013-01-01

    The purpose of this study was to examine relationships among memory aging knowledge and memory self-appraisal in college students and community-dwelling older adults. Participants completed the Knowledge of Memory Aging Questionnaire ([KMAQ] Cherry, Brigman, Hawley, & Reese, 2003) and the Memory Functioning Questionnaire ([MFQ] Gilewski, Zelinski,…

  8. Relationship between socioeconomic status and quality of life in older adults : a path analysis

    NARCIS (Netherlands)

    Bielderman, A.; de Greef, M. H. G.; Krijnen, W. P.; van der Schans, C. P.

    2015-01-01

    The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults. A cross-sectional design was used to examine the relationships. A

  9. Mild Memory Impairment in Healthy Older Adults Is Distinct from Normal Aging

    Science.gov (United States)

    Cargin, J. Weaver; Maruff, P.; Collie, A.; Masters, C.

    2006-01-01

    Mild memory impairment was detected in 28% of a sample of healthy community-dwelling older adults using the delayed recall trial of a word list learning task. Statistical analysis revealed that individuals with memory impairment also demonstrated relative deficits on other measures of memory, and tests of executive function, processing speed and…

  10. Do Sedentary Older Adults Benefit from Community-Based Exercise? Results from the Active Start Program

    Science.gov (United States)

    Yan, Tingjian; Wilber, Kathleen H.; Aguirre, Rosa; Trejo, Laura

    2009-01-01

    Purpose: This study assessed the effectiveness of Active Start, a community-based behavior change and fitness program, designed to promote physical activity among sedentary community-dwelling older adults. Design and Methods: A quasi-experimental design was used. Data were analyzed using a within-group pretest-post-test design to calculate changes…

  11. Developing a Framework and Priorities to Promote Mobility among Older Adults

    Science.gov (United States)

    Anderson, Lynda A.; Slonim, Amy; Yen, Irene H.; Jones, Dina L.; Allen, Peg; Hunter, Rebecca H.; Goins, R. Turner; Leith, Katherine H.; Rosenberg, Dori; Satariano, William A.; McPhillips-Tangum, Carol

    2014-01-01

    Mobility, broadly defined as movement in all of its forms from ambulation to transportation, is critical to supporting optimal aging. This article describes two projects to develop a framework and a set of priority actions designed to promote mobility among community-dwelling older adults. Project 1 involved a concept-mapping process to solicit…

  12. Memory Aging Knowledge and Memory Self-Appraisal in Younger and Older Adults

    Science.gov (United States)

    Cherry, Katie E.; Brigman, Susan; Reese-Melancon, Celinda; Burton-Chase, Allison; Holland, Kayla

    2013-01-01

    The purpose of this study was to examine relationships among memory aging knowledge and memory self-appraisal in college students and community-dwelling older adults. Participants completed the Knowledge of Memory Aging Questionnaire ([KMAQ] Cherry, Brigman, Hawley, & Reese, 2003) and the Memory Functioning Questionnaire ([MFQ] Gilewski,…

  13. Suicide Ideation in Older Adults: Relationship to Mental Health Problems and Service Use

    Science.gov (United States)

    Corna, Laurie M.; Cairney, John; Streiner, David L.

    2010-01-01

    Purpose: To assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use. Design and Methods: We use data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2). We estimate the prevalence of…

  14. Factors Affecting Mobility in Community-dwelling Older Koreans with Chronic Illnesses

    Directory of Open Access Journals (Sweden)

    Hye-A Yeom, PhD, RN, ANP-C

    2015-03-01

    Conclusions: A high-risk group for mobility limitation includes low income, sedentary older men who are at risk for increased fatigue and sleep deficit. Further research should incorporate other psychological and lifestyle factors such as depression, smoking, drinking behavior, and/or obesity into the prediction model of mobility to generate specific intervention strategies for mobility enhancement recommendations for older adults.

  15. Predictive Value of Functional Gait Assessment and Berg Balance Scale for Fall in Community-dwelling Older Adults%功能性步态评价与Berg平衡量表对社区老年人跌倒风险的预测价值①

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To compare the prediction of Functional Gait Assessment (FGA) and Berg balance scale (BBS) for fall among community-dwelling older adults aged 75~85 years old. Methods 162 older adults randomly selected from 3 communities in Beijing were evaluated with FGA and BBS. They were divided as fallers and nonfallers according to the history of fall during the last year. Results The scores of FGA and BBS increased significantly in the nonfallers compared with the fallers (P<0.001). The total scores of FGA correlated with the scores of BBS (r=0.723, P<0.001). The total scores of FGA significantly correlated with the scores of items of FGA (P<0.01), ex-cept that of walking with eyes closed (P=0.31). According to the Receiver Operating Characteristic (ROC) Curve, the area under the curve was 0.901 for FGA, and 0.872 for BBS. According to the Youden index, the cutoff value of FGA was 19.5, with sensitivity of 85.5% and specificity of 81.2%. The cutoff value of BBS was 48.5, with sensitivity of 78.3%and specificity of 83.3%. Conclusion FGA is more effec-tive than BBS for predicting the fall in community-dwelling older adults, which is more sensitive and similarly specific.%  目的比较功能性步态评价(FGA)和Berg平衡量表(BBS)对75~85岁中国社区老年人跌倒的预测价值。方法随机选取北京市3个社区75~85岁老年人162人进行FGA、BBS评估,根据过去1年内是否跌倒分为跌倒组和非跌倒组。结果跌倒组和非跌倒组FGA和BBS均有非常高度显著性差异(P<0.001)。FGA总分与BBS总分显著正相关(r=0.723, P=0.001)。除闭眼行走(P=0.31)外,FGA总分与其他分项明显正相关(P<0.01);FGA受试者工作特征曲线下面积比为0.901,BBS为0.872。根据Youden指数,FGA对跌倒的预测值为19.5(满分30分),敏感性85.5%,特异性81.2%;BBS的预测值为48.5(满分56分),敏感性78.3%,特异性83.3%。结论 FGA预测社区老年人跌倒的敏感性优于BBS,特异性与BBS相似,总体效能优于BBS。

  16. Parenting style, resilience, and mental health of community-dwelling elderly adults in China

    National Research Council Canada - National Science Library

    Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

    2016-01-01

    .... In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale...

  17. Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease.

    Science.gov (United States)

    Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

    2017-04-10

    Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005-2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05-1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07-1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84-1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26-3.48). Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. © 2017 Canadian Medical Association or its licensors.

  18. High Blood Pressure: Unique to Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z High Blood Pressure Hypertension Unique to Older Adults This section provides ... Pressure Targets are Different for Very Old Adults High blood pressure (also called hypertension) increases your chance of having ...

  19. A self-assessment tool to measure older adults' perceptions regarding physical fitness and exercise activity.

    Science.gov (United States)

    Devereaux Melillo, K; Williamson, E; Futrell, M; Chamberlain, C

    1997-06-01

    The purpose of this research was to qualitatively generate and psychometrically assess an instrument which assesses the self-perceived physical fitness and exercise activity levels of community-dwelling older adults and examines perceived factors which enhance or impede their exercise activity level. This research was carried out in two stages: qualitative and quantitative. Items for the instrument were generated through qualitative interviews with 23 community-dwelling older adults, 9 males and 14 females, with an age range of 63 to 82 years. From this qualitative study, 50 items were generated, representing nine categories of elements which enhance or impede physical activity. The 50 items were incorporated into a 4-point, forced-choice, Likert format instrument which was pilot tested for clarity and ease of administration with a convenience sample of community-dwelling older adults. Following the pilot testing, 41 items were retained. The 41-item instrument, entitled Physical Fitness and Exercise Activity Levels of Older Adults Scale, was categorized into the following subscales: Physical Fitness, Barriers, Motivators, and Exercise Frequency. Initial testing of the Physical Fitness and Exercise Activity Levels of Older Adults Scale seems to indicate adequate validity and reliability. Correlation coefficients for the total instrument, as well as the subscales, were significantly positive for both stability and internal consistency. Results with respect to predictive validity were mixed. The Physical Fitness and Motivators subscales were significant predictors of Exercise Frequency. Although the correlation between the Barriers subscale and Exercise Frequency was negative, it was non-significant.

  20. Determinants of participation in colorectal cancer screening among community-dwelling Chinese older people: Testing a comprehensive model using a descriptive correlational study.

    Science.gov (United States)

    Leung, Doris Y P; Wong, Eliza M L; Chan, Carmen W H

    2016-04-01

    The prevalence of colorectal cancer (CRC) among older people is high. Screening for CRC presents a cost-effective secondary prevention and control strategy which results in a significant reduction in mortality. This study aims to describe the prevalence of CRC screening and examine its risk factors among Chinese community-dwelling older people guided by a comprehensive model combining Health Belief Model and Extended Parallel Processing Model. A descriptive correlational study was conducted. A convenience sample of 240 community-dwelling adults aged ≥60 was recruited in May-July in 2012 in Hong Kong. Participants were asked to complete a questionnaire which collected information on demographic variables, CRC-related psychosocial variables and whether they had a CRC screening in the past 10 years. Among the participants, 25.4% reported having a CRC screening test. Results of logistic regression analyses indicated that participants with a higher level in cue to action, and lower perceived knowledge barriers and severity-fear were significantly associated with participation in CRC screening. But there were no significant associations between fatalism and cancer fear with screening. The prevalence of CRC screening was low in Hong Kong Chinese community-dwelling elders. A number of modifiable factors associated with CRC screening were identified which provides specific targets for interventions. This study also adds to the knowledge regarding the associations between fatalism and fear with CRC screening behaviors among Chinese older people. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Flashbulb memories in older adults.

    Science.gov (United States)

    Cohen, G; Conway, M A; Maylor, E A

    1994-09-01

    In this study of age differences in flashbulb memory, groups of young and older adults gave detailed accounts of how they heard the news of the resignation of the British Prime Minister Margaret Thatcher. They were tested within 14 days after the event and again 11 months later. They also gave ratings for the encoding variables (surprise, emotion, importance, knowledge, and interest) and for frequency of rehearsal. Memories that met a strict criterion of consistency between the original and delayed responses were classified as flashbulb memories. Although 90% of young Ss had flashbulb memories, only 42% of the elderly met the criterion. The age groups also differed in the type of details remembered and in the relationship between the encoding and rehearsal variables and the occurrence of flashbulb memory. The age-related deficit in flashbulb memory is related to source amnesia and to a deficit in memory for context.

  2. Depressive Symptoms Affect Working Memory in Healthy Older Adult Hispanics.

    Science.gov (United States)

    Salazar-Villanea, Monica; Liebmann, Edward; Garnier-Villarreal, Mauricio; Montenegro-Montenegro, Esteban; Johnson, David K

    2015-10-01

    Low and middle income nations will experience an unprecedented growth of the elderly population and subsequent increase in age-related neurological disorders. Worldwide prevalence and incidence of all-types of neurological disorders with serious mental health complications will increase with life expectancy across the globe. One-in- ten individuals over 75 has at least moderate cognitive impairment. Prevalence of cognitive impairment doubles every 5 years thereafter. Latin America's population of older adult's 65 years and older is growing rapidly, yet little is known about cognitive aging among healthy older Latinos. Clinically significant depressive symptomatology is common among community-dwelling older adults and is associated with deficits across multiple cognitive domains, however much of the literature has not modeled the unique effects of depression distinct from negative and low positive affect. Our objective was to understand how mental health affects cognitive health in healthy aging Latinos. The present study used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to examine the relative effects of Negative Affect, Positive Affect and Geriatric Depression on Verbal Memory, Verbal Reasoning, Processing Speed, and Working Memory in healthy aging Latinos. Data was collected from a sample of healthy community dwelling older adults living in San Jose, Costa Rica. Modeling of latent variables attenuated error and improved measurement reliability of cognition, affect, and depression variables. Costa Ricans enjoy a notoriety for being much happier than US citizens and are renowned as one of the happiest nations in the world in global surveys. This was born out in these data. Costa Rican affective profiles differed substantively from US profiles. Levels of negative affect and depression were similar to US samples, but their levels of positive affect were much higher. Cognitive performance of these Costa Rican older adults was similar to US

  3. Beers versus STOPP criteria in polyharmacy community-dwelling older patients

    Directory of Open Access Journals (Sweden)

    10.7399/fh.2016.40.3.9706

    2016-05-01

    Full Text Available Objective: To assess potentially inappropriate prescribing (PIP using Beers (2012 version and STOPP (2008 version criteria in polypharmacy, community-dwelling, older patients. Methods: From the information collected in the invoicing data of the prescriptions and the electronic medical records, a sample was selected of 223 ≥ 65-year-old patients who were taking simultaneously 10 or more drugs per day. Beers and STOPP criteria were separately applied, and the results obtained with the two methods were compared. Results: A total of 141 (63.2% patients presented at least one Beers criterion. The two most frequently observed Beers criteria independent of diagnosis were the use of benzodiazepines and the use of non-COX-2-selective non-steroidal anti-inflammatory drugs. With regard to Beers criteria considering diagnosis, the most frequent were the use of anticholinergic drugs in patients with lower urinary tract symptoms or benign prostatic hyperplasia, and the use of benzodiazepines, antipsychotics, zolpidem or H2-antihistamines, in patients with dementia or cognitive impairment. A total of 165 (73.9% patients had at least one PIP according to the STOPP criteria. Duplicate drug classes and long-term use of long-acting benzodiazepines were the two most frequent STOPP criteria. Discussion: Our study identified a high frequency of PIP in polymedicated community-dwelling older patients. Simultaneous application of Beers and STOPP criteria represents a useful tool to improve prescribing in this population group.

  4. Memory complaints in older adults: Prognostic value and stability in reporting over time

    Directory of Open Access Journals (Sweden)

    Diane B Howieson

    2015-02-01

    Full Text Available Objective: The purpose of this longitudinal study was to examine the prognostic value of subjective memory complaints in 156 cognitively intact community-dwelling older adults with a mean age of 83 years. Methods: Participants were assessed for subjective memory complaints, cognitive performance, functional status, and mood at annual evaluations with a mean follow-up of 4.5 years. Results: Subjective memory complaint at entry (n = 24 was not associated with impaired memory performance and did not predict memory decline or progression to incipient dementia. Memory complaints were inconsistent across examinations for 62% of participants who reported memory problems. Conclusion: Memory complaints by older adults are inconsistent over time. Memory complaints’ value as a research criterion for selecting people at risk of dementia is weak among community-dwelling older adults. Age, length of follow-up, and other population characteristics may affect the implication of self-reported memory problems.

  5. Older adults' acceptance of psychological, pharmacological, and combination treatments for geriatric depression.

    Science.gov (United States)

    Hanson, Ashley E; Scogin, Forrest

    2008-07-01

    We examined older adults' ratings of the acceptability of geriatric depression treatments. We presented 120 community-dwelling participants with vignettes describing an older adult experiencing either mild to moderate or severe depression. Participants rated the acceptability of three different treatments: cognitive therapy (CT), antidepressant medication (AM), and a combination treatment of CT and AM (COM). For general acceptability, participants rated COM as a more acceptable treatment for depression than both CT and AM. With respect to perceived negative aspects of treatments, they rated CT as a more acceptable treatment for mild to moderate depression than both AM and COM. Participants rated both COM and CT as more acceptable treatments for severe depression than AM. Results indicate that combining psychotherapy and AM may be viewed as most acceptable by community-dwelling, nondepressed older adults.

  6. Training Older Adult Free Recall Rehearsal Strategies.

    Science.gov (United States)

    Schmitt, Frederick A.; And Others

    1981-01-01

    Three groups of older adults were compared on a free recall task with categorizable lists. Data showed that older adults' memory performance is modifiable and that efficient performance is obtained when instructional training is aimed at the processes that are crucial to task performance. (Author)

  7. Exploring Older Adults' Health Information Seeking Behaviors

    Science.gov (United States)

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

  8. Bender Gestalt Performance of Normal Older Adults.

    Science.gov (United States)

    Lacks, Patricia; Storandt, Martha

    1982-01-01

    Provides normative data on the Bender Gestalt Test (BGT) with a sample of 334 normal older adults. Showed that these older adults do not perform on the BGT in a manner that can be called brain damaged. Use of the cut-off score developed with younger persons appears appropriate. (Author)

  9. Older Adults Have Difficulty in Decoding Sarcasm

    Science.gov (United States)

    Phillips, Louise H.; Allen, Roy; Bull, Rebecca; Hering, Alexandra; Kliegel, Matthias; Channon, Shelley

    2015-01-01

    Younger and older adults differ in performance on a range of social-cognitive skills, with older adults having difficulties in decoding nonverbal cues to emotion and intentions. Such skills are likely to be important when deciding whether someone is being sarcastic. In the current study we investigated in a life span sample whether there are…

  10. Textile Recycling, Convenience, and the Older Adult.

    Science.gov (United States)

    Domina, Tanya; Koch, Kathryn

    2001-01-01

    Results of a study to examine the recycling practices and needs of older adults (n=217) indicated that older adults do recycle traditional materials, but need accommodations for physical limitations. They report textile recycling as time consuming and difficult and used donations to religious organizations as their principal means of textile…

  11. Exploring Older Adults' Health Information Seeking Behaviors

    Science.gov (United States)

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

  12. Older Adults' Acceptance of Information Technology

    Science.gov (United States)

    Wang, Lin; Rau, Pei-Luen Patrick; Salvendy, Gavriel

    2011-01-01

    This study investigated variables contributing to older adults' information technology acceptance through a survey, which was used to find factors explaining and predicting older adults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…

  13. Training Older Adults to Access Health Information

    Science.gov (United States)

    Bertera, Elizabeth M.; Bertera, Robert L.; Morgan, Russell; Wuertz, Ellen; Attey, Alfred M. O.

    2007-01-01

    Many older adults do not use health information available on the Internet. Older adults residing in affordable housing were taught to use the NIHSeniorHealth.gov Web site. Participants were predominantly African American women with limited education and income (N = 42). Outcomes included changes in computer and health Web site navigation skills.…

  14. Interpretations of Child Behavior by Older Adults.

    Science.gov (United States)

    Forrest, Constance R.; Docherty, Edward M., Jr.

    This study examined sex-role typing in older adults' interpretations of young children's behavior. Participants were 48 older adults averaging 64.7 years of age. Videotapes were made of the play behavior of each of two toddlers, a female and a male matched in body type, hair length, dress (plain tee shirt and shorts), and in the activities in…

  15. Older Adults' Acceptance of Information Technology

    Science.gov (United States)

    Wang, Lin; Rau, Pei-Luen Patrick; Salvendy, Gavriel

    2011-01-01

    This study investigated variables contributing to older adults' information technology acceptance through a survey, which was used to find factors explaining and predicting older adults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…

  16. Scoping review report: obesity in older adults.

    Science.gov (United States)

    Decaria, J E; Sharp, C; Petrella, R J

    2012-09-01

    Obesity is associated with an increased risk for early death, heart disease and stroke, disability and several other comorbidities. Although there is concern about the potential burden on health-care services with the aging demographic and the increasing trend of obesity prevalence in older adults, evidence on which to base management strategies is conflicting for various reasons. The analytic framework for this review is based on a scoping review methodology, and was conducted to examine what is known about the diagnosis, treatment and management of obesity in older adults. A total of 492 relevant research articles were identified using PubMed, Scirus, EBSCO, Clinicaltrials.gov, Cochrane Reviews and Google Scholar. The findings of this review indicate that the current WHO (World Health Organization)-recommended body mass index, waist circumference and waist-to-hip ratio obesity thresholds for the general adult population may not be appropriate for older adults. Alternatively, weight change or physical fitness may be more useful measures of mortality and health risk in obese older adults. Furthermore, although obesity in older adults is associated with several disorders that increase functional disability, epidemiological evidence suggests that obesity is protective against mortality in seniors. Consequently, the trend toward increasing prevalence of obesity in older adults will lead to an increase in unhealthy life years and health-care costs. The findings from this review also suggest that treatment strategies for obese older adults should focus on maintaining body weight and improving physical fitness and function rather than weight loss, and that a combination of aerobic and resistance exercise appears to be the most effective strategy. In conclusion, this review demonstrates the need for more research to clarify the definition of obesity in older adults, to establish criteria for evaluating when to treat older adults for obesity, and to develop effective

  17. Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland

    Science.gov (United States)

    Büla, Christophe; Guessous, Idris; Rodondi, Nicolas; Goy, René; Demont, Maurice; Santos-Eggimann, Brigitte

    2017-01-01

    Objectives The burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact. Design A large cross-sectional population-based study. Setting Community in 2 regions of French-speaking Switzerland. Participants Community-dwelling older adults aged 68 years and older in 2011 (N=5300). Outcomes Disability in BADL defined as difficulty or help needed with any of dressing, bathing, eating, getting in/out of bed or an arm chair, and using the toilet. Overall QoL dichotomised as favourable (ie, excellent or very good) or unfavourable (ie, good, fair or poor). Disturbance by any of the following 14 chronic symptoms for at least 6 months: joint pain, back pain, chest pain, dyspnoea, persistent cough, swollen legs, memory gaps, difficulty concentrating, difficulty making decisions, dizziness/vertigo, skin problems, stomach/intestine problems, urinary incontinence and impaired sexual life. Results Only 17.1% of participants did not report being disturbed by any of these chronic symptoms. Weighted prevalence ranged from 3.1% (chest pain) to 47.7% (joint pain). Most chronic symptoms were significantly associated with disability in BADL or unfavourable QoL, with substantial gender differences. The number of chronic symptoms was significantly associated with disability in BADL and unfavourable QoL, with gradients suggesting dose–response relationships. Joint pain and back pain had the highest population attributable fractions. Conclusions Chronic symptoms are highly prevalent in older people, and are associated with disability in BADL and unfavourable QoL, particularly when multiple chronic symptoms co-occur. Owing to their high public health impact, musculoskeletal chronic

  18. Urinary tract infection in older adults

    OpenAIRE

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-01-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based ap...

  19. Discourse Performance in Older Adults.

    Science.gov (United States)

    North, Alvin J.; And Others

    1986-01-01

    Assessed older (N=33) and middle-aged (N=18) women on linguistic discourse tasks. Subjects were interviewed, administered cognitive tests, and given narrative and procedural discourse tasks. Older subjects generally performed more poorly than did middle-aged subjects. Within the older group, measures of quality of disclosure were generally…

  20. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial

    NARCIS (Netherlands)

    Uffelen, J.G.Z. van; Chinapaw, M.J.M.; Mechelen, W. van; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI.

  1. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial

    NARCIS (Netherlands)

    Uffelen, J.G.Z. van; Chinapaw, M.J.M.; Mechelen, W. van; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI. Interve

  2. Stress on health-related quality of life in older adults: the protective nature of mindfulness

    OpenAIRE

    de Frias, Cindy M.; Whyne, Erum

    2014-01-01

    Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. Methods: In this cross-sectional study, 134 healthy, community-dwelling adults (ages 50–85 years) were recruited from Dallas, TX. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of sel...

  3. White matter hyperintensities are an independent predictor of physical decline in community-dwelling older people.

    Science.gov (United States)

    Zheng, Jacqueline J J; Delbaere, Kim; Close, Jacqueline C T; Sachdev, Perminder; Wen, Wei; Brodaty, Henry; Lord, Stephen R

    2012-01-01

    Ageing is associated with physical disability, but little is known about the influence of white matter hyperintensities (WMHs) on physical function decline in older people. To investigate the role of WMHs as a predictor of decline in physical function in cognitively intact older people. 287 community-dwelling people aged 70-90 years underwent the Physiological Profile Assessment (PPA) and assessments of total and regional WMH volumes, cognitive function and comorbidities. Participants underwent reassessment of the PPA 12 months later, and those in the top quartile for increases in PPA scores over the year were regarded as having declined physically. Multivariate logistic regression analyses revealed that people with WMH volumes in the 4th quartile showed greater physical decline (odds ratio 3.02, 95% confidence interval 1.02-8.95) while controlling for age, baseline physical function, general health, physical activity and cognitive function. Subsequent univariate analyses indicated that WMHs in the deep fronto-parietal and periventricular parieto-occipital regions had the strongest associations with physical decline. These findings indicate that WMHs are an independent predictor of decline in physical function and suggest that interventions that focus on preventing the development or progression of white matter lesions may help preserve physical function in older people. Copyright © 2012 S. Karger AG, Basel.

  4. Correlates of Depressive Symptoms in Older Adults with Diabetes

    Directory of Open Access Journals (Sweden)

    LaRita C. Jones

    2016-01-01

    Full Text Available Investigators examined correlates of depressive symptoms within a sample of older adults with diabetes. Participants completed a structured telephone interview with measures including depressive symptoms, health conditions, cognitive function, and diabetes distress. Correlations and hierarchical linear regression models were utilized to examine bivariate and covariate-adjusted correlates of depressive symptoms. The sample included 246 community-dwelling adults with diabetes (≥65 years old. In bivariate analyses, African Americans, individuals with specific health issues (neuropathy, stroke, respiratory issues, arthritis, and cardiac issues, and those with higher levels of diabetes distress reported more depressive symptoms. Older age, higher education, more income, and better cognitive function were inversely associated with depressive symptoms. In the final covariate-adjusted regression model, stroke (B = .22, p<.001, cognitive function (B = −.14, p<.01, and higher levels of diabetes-related distress (B = .49, p<.001 each were uniquely associated with more depressive symptoms. Diabetes distress partially mediated the associations between cardiac issues and depressive symptoms and between cognitive function and depressive symptoms. Findings suggest that interventions targeted at helping older adults manage their diabetes-related distress and reducing the likelihood of experiencing additional health complications may reduce depressive symptoms within this population.

  5. Correlates of Depressive Symptoms in Older Adults with Diabetes.

    Science.gov (United States)

    Jones, LaRita C; Clay, Olivio J; Ovalle, Fernando; Cherrington, Andrea; Crowe, Michael

    2016-01-01

    Investigators examined correlates of depressive symptoms within a sample of older adults with diabetes. Participants completed a structured telephone interview with measures including depressive symptoms, health conditions, cognitive function, and diabetes distress. Correlations and hierarchical linear regression models were utilized to examine bivariate and covariate-adjusted correlates of depressive symptoms. The sample included 246 community-dwelling adults with diabetes (≥ 65 years old). In bivariate analyses, African Americans, individuals with specific health issues (neuropathy, stroke, respiratory issues, arthritis, and cardiac issues), and those with higher levels of diabetes distress reported more depressive symptoms. Older age, higher education, more income, and better cognitive function were inversely associated with depressive symptoms. In the final covariate-adjusted regression model, stroke (B = .22, p < .001), cognitive function (B = -.14, p < .01), and higher levels of diabetes-related distress (B = .49, p < .001) each were uniquely associated with more depressive symptoms. Diabetes distress partially mediated the associations between cardiac issues and depressive symptoms and between cognitive function and depressive symptoms. Findings suggest that interventions targeted at helping older adults manage their diabetes-related distress and reducing the likelihood of experiencing additional health complications may reduce depressive symptoms within this population.

  6. Poor Oral Health and Diet in Relation to Weight Loss, Stable Underweight, and Obesity in Community-Dwelling Older Adults: A Cross-Sectional Study From the JAGES 2010 Project.

    Science.gov (United States)

    Nakamura, Mieko; Ojima, Toshiyuki; Nakade, Miyo; Ohtsuka, Rika; Yamamoto, Tatsuo; Suzuki, Kayo; Kondo, Katsunori

    2016-06-05

    Involuntary weight loss and underweight increase the risks of mortality and disability in older people. However, the association and interaction of poor oral health and dietary intake with body mass index (BMI) have not been elucidated. Data were analyzed for 96 794 respondents aged >65 years who were randomly selected from 31 Japanese municipalities in the Japan Gerontological Evaluation Study. Weight loss was defined as ≥2-3 kg of loss over the preceding 6 months. BMI was evaluated in respondents without weight loss. Multiple logistic regression analysis was performed with weight loss, underweight, and obesity as dependent variables and having fewer teeth (food intake as independent variables, with adjustment for potential confounders. Weight loss was associated with having fewer teeth (men: odds ratio [OR] 1.3; 95% confidence interval [CI], 1.2-1.3; women: OR 1.2; 95% CI, 1.1-1.3) and infrequent fruit/vegetable intake (men: OR 1.1; 95% CI, 1.1-1.2; women: OR 1.4; 95% CI, 1.3-1.5) and fish/meat intake (OR 1.2; 95% CI, 1.1-1.3 for both sexes). No interaction was observed between having fewer teeth and food intake. Obesity was associated with the same factors: having fewer teeth (ORs 1.2 and 1.3 for men and women, respectively) and infrequent intake of fruit/vegetables (ORs 1.1 and 1.2 for men and women, respectively) and fish/meat (OR 1.1 for both sexes). Infrequent fruit/vegetable intake showed a higher OR for underweight in women with fewer teeth than for others. Having fewer teeth and infrequent food intake were associated with both weight loss and obesity. A significant interaction was observed in the associations of having fewer teeth and infrequent food intake with underweight in women.

  7. What factors influence community-dwelling older people’s intent to undertake multifactorial fall prevention programs?

    Directory of Open Access Journals (Sweden)

    Hill KD

    2014-11-01

    from the theoretical model positively influenced intention to participate in the intervention: personal perception of intervention effectiveness, self-perceived risk of falls, self-perceived risk of injury, and inability to walk up/down steps without a handrail (P<0.05.Conclusion: Multifactorial falls clinic-type interventions are not commonly accessed or considered as intended fall prevention approaches among community-dwelling older people, even among those with falls in the past 12 months. Factors identified as influencing intention to undertake these interventions may be useful in promoting or targeting these interventions. Keywords: falls prevention, falls clinics, older adults, motivation

  8. Advances in Psychotherapy for Depressed Older Adults.

    Science.gov (United States)

    Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

    2017-09-01

    We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

  9. Heart Failure: Unique to Older Adults

    Science.gov (United States)

    ... 3orMore Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... to help your body reduce the extra fluid. Depression and Heart Failure If you have chronic heart ...

  10. Scoping review report: obesity in older adults

    National Research Council Canada - National Science Library

    Decaria, J E; Sharp, C; Petrella, R J

    2012-01-01

    ...es. Although there is concern about the potential burden on health-care services with the aging demographic and the increasing trend of obesity prevalence in older adults, evidence on which to base...

  11. Four Medication Safety Tips for Older Adults

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates 4 Medication Safety Tips for Older Adults Share Tweet Linkedin ... dose yourself. back to top 2. Keep a Medication List Write down what you’re taking and ...

  12. Medication adherence among older adults with schizophrenia.

    Science.gov (United States)

    Leutwyler, Heather C; Fox, Patrick J; Wallhagen, Margaret

    2013-02-01

    Older adults with schizophrenia are a growing segment of the population, yet their physical and mental health status is extremely poor. This article presents findings from a qualitative study that explored the understanding older adults with schizophrenia have of their physical health status. The study was conducted among 28 older adults with schizophrenia from a variety of settings using semi-structured interviews and participant observation. Self-management of psychiatric and non-psychiatric medications and its effect on participants' health status was one of the central themes that emerged from the study. Different styles of medication adherence were identified and factors associated with each style are presented. The findings provide insights into the design of clinical interventions aimed at promoting medication adherence among older adults with schizophrenia.

  13. Falls Prevention: Unique to Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Falls Prevention Unique to Older Adults This section provides ... and Muscle Strengthening Exercises As part of your fall prevention program, you should follow an exercise program ...

  14. Older Adults' Knowledge of Internet Hazards

    Science.gov (United States)

    Grimes, Galen A.; Hough, Michelle G.; Mazur, Elizabeth; Signorella, Margaret L.

    2010-01-01

    Older adults are less likely to be using computers and less knowledgeable about Internet security than are younger users. The two groups do not differ on trust of Internet information. The younger group shows no age or gender differences. Within the older group, computer users are more trusting of Internet information, and along with those with…

  15. Vaccine preferences and acceptance of older adults

    NARCIS (Netherlands)

    Eilers, R.; de Melker, H. E.; Veldwijk, J.; Krabbe, P. F. M.

    2017-01-01

    Background: Expanding vaccination programs for the older population might be important as older adults are becoming a larger proportion of the general population. The aim of this study is to determine the relative importance of vaccine and disease specific characteristics and acceptance for Dutch

  16. Back complaints in older adults

    NARCIS (Netherlands)

    J. Scheele (Jantine)

    2013-01-01

    textabstractWith the aging of the Dutch population, the number of older aged back pain patients is also expected to increase. However, information on the course and prognosis of older patients with back pain in general practice is very scarce. Back pain is a common musculoskeletal disorder, also in

  17. Back complaints in older adults

    NARCIS (Netherlands)

    J. Scheele (Jantine)

    2013-01-01

    textabstractWith the aging of the Dutch population, the number of older aged back pain patients is also expected to increase. However, information on the course and prognosis of older patients with back pain in general practice is very scarce. Back pain is a common musculoskeletal disorder, also in

  18. Prospective memory on a novel clinical task in older adults with mild cognitive impairment and subjective cognitive decline

    OpenAIRE

    Rabin, Laura A.; Chi, Susan Y.; Wang, Cuiling; Fogel, Joshua; Kann, Sarah J.; Aronov, Avner

    2014-01-01

    Despite the relevance of prospective memory to everyday functioning and the ability to live independently, prospective memory tasks are rarely incorporated into clinical evaluations of older adults. We investigated the validity and clinical utility of a recently developed measure, the Royal Prince Alfred Prospective Memory Test (RPA-ProMem), in a demographically diverse, non-demented, community-dwelling sample of 257 older adults (mean age = 80.78 years, 67.7% female) with amnestic mild cogni...

  19. Cognitive Behavioral Psychotherapy with Older Adults

    OpenAIRE

    Knight, Bob G.; Satre, Derek

    1999-01-01

    Cognitive behavioral psychotherapy is readily adaptable to use with older adults. This review integrates discussion of cognitive and behavioral intervention techniques with recent research and clinical observations in the field of gerontology. Cognitive changes with aging, personality and emotional development, cohort effects, and the social environment of older adults are discussed in relation to psychotherapy. Applications of cognitive behaivor therapy to specific late life problems such as...

  20. Prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP) definition: findings from the Hertfordshire Cohort Study (HCS)

    National Research Council Canada - National Science Library

    Patel, Harnish P; Syddall, Holly Emma; Jameson, Karen; Robinson, Sian; Denison, Hayley; Roberts, Helen C; Edwards, Mark; Dennison, Elaine; Cooper, Cyrus; Aihie Sayer, Avan

    2013-01-01

    sarcopenia is associated with adverse health outcomes. The aim of this study was to describe the prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP...

  1. Using a Smartphone-Based Ecological Momentary Assessment Protocol With Community Dwelling Older African Americans.

    Science.gov (United States)

    Fritz, Heather; Tarraf, Wassim; Saleh, Dan J; Cutchin, Malcolm P

    2017-09-01

    Little is known about the feasibility of smartphone-based Ecological Momentary Assessment (EMA) approaches to collect psychosocial data from older populations, especially disadvantaged older populations. In response to this gap, this report provides evidence of the feasibility and utility of a smartphone-based EMA approach for real-time assessment with older African Americans. In addition, we share lessons learned about how to improve utility. Ninety-seven older African Americans ages 55 and older (range: 55-95 years) used an Android smartphone loaded with an EMA application to provide data about their everyday activities and stress four times per day for seven consecutive days. Exit interviews early in the study suggested enhancements to the EMA interface. Adherence was demonstrated with response completion rates of 92-98% on EMA measures and no participant attrition based on the EMA protocol. Our findings suggest using a smartphone-based EMA approach for data collection is feasible and has utility with older African Americans. We most likely enhanced adherence by testing, training, monitoring, and adapting the EMA protocol using input from older adults early in the EMA design process.

  2. Older adults. An 11-year longitudinal study of adult protective service use.

    Science.gov (United States)

    Lachs, M S; Williams, C; O'Brien, S; Hurst, L; Horwitz, R

    1996-02-26

    Little is known about the epidemiology of adult protective services agency (APS) utilization, the state entities charged with assessment and advocacy for disenfranchised older adults. To determine the prevalence of utilization by older adults and risk factors for APS. A longitudinal study using the New Haven Established Population for Epidemiologic Studies in the Elderly population, a cohort of 2812 community-dwelling adults who were older than 65 years in 1982. The main outcome measure was referral to the state ombudsman on aging for protective services. Over the 11-year follow-up period, 209 cohort members (7.4%) were referred to the ombudsman 302 times as protective service cases for a community prevalence of 6.4% after adjusting for the sampling strategy of the cohort. Self-neglect was the most common indication for referral (73% of the cases). While in bivariate analyses a variety of baseline sociodemographic features, functional impairments, medical conditions, and social network factors were associated with APS use, in multivariable analysis only sociodemographic variables remained independent risk factors including low income (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.8 to 3.9), nonwhite race (OR, 2.2; 95% CI, 1.3 to 3.7), and age older than 75 years at cohort inception (OR, 1.9; 95% CI, 1.1 to 3.0). Prevalence of APS use by older adults is substantial, and sociodemographic features were the most compelling risk factors in our cohort. As the population ages, the number of older adults at risk for abuse, neglect, self-neglect, exploitation, and abandonment will increase; physicians will need to become familiar with APS referral pathways and mandatory reporting laws in their states.

  3. Offset analgesia is reduced in older adults.

    Science.gov (United States)

    Naugle, Kelly M; Cruz-Almeida, Yenisel; Fillingim, Roger B; Riley, Joseph L

    2013-11-01

    Recent studies indicate that aging is associated with dysfunctional changes in pain modulatory capacity, potentially contributing to increased incidence of pain in older adults. However, age-related changes in offset analgesia (offset), a form of temporal pain inhibition, remain poorly characterized. The purpose of this study was to investigate age differences in offset analgesia of heat pain in healthy younger and older adults. To explore the peripheral mechanisms underlying offset, an additional aim of the study was to test offset at 2 anatomical sites with known differences in nociceptor innervation. A total of 25 younger adults and 20 older adults completed 6 offset trials in which the experimental heat stimulus was presented to the volar forearm and glabrous skin of the palm. Each trial consisted of 3 continuous phases: an initial 15-second painful stimulus (T1), a slight increase in temperature from T1 for 5 seconds (T2), and a slight decrease back to the initial testing temperature for 10 seconds (T3). During each trial, subjects rated pain intensity continuously using an electronic visual analogue scale (0-100). Older adults demonstrated reduced offset compared to younger adults when tested on the volar forearm. Interestingly, offset analgesia was nonexistent on the palm for all subjects. The reduced offset found in older adults may reflect an age-related decline in endogenous inhibitory systems. However, although the exact mechanisms underlying offset remain unknown, the absence of offset at the palm suggests that peripheral mechanisms may be involved in initiating this phenomenon.

  4. Treatment of periodontal disease in older adults.

    Science.gov (United States)

    Renvert, Stefan; Persson, G Rutger

    2016-10-01

    Within the next 40 years the number of older adults worldwide will more than double. This will impact periodontal treatment needs and presents a challenge to health-care providers and governments worldwide, as severe periodontitis has been reported to be the sixth most prevalent medical condition in the world. Older adults (≥ 80 years of age) who receive regular dental care retain more teeth than those who do not receive such care, but routine general dental care for these individuals is not sufficient to prevent the progression of periodontitis with the same degree of success as in younger individuals. There is a paucity of data on the efficacy of different periodontal therapies for older individuals. However, considering the higher prevalence of chronic medical conditions seen in older adults, it cannot be assumed that periodontal therapy will yield the same degree of success seen in younger individuals. Furthermore, medications can influence the status of the periodontium and the delivery of periodontal care. As an example, anticoagulant drugs are common among older patients and may be a contraindication to certain treatments. Newer anticoagulants will, however, facilitate surgical intervention in older patients. Furthermore, prescription medications taken for chronic conditions, such as osteoporosis and cardiovascular diseases, can affect the periodontium in a variety of ways. In summary, consideration of socio-economic factors, general health status and multiple-drug therapies will, in the future, be an important part of the management of periodontitis in older adults.

  5. Older adult education in Lithuanian ageing society

    Directory of Open Access Journals (Sweden)

    Zemaitaityte I.

    2016-01-01

    Full Text Available The article analyzes the phenomenon of the demographic ageing of the population and educational opportunities for older adults in Lithuania. Ageing population is a natural outcome of demographic evolution of society. However, a growing number of older people in Lithuania as well as in other European countries requires continuous revision of societal resources in social security, economics, education, health care areas and their adjustment to the new demands. Though current discussion in Lithuania highlights the inclusion of older adults into active social life through educational activities, the studies in diverse areas show that a small number of older people take part in lifelong learning. For this reason and in the attempt to make older people feel satisfaction with life it is necessary to encourage their activity, to promote their social roles, to give them opportunities to take up voluntary tasks, educational and cultural functions and study new subjects.

  6. 'Planning ahead' among community-dwelling older people from culturally and linguistically diverse background: a cross-sectional survey.

    Science.gov (United States)

    Jeong, Sarah; Ohr, Seok; Pich, Jacqueline; Saul, Peter; Ho, Alan

    2015-01-01

    To explore preparedness of end-of-life care planning among community-dwelling older persons of culturally and linguistically diverse background. To improve end-of-life care through advance care planning, the key concept 'Planning ahead' has been promoted in Australia. However, since the introduction of the model in 2008, it is not known whether 'Planning Ahead' practice by older people from culturally and linguistically diverse backgrounds has improved. A cross-sectional survey. A total of 453 community older adults (65+) who attended 17 day care centres in a region were invited to participate in the study. A total of 229 people completed the survey with a response rate of 50·5%. The questions relevant to this study include: (1) awareness of enduring guardian, advance care directive and advance care planning, (2) the preference for substitute decision-makers and (3) the challenges experienced with advance care planning. Awareness of advance care planning was low, and completion of advance care directive was very low. 37·5% of Anglo Celtic group had an enduring guardian, compared with 15·5, 24·1 and 13·3% from Mediterranean, Eastern European and Asia/Pacific group, respectively. Children were the most preferred substitute decision-makers more for Asia/Pacific group than Anglo Celtic, Mediterranean and Eastern Europeans. The various difficulties experienced included being time-consuming, difficult to understand terms and forms, and do not know how to do it. Regardless of cultural and ethnic backgrounds, a low level of 'Planning ahead' practices was apparent because of a lack of understanding of the concept, the forms and the processes involved. The gap identified between the existing legal/ethical frameworks and the preferences of older people as substitute decision-makers adds new knowledge for further discussion. Nursing professionals are provided with an opportunity to improve their practice to meet the needs of older persons and their families in planning

  7. Dual diagnosis in older adults: a review.

    Science.gov (United States)

    Searby, Adam; Maude, Phil; McGrath, Ian

    2015-02-01

    Dual diagnosis is associated with frequent relapse, poor treatment engagement and overall unsatisfactory treatment outcomes. A comprehensive review of the contemporary literature examining this issue was conducted, finding a paucity of literature concerning dual diagnosis in older adults. Of the literature appraised for this review, a number of studies examined US Veteran's Affairs populations, which were largely male. Studies concerning older mental health populations were scarce. During the literature search, a number of background studies that influenced contemporary research regarding dual diagnosis in older adults were found; these studies were examined regarding their contribution to contemporary paradigms concerning older adults with co-occurring mental illness and substance use disorders. This review presents the results of the contemporary literature concerning dual diagnosis in older adults. Several recurring themes emerge from the literature, including the notion of a statistically small population that, in absolute terms, represents a sizeable number of individuals coming to the attention of aged mental health services in the future. Additionally, the potential for under-diagnosis in this cohort is highlighted, potentially creating a hidden population of older adults with dual diagnosis.

  8. User-based motion sensing and fuzzy logic for automated fall detection in older adults

    DEFF Research Database (Denmark)

    Boissy, Patrice; Choquette, Stéphane; Hamel, Mathieu;

    2007-01-01

    More than one third of community-dwelling older adults and up to 60% of nursing home residents fall each year, with 10-15% of fallers sustaining a serious injury. Reliable automated fall detection can increase confidence in people with fear of falling, promote active safe living for older adults,...... detection of fall events based on user-based motion sensing and fuzzy logic shows promising results. Additional rules and optimization of the algorithm will be needed to decrease the false-positive rate....

  9. Medication Use Among Ethnically Diverse Older Adults in the United States.

    Science.gov (United States)

    Chiang-Hanisko, Lenny; Williams, Christine L; Newman, David; Tappen, Ruth M

    2015-01-01

    As primary consumers of health care and prescription medication, older adults are more susceptible to potential drug-related adverse effects and medication interactions. With growing diversity among the older adult population, understanding ethnic differences in medication use becomes increasingly important. The current study describes polypharmacy and the occurrence of underprescribing among community-dwelling, low-income individuals 55 and older from four ethnic groups: (a) African American, (b) Afro-Caribbean, (c) European American, and (d) Hispanic American. Results revealed that number of illnesses, income level, and age were three major predictors associated with polypharmacy. No underprescription was identified. Overall, prevalence of polypharmacy was 47.5%. European American individuals had the highest prevalence followed by Hispanic American, African American, and Afro-Caribbean individuals. When caring for older adults from various ethnic groups, nurses should focus their efforts on those who have multiple illnesses and sufficient income to purchase medications to reduce the risk of polypharmacy.

  10. Brain Health Knowledge in Community-Dwelling Older Adults

    Science.gov (United States)

    Park, Carolyn S.; Troutman-Jordan, Meredith; Nies, Mary A.

    2012-01-01

    Aging and its effects on a person's quality of life are a growing health concern and burden for many Americans. Recently, studies have shown that adopting certain healthy behaviors may help maintain and or prevent age-related health issues such as cognitive decline. However, many people are unaware of these newfound facts. Furthermore, there is…

  11. Brain Health Knowledge in Community-Dwelling Older Adults

    Science.gov (United States)

    Park, Carolyn S.; Troutman-Jordan, Meredith; Nies, Mary A.

    2012-01-01

    Aging and its effects on a person's quality of life are a growing health concern and burden for many Americans. Recently, studies have shown that adopting certain healthy behaviors may help maintain and or prevent age-related health issues such as cognitive decline. However, many people are unaware of these newfound facts. Furthermore, there is…

  12. A survey of foot problems in community-dwelling older Greek Australians

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2011-10-01

    Full Text Available Abstract Background Foot problems are common in older people and are associated with impaired mobility and quality of life. However, the characteristics of foot problems in older Australians for whom English is a second language have not been evaluated. Methods One hundred and four community-dwelling people aged 64 to 90 years with disabling foot pain (according to the case definition of the Manchester Foot Pain and Disability Index, or MFPDI were recruited from four Greek elderly citizens clubs in Melbourne, Australia. All participants completed a Greek language questionnaire consisting of general medical history, the Medical Outcomes Study Short-Form 36 (SF-36 questionnaire, the MFPDI, and specific questions relating to foot problems and podiatry service utilisation. In addition, all participants underwent a brief clinical foot assessment. Results The MFPDI score ranged from 1 to 30 (median 14, out of a total possible score of 34. Women had significantly higher total MFPDI scores and MFPDI subscale scores. The MFPDI total score and subscale scores were significantly associated with most of the SF-36 subscale scores. The most commonly reported foot problem was difficulty finding comfortable shoes (38%, and the most commonly observed foot problem was the presence of hyperkeratotic lesions (29%. Only 13% of participants were currently receiving podiatry treatment, and 40% stated that they required more help looking after their feet. Those who reported difficulty finding comfortable shoes were more likely to be female, and those who required more help looking after their feet were more likely to be living alone and have osteoarthritis in their knees or back. Conclusions Foot problems appear to be common in older Greek Australians, have a greater impact on women, and are associated with reduced health-related quality of life. These findings are broadly similar to previous studies in English-speaking older people in Australia. However, only a small

  13. Urinary tract infection in older adults.

    Science.gov (United States)

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-10-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.

  14. Urinary tract infection in older adults

    Science.gov (United States)

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-01-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults. PMID:24391677

  15. Memory enhancement program for community-based older adults: development and evaluation.

    Science.gov (United States)

    Caprio-Prevette, M D; Fry, P S

    1996-01-01

    The purpose of the study was to develop a multifactorial memory enhancement program for community-dwelling older adults aimed at encouraging positive beliefs and behaviors about memory function and abilities in later life. The study evaluated the effectiveness of cognitive restructuring techniques (56 subjects) as compared to traditional memory training techniques (61 subjects) for purposes of enhancing memory performance. Posttest assessments were conducted after 10 weeks of memory training. Follow-up assessments were conducted 9 weeks later to assess maintenance of memory performance and memory beliefs. Three 2 x 3 (Treatment x Time) repeated measures multivariate analyses of variance were conducted to evaluate the effects of two types of intervention on memory performance, memory perception, and affective symptomatology over time. Results suggest that cognitive restructuring techniques may help community-dwelling older adults gain control over their beliefs about memory and thereby enhance their memory performance.

  16. Functional predictors of stair-climbing speed in older adults.

    Science.gov (United States)

    Hinman, Martha R; O'Connell, Janelle K; Dorr, Melissa; Hardin, Robyn; Tumlinson, Allison B; Varner, Bria

    2014-01-01

    Falls on stairs are a common cause of injury and death among older adults. Although stair climbing is a component of some instruments that assess activities of daily living, normal speeds for safe stairway ambulation have not been established. Furthermore, little is known about which components of functional mobility are most highly associated with stair-climbing speed. The purposes of this study were to determine the range of normal stair-climbing speeds for ambulatory, community-dwelling older adults and identify which functional mobility tests could best explain this speed. Twenty men and 34 women older than 65 years completed 6 functional mobility tests, including timed heel rises, timed chair stands, functional reach, one-legged stance time (OLST), a timed step test (alternately touching a step 10 times), and self-selected gait speed. Participants were then timed as they ascended and descended a flight of 8 to 10 steps. Combined ascent-descent times were used to calculate stair-climbing speed in steps per second. Stepwise regression techniques determined the best functional predictors for stair-climbing speed. Participants ascended and descended stairs at an average speed of 1.3 steps per second; men tended to ambulate stairs more quickly than women. The best predictors of stair-climbing speed were usual gait speed and OLST (R = 0.79; P = .01), which explained 63% of the variance in stair-climbing speed. Our results were similar to others who reported stair-climbing speeds ranging from 1.1 to 1.7 steps per second for older adults. However, the 2 predictors identified in this study provide a simpler and more accurate model for estimating stair-climbing speed than has been previously reported. Further research is needed to determine whether this speed is sufficient for negotiating stairs in an emergency. In addition, further study is needed to determine which tests/measures best differentiate individuals who can and cannot independently climb a typical flight of

  17. CPR - adult and child 9 years and older

    Science.gov (United States)

    Cardiopulmonary resuscitation - adult; Rescue breathing and chest compressions - adult; Resuscitation - cardiopulmonary - adult; Cardiopulmonary resuscitation - child 9 years and older; Rescue breathing ...

  18. Executive function processes predict mobility outcomes in older adults.

    Science.gov (United States)

    Gothe, Neha P; Fanning, Jason; Awick, Elizabeth; Chung, David; Wójcicki, Thomas R; Olson, Erin A; Mullen, Sean P; Voss, Michelle; Erickson, Kirk I; Kramer, Arthur F; McAuley, Edward

    2014-02-01

    To examine the relationship between performance on executive function measures and subsequent mobility outcomes in community-dwelling older adults. Randomized controlled clinical trial. Champaign-Urbana, Illinois. Community-dwelling older adults (N = 179; mean age 66.4). A 12-month exercise trial with two arms: an aerobic exercise group and a stretching and strengthening group. Established cognitive tests of executive function (flanker task, task switching, and a dual-task paradigm) and the Wisconsin card sort test. Mobility was assessed using the timed 8-foot up and go test and times to climb up and down a flight of stairs. Participants completed the cognitive tests at baseline and the mobility measures at baseline and after 12 months of the intervention. Multiple regression analyses were conducted to determine whether baseline executive function predicted postintervention functional performance after controlling for age, sex, education, cardiorespiratory fitness, and baseline mobility levels. Selective baseline executive function measurements, particularly performance on the flanker task (β = 0.15-0.17) and the Wisconsin card sort test (β = 0.11-0.16) consistently predicted mobility outcomes at 12 months. The estimates were in the expected direction, such that better baseline performance on the executive function measures predicted better performance on the timed mobility tests independent of intervention. Executive functions of inhibitory control, mental set shifting, and attentional flexibility were predictive of functional mobility. Given the literature associating mobility limitations with disability, morbidity, and mortality, these results are important for understanding the antecedents to poor mobility function that well-designed interventions to improve cognitive performance can attenuate. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  19. The Digital Divide and urban older adults.

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    Cresci, M Kay; Yarandi, Hossein N; Morrell, Roger W

    2010-01-01

    Computers and the Internet offer older adults opportunities and resources for independent living. However, many urban older adults do not use computers. This study examined the demographic, health, and social activities of urban older adults to determine variables that might predict the use and nonuse of computers in this population. A secondary data analysis was performed using the 2001 Detroit City-Wide Needs Assessment of Older Adults (n = 1410) data set. Logistic regression was used to explore potential differences in predictor variables between computer users and nonusers. Overall, computer users were younger (27%), had a higher level of education, were more likely to be employed, had an annual income greater than $20,000, and were healthier and more active than nonusers. They also were more likely to have memberships in community organizations and do volunteer work. Preferred computer activities included conducting Internet searches, playing games, writing, and communicating with family members and friends. The results suggest significant differences in demographic and health-related characteristics between computer users and nonusers among urban older adults. Although about a quarter of participants in this study used computers, the Digital Divide continues to exist in urban settings for scores of others.

  20. Sexually transmitted infections and older adults.

    Science.gov (United States)

    Johnson, Beverly K

    2013-11-01

    Older adults continue to be sexually active in their later years. A range of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV have been reported among older adults. Risk factors for STIs in older populations include (a) normal sexual changes associated with aging (e.g., increased time to attain an erection, decreased vaginal lubrication, decreases in sexual hormones); (b) psychosocial changes (e.g., loss of partner or spouse and re-entering the dating scene); and (c) risky sexual behaviors, including no or infrequent use of condoms. Screening of adults for STIs should occur regardless of age based on guidelines such as those from the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force. As discussed in this article, nurses can use assessment guides and engage in interventions such as counseling and education with older adults to reduce STI risk or refer for treatment. Numerous online resources exist for both nurses and older adults to increase knowledge of STIs.

  1. Health Tips for Older Adults

    Science.gov (United States)

    ... a healthy weight is for you. Among older people, being underweight is of concern and may be related to not having enough ... other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials ...

  2. What do we know about older abusers? a typology of violent husbands dwelling in lifelong intimate violence relationships.

    Science.gov (United States)

    Band-Winterstein, Tova

    2013-07-01

    Most research on intimate partner violence to date has focused on young men. Although interest and research regarding older abused women has increased in recent years, research on the voices and experiences of older abusive men is still scarce. The purpose of this article is to present a typology of older battering men dwelling in lifelong intimate violence relationships. Fifteen older Israeli abusive men, aged 65 to 84 years, were interviewed in depth. Four types were identified: the "Non-quitter," the "Cover-up"-er, the "In-between"-er, and the "Normalizer." These types were constructed based on four dimensions: the construction of violence over the years, the perception of the spouse over the years, losses accompanying the violent relationship, and the meaning of violence in old age. The four types enable an in-depth look at the experiential world of older abusers and paint a complex picture of various ways in which abusive men live with violence over time.

  3. Correlation between thoracolumbar curvatures and respiratory function in older adults

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    Rahman NNAA

    2017-03-01

    Full Text Available Nor Najwatul Akmal Ab Rahman,1 Devinder Kaur Ajit Singh,1 Raymond Lee2 1Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia; 2School of Applied Sciences, London South Bank University, London, UK Abstract: Aging is associated with alterations in thoracolumbar curvatures and respiratory function. Research information regarding the correlation between thoracolumbar curvatures and a comprehensive examination of respiratory function parameters in older adults is limited. The aim of the present study was to examine the correlation between thoracolumbar curvatures and respiratory function in community-dwelling older adults. Thoracolumbar curvatures (thoracic and lumbar were measured using a motion tracker. Respiratory function parameters such as lung function, respiratory rate, respiratory muscle strength and respiratory muscle thickness (diaphragm and intercostal were measured using a spirometer, triaxial accelerometer, respiratory pressure meter and ultrasound imaging, respectively. Sixty-eight community-dwelling older males and females from Kuala Lumpur, Malaysia, with mean (standard deviation age of 66.63 (5.16 years participated in this cross-sectional study. The results showed that mean (standard deviation thoracic curvature angle and lumbar curvature angles were -46.30° (14.66° and 14.10° (10.58°, respectively. There was a significant negative correlation between thoracic curvature angle and lung function (forced expiratory volume in 1 second: r=-0.23, P<0.05; forced vital capacity: r=-0.32, P<0.05, quiet expiration intercostal thickness (r=-0.22, P<0.05 and deep expiration diaphragm muscle thickness (r=-0.21, P<0.05. The lumbar curvature angle had a significant negative correlation with respiratory muscle strength (r=-0.29, P<0.05 and diaphragm muscle thickness at deep inspiration (r=-0.22, P<0.05. However, respiratory rate

  4. Older Adults with Dementia Are Sedentary for Most of the Day.

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    Helena J M van Alphen

    Full Text Available Self-reported data suggest that older adults with dementia are inactive. The purpose of the present study was to objectively assess the physical activity (PA levels of community-dwelling and institutionalized ambulatory patients with dementia, and to compare with the PA levels of cognitive healthy older adults.We used actigraphy to assess the PA levels in institutionalized (n = 83, age: 83.0 ± 7.6, Mini-Mental-State Examination (MMSE: 15.5 ± 6.5 and community-dwelling dementia patients (n = 37, age: 77.3 ± 5.6, MMSE-score: 20.8 ± 4.8, and healthy older adults (n = 26, age: 79.5 ± 5.6, MMSE-score: 28.2 ± 1.6. We characterized PA levels based on the raw data and classified <100 counts/min as sedentary behavior.Institutionalized dementia patients had the lowest daily PA levels (1.69 ± 1.33 counts/day, spent 72.1% of the day sedentary, and were most active between 8:00 and 9:00 am. Institutionalized vs. community-dwelling dementia patients had 23.5% lower daily PA levels (difference M = 0.52, p = .004 and spent 9.3% longer in sedentariness (difference M = 1.47, p = .032. Community-dwelling dementia patients spent 66.0% of the day sedentary and were most active between 9:00 to 10:00 am with a second peak between 14:00 to 15:00. Community-dwelling dementia patients vs healthy older adults' daily PA levels and sedentary time were 21.6% lower and 8.9% longer, respectively (difference M = 0.61, p = .007; difference M = 1.29, p = .078.Institutionalized and community-dwelling dementia patients are sedentary for most of the day and the little PA they perform is of lower intensity compared to their healthy peers. Their highest PA peak is when they get out of bed in the morning. In addition, it seems that institutionalized living is associated with lower PA levels in dementia patients. These are the first results that objectively characterize institutionalized as well as community-dwelling dementia patients' PA levels and confirm that dementia patients

  5. Bridging the digital divide in older adults: a study from an initiative to inform older adults about new technologies

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    Wu YH

    2015-01-01

    Full Text Available Ya-Huei Wu,1,2 Souad Damnée,1,2 Hélène Kerhervé,1,2 Caitlin Ware,1,3 Anne-Sophie Rigaud1,2 1Department of Clinical Gerontology, Broca Hospital, Assistance Publique-Hôpitaux de Paris, 2Research Team 4468, Paris Descartes University, 3Centre de Recherche en Psychanalyse, Médicine et la Société, Paris Diderot University, Paris, France Purpose: In a society where technology progresses at an exponential rate, older adults are often unaware of the existence of different kinds of information and communication technologies (ICTs. To bridge the gap, we launched a 2-year project, during which we conducted focus groups (FGs with demonstrations of ICTs, allowing older adults to try them out and to share their opinions. This study aimed at investigating how participants perceived this kind of initiative and how they reacted to different kinds of ICTs.Patients and methods: In total, 14 FGs were conducted with community-dwelling older adults, with a frequency of two FGs on the same topic once per trimester. Twenty-three older adults (four men and 19 women attended at least one FG but only nearly half of them were regular attendants (ten participating in at least five sessions. Age of participants ranged from 63 years to 88 years, with a mean of 77.1 years. All of them had completed secondary education. The analyses of the data were performed according to inductive thematic analysis.Results: Four overarching themes emerged from the analysis. The first concerned participants’ motivation for and assessment of the project. The second theme identified the underlying factors of the “digital divide” between the younger and the older generations. The third theme concerned the factors of technology adoption among older adults. The fourth one identified participants’ attitudes toward assistive ICTs, designed specifically for older adults (“gerontechnologies”.Discussions and conclusion: This project encouraging older adults to be informed about

  6. Gait patterns in a community-dwelling population aged 50 years and older.

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    Verlinden, V J A; van der Geest, J N; Hoogendam, Y Y; Hofman, A; Breteler, M M B; Ikram, M A

    2013-04-01

    Poor gait is an important risk factor for falls and associated with higher morbidity and mortality. It is well established that older age is associated with worse gait, but it remains unclear at what age this association is first seen. Moreover, previous studies focused mainly on normal walking, but gait also encompasses turning and tandem walking. In a large study of community-dwelling middle-aged and elderly persons we investigated the association of age with gait, focusing on normal walking, turning and tandem walking. In 1500 persons aged 50 years and over, we measured gait using an electronic walkway. Participants performed normal walks, turning and a tandem walk. With principal components analysis of 30 variables we summarized gait into five known gait factors: Rhythm, Variability, Phases, Pace and Base of Support; and uncovered two novel gait factors: Tandem and Turning. The strongest associations with age were found for Variability (difference in Z-score -0.29 per 10 years increase (95% confidence interval: -0.34; -0.24)), Phases (-0.31 per 10 years (-0.36; -0.27)) and Tandem (-0.25 per 10 years (-0.30; -0.20)). Additionally, these factors already showed association with the youngest age groups, from 55 to 60 years of age and older. Our study shows that Variability, Phases and Tandem have the strongest association with age and are the earliest to demonstrate a poorer gait pattern with higher age. Future research should further investigate how these gait factors relate with gait-related diseases in their earliest stages.

  7. Dietary patterns and diet quality among diverse older adults: The University of Alabama at Birmingham study of aging

    Science.gov (United States)

    Objectives: To characterize dietary patterns among a diverse sample of older adults (= 65 years). Design: Cross-sectional. Setting: Five counties in west central Alabama. Participants: Community-dwelling Medicare beneficiaries (N=416; 76.8 ± 5.2 years, 56% female, 39% African American) in the Univer...

  8. The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning among Older Adults

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    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2013-01-01

    The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas…

  9. The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning among Older Adults

    Science.gov (United States)

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2013-01-01

    The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas…

  10. [Substance abuse in older adults].

    Science.gov (United States)

    Bitar, Raoul; Dürsteler, Kenneth M; Rösner, Susanne; Grosshans, Martin; Herdener, Marcus; Mutschler, Jochen

    2014-09-03

    In respect of demographic change, the number of older patients with substance abuse and addiction is on the raise. In this review we present important clinical and therapeutic aspects of substance abuse and addiction in the elderly and focus on alcohol, benzodiazepines and opioids. Daily and risky alcohol consumption is common among older people. They also have an increased risk getting alcohol-related complications. For early detection, laboratory parameters and questionnaires such as the AUDIT-C are suitable. Therapeutically brief interventions have been proved successful. Also, abuse of benzodiazepines, especially low-dose addiction, is widespread among older persons, although often overlooked, and patients often do not recognize their addiction. The physician has to know the correct indication, adequate dosage and pharmacological interactions. A slow-dose reduction is recommended in case of addiction. Thanks to opioid substitution therapy, patients with an opioidaddiction can reach a higher age. Age influences the effects of the substitute, which may require an adjustment of the dosage. Treatment of elderly patients should be based on their needs and resources and is usually very effective.

  11. Acceptance and Commitment Therapy with Older Adults: Rationale and Considerations

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    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…

  12. Acceptance and Commitment Therapy with Older Adults: Rationale and Considerations

    Science.gov (United States)

    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…

  13. Comprehension of Health-Related Written Materials by Older Adults

    Science.gov (United States)

    Liu, Chiung-Ju; Kemper, Susan; Bovaird, James A.

    2009-01-01

    This study examined how Flesch Reading Ease and text cohesion affect older adults' comprehension of common health texts. All older adults benefited when high Flesh Reading Ease was combined with high cohesion. Older adults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, older adults…

  14. Consequences of interaction of functional, somatic, mental and social problems in community-dwelling older people.

    Directory of Open Access Journals (Sweden)

    Anne H van Houwelingen

    Full Text Available This study explores the combination of four common health problems in older people and whether problems on four domains result in an additional effect on indicators of poor health. For this purpose, a total of 2681 participants (32% male, mean age 82 years of the Integrated Systematic Care for Older People (ISCOPE study were screened on the presence of health problems on four domains (functional, somatic, mental, social with the postal ISCOPE questionnaire. Extensive interview data on health indicators were obtained at baseline and at 12-months follow-up, including disability (Groningen Activities Restriction Scale, GARS, cognitive function (Mini-Mental State Examination, MMSE, depressive symptoms (Geriatric Depression Scale-15, GDS, loneliness (loneliness scale of De Jong Gierveld, and health-related quality of life (EQ-5D. General practitioner (GP contact time (min/year was estimated via GP electronic medical records. Of the study population, 9% had no health problems according to the screening, 8% had problems on one domain, 27% on two, 38% on three and 18% on four domains. At baseline, the number of health domains with problems was associated with poorer scores on the GARS, the MMSE, the GDS-15, the loneliness scale, the EQ-5D and with more GP contact time (p <0.001. Problems on all four domains had an additional negative effect on these health indicators (all pinteraction <0.001. At follow-up, an increased number of domains with problems was associated with an increased decline in health indicators (all p<0.001 and with an additional negative effect on GP contact time of the presence of problems on all four domains (pinteraction <0.001. We conclude that combinations of functional, somatic, mental and social problems are associated with poor health indicators in community-dwelling older people. Since problems on four domains have an additional effect on health, individuals with combined functional, somatic, mental and social problems could

  15. Older Adults Engaging in Online Dating: What Gerontological Nurses Should Know.

    Science.gov (United States)

    Wion, Rachel K; Loeb, Susan J

    2015-10-01

    Many older adults maintain interest in intimate partner relationships and actively seek dates. Online dating websites are gaining popularity as being a convenient way to link with potential dates, particularly for women and individuals who live in independent dwellings or rural areas. Several online dating websites market exclusively to individuals 50 and older. Although connecting with others via the Internet can decrease social isolation, there are potential risks involved in online dating. Health care providers do not always assess dating and sexual health in the older adult population. Nurses are in a position to assess the dating relationships of older patients and can ask targeted questions to determine if patients are in a potentially risky relationship. A non-judgmental attitude and compassionate approach is essential. Knowledge of safe practices, alerting red flags, and available resources are essential tools for gerontological nurses to possess.

  16. Relationship between Auditory and Cognitive Abilities in Older Adults.

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    Stanley Sheft

    Full Text Available The objective was to evaluate the association of peripheral and central hearing abilities with cognitive function in older adults.Recruited from epidemiological studies of aging and cognition at the Rush Alzheimer's Disease Center, participants were a community-dwelling cohort of older adults (range 63-98 years without diagnosis of dementia. The cohort contained roughly equal numbers of Black (n=61 and White (n=63 subjects with groups similar in terms of age, gender, and years of education. Auditory abilities were measured with pure-tone audiometry, speech-in-noise perception, and discrimination thresholds for both static and dynamic spectral patterns. Cognitive performance was evaluated with a 12-test battery assessing episodic, semantic, and working memory, perceptual speed, and visuospatial abilities.Among the auditory measures, only the static and dynamic spectral-pattern discrimination thresholds were associated with cognitive performance in a regression model that included the demographic covariates race, age, gender, and years of education. Subsequent analysis indicated substantial shared variance among the covariates race and both measures of spectral-pattern discrimination in accounting for cognitive performance. Among cognitive measures, working memory and visuospatial abilities showed the strongest interrelationship to spectral-pattern discrimination performance.For a cohort of older adults without diagnosis of dementia, neither hearing thresholds nor speech-in-noise ability showed significant association with a summary measure of global cognition. In contrast, the two auditory metrics of spectral-pattern discrimination ability significantly contributed to a regression model prediction of cognitive performance, demonstrating association of central auditory ability to cognitive status using auditory metrics that avoided the confounding effect of speech materials.

  17. Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

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    Shah Raj C

    2012-10-01

    Full Text Available Abstract Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL. The odds ratio and 95% Confidence Interval (CI were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6 and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6. At baseline, 718 (82.5% participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65. Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total

  18. Measuring sleep quality in older adults: a comparison using subjective and objective methods.

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    Glenn J Landry

    2015-09-01

    Full Text Available Sleep quality decreases with aging and thus sleep complaints are prevalent in older adults, particularly for those with cognitive impairment and dementia. For older adults, emerging evidence suggests poor sleep quality increases risk of developing cognitive impairment and dementia. Given the aging population – and the impending economic burden associated with increasing numbers of dementia patients – there is pressing need to improve sleep quality among older adults. As such, research efforts have increased focus on investigating the association between age-related sleep changes and cognitive decline in older adults. Sleep quality is a complex construct to evaluate empirically, and yet the Pittsburg Sleep Quality Index (PSQI is commonly used in studies as their only measure of sleep quality. Furthermore, the PSQI may not be the best sleep quality measure for older adults, due to its reliance on the cognitive capacity to reflect on the past month. Further study is needed to determine the PSQI’s validity among older adults. Thus, the current study examined sleep quality for 78 community dwelling adults 55+ to determine the PSQI’s predictive validity for objective sleep quality (as measured by actigraphy. We compared two subjective measures of sleep quality – the PSQI and Consensus Sleep Diary (CSD – with actigraphy (MotionWatch 8; camntech. Our results suggest perceived sleep quality is quite different from objective reality, at least for adults 55+. Importantly, we show this difference is unrelated to age, gender, education, or cognitive status (assessed using standard screens. Previous studies have shown the PSQI to be a valuable tool for assessing subjective sleep quality; however, our findings indicate for older adults the PSQI should not be used as a substitute for actigraphy, or vice versa. Hence, we conclude best practice is to include both subjective and objective measures when examining sleep quality in older adults (i.e., the

  19. Assessment of older adults' satisfaction with adult protective services investigation and assistance.

    Science.gov (United States)

    Booker, James G; Breaux, Mary; Abada, Sharon; Xia, Rui; Burnett, Jason

    2017-05-12

    This study examined elder self-neglect client satisfaction with services provided by an Adult Protective Services (APS) program. A total of 77 community-dwelling older adults with APS-substantiated self-neglect responded to the standardized and widely used 8-item Client Satisfaction Questionnaire. Approximately 75% of the participants reported being satisfied with the overall services. They felt that the services provided were responsive to their need(s) and helped them deal with their problem(s). Greater than 80% responded that they would refer a friend, would utilize APS in the future if necessary, and were at least satisfied with the amount of help received. The extent to which their needs were met received the lowest satisfaction scores. Future studies are needed to examine elder self-neglect client satisfaction in relation to specific services.

  20. Predicting falls in older adults using the four square step test.

    Science.gov (United States)

    Cleary, Kimberly; Skornyakov, Elena

    2017-10-01

    The Four Square Step Test (FSST) is a performance-based balance tool involving stepping over four single-point canes placed on the floor in a cross configuration. The purpose of this study was to evaluate properties of the FSST in older adults who lived independently. Forty-five community dwelling older adults provided fall history and completed the FSST, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Tinetti in random order. Future falls were recorded for 12 months following testing. The FSST accurately distinguished between non-fallers and multiple fallers, and the 15-second threshold score accurately distinguished multiple fallers from non-multiple fallers based on fall history. The FSST predicted future falls, and performance on the FSST was significantly correlated with performance on the BBS, TUG, and Tinetti. However, the test is not appropriate for older adults who use walkers. Overall, the FSST is a valid yet underutilized measure of balance performance and fall prediction tool that physical therapists should consider using in ambulatory community dwelling older adults.

  1. Anthropometric Indicators in Hypertriglyceridemia Discrimination: Application as Screening Tools in Older Adults.

    Science.gov (United States)

    Júnior, Carlos Alencar Souza Alves; Coqueiro, Raildo da Silva; Carneiro, José Ailton Oliveira; Pereira, Rafael; Barbosa, Aline Rodrigues; de Magalhães, Amélia Cristina Mendes; Oliveira, Márcio Vasconcelos; Fernandes, Marcos Henrique

    2016-01-01

    The use of anthropometric indicators as discriminators of hypertriglyceridemia has not been thoroughly investigated. The purpose of this article is to comparatively evaluate anthropometric indicators as discriminators of hypertriglyceridemia in older Brazilian adults. This cross-sectional study derived from population-based epidemiological research involving 316 community-dwelling older adults (60-105 years old). Except for the conicity index and the body adiposity index in the group of women, all other anthropometric indicators (i. e., body mass index, waist and calf circumferences, triceps skinfold thickness, and waist-stature and waist-hip ratios) were sufficient to identify hypertriglyceridemia in the population. We endorse anthropometric indicators for use in screening for hypertriglyceridemia in older Brazilian adults.

  2. Companionship in the neighborhood context: older adults' living arrangements and perceptions of social cohesion.

    Science.gov (United States)

    Bromell, Lea; Cagney, Kathleen A

    2014-03-01

    This study investigated the impact of neighborhood social cohesion on the perceived companionship of nearly 1,500 community-dwelling older adults from the Neighborhood, Organization, Aging and Health project (NOAH), a Chicago-based study of older adult well-being in the neighborhood context. We hypothesized that the relationship between neighborhood-level social cohesion and individual residents' reports of companionship would be more pronounced among those who lived alone than those who resided with others. Controlling for age, gender, education, race, marital status, length of neighborhood residence, and self-rated health, neighborhood social cohesion predicted companionship among those who lived alone; for a one-unit increase in neighborhood social cohesion, the odds of reporting companionship increased by half. In contrast, social cohesion did not predict the companionship of those who resided with others. The results suggest that older adults who live alone particularly profit from the benefits of socially cohesive neighborhood environments.

  3. A longitudinal examination of sleep quality and physical activity in older adults.

    Science.gov (United States)

    Holfeld, Brett; Ruthig, Joelle C

    2014-10-01

    The relationship between sleep quality and physical activity is bidirectional, yet prior research on older adults has mainly focused on investigating whether increasing levels of physical activity leads to improvements in sleep quality. The current longitudinal study examined both directional relationships by assessing sleep quality and physical activity twice over a two-year period among 426 community-dwelling older adults (ages 61-100). A cross-lagged panel analysis that included age, gender, perceived stress, functional ability, and severity of chronic health conditions as covariates, revealed that better initial sleep quality predicted higher levels of later physical activity beyond the effects of prior physical activity; whereas initial physical activity did not predict later sleep quality after accounting for prior sleep quality. These findings highlight sleep quality as an important contributor to a physically active lifestyle among older adults.

  4. Evaluation of a Digital Companion for Older Adults with Mild Cognitive Impairment

    Science.gov (United States)

    Demiris, George; Thompson, Hilaire J.; Lazar, Amanda; Lin, Shih-Yin

    2016-01-01

    Study Objective: The purpose of this study was to examine the feasibility of a digital companion system used by older adults with mild cognitive impairment (MCI). We utilized a commercially available system that is comprehensive in its functionalities (including conversation ability, use of pictures and other media, and reminders) to explore the system’s impact on older adults ‘ social interactions, anxiety, depressive symptoms, and acceptance of the system. Study Design: We conducted a three-month mixed methods evaluation study of the digital companion. Results: Ten female community-dwelling older adults (average age 78.3 years) participated in the study. Overall, participants utilized the tool regularly and appreciated its presence and their interactions. Participants scored higher at the end of the study in cognition and social support scales, and lower in presence of depressive symptoms. Conclusion: Findings indicate the feasibility of a digital companion for people with MCI and inform the need for additional research. PMID:28269845

  5. Understanding fall meaning and context in marketing balance classes to older adults.

    Science.gov (United States)

    Clark, Lauren; Thoreson, Sallie; Goss, Cynthia W; Zimmer, Lorena Marquez; Marosits, Mark; DiGuiseppi, Carolyn

    2013-02-01

    This study explored older, community-dwelling adults' attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥ 60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their "comfort zones" to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success.

  6. Older adults' perceptions of home telehealth services.

    Science.gov (United States)

    Cimperman, Miha; Brenčič, Maja Makovec; Trkman, Peter; Stanonik, Mateja de Leonni

    2013-10-01

    The success of home telemedicine depends on end-user adoption, which has been slow despite rapid advances in technological development. This study focuses on an examination of significant factors that may predict the successful adoption of home telemedicine services (HTS) among older adults. Based on previous studies in the fields of remote patient monitoring, assisted living technologies, and consumer health information technology acceptance, eight factors were identified as a framework for qualitative testing. Twelve focus groups were conducted with an older population living in both urban and rural environments. The results reveal seven predictors that play an important role in perceptions of HTS: perceived usefulness, effort expectancy, social influence, perceived security, computer anxiety, facilitating conditions, and physicians' opinion. The results provide important insights in the field of older adults' acceptance of HTS, with guidelines for the strategic planning, developing, and marketing of HTS for the graying market.

  7. Mobility in Older Adults: A Comprehensive Framework

    Science.gov (United States)

    Webber, Sandra C.; Porter, Michelle M.; Menec, Verena H.

    2010-01-01

    Mobility is fundamental to active aging and is intimately linked to health status and quality of life. Although there is widespread acceptance regarding the importance of mobility in older adults, there have been few attempts to comprehensively portray mobility, and research has to a large extent been discipline specific. In this article, a new…

  8. Older adults abuse in three Brazilian cities

    Directory of Open Access Journals (Sweden)

    Rosalina Aparecida Partezani Rodrigues

    Full Text Available ABSTRACT Objective: To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013. Method: Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence. Results: Psychological abuse predominated and most cases occurred in the older adults own home. In the cities of Ribeirão Preto and João Pessoa, the older adults presented similar rates for both gender. Regarding the standardized rates, in João Pessoa, there was a rise of this type of abuse in the two first years, and later there was a certain stability. In the city of Teresina, there was an increase, also observed in the city of Ribeirão Preto in the three first years, followed by a decrease. Conclusion: Older adults abuse is a cultural phenomenon difficult to be reported by them, since it occurs in the family context.

  9. Blueberry supplementation improves memory in older adults

    Science.gov (United States)

    The prevalence of dementia, in particular Alzheimer’s disease, is increasing with the expansion of the older adult population. In the absence of effective therapy, preventive approaches are essential to mitigate this public health problem. Blueberries contain polyphenolic compounds, most prominent...

  10. Emergency Preparedness Concerns for Older Adults

    Centers for Disease Control (CDC) Podcasts

    2009-01-26

    This podcast discusses the special concerns many older adults face during a disaster. It is primarily targeted to public health and aging services professionals.  Created: 1/26/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) and Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER).   Date Released: 1/26/2009.

  11. Nutritional strategies for frail older adults.

    Science.gov (United States)

    Posthauer, Mary Ellen; Collins, Nancy; Dorner, Becky; Sloan, Colleen

    2013-03-01

    The objectives of this continuing education article are to analyze the aging process and its effect on the nutritional status of frail older adults; determine how sarcopenia, anorexia, malnutrition, and Alzheimer disease increase the risk for pressure ulcer development and impact the healing process; and to apply evidence-based nutrition guidelines and implement practical solutions for wound healing.

  12. Attitudes toward Advertisements of the Older Adults

    Science.gov (United States)

    Estrada, M.; Moliner, M. A.; Sanchez, J.

    2010-01-01

    In this study we will analyze the attitude of older adults to advertisements, differentiating between advertisements that contain rhetorical figures (trope ads) and those that do not (explicit ads). We will also study their attitude toward the brand advertised according to their degree of involvement with the product. In the course of the…

  13. Older adult loneliness : myths and realities

    NARCIS (Netherlands)

    Dykstra, P.A

    2009-01-01

    The focus in this paper is on the social domain of quality of life, and more particularly loneliness. The empirical literature on older adult loneliness is reviewed, thereby challenging three often-held assumptions that figure prominently in public debates on loneliness. The first assumption that lo

  14. Older adult loneliness: myths and realities [Review

    NARCIS (Netherlands)

    Dykstra, P.A.

    2009-01-01

    The focus in this paper is on the social domain of quality of life, and more particularly loneliness. The empirical literature on older adult loneliness is reviewed, thereby challenging three often-held assumptions that figure prominently in public debates on loneliness. The first assumption that lo

  15. Older adult loneliness: myths and realities

    NARCIS (Netherlands)

    P.A. Dykstra (Pearl)

    2009-01-01

    textabstractThe focus in this paper is on the social domain of quality of life, and more particularly loneliness. The empirical literature on older adult loneliness is reviewed, thereby challenging three often-held assumptions that figure prominently in public debates on loneliness. The first assump

  16. Dental hygiene students' perceptions of older adults.

    Science.gov (United States)

    Wiener, R Constance; Shockey, Alcinda Trickett; Long, D Leann

    2014-12-01

    Geriatric education is an important component of the dental hygiene curriculum because, in it, students acquire skills and attitudes to help provide quality care to older adults. The purpose of this study was to determine if off-site exposure to nursing home residents with supervised oversight had the potential to improve dental hygiene students' attitudes toward older adults. Senior dental hygiene students at one school completed a pre-nursing home experience questionnaire. A series of geriatric lectures and discussions, which included discussions about students' anxieties of working with institutionalized older adults, were held prior to the nursing home experience. The students then participated in two supervised four-hour nursing home experiences, were debriefed after the experiences, and completed a second questionnaire. Of thirty-nine potential participants in the study, thirty-two took part in the pre-nursing home experience questionnaire (82.1 percent). They had a mean split Fabroni score of 34.2 (95 percent confidence interval: 32.2, 36.3). The thirty participants in the post-experience questionnaire (76.9 percent of total) had a mean split score of 32.7 (95 percent confidence interval: 30.1, 35.3). This study failed to reject the null hypothesis of no mean difference between the pre- and post-nursing home experience; however, the post-experience mean score was lower than the pre-nursing home experience mean score, indicating a more positive attitude toward older adults after the experience.

  17. Attitudes toward Advertisements of the Older Adults

    Science.gov (United States)

    Estrada, M.; Moliner, M. A.; Sanchez, J.

    2010-01-01

    In this study we will analyze the attitude of older adults to advertisements, differentiating between advertisements that contain rhetorical figures (trope ads) and those that do not (explicit ads). We will also study their attitude toward the brand advertised according to their degree of involvement with the product. In the course of the…

  18. A Nutritional Questionnaire for Older Adults.

    Science.gov (United States)

    Fanelli, Marie T.; Abernethy, Marilyn M.

    1986-01-01

    Describes a questionnaire assessing nutritional knowledge and eating behaviors of older adults. The questionnaire consists of six sections: demographic and personal information, food resources, food consumption patterns, dietary practices related to health, activity patterns, and nutritional knowledge. Study results demonstrating the…

  19. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  20. Heart failure in community-dwelling older persons: aims, design and adherence rate of the ICARe Dicomano project: an epidemiologic study. Insufficienza Cardiaca negli Anziani Residenti a Dicomano.

    Science.gov (United States)

    Di Bari, M; Marchionni, N; Ferrucci, L; Pini, R; Antonini, E; Chiarlone, M; Marsilii, A; De Alfieri, W; Fumagalli, S; Masotti, G

    1999-06-01

    The prevalence of heart failure (HF) increases with age, and HF is a major cause of disability and mortality in older persons. Detection of HF in epidemiological studies has relied on criteria validated only in young and middle-age adults, and, therefore, may prove inadequate in older subjects, because they do not take into account the pathophysiologic and clinical peculiarities of HF in old age. Thus, the true prevalence of HF in the older general population remains uncertain and has probably been underestimated in previous studies. Moreover, the mechanism and the extent by which HF hinders physical functioning in older people has not been fully elucidated. This paper describes the design of the ICARe study, carried out in an older home-dwelling population to collect data about: (1) the sensitivity and specificity of diagnostic criteria used previously in epidemiological studies of HF; (2) the prevalence of the different pathophysiologic forms of HF; and (3) the impact of HF on overall health status, and on physical functioning, in the absence or presence of chronic comorbidity. This was a cross-sectional survey. Eligible were all community-dwelling persons aged 65 years or older recorded in the Registry Office of Dicomano, a small town nearby Florence (Italy). All the domains of multidimensional geriatric assessment were explored through different phases of the study (home interview, laboratory testing, geriatric visit) that comprised an extensive cardiopulmonary instrumental assessment including: color Doppler echocardiography, echotomography of the carotid arteries used in an original method to determine arterial compliance, and bell spirometry. Presence of major chronic conditions was ascertained by predefined, standard algorithms that were based largely on clinical examination. There were 864 older persons eligible for the ICARe study. Even with a substantial decline from home interview (91.2%) to the cardiopulmonary study (71.1%), the adherence rate remained

  1. Body Composition Outcomes of a Qigong Intervention Among Community-Dwelling Aging Adults.

    Science.gov (United States)

    Chang, Mei-Ying; Chen, Hsiao-Yu

    2016-12-01

    Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.

  2. Older adults challenged financially when adult children move home.

    Science.gov (United States)

    Wallace, Steven P; Padilla-Frausto, D Imelda

    2014-02-01

    This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that older adults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income older adults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of older adults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs.

  3. Reference values and age and sex differences in physical performance measures for community-dwelling older Japanese: a pooled analysis of six cohort studies.

    Directory of Open Access Journals (Sweden)

    Satoshi Seino

    Full Text Available OBJECTIVES: To determine age- and sex-specific reference values for six physical performance measures, i.e. hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces, and to investigate age and sex differences in these measures among community-dwelling older Japanese adults. METHODS: We conducted a pooled analysis of data from six cohort studies collected between 2002 and 2011 as part of the Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older (2168 men, 2515 women; mean age: 74.0 years in men and 73.9 years in women. RESULTS: Unweighted simple mean (standard deviation hand-grip strength, one-legged stance, usual gait speed, usual gait step length, maximum gait speed, and maximum gait step length were 31.7 (6.7 kg, 39.3 (23.0 s, 1.29 (0.25 m/s, 67.7 (10.0 cm, 1.94 (0.38 m/s, and 82.3 (11.6 cm, respectively, in men and 20.4 (5.0 kg, 36.8 (23.4 s, 1.25 (0.27 m/s, 60.8 (10.0 cm, 1.73 (0.36 m/s, and 69.7 (10.8 cm, respectively, in women. All physical performance measures showed significant decreasing trends with advancing age in both sexes (all P<0.001 for trend. We also constructed age- and sex-specific appraisal standards according to quintiles. With increasing age, the sex difference in hand-grip strength decreased significantly (P<0.001 for age and sex interaction. In contrast, sex differences significantly increased in all other measures (all P<0.05 for interactions except step length at maximum pace. CONCLUSION: Our pooled analysis yielded inclusive age- and sex-specific reference values and appraisal standards for major physical performance measures in nondisabled, community-dwelling, older Japanese adults. The characteristics of age-related decline in physical performance measures differed between sexes.

  4. A 9-Week Jaques-Dalcroze Eurhythmics Intervention Improves Single and Dual-Task Gait Speed in Community-Dwelling Older People.

    Science.gov (United States)

    Ferguson-Stegall, Lisa; Vang, Mandy; Wolfe, Anthony S; Thomsen, Kathy M

    2017-09-01

    Falls are a major public health concern among older adults, and most occur while walking, especially under dualtask conditions. Jaques-Dalcroze eurhythmics (JDE) is a music-based movement training program that emphasizes multitask coordinated movement. A previous 6-mo JDE study in older people demonstrated improved gait and balance; however, the effects of short-term JDE interventions on fall risk-related outcomes are largely unknown. We conducted a preliminary investigation on whether a 9-week JDE intervention improved gait and stability in a community-dwelling older cohort, hypothesizing that improvements would occur in all outcome measures. Nine participants (78.9 ± 12.3 y) completed the supervised JDE intervention (once/week for 60 min). Gait speed was determined by the 6-m timed walk test (6MTW); dual-task gait speed was determined by another 6MTW while counting backward from 50 aloud; and coordinated stability was assessed using a Swaymeter-like device. Gait speed (0.92 ± 0.11 vs 1.04 ± 0.12 m/sec, P = .04) and dual-task gait speed (0.77 ± 0.09 vs 0.92 ± 0.11 m/sec, P = .0005) significantly improved. This novel intervention is an effective short-term physical activity option for those that plan physical activity or fall-risk reduction programs for the older people.

  5. Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition

    Directory of Open Access Journals (Sweden)

    Tomstad ST

    2012-12-01

    Full Text Available Solveig T Tomstad,1,2 Ulrika Söderhamn,2 Geir Arild Espnes,3 Olle Söderhamn21Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, Norway; 2Centre for Caring Research – Southern Norway, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition.Aim: The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition.Methods: Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method.Findings: Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life

  6. Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults

    DEFF Research Database (Denmark)

    Shah, Amil M; Claggett, Brian; Kitzman, Dalane

    2017-01-01

    BACKGROUND: Although age-associated changes in left ventricular diastolic function are well recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values for in...

  7. Older and Wiser: Adult Learning and Ethnic Minority Elders.

    Science.gov (United States)

    Dadzie, Stella

    1993-01-01

    The British "Older and Wiser" project demonstrated the need for educational opportunities for older adults from minority groups. The double barriers of ageism and racism faced by these adults must be addressed. (SK)

  8. Could Obesity Undermine Memory Training in Older Adults?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163198.html Could Obesity Undermine Memory Training in Older Adults? Study adds ... training is less beneficial for older adults with obesity, but we really don't know why," said ...

  9. Older Adults and Drinking | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Rethinking Drinking Older Adults and Drinking Past Issues / Spring 2014 Table of ... quickly than when they were younger. Drinking puts older adults at greater risk for falls, car crashes, and ...

  10. What Older Adults Need to Know about Retail Clinics

    Science.gov (United States)

    What Older Adults Need to Know about Retail Clinics Expert Information from Healthcare Professionals Who Specialize in the Care of Older Adults Retail clinics are medical clinics based in pharmacies, supermarkets, ...

  11. Cognitive Impairment and Disability in Older Japanese Adults.

    Directory of Open Access Journals (Sweden)

    Hiroyuki Shimada

    Full Text Available The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23 with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs, MCIs with GCI, MCI multiple domain (MCIm, and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8% experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs were determined: MCIs (HR, 2.04; 95% CI, 1.39-3.00, MCIs with GCI (HR, 2.10; 95% CI, 1.21-3.62, MCIm (HR, 2.32; 95% CI, 1.39-3.85, and MCIm with GCI (HR, 4.23; 95% CI, 2.73-6.57. These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons.

  12. Cognitive Impairment and Disability in Older Japanese Adults.

    Science.gov (United States)

    Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Suzuki, Takao

    2016-01-01

    The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years) enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs), MCIs with GCI, MCI multiple domain (MCIm), and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8%) experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs) were determined: MCIs (HR, 2.04; 95% CI, 1.39-3.00), MCIs with GCI (HR, 2.10; 95% CI, 1.21-3.62), MCIm (HR, 2.32; 95% CI, 1.39-3.85), and MCIm with GCI (HR, 4.23; 95% CI, 2.73-6.57). These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons.

  13. Chronic Eccentric Exercise and the Older Adult.

    Science.gov (United States)

    Gluchowski, Ashley; Harris, Nigel; Dulson, Deborah; Cronin, John

    2015-10-01

    Eccentric exercise has gained increasing attention as a suitable and promising intervention to delay or mitigate the known physical and physiological declines associated with aging. Determining the relative efficacy of eccentric exercise when compared with the more conventionally prescribed traditional resistance exercise will support evidence-based prescribing for the aging population. Thus, original research studies incorporating chronic eccentric exercise interventions in the older adult population were included in this review. The effects of a range of eccentric exercise modalities on muscular strength, functional capacity, body composition, muscle architecture, markers of muscle damage, the immune system, cardiovascular system, endocrine system, and rating of perceived exertion were all reviewed as outcomes of particular interest in the older adult. Muscular strength was found to increase most consistently compared with results from traditional resistance exercise. Functional capacity and body composition showed significant improvements with eccentric endurance protocols, especially in older, frail or sedentary cohorts. Muscle damage was avoided with the gradual progression of novel eccentric exercise, while muscle damage from intense acute bouts was significantly attenuated with repeated sessions. Eccentric exercise causes little cardiovascular stress; thus, it may not generate the overload required to elicit cardiovascular adaptations. An anabolic state may be achievable following eccentric exercise, while improvements to insulin sensitivity have not been found. Finally, rating of perceived exertion during eccentric exercise was often significantly lower than during traditional resistance exercise. Overall, evidence supports the prescription of eccentric exercise for the majority of outcomes of interest in the diverse cohorts of the older adult population.

  14. Life satisfaction and frailty among older adults

    Directory of Open Access Journals (Sweden)

    Katarina Wilhelmson

    2013-09-01

    Full Text Available Functional and physical impairment are factors believed to lead to declined life satisfaction among older adults. This study aimed to examine life satisfaction among older adults and the influence of frailty. Baseline data from two studies addressing frail older adults aged 80+ in Gothenburg, Sweden, (n=577 were used. Frailty was measured through eight indicators. Life satisfaction was measured with Fugl-Meyer’s instrument LiSat-11. Perceived life satisfaction was rather high within the studied population, with 66% being satisfied with life as a whole. Most life satisfaction items were significantly associated with frailty status, with non-frail participants being satisfied to a higher extent for all items with the exception of financial situation, sexual life and partnership relation. The factors significantly explaining life satisfaction were psychological health, partner relationship, leisure and ADL. This study shows that older adults’ satisfaction with life as a whole is almost as high as in younger age groups. Respondents with higher degree of frailty reported significantly lower degrees of life satisfaction, indicating a possibility to maintain life satisfaction by preventing or delaying the development of frailty.

  15. Multimorbidity Combinations and Disability in Older Adults.

    Science.gov (United States)

    Quiñones, Ana R; Markwardt, Sheila; Botoseneanu, Anda

    2016-06-01

    Multimorbidity (multiple co-occurring chronic diseases) is associated with greater likelihood of disability and mortality, above and beyond the risk attributable to individual diseases. This study identifies prevalent multimorbidity patterns and evaluates their association with disability among U.S. older adults. Prospective cohort study using longitudinal Health and Retirement Study data (2010-2012). We included 8,782 participants aged 65 years and older and used negative binomial models to examine prospective disability, measured by the combined activities of daily living-instrumental activities of daily living index. Multimorbidity was defined as the co-occurring combination of at least two of the following chronic diseases: hypertension, cardiovascular disease, lung disease, diabetes, cancer, arthritis, stroke, cognitive impairment, or high depressive symptoms (CES-D score ≥ 4). We found 291 unique disease combinations with 1 to 1,167 older adults per disease combination. The three most prevalent combinations were: (a) hypertension and arthritis (n = 1,167); (b) hypertension, arthritis, and cardiovascular disease (n = 510); and (c) hypertension, arthritis, and diabetes (n = 430). Only one of the prevalent combinations included depressive symptoms (in combination with arthritis, hypertension; n = 129). This group showed the highest level of activities of daily living-instrumental activities of daily living disability compared to healthy participants or participants with a single disease (either included in the combination or different from diseases in the combination) even after adjusting for age, gender, education, race/ethnicity, and body mass index. Clinicians stand to gain from a better understanding of which disease combinations are more and less disabling among older adults. Understanding how multimorbidity combinations relate to functional status is an important step towards reducing disability and sustaining independent living among older adults.

  16. Child's play: the creativity of older adults.

    Science.gov (United States)

    Capps, Donald

    2012-09-01

    In this article, I discuss Paul W. Pruyser's view presented in his article "An Essay on Creativity" (Pruyser in Bull Menninger Clin 43:294-353, 1979) that creative persons manifest early childhood qualities of playfulness, curiosity, and pleasure seeking and that adaptation is itself a form of creativity. I then discuss his article "Creativity in Aging Persons" (Pruyser in Bull Menninger Clin 51:425-435, 1987) in which he presents his view that aging itself is a potentially creative process, that creativity among older adults is not limited to the talented few, and that older adulthood has several specific features that are conducive to creativity. Significant among these features are object loss (especially involving human relationships) and functional loss (due to the vicissitudes of aging). Noting his particular emphasis on object loss and its role in late-life creativity, I focus on functional loss, and I emphasize the importance of adaptation in sustaining the creativity of older adults who experience such loss. I illustrate this adaptation by considering well-known painters who in late life suffered visual problems common to older adults. I suggest that in adapting to their visual problems these artists drew on the early childhood qualities (playfulness, curiosity and pleasure seeking) that all creative persons possess and that they are therefore illustrative for other older adults who are experiencing functional losses. I conclude with Erik H. Erikson's (Toys and reasons: stages in the ritualization of experience, W. W. Norton, New York, 1977) and Paul W. Pruyser's (Pastor Psychol 35:120-131, 1986) reflections on the relationship between seeing and hoping.

  17. Drug-Alcohol Interactions Among Older Adults in the United States

    Science.gov (United States)

    Qato, Dima M.; Manzoor, Beenish S.; Lee, Todd

    2015-01-01

    Objectives The older adult population in the United States (U.S.) uses multiple medications and more than half of older adults drink alcohol regularly. In addition, older adults are more likely to experience adverse effects of medications and alcohol consumption may put them at higher risk. Our primary objective is to characterize the extent and nature of drug-alcohol interactions among older adults in the U.S. Design, Setting, Participants, Measurements We used a nationally-representative population-based sample of community-dwelling older adults in the U.S. Regular drinkers were defined as respondents that consumed alcohol at least weekly. Medication use was defined as the use of a prescription or non-prescription medication or dietary supplement at least daily or weekly. Micromedex was used to determine drug interactions with alcohol and their corresponding severity. Results Among the 2,975 older adults in the sample, more than 41% (N=1106) consume alcohol regularly and more than 20% (N=567) are at-risk for a drug-alcohol interaction because they are regular drinkers and concurrently using alcohol interacting medications. More than 90% of these interactions were of moderate or major severity. Antidepressants and analgesics were the most commonly used alcohol-interacting medications among regular drinkers. Older adult men with multiple chronic conditions had the highest prevalence of potential drug-alcohol interactions. Conclusion The potential for drug-alcohol interactions among the older adult population in the U.S. may have important clinical implications. Efforts to better understand and prevent the use of alcohol-interacting medications among regular drinkers, particularly heavy drinkers, are warranted in this population. PMID:26503899

  18. Guardianship primavera: a first look at factors associated with having a legal guardian using a nationally representative sample of community-dwelling adults.

    Science.gov (United States)

    Reynolds, S L

    2002-05-01

    Although guardianship is an intrusive intervention that usually removes an adult's basic civil rights, studies of factors that place adults at risk for guardianship have largely been based on small studies of court files. While important and informative, these studies do not allow us to draw anything but tentative conclusions on risk factors for guardianship. The purpose of this article is to examine risk factors for having a legal guardian using a nationally representative sample for the first time. Logistic regression was conducted on the probability of having a legal guardian, using the Andersen model of health care utilization adapted for factors implied by the guardianship literature. The National Health Interview Supplement on Disability (1995) sample consisted of 65,013 adults aged 19 and older, and a sub-sample aged 60 and older (n = 13,784). Results indicate, first, that the prevalence of guardianship in community-dwelling adults is 0.3 percent, or over 750,000 people. Second, particularly for older adults, increasing age, having physical or emotional limitations, a small family network, and not living with a spouse are associated with having a guardian. Decreasing size of family networks and increasing marital disruption in future cohorts of older adults may suggest increasing need for legal guardianship. Further study should be conducted to replicate these findings in other large data sets and in extensive community studies.

  19. 蒙特利尔认知评估量表北京版在沈阳市社区老年人群中的初步应用%A preliminary study of the application of Montreal Cognitive Assessment Beijing version in community dwelling older adults residing in Shenyang

    Institute of Scientific and Technical Information of China (English)

    孙宇任; 安畅; 何伟; 朱宇章; 刘盈

    2012-01-01

    Objective To assess the value of the Beijing version of Montreal Cognitive Assessment ( MoCA) in community dwelling older adults residing in Shenyang,China.Methods The stratified random sampling method was used to investigate the population over 60 years old in 4 communities of Shenyang in the year 2011.Mini-Mental State Examination (MMSE) and the Beijing version of MoCA were administered to all participants.258 old people finished the assessment.Results The internal consistency of the MoCA Beijing version was good,yielding a Cronbach alpha of 0.836.The correlation between the MoCA Beijing version and the MMSE was good(r=0.623,P<0.001 ).Only 15.1% participants had an education of over 12 years,but 26.3% participants had an education of 6 years or less.Only 3 items of MoCA Beijing version ( naming lion,forward digit span,recall daisy) showed no significant difference between persons with and without over 6 years of education.Conclusions The results indicates that the Beijing version of MoCA have good reliability and validity.This study shows that an education of 6 years or less might be the proper population to add the one point in China,and the cutoff-point of 26 for normal is too high for Chinese population.%目的 研究蒙特利尔认知评估量表(MoCA)北京版在沈阳市社区老年人群中应用的可行性以及量表的不足之处.方法 于2011年在沈阳市4个社区采用MoCA北京版与简易精神状态检查量表(MMSE)对258例社区老年人进行认知功能测评.结果 MoCA北京版的Cronbach's α为0.836,MoCA北京版与M MSE评定结果高度相关(r=0.623,P<0.01).受访者受教育程度>12年者仅占15.1%,≤6年者占26.3%,若以受教育程度≤6年分界,仅有命名狮子、顺背数字、回忆菊花3个题目的得分差异无统计学意义.结论北京版MoCA量表对社区老年人认知功能的筛查是简便可行的,建议将加分教育程度界点调整为≤6年;“总分26 ~30分为正常”的评判标准过高.

  20. Prevalence and sociodemographic characteristics associated with benzodiazepines use among community dwelling older adults: the Bambuí Health and Aging Study (BHAS Prevalência e características sociodemográficas associadas ao uso de benzodiazepínicos por idosos residentes na comunidade: projeto Bambuí

    Directory of Open Access Journals (Sweden)

    Jussara Mendonça Alvarenga

    2008-03-01

    Full Text Available OBJECTIVES: To assess the prevalence and sociodemographic characteristics associated with benzodiazepine use among community-dwelling older adults. METHOD: 1606 subjects, aged > 60 years, corresponding to 92% of the residents of Bambuí city, participated in this study. The information about medication use was obtained by means of a standard interview and the review of medication packaging. Substances were classified using the Anatomical Therapeutic Chemical Index. RESULTS: The prevalence of benzodiazepine current use was 21.7% (26.7% among females and 14.0% among males. From these, 68.7% had been taking the medication for over one year, 31.3% for over five years and 53.2% were using long half-life benzodiazepines. The medication most frequently used was bromazepam (35.6%, followed by diazepam (22.5%, clonazepam (12.6% and lorazepam (7.8%. After adjustment for confounders, female gender (RP = 1.93; CI95% = 1.51-2.46 was the only sociodemographic characteristic found to be independently associated with substance consumption. CONCLUSIONS: The prevalence of benzodiazepine use in the study population was high, but within the variation observed in developed countries. Chronic use of benzodiazepines and long half-life medications predominated.OBJETIVOS: Determinar a prevalência e características sociodemográficas associadas ao uso de benzodiazepínicos entre idosos residentes na comunidade. MÉTODO: Participaram deste estudo transversal 1.606 indivíduos, que correspondem a 92% do total de residentes na cidade de Bambuí-MG com idade > 60 anos. As informações sobre uso de medicamentos foram obtidas por meio de entrevista padronizada e verificação da embalagem. A classificação do princípio ativo foi baseada no Anatomical Therapeutic Chemical Index. RESULTADOS: A prevalência do uso de benzodiazepínicos foi de 21,7% (26,7% entre as mulheres e 14,0% entre os homens; 68,7% faziam uso do medicamento há pelo menos um ano, 31,3% há pelo menos

  1. The Mental Health of Older LGBT Adults.

    Science.gov (United States)

    Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

    2016-06-01

    There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.

  2. Reviewing and Critiquing Computer Learning and Usage among Older Adults

    Science.gov (United States)

    Kim, Young Sek

    2008-01-01

    By searching the keywords of "older adult" and "computer" in ERIC, Academic Search Premier, and PsycINFO, this study reviewed 70 studies published after 1990 that address older adults' computer learning and usage. This study revealed 5 prominent themes among reviewed literature: (a) motivations and barriers of older adults' usage of computers, (b)…

  3. Older adults' reasons for using technology while aging in place

    NARCIS (Netherlands)

    Sebastiaan T.M. Peek; Katrien G. Luijkx; Claire S. van der Voort; Sil Aarts; Maurice D. Rijnaard; Marianne E. Nieboer; Joost van Hoof; Hubertus J.M. Vrijhoef; Eveline J.M. Wouters

    2015-01-01

    Background: Most older adults prefer to age in place, and supporting older adults to remain in their own homes and communities is also favored by policy makers. Technology can play a role in staying independent, active and healthy. However, the use of technology varies considerably among older adult

  4. Effects of a Forgiveness Intervention for Older Adults

    Science.gov (United States)

    Allemand, Mathias; Steiner, Marianne; Hill, Patrick L.

    2013-01-01

    The authors' aim in the present study was to examine the effects of a brief forgiveness intervention for older adults. The psychoeducational group intervention consists of (a) established core components of previous forgiveness interventions and (b) additional components considering specific needs of older adults. Seventy-eight older adults (mean…

  5. Why few older adults participate in complex motor skills: a qualitative study of older adults' perceptions of difficulty and challenge

    National Research Council Canada - National Science Library

    Kraft, Katarina P; Steel, Kylie A; Macmillan, Freya; Olson, Rebecca; Merom, Dafna

    2015-01-01

    ...) were conducted with older adults (aged 61-92 years; N = 36) using a semi-structured question guide, to explore older adults' perceptions of difficulty and challenges associated with physical activity types...

  6. The relationships between serum fructosamine concentrations and lipid profiles in community-dwelling adults.

    Science.gov (United States)

    Peng, You-Fan; Wei, Ye-Sheng

    2017-07-31

    We examined the epidemiological associations between serum fructosamine and dyslipidemia indices in community-dwelling adults. Clinical characteristics and lipid profiles were analyzed in 1352 community-dwelling adults. The demographic characteristics and laboratory results were grouped according to the quartiles of serum fructosamine concentrations in all eligible individuals. From the bottom to the top quartile of serum fructosamine, there were graded increases in age, total cholesterol (TC), fasting blood glucose (FBG), total protein (TP), triglyceride (TG), total cholesterol/ high density lipoprotein-cholesterol (TC/HDL-C) and atherogenic index of plasma (AIP). Serum fructosamine was positive correlated with age, TC, FBG, TP, TG, TC/HDL-C and AIP in whole individuals. The positive correlations were then observed in both genders between serum fructosamine and TC, FBG, TP, TG. Two dominant factors were identified by principal component analysis. Logistic regression analysis showed that the two factors were associated with increased serum fructosamine with adjustment for gender, age, body mass index (BMI), FBG and TP. The similar results were observed in males, but not in females. Dyslipidemia tends to contribute to increased serum fructosamine concentrations in study population, suggesting that elevated serum fructosamine may herald an increased risk of cardiovascular disease among community-dwelling adults, especially in males.

  7. Opinions of dentists on the barriers in providing oral health care to community-dwelling frail older people: a questionnaire survey

    NARCIS (Netherlands)

    Bots-VantSpijker, P.C.; Bruers, J.J.M.; Bots, C.P.; Vanobbergen, J.N.O.; De Visschere, L.M.J.; de Baat, C.; Schols, J.M.G.A.

    2016-01-01

    Objective: The aim of this study was to investigate to what extent dentists in the Netherlands experience barriers in providing oral health care to community-dwelling older people. Background: As most publications on the barriers in providing oral health care to older people consist of surveys on or

  8. The 24-h distribution of falls and person-hours of physical activity in the home are strongly associated among community-dwelling older persons

    NARCIS (Netherlands)

    Wijlhuizen, G.J.; Chorus, A.M.J.; Hopman-Rock, M.

    2008-01-01

    Objectives: Most research on falls among older persons focuses on health-related factors that affect the ability to maintain balance. The objective of the study is to determine the association between physical activity and occurrence of falls among community-dwelling older persons. Methods: The dist

  9. Astrophysics for Older adults in Chicago.

    Science.gov (United States)

    Grin, Daniel; Landsberg, Randall H.; Flude, Karen

    2017-01-01

    Gerontology research continues to show that the adage "Use it or Lose it" is a clinical fact when it comes to cognitive engagement post-retirement. Here, I'll discuss a new program developed at the Kavli Institute for Cosmological Physics, bringing classes on astrophysics to older adults throughout the city, at retirement homes, at senior center, and at public libraries, bookended by an engaging trip to the Adler Planetarium. In my presentation, I'll present the gerontological and policy motivations for this program, the presenter training techniques, our partner collaboration strategy, and the results of our effort, which engaged hundreds of older adults throughout Chicago from a variety of socioeconomic strata.

  10. Perception of older adults receiving palliative care

    Directory of Open Access Journals (Sweden)

    Fernanda Laporti Seredynskyj

    2014-06-01

    Full Text Available The present study aimed at understanding the perception of older adults who are receiving palliative oncological care on self care in relation to different stages of the disease and how such perception affected their lives. This is a qualitative study using oral history conducted with 15 older adults receiving palliative chemotherapy treatment in a health institution. The following categories emerged: social network, perspectives for confronting life, changes and spirituality. It is necessary for nursing staff to understand this process so that the measures implemented take into account all of the implications of the disease and aim at improving quality of life.   doi: 10.5216/ree.v16i2.22795.

  11. Risk Factors for Urosepsis in Older Adults

    Directory of Open Access Journals (Sweden)

    Brian C. Peach MSN

    2016-04-01

    Full Text Available Objective: To identify factors that predispose older adults to urosepsis and urosepsis-related mortality. Method: A systematic search using PubMed and CINAHL databases. Articles that met inclusion criteria were assessed using the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE criteria and were scored on a 4-point Likert-type scale. Results: A total of 180 articles were identified, and six met inclusion criteria. The presence of an internal urinary catheter was associated with the development of urosepsis and septic shock. Although a number of factors were examined, functional dependency, number of comorbidities, and low serum albumin were associated with mortality across multiple studies included in this review. Discussion: Little scientific evidence is available on urosepsis, its associated risk factors, and those factors associated with urosepsis-related mortality in older adults. More research is warranted to better understand urosepsis in this vulnerable population in an effort to improve the quality of patient care.

  12. Polypharmacy in Older Adults with Cancer

    Science.gov (United States)

    Maggiore, Ronald J.; Gross, Cary P.

    2010-01-01

    The definition of “polypharmacy” ranges from the use of a large number of medications; the use of potentially inappropriate medications, which can increase the risk for adverse drug events; medication underuse despite instructions to the contrary; and medication duplication. Older adults are particularly at risk because they often present with several medical conditions requiring pharmacotherapy. Cancer-related therapy adds to this risk in older adults, but few studies have been conducted in this patient population. In this review, we outline the adverse outcomes associated with polypharmacy and present polypharmacy definitions offered by the geriatrics literature. We also examine the strengths and weaknesses of these definitions and explore the relationships among these definitions and what is known about the prevalence and impact of polypharmacy. PMID:20418534

  13. Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition

    Directory of Open Access Journals (Sweden)

    Muntinga Maaike E

    2012-04-01

    Full Text Available Abstract Background Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care professionals. We aim to address these challenges by introducing the geriatric care model, based on the chronic care model, and to evaluate its effects on the quality of life of community-dwelling frail older adults. Methods/design In a 2-year stepped-wedge cluster randomised clinical trial with 6-monthly measurements, the chronic care model will be compared with usual care. The trial will be carried out among 35 primary care practices in two regions in the Netherlands. Per region, practices will be randomly allocated to four allocation arms designating the starting point of the intervention. Participants: 1200 community-dwelling older adults aged 65 or over and their primary informal caregivers. Primary care physicians will identify frail individuals based on a composite definition of frailty and a polypharmacy criterion. Final inclusion criterion: scoring 3 or more on a disability case-finding tool. Intervention: Every 6 months patients will receive a geriatric in-home assessment by a practice nurse, followed by a tailored care plan. Expert teams will manage and train practice nurses. Patients with complex care needs will be reviewed in interdisciplinary consultations. Evaluation: We will perform an effect evaluation, an economic evaluation, and a process evaluation. Primary outcome is quality of life as measured with the Short Form-12 questionnaire. Effect analyses will be based on the “intention-to-treat” principle, using multilevel regression analysis. Cost measurements will be administered continually during the study period. A cost-effectiveness analysis and cost-utility analysis will be conducted comparing mean total costs to functional

  14. Recognition of dementia in hospitalized older adults.

    Science.gov (United States)

    Maslow, Katie; Mezey, Mathy

    2008-01-01

    Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.

  15. Chronic use of benzodiazepines among older adults

    Directory of Open Access Journals (Sweden)

    Jussara Mendonça Alvarenga

    2014-12-01

    Full Text Available OBJECTIVE To analyze the perception of and motivation for the chronic use of benzodiazepine among older adults. METHODS A qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the “signs, meanings, and actions” model. RESULTS The main reasons pointed out for the use of benzodiazepines were “nervousness”, “sleep problems”, and “worry” due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems. CONCLUSIONS Benzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life’s problems in old age. Although it relieves the “nerves”, the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population.

  16. Osteoporosis Screening Preferences of Older Adults

    OpenAIRE

    Nayak, Smita; Roberts, Mark S.; Greenspan, Susan L

    2009-01-01

    We aimed to examine older adults' osteoporosis screening test preferences, willingness to travel for screening, and willingness to pay for screening. A survey was mailed to 1830 women and men ≥ 60 years old in Pennsylvania, assessing screening test preference (among dual-energy x-ray absorptiometry (DXA), heel quantitative ultrasound (QUS), and risk assessment tools), willingness to travel 20 miles for a better screening test, and willingness to pay $100 for a better screening test, as well a...

  17. Dental Hygiene Students’ Perceptions of Older Adults

    Science.gov (United States)

    Wiener, R. Constance; Shockey, Alcinda Trickett; Long, D. Leann

    2015-01-01

    Geriatric education is an important component of the dental hygiene curriculum because, in it, students acquire skills and attitudes to help provide quality care to older adults. The purpose of this study was to determine if off-site exposure to nursing home residents with supervised oversight had the potential to improve dental hygiene students’ attitudes toward older adults. Senior dental hygiene students at one school completed a pre-nursing home experience questionnaire. A series of geriatric lectures and discussions, which included discussions about students’ anxieties of working with institutionalized older adults, were held prior to the nursing home experience. The students then participated in two supervised four-hour nursing home experiences, were debriefed after the experiences, and completed a second questionnaire. Of thirty-nine potential participants in the study, thirty-two took part in the pre-nursing home experience questionnaire (82.1 percent). They had a mean split Fabroni score of 34.2 (95 percent confidence interval: 32.2, 36.3). The thirty participants in the post-experience questionnaire (76.9 percent of total) had a mean split score of 32.7 (95 percent confidence interval: 30.1, 35.3). This study failed to reject the null hypothesis of no mean difference between the pre- and post-nursing home experience; however, the post-experience mean score was lower than the pre-nursing home experience mean score, indicating a more positive attitude toward older adults after the experience. PMID:25480277

  18. Treatment of specific phobia in older adults

    OpenAIRE

    Pachana, Nancy A; Rana M Woodward; Gerard JA Byrne

    2007-01-01

    Nancy A Pachana1, Rana M Woodward1, Gerard JA Byrne21School of Psychology, University of Queensland, Brisbane, Australia 2School of Medicine, University of Queensland, Brisbane, AustraliaAbstract: Phobias are common in later life, yet treatment research in this population remains scant. The efficacy of exposure therapy, in combination with other Cognitive-Behavioral Therapy (CBT) components, in the treatment of specific phobia with a middle and older aged sample was examined. Sixteen adults a...

  19. Normative Spatiotemporal Gait Parameters in Older Adults

    OpenAIRE

    Hollman, John H; McDade, Eric M.; Petersen, Ronald C.

    2011-01-01

    While factor analyses have characterized pace, rhythm and variability as factors that explain variance in gait performance in older adults, comprehensive analyses incorporating many gait parameters have not been undertaken and normative data for many of those parameters are lacking. The purposes of this study were to conduct a factor analysis on nearly two dozen spatiotemporal gait parameters and to contribute to the normative database of gait parameters from healthy, able-bodied men and wome...

  20. Influences on Neighborhood Walking in Older Adults

    OpenAIRE

    Gallagher, Nancy Ambrose; Clarke, Philippa J.; Ronis, David L.; Cherry, Carol Loveland; Nyquist, Linda; Gretebeck, Kimberlee A.

    2012-01-01

    The purpose of this cross-sectional survey study was to examine the influence of self-efficacy, outcome expectations and environment on neighborhood walking in older adults with (n=163, mean age=78.7, SD=7.96 years) and without (n=163, mean age=73.6, SD=7.93 years) mobility limitations (controlling for demographic characteristics). Measures included: Neighborhood Physical Activity Questionnaire, Multidimensional Outcome Expectations for Exercise Scale, Neighborhood Environment Walkability Sca...

  1. Chronic use of benzodiazepines among older adults.

    Science.gov (United States)

    Alvarenga, Jussara Mendonça; Giacomin, Karla Cristina; Loyola Filho, Antônio Ignácio de; Uchoa, Elizabeth; Firmo, Josélia Oliveira Araújo

    2014-12-01

    OBJECTIVE To analyze the perception of and motivation for the chronic use of benzodiazepine among older adults. METHODS A qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the "signs, meanings, and actions" model. RESULTS The main reasons pointed out for the use of benzodiazepines were "nervousness", "sleep problems", and "worry" due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems. CONCLUSIONS Benzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life's problems in old age. Although it relieves the "nerves", the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population.

  2. Protection motivation theory and alcohol use attitudes among older adults.

    Science.gov (United States)

    Runge, C; Prentice-Dunn, S; Scogin, F

    1993-08-01

    Responses of 17 elderly persons and 20 VA inpatients with alcohol-abuse problems (all 60 yr. or older) to an Alcohol Attitude Survey administered by telephone and interview were examined. Inpatients felt more vulnerable, perceived higher costs in moderating drinking, and showed lower response efficacy. Inpatients consumed substantially more alcohol than the community-dwelling elders. Hypotheses for study were generated.

  3. Treatment of specific phobia in older adults

    Directory of Open Access Journals (Sweden)

    Nancy A Pachana

    2007-10-01

    Full Text Available Nancy A Pachana1, Rana M Woodward1, Gerard JA Byrne21School of Psychology, University of Queensland, Brisbane, Australia 2School of Medicine, University of Queensland, Brisbane, AustraliaAbstract: Phobias are common in later life, yet treatment research in this population remains scant. The efficacy of exposure therapy, in combination with other Cognitive-Behavioral Therapy (CBT components, in the treatment of specific phobia with a middle and older aged sample was examined. Sixteen adults aged 45–68 with DSM-IV diagnosis of a specific phobia received a manualized intervention over ten weeks, and were compared with a control group. Results indicated significant time effects in the treatment group for the primary outcome variables of phobic severity and avoidance as well as secondary outcome variables including depression and anxiety. Symptom presence and severity also significantly declined in the treatment group. No significant changes in state anxiety were noted across the treatment period. Such results provide support for the efficacy of exposure combined with CBT treatment for specific phobia in middle to older aged adults.Keywords: anxiety, phobia, older adults, cognitive behavioral therapy

  4. Parental longevity correlates with offspring’s optimism in two cohorts of community-dwelling older subjects

    OpenAIRE

    Rius-Ottenheim, N.; Kromhout, D; de Craen, A. J. M.; Geleijnse, J.M.; Mast, Van der, R.C.; Zitman, F G; Westendorp, R. G.; Slagboom, E.; Giltay, E.J.

    2011-01-01

    Dispositional optimism and other positive personality traits have been associated with longevity. Using a familial approach, we investigated the relationship between parental longevity and offspring’s dispositional optimism among community-dwelling older subjects. Parental age of death was assessed using structured questionnaires in two different population-based samples: the Leiden Longevity Study (n = 1,252, 52.2% female, mean age 66 years, SD = 4) and the Alpha Omega Trial (n = 769, 22.8% ...

  5. Pain in Older Adults: Epidemiology, Impact and Barriers to Management

    OpenAIRE

    Schofield, Pat

    2007-01-01

    There will be increased numbers of older adults in society in the next few decades.Older adults are more likely to have pain problems and other co-morbidities.Generally pain is poorly managed in older adults and this becomes worse when cognitive impairment exists.The impact of chronic pain on older adults will be greater than that of their younger counterparts in terms of social isolation.Attitudes and barriers exist in both the older adults themselves and their younger counterparts.

  6. A causal model of depression among older adults in Chon Buri Province, Thailand.

    Science.gov (United States)

    Piboon, Kanchana; Subgranon, Rarcharneeporn; Hengudomsub, Pornpat; Wongnam, Pairatana; Louise Callen, Bonnie

    2012-02-01

    The purposes of this study are to develop and empirically test a theoretical model that examines the relationships between a set of predictors and depression among older adults. A biopsychosocial model was tested with 317 community dwelling older adults residing in Chon Buri Province, Thailand. A face-to-face interview was used in a cross-sectional community-based survey. A hypothesized model of depression was tested by using path analysis. It was found that the modified model fitted the data and the predictors accounted for 60% of the variance in depression. Female gender, activities of daily living, loneliness, stressful life events, and emotional-focused coping had a positive direct effect on depression. Social support and problem-focused coping had a negative direct effect on depression. Additionally, perceived stress, stressful life events, loneliness, and income had a negative indirect effect on depression through social support. Female gender, activities of daily living, and perceived stress also had a positive indirect effect on depression through emotional-focused coping. Stressful life events, perceived stress, and income had a negative indirect effect on depression through problem-focused coping. These findings contribute to a better understanding of the variables that predict depression in older adults. Thus, health care providers should consider the effects of these contributing factors on depression in the older adult person and can devise a program to prevent and promote health in older adults alleviating depression.

  7. Older, wiser, and happier? Comparing older adults' and college students' self-defining memories.

    Science.gov (United States)

    Singer, Jefferson; Rexhaj, Blerim; Baddeley, Jenna

    2007-11-01

    The present study compared self-defining memories in adults 50 years of age and older to the self-defining memories of college students. Findings are largely congruent with previous memory and ageing research, but shed additional light on how personal memories are employed to achieve a sense of identity and continuity in older adults. Older adults' self-defining memories, compared to those of younger adults, were more positive in emotional tone, more summarised and less detailed, and more likely to contain integrative meaning. The implications of these findings for assessing normative personal memory in older adults are discussed along with more general observations about narrative identity in older adulthood.

  8. Physical functions, health-related outcomes, nutritional status, and blood markers in community-dwelling cancer survivors aged 75 years and older.

    Science.gov (United States)

    Ihira, Hikaru; Mizumoto, Atsushi; Makino, Keitarou; Yasuda, Keisuke; Yoko, Yoko; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Furuna, Taketo

    2014-01-01

    A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of their life. The purpose of this study was to examine whether physical functions, health-related outcomes, nutritional status and blood markers in community-dwelling cancer survivors aged 75 years and older are different from those who do not have cancer Two hundred seventy-five participants were asked by physicians, nurses, and physical therapists, questions regarding cancer history in a face-to-face interview. Data were collected for demographic information, physical functions, such as handgrip strength, knee extension power, abdominal muscle strength, static standing balance, walking speed and the timed-up-and-go test, health-related outcomes, nutritional status, and blood markers. The measured parameters of survivor diagnosed with cancer were compared with those without a history of cancer. Thirty-seven older adults were previously diagnosed with cancer. Female cancer survivors had lower knee extension power (paged 75 years and older differs from that in women with no history of cancer.

  9. Gender differences in hypertension control among older korean adults: Korean social life, health, and aging project.

    Science.gov (United States)

    Chu, Sang Hui; Baek, Ji Won; Kim, Eun Sook; Stefani, Katherine M; Lee, Won Joon; Park, Yeong-Ran; Youm, Yoosik; Kim, Hyeon Chang

    2015-01-01

    Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

  10. The construct of financial capacity in older adults.

    Science.gov (United States)

    Caboral-Stevens, Meriam; Medetsky, Mark

    2014-08-01

    In the United States, older adults hold approximately 34% of the nation's wealth. The combination of wealth, cognitive decline, and impaired financial capacity is a growing challenge to our society. As America ages, one of the most pressing challenges facing older adults is living an independent and autonomous life. Financial capacity (FC) is one of the instrumental activities of daily living considered the single best predictor of capacity for independent living in older adults. FC issues arise when an older adult experiences cognitive loss or dementia. Therefore, the purposes of this article are to: (a) review the construct of FC focusing on older adults, (b) discuss the different models of FC, (c) describe ways to assess FC in older adults, (d) identify indicators of FC impairment in older adults, and (e) discuss implications for practice.

  11. Optimal management of ADHD in older adults

    Directory of Open Access Journals (Sweden)

    Torgersen T

    2016-01-01

    Full Text Available Terje Torgersen,1,2 Bjorn Gjervan,2,3 Michael B Lensing,4 Kirsten Rasmussen5,6 1Department of Østmarka, St Olav’s Hospital, 2Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 3Department of Psychiatry, Helse Nord-Trondelag Hospital Trust, Kirkegata, Levanger, 4NevSom, Norwegian Center of Expertise for Neurodevelopmental Disorders and Hypersomnias, Women and Children’s Division, Oslo University Hospital, Oslo, 5St Olav’s Hospital, Broset Center for Research and Education in Forensic Psychiatry, Trondheim, 6Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway Background: The manifestation of attention-deficit/hyperactivity disorder (ADHD among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed.Method: A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years.Results: ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should

  12. Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial

    OpenAIRE

    Spink, Martin J; Menz, Hylton B.; Fotoohabadi, Mohammad R; Wee, Elin; Landorf, Karl B.; Hill, Keith D; Stephen R Lord

    2011-01-01

    Objective To determine the effectiveness of a multifaceted podiatry intervention in preventing falls in community dwelling older people with disabling foot pain. Design Parallel group randomised controlled trial. Setting University health sciences clinic in Melbourne, Australia. Participants 305 community dwelling men and women (mean age 74 (SD 6) years) with disabling foot pain and an increased risk of falling. 153 were allocated to a multifaceted podiatry intervention and 152 to routine pod...

  13. Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people

    Directory of Open Access Journals (Sweden)

    Tomstad ST

    2012-03-01

    Full Text Available Solveig T Tomstad1, Ulrika Söderhamn2, Geir Arild Espnes3, Olle Söderhamn21Department of Social Work and Health Science, Faculty of Sciences and Technology Management, NTNU, Trondheim, Norway and Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 2Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, NorwayBackground: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people.Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues.Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years in southern Norway. The study group included 158 (35.1% participants. Data were analysed using statistical methods.Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help

  14. Nutritional Status and Habitual Dietary Intake Are Associated with Frail Skin Conditions in Community-Dwelling Older People.

    Science.gov (United States)

    Iizaka, S; Nagata, S; Sanada, H

    2017-01-01

    Prevention of frail skin is important in older people because frail skin is associated with a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual dietary intake with skin conditions in community-dwelling older people. Cross-sectional study. Three community settings in Japan from autumn to winter. Older people aged ≥65 years without care-need certification (n=118). Malnutrition and obesity were evaluated to assess the nutritional status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg. Multiple linear regression analysis was performed with adjustment for confounders. The mean (standard deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018) was associated with a lower SRRC score. Higher intakes of α-tocopherol (p=0.050) and vitamin C (p=0.017) were associated with increased dermal intensity. A body mass index ≥25 (p=0.016) was associated with decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated with a better skin condition. Plant fat, antioxidant vitamins, and a dietary pattern characterized by vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-dwelling older people.

  15. Older adults' reasons for using technology while aging in place

    NARCIS (Netherlands)

    Peek, S.T.M.; Luijkx, K.G.; Rijnaard, M.D.; Nieboer, M.; van der Voort, C.S.; Aarts, S.; van Hoof, J.; Vrijhoef, H.J.M.; Wouters, E.J.M.

    2016-01-01

    Background: Most older adults prefer to age in place, and supporting older adults to remain in their own homes and communities is also favored by policy makers. Technology can play a role in staying independent, active and healthy. However, the use of technology varies considerably among older

  16. Older adults' reasons for using technology while aging in place

    NARCIS (Netherlands)

    Katrien G. Luijkx; Claire S. van der Voort; Sil Aarts; Maurice D. Rijnaard; Marianne E. Nieboer; Joost van Hoof; Hubertus J.M. Vrijhoef; Eveline J.M. Wouters; Sebastiaan T.M. Peek

    2015-01-01

    Background: Most older adults prefer to age in place, and supporting older adults to remain in their own homes and communities is also favored by policy makers. Technology can play a role in staying independent, active and healthy. However, the use of technology varies considerably among older

  17. Organizational Support and Volunteering Benefits for Older Adults

    Science.gov (United States)

    Tang, Fengyan; Choi, Eunhee; Morrow-Howell, Nancy

    2010-01-01

    Purpose: This study tested a theoretical model of volunteering benefits and examined the mechanism through which volunteering benefits older adults. Design and Methods: This is a 2-wave study of 253 older adult volunteers serving in 10 volunteer programs. Older volunteers completed the mailed surveys in 2005 and 2006. Structural equation modeling…

  18. Explicit Instruction, Bilingualism, and the Older Adult Learner

    Science.gov (United States)

    Cox, Jessica G.

    2017-01-01

    Little is known about older adult language learners and effects of aging on L2 learning. This study investigated learning in older age through interactions of learner-internal and -external variables; specifically, late-learned L2 (bilingualism) and provision of grammar explanation (explicit instruction, EI). Forty-three older adults (age 60+) who…

  19. Cultural Diversity Among Older Adults: Addressing Health Education

    Science.gov (United States)

    Haber, David

    2005-01-01

    The diversity of the older adult population is increasing, and health professionals need to learn new knowledge and skills to improve the adherence of older ethnic clients to their health recommendations. Much of the existing research literature on diversity in gerontology concludes that ethnic older adults are at a health disadvantage. Few if any…

  20. Association between mild anemia and executive function impairment in community-dwelling older women: The Women's Health and Aging Study II.

    Science.gov (United States)

    Chaves, Paulo H M; Carlson, Michelle C; Ferrucci, Luigi; Guralnik, Jack M; Semba, Richard; Fried, Linda P

    2006-09-01

    To evaluate the relationship between mild anemia and executive function in community-dwelling older women. Cross-sectional. Community-based. High-functioning subjects participating in the baseline assessment of the Women's Health and Aging Study (WHAS) II, Baltimore, Maryland, 1994 to 1996. WHAS II eligibility criteria included aged 70 to 80, a Mini-Mental State Examination score of 24 or greater, and absence of advanced disability (difficulty in no more than 1 domain of physical function). Included in this study were 364 subjects with a hemoglobin concentration 10 g/dL or greater and known executive function status. Trail Making Test (TMT) Parts B and A. Tertiles of time to complete each test were used to define best (bottom), intermediate, and worst (top) performance. Tertiles of the difference TMT-B minus TMT-A were calculated. Anemia defined as hemoglobin concentration less than 12 g/dL. The percentage of subjects in the worst TMT-B, TMT-A, and TMT-B minus TMT-A performance tertile was highest for those with anemia. Prevalent anemia substantially increased the likelihood of performing worst (as opposed to best) on the TMT-B (odds ratio (OR) = 5.2, 95% confidence interval (CI) = 1.3-20.5), TMT-A (OR = 4.8, 95% CI = 1.5-15.6), and TMT-B minus TMT-A (OR = 4.2, 95% CI = 1.0-17.2), even after controlling for age, education, race, prevalent diseases, and relevant physiological and functional parameters. This study provides preliminary evidence in support of the hypothesis that mild anemia might be an independent risk factor for executive function impairment in community-dwelling older adults. Whether such an association is causal or noncausal remains to be determined.

  1. Recognition of Rapid Speech by Blind and Sighted Older Adults

    Science.gov (United States)

    Gordon-Salant, Sandra; Friedman, Sarah A.

    2011-01-01

    Purpose: To determine whether older blind participants recognize time-compressed speech better than older sighted participants. Method: Three groups of adults with normal hearing participated (n = 10/group): (a) older sighted, (b) older blind, and (c) younger sighted listeners. Low-predictability sentences that were uncompressed (0% time…

  2. Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.

    Science.gov (United States)

    Hooten, W Michael; Lamer, Tim J; Twyner, Channing

    2015-06-01

    The hyperalgesic effects of long-term opioid use in community-dwelling adults with chronic pain have not been widely reported. Therefore, the primary aim of this study was to determine the associations between opioid use and heat pain (HP) perception in a sample of community-dwelling adults with chronic pain. The study cohort involved 187 adults (85 opioid and 102 nonopioid) with chronic pain consecutively admitted to an outpatient interdisciplinary pain treatment program. Heat pain perception was assessed using a validated quantitative sensory test method of levels. An effect of opioid use was observed for nonstandardized (P = 0.004) and standardized (P = 0.005) values of HP 5-0.5 in which values of the opioid group were lower (more hyperalgesic) compared with those of the nonopioid group. HP 5-0.5 is a measure of the slope of the line connecting HP 0.5 (HP threshold) and HP 5 (intermediate measure of HP tolerance). In univariable (P = 0.019) and multiple variable (P = 0.003) linear regression analyses (adjusted for age, sex, body mass index, work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower (more hyperalgesic) nonstandardized values of HP 5-0.5. Similarly, in univariable (P = 0.004) and multiple variable (P = 0.011) linear regression analyses (adjusted for work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower standardized values of HP 5-0.5. In this sample of community-dwelling adults, these observations suggest that long-term opioid use was associated with hyperalgesia independent of other clinical factors known to influence HP perception.

  3. Parenting style, resilience, and mental health of community-dwelling elderly adults in China.

    Science.gov (United States)

    Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

    2016-07-08

    Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China. In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale. Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience. The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

  4. Effects of Exercise Intervention on Vascular Risk Factors in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial

    OpenAIRE

    Kazuki Uemura; Takehiko Doi; Hiroyuki Shimada; Hyuma Makizako; Daisuke Yoshida; Kota Tsutsumimoto; Yuya Anan; Takao Suzuki

    2012-01-01

    Aims The purpose of this study is to clarify the effects of exercise intervention on vascular risk factors in older adults with mild cognitive impairment (MCI). Methods Community-dwelling older adults who met the definition of MCI using the Petersen criteria (n = 100; mean age = 75.3 years) were randomly allocated to the exercise (n = 50) or education control group (n = 50). Participants in the exercise group exercised under the supervision of physiotherapists for 90 min/day, 2 days/week, 80 ...

  5. A Randomized Trial of a Multifaceted Intervention to Reduce Falls among Community-Dwelling Adults

    Science.gov (United States)

    Fox, Patrick J.; Vazquez, Laurie; Tonner, Chris; Stevens, Judy A.; Fineman, Norman; Ross, Leslie K.

    2010-01-01

    Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in…

  6. An intervention to help older adults maintain independence safely.

    Science.gov (United States)

    Ganong, Lawrence H; Coleman, Marilyn; Benson, Jacquelyn J; Snyder-Rivas, Linley A; Stowe, James D; Porter, Eileen J

    2013-05-01

    Older adults who live alone are at risk for problems (e.g., falling, sudden illness). To maintain themselves safely at home they may benefit from planning to prevent problems. The purpose of this study was to evaluate an intervention designed to train family members or friends as to how to help older adults who were living alone make plans to maintain independence safely in their homes and to make behavioral and household changes to enhance safety. Support network members of 19 older adults randomly assigned to the intervention group were taught to use multiple segment vignettes to assist the older adults in creating plans for living safely. Older adults in the control group (n = 21) were asked to engage in an unstructured discussion about home safety with their network members. Older adults in the intervention group developed safer plans and made more household and behavioral changes than did control group adults.

  7. Spatial navigation in young versus older adults

    Directory of Open Access Journals (Sweden)

    Ivana eGazova

    2013-12-01

    Full Text Available Older age is associated with changes in the brain, including the medial temporal lobe, which may result in mild spatial navigation deficits, especially in allocentric navigation. The aim of the study was to characterize the profile of real-space allocentric (world-centered, hippocampus dependent and egocentric (body-centered, parietal lobe dependent navigation and learning in young vs. older adults, and to assess a possible influence of gender. We recruited healthy participants without cognitive deficits on standard neuropsychological testing, white matter lesions or pronounced hippocampal atrophy: 24 young participants (18-26 years old and 44 older participants stratified as participants 60-70 years old (n=24 and participants 71-84 years old (n=20. All underwent spatial navigation testing in the real-space human analog of the Morris Water Maze, which has the advantage of assessing separately allocentric and egocentric navigation and learning. Of the 8 consecutive trials, trials 2-8 were used to reduce bias by a rebound effect (more dramatic changes in performance between trials 1 and 2 relative to subsequent trials. The participants who were 71-84 years old (p< .001, but not those 60-70 years old, showed deficit in allocentric navigation compared to the young participants. There were no differences in egocentric navigation. All three groups showed spatial learning effect (p´s ≤.01. There were no gender differences in spatial navigation and learning. The linear regression limited to older participants showed linear (β=0.30, p=.045 and quadratic (β=0.30, p=.046 effect of age on allocentric navigation. There was no effect of age on egocentric navigation. These results demonstrate that navigation deficits in older age may be limited to allocentric navigation, whereas egocentric navigation and learning may remain preserved. This specific pattern of spatial navigation impairment may help differentiate normal aging from prodromal Alzheimer

  8. Feasibility of reducing older adults' sedentary time.

    Science.gov (United States)

    Gardiner, Paul A; Eakin, Elizabeth G; Healy, Genevieve N; Owen, Neville

    2011-08-01

    Sedentary time (too much sitting, as distinct from lack of exercise) is a prevalent risk to health among older adults. Examine the feasibility of an intervention to reduce and break up sedentary time in older adults. A pre-experimental (pre-post) study. A total of 59 participants aged ≥60 years from Brisbane, Australia. Data were collected between May and December 2009 and analyzed in 2010. One face-to-face goal-setting consultation and one individually tailored mailing providing feedback on accelerometer-derived sedentary time, grounded in social cognitive theory and behavioral choice theory. Program reach and retention; changes in accelerometer-derived sedentary time, light-intensity physical activity (LIPA), and moderate-to-vigorous-intensity physical activity (MVPA) (assessed over 6 days in pre- and post-intervention periods); and participant satisfaction. Reach was 87.5% of those screened and eligible; retention was 100%. From pre- to post-intervention, participants decreased their sedentary time [-3.2% (95% CI= -4.18, -2.14), p<0.001], increased their breaks in sedentary time per day [4.0 (1.48, 6.52), p=0.003], and increased their LIPA [2.2% (1.40, 2.99), p<0.001] and MVPA [1.0% (0.55, 1.38), p<0.001]. Significantly greater reductions in sedentary time were made after 10:00am, with significantly greater number of breaks occurring between 7:00pm and 9:00pm. Participants reported high satisfaction with the program (median 9/10). Sedentary time in older adults can be reduced following a brief intervention based on goal setting and behavioral self-monitoring. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Barriers, Motivations, and Preferences for Physical Activity Among Female African American Older Adults

    Directory of Open Access Journals (Sweden)

    Neha P. Gothe PhD

    2016-11-01

    Full Text Available According to the Centers for Disease Control and Prevention, less than 11% of adults more than the age of 65 meet the 2008 Physical Activity Guidelines for Americans. Among minority populations, only 5% of non-Hispanic Black older adults met the guidelines. Given our limited understanding of psychosocial and environmental factors that affect physical activity participation in these groups, the purpose of our focus groups was to investigate barriers, motivators, and preferences of physical activity for community-dwelling African American older adults. Three focus groups were conducted with female African American older adults (N = 20. Questions posed to each focus group targeted motivations and barriers toward physical activity as well as their preferences for physical activity. The motivations included perceived health benefits of physical activity, social support, and enjoyment associated with engagement in physical activity. Prominent barriers included time and physical limitations, peer pressure and family responsibilities, and weather and poor neighborhood conditions. Group activities involving a dance component and novel exercises such as tai-chi or yoga were preferred choices. These findings should be taken into consideration when designing and implementing research or community physical activity programs for female African American older adults.

  10. Hypersexuality among cognitively impaired older adults.

    Science.gov (United States)

    Wallace, Meredith; Safer, Meredith

    2009-01-01

    Hypersexuality, also referred to in the literature as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others. For older adults, the literature generally attributes the behavior to biochemical or physiological changes that accompany cognitive impairment-specifically, dementia. Although less common than other behavioral issues, such as aggression and agitation, hypersexuality presents complex logistical and ethical problems for caregivers. This article reviews the current literature on hypersexual behavior. Assessment essentials as well as nonpharmacological and pharmacological treatment approaches are discussed, identifying the need for standardization as well as caregiver education and training.

  11. Acute myeloid leukemia in the older adults

    Directory of Open Access Journals (Sweden)

    Antonio M. Almeida

    2016-01-01

    Full Text Available AML is an aggressive hematological malignancy with highest incidence in the older adults. The adverse features of AML in the elderly, and the frailties and comorbidities frequently present in them, make their management a particularly difficult therapeutic challenge. In this context, it is important to assess carefully patient- as well as disease-associated prognostic features with validated tools. The fittest patients should be considered for curative therapy, such as bone marrow transplantation, whereas low intensity options may be more appropriate for frail patients. Here we review how to assess patients with elderly AML and the treatments options available for them.

  12. Potentially inappropriate medication use: the Beers' Criteria used among older adults with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Lee D

    2013-09-01

    Full Text Available INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3 years and 59% were women. The median number of medications used was 6 (range 1-21 medications. The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49% of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale ≥5 and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54. DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed.

  13. Introducing a Third Timed Up & Go Test Trial Improves Performances of Hospitalized and Community-Dwelling Older Individuals.

    Science.gov (United States)

    Bloch, Mette L; Jønsson, Line R; Kristensen, Morten T

    Originally, the Timed Up & Go (TUG) test was described as including a practice trial before a timed trial, but recent studies in individuals with hip fracture have reported that performance improved with a third trial and that high intertester reliability was achieved when the fastest of 3 timed trials was used. Thus, the fastest of 3 TUG trials is recommended when testing individuals with hip fracture. To our knowledge, no study has examined the number of trials needed to achieve performance stability on the TUG test (defined as no further improvement on subsequent trials) when performed by older individuals without hip fracture. The aim of the study, therefore, was to examine whether a third TUG trial is faster than either of 2 TUG trials conducted according to standardized TUG instructions and whether the fastest of 3 trials is the most appropriate measure to apply in hospitalized and community-dwelling older individuals. Eighty-two participants (50 from a geriatric hospital unit and 32 from an outpatient geriatric center; 52 women, 30 men) with a mean (SD) age of 83.6 (7.9) years were included in this cross-sectional study. All participants (except one from the hospital unit) performed 3 TUG trials, as fast as safely possible on the same day, and separated by up to 1-minute pauses. A rollator (4-wheeled rolling walker) was used as a standardized walking aid in the geriatric hospital unit, whereas participants used their normal walking aid (if any) in the outpatient geriatric center. The fastest trial was trial 3 for 47 (57%), trial 2 for 25 (31%), and trial 1 for 10 (12%). Repeated-measures analyses of variance with Bonferroni corrections showed that TUG times improved from trial 1 to trial 3 (P timed trials was significantly (P < .001) faster than the other 2 trials. We suggest that the fastest of the 3 TUG trials is recorded instead of the second trial in both hospitalized and community-dwelling older individuals.

  14. Motivation to Learn among Older Adults in Taiwan

    Science.gov (United States)

    Chang, Dian-Fu; Lin, Sung-Po

    2011-01-01

    This study analyzed the survey on adults administered by the Ministry of Education in Taiwan in 2008, and logistic regression analysis showed a close relationship between learning motivations of older adults. The finding revealed that the higher age or the lower education attainment of older adults, the lower their learning motivation. The…

  15. Motivation to Learn among Older Adults in Taiwan

    Science.gov (United States)

    Chang, Dian-Fu; Lin, Sung-Po

    2011-01-01

    This study analyzed the survey on adults administered by the Ministry of Education in Taiwan in 2008, and logistic regression analysis showed a close relationship between learning motivations of older adults. The finding revealed that the higher age or the lower education attainment of older adults, the lower their learning motivation. The…

  16. Prevalence and Cognitive Bases of Subjective Memory Complaints in Older Adults: Evidence from a Community Sample

    Directory of Open Access Journals (Sweden)

    Thomas Fritsch

    2014-01-01

    Full Text Available Objectives. To estimate the prevalence of subjective memory complaints (SMCs in a sample of community-dwelling, older adults and to examine cognitive bases of these complaints. Participants. 499 community-dwelling adults, 65 and older. Measurements. A telephone survey consisting of cognitive tests and clinical and sociodemographic variables. SMCs were based on subjects' evaluations and subjects' perceptions of others' evaluations. Analysis. Logistic regression was used to model the risk for SMCs as a function of the cognitive, clinical, and sociodemographic variables. We tested for interactions of the cognitive variables with age, education, and gender. Results. 27.1% reported memory complaints. Among the younger age, better objective memory performance predicted lower risk for SMCs, while among the older age, better memory had no effect on risk. Among the better-educated people, better global cognitive functioning predicted lower risk for SMCs, while among the less-educated people, better global cognitive functioning had no effect on SMC risk. When predicting others' perceptions, better objective memory was associated with lower risk for SMCs. Conclusion. Objective memory performance and global cognitive functioning are associated with lower risk for SMCs, but these relationships are the strongest for the younger age and those with more education, respectively. Age and education may affect the ability to accurately appraise cognitive functioning.

  17. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services.

    Science.gov (United States)

    Ewen, Heidi H; Washington, Tiffany R; Emerson, Kerstin G; Carswell, Andrew T; Smith, Matthew Lee

    2017-03-22

    Background: The majority of older adults prefer to remain in their homes, or to "age-in-place." To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults' residential environment is associated with their health status and HCBS utilization. Building upon the Person-Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well

  18. Accuracy of VO2(max) prediction equations in older adults.

    Science.gov (United States)

    Peterson, Matthew J; Pieper, Carl F; Morey, Miram C

    2003-01-01

    We explored the accuracy and bias of prediction equations (ACSM and Foster) in older, deconditioned men and women. We also examined the predictors of VO2(max) to further understand which variables affect respiratory fitness in the elderly. One hundred seventy-one community dwelling, men (72.6 +/- 4.8 yr) and women (71.0 +/- 5.1 yr) screened in a clinical trial were retrospectively examined. VO2(max) was measured using a standardized protocol with gas exchange measured. Measured VO2 (max) values were compared with prediction equations via mean difference analyses, and bias was explored using Bland-Altman analyses. Regression analysis determined significant predictors of measured VO2 (max). Alpha was PVO2 (max), 21.7 +/- 4.8 and 17.3 +/- 4.0, respectively. ACSM overestimated VO2 (max) in men and women, 26.3 +/- 8.2 and 20.9 +/- 7.3, respectively. By using Bland-Altman plots, ACSM showed significant overestimation bias in more fit women (r = 0.29), whereas Foster showed no estimation bias in either gender. Significant predictors of VO2 (max) were gender, BMI, age, treadmill grade, and speed, with an equation R(2) of 0.70. A measure of current activity levels did not make it into the final model ( P= 0.0505) but is worthy of future consideration using more sensitive measures than ours. ACSM is not appropriate for use when treadmill testing older adults. We believe the Foster equation's VO2 (max) prediction accuracy is acceptable, showing no bias along a continuum of aerobic capacity.

  19. Fruit and vegetable intake among older adults: a scoping review.

    Science.gov (United States)

    Nicklett, Emily J; Kadell, Andria R

    2013-08-01

    Older adults are the fastest growing segment of the world population. Older adults are also at heightened risk of chronic conditions (such as diabetes, heart disease, and cancer) and specific geriatric conditions (such as cognitive impairment, frailty, and falls). Research studies have examined the relationship between fruit and vegetable intake and subsequent health outcomes and the correlates of fruit and vegetable intake in the U.S. population. However, relatively few studies have specifically examined health impacts and correlates of fruit and vegetable intake among older adults, who have unique biophysical and socioeconomic circumstances. Evidence is reviewed to (1) describe findings related to consumption and chronic, geriatric, and other health outcomes among older adults and (2) describe patterns in fruit and vegetable consumption among older adults and how these patterns vary within and among populations. This review addresses specific barriers faced by older adults in obtaining and consuming fruits and vegetables in community settings. Recommendations for practice and policy are discussed.

  20. Self-discipline and self-consciousness predict subjective memory in older adults.

    Science.gov (United States)

    Pearman, Ann; Storandt, Martha

    2005-05-01

    Research has shown the personality variables of conscientiousness and neuroticism to be related to subjective memory in older adults. This study was designed to determine the specific facets of these traits involved in the relation between personality and memory complaints. Subjective memory evaluations were examined in 85 community-dwelling people aged 56 to 94 years. Regression analysis revealed that one facet of conscientiousness (self-discipline) and two facets of neuroticism (self-consciousness and anxiety) explained almost one third of the variance in subjective memory complaints. Anxiety acted as a suppressor variable to enhance the contribution of self-consciousness. Objective measures of episodic and prospective memory were not related to subjective memory. Effective treatments of memory complaints in healthy older adults may have to focus on enhancing self-discipline and self-concept.