Association of frailty in hospitalized and institutionalized elderly in the community-dwelling

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Suzele Cristina Coelho Fabrício-Wehbe

2016-08-01

Full Text Available ABSTRACT Objective: to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents. Method: the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS, and functional capacity through the Functional Independence Measure. Results: we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years. Conclusion: the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.

Relation between functional mobility and dynapenia in institutionalized frail elderly.

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Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

2017-01-01

To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test.

Effects of a reminiscence program among institutionalized elderly adults.

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Meléndez-Moral, Juan Carlos; Charco-Ruiz, Laura; Mayordomo-Rodríguez, Teresa; Sales-Galán, Alicia

2013-01-01

Institutionalization during old age requires tremendous adaptability. Among the main consequences of the difficulty of adapting to the institutional context are prevalent depressive symptoms and low well-being. Reminiscence therapy has proven to be among the most effective at minimizing these outcomes. This study purpose was to investigate the usefulness of reminiscence intervention in an elderly, institutionalized sample. Following a group format, the intervention lasted eight sessions and compared a treatment group and a control group, using pre-post measures and a single-blind design. We predicted that reminiscence intervention would have a positive impact on depressive symptoms, self-esteem, life satisfaction, and psychological well-being. Significant results were obtained, including a drop in depressive symptoms and improved self-esteem, satisfaction, and psychological well-being. We conclude that reminiscence intervention yielded positive effects in institutionalized, elderly participants.

[Predictors of cognitive impairment in population over 64 years institutionalized and non-institutionalized].

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Leiva-Saldaña, Antonio; Sánchez-Ramos, José Luis; León-Jariego, José Carlos; Palacios-Gómez, Leopoldo

2016-01-01

Describe the factors which can be associated with cognitive impairment in institutionalized and non-institutionalized elderly. Cross-sectional study of 200 people aged over 64 in Huelva (Spain) in 2014. Of these, 100 people were institutionalized in a residential facility and 100 were not. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE-35), basic activities of daily living by Barthel index, general health through the Goldberg GHQ-28 and social, clinical and behavioural variables were contemplated in the study. The association of cognitive impairment with all the variables was analysed using Chi-square test. Finally, a multivariate analysis was performed using logistic regression to identify possible joint influence of variables to study on the cognitive impairment. The prevalence of cognitive impairment in those institutionalized was 47%, higher than that of non-institutionalized group which was only 8% (p<.001). The dependence for basic activities for daily living and learning activities were the only variables in both groups which were associated with the cognitive impairment. Institutionalization (OR=5.368), age (OR=1.066) and dependence for basic activities (OR=5.036) were negatively associated with CI, while learning activities (OR=.227) were associated in a positive way. Conducting learning activities and the promotion of personal autonomy can delay cognitive impairment in older people. It is important to include cognitive stimulation programs aimed at the old population, especially in residential institutions. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Factors Associated with Anemia in the Institutionalized Elderly.

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Emanuelle Cruz da Silva

Full Text Available As a common problem in long-term care facilities (LTCFs, anemia affects 25-63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%, as normocytic and normochromic anemia, with no anisocytosis (69.75%. Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04-2.72 and with moderate (PR: 1.98; 95% CI: 1.07-3.63 and total (PR: 2.61; 95% CI: 1.34-5.07 dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00-3.77. The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence.

Adherence to the Mediterranean diet pattern, cognitive status and depressive symptoms in an elderly non-institutionalized population.

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Hernández-Galiot, Ana; Goñi, Isabel

2017-03-30

Scientific evidence indicates that adherence to the Mediterranean diet protects against the deterioration of cognitive status and depressive symptoms during aging. However, few studies have been conducted in elderly non-institutionalized subjects. This study evaluated the relation between the adherence to the Mediterranean dietary pattern and cognitive status and depressive symptoms in an elderly population over 75 years. A cross-sectional study was conducted in a Mediterranean city (Garrucha, Spain) in 79 elderly people over 75 (36 men and 41 women). Adherence to the Mediterranean dietary pattern was determined using the Mediterranean Diet Adherence Screener (MEDAS). Cognitive function was determined by the Mini Mental State Examination (MMSE), and depressive symptoms were assessed by the Geriatric Depression Scale (GDS). Most of population showed a very high adherence to the Mediterranean diet pattern and optimal cognitive and affective status. They consumed olive oil as their main source of fat, high levels of fish and fruit, low levels of foods with added sugars, and a low consumption of red meat. A significant relation between the MEDAS and MMSE scores was found. However, no relationship was observed between the MEDAS and GDS. The Mediterranean diet pattern was positively related with the cognitive function, although the infl uence of a healthy dietary pattern on the symptomatology of depression was unclear. However, an effective strategy against cognitive function and depression would be to improve physical activity rates, establish lifelong healthy eating habits, and consume a nutritionally-rich diet in order to enhance quality of life of the elderly.

Filipino Arts among Elders in Institutionalized Care Settings

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de Guzman, Allan B.; Satuito, James Cyril B.; Satumba, Miko Anne E.; Segui, Diego Rey A.; Serquina, Faith Evelyn C.; Serrano, Lawrence Jan P.; Sevilla, Madelyn D.

2011-01-01

The use of traditional art in recreational therapies is unexplored. This paper, thus, attempts to surface the unique power of traditional Filipino arts (TFA) as synergizing lens in capturing the individual and the collective experiences of a select group of Filipino elderly in an institutionalized care setting relative to their feelings of…

Hypotensive responses to common daily activities in institutionalized elderly. A potential risk for recurrent falls.

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Jonsson, P V; Lipsitz, L A; Kelley, M; Koestner, J

1990-07-01

Transient hypotension may be one of many factors contributing to the high prevalence of falls among elderly people. To determine the frequency and magnitude of hypotensive responses to common daily activities, and their potential relationship to falls in the elderly, we examined blood pressure (BP) and heart rate during a standardized series of activities in 38 institutionalized recurrent fallers (age, 87 +/- 6 years), 20 institutionalized nonfallers (age, 85 +/- 5 years), and 10 healthy young control subjects (age, 24 +/- 3 years). The coefficient of variation for systolic BP during all activities was higher in elderly subjects (fallers, 14% +/- 5%; nonfallers, 12% +/- 3%) than in young control subjects (8% +/- 1%). In contrast, the coefficient of variation for heart rate during all activities was higher in young subjects than in the elderly subjects. Elderly subjects had marked BP reduction following meals and nitroglycerin, which was significantly greater in fallers than in nonfallers, independent of the cause of the fall. Thus, institutionalized elderly have marked BP variability and hypotensive responses to meals and nitroglycerin. A decline in BP during common preload-reducing stresses may predispose some elderly people to falls.

Institutionalized elderly people oral health status and treatment needs assessment in kathmandu district

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Sunita Khanal

2018-01-01

Full Text Available Context: In Nepal, Senior citizens are the people who are 60 years and above as defined by the senior citizen act 2063. According to the 2011 census of Nepal, there were 2.1 million elderly inhabitants which constituted 8.1% of total population of Nepal. Aim: To assess the oral health status and treatment needs of institutionalized elderly people. Objectives: To assess the periodontal status, prosthetic status, and prosthetic needs and to compare community periodontal index and the loss of attachment (LOA with age and gender. Setting and Design: A cross-sectional study was conducted in six different old age homes of Kathmandu district. Materials and Methods: The study was conducted among 200 elderly living in six old age homes of Kathmandu district after obtaining consent from the concerned authorities. The clinical findings were recorded using the World Health Organization Oral Health Assessment Form 1997. SPSS version 20 software was used for data analysis and P ≤ 0.05 was considered statistically significant. Results: Among 200 elderly examined, 69 (34.5% were male and 131 (65.5% were female. During probing, calculus was detected among 37.5% of people. The highest prevalence of LOA 4–5 mm was found among 40.5% of people. The prosthetic need was 83%, of which 20% required complete denture, 63% required partial denture. On applying Chi-square test, LOA score was found to be statistically significant between male and female (P = 0.015. Conclusion: The oral health status of the institutionalized elderly was found to be poor.

Plasma zinc in institutionalized elderly individuals: Relation with immune and cardiometabolic biomarkers.

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Sales, Márcia Cristina; de Oliveira, Larissa Praça; de Araújo Cabral, Natalia Louise; de Sousa, Sara Estéfani Soares; das Graças Almeida, Maria; Lemos, Telma Maria Araújo Moura; de Oliveira Lyra, Clélia; de Lima, Kenio Costa; Sena-Evangelista, Karine Cavalcanti Mauricio; de Fatima Campos Pedrosa, Lucia

2018-04-24

Changes in zinc metabolism caused by aging and the institutionalization process may contribute to zinc deficiency in elderly individuals. Hypozincemia results in changes in glycemic, lipid, and inflammatory profiles. The aim of this study was to evaluate plasma zinc concentrations and their relationships with sociodemographic, dietary, inflammatory, and cardiometabolic biomarkers in institutionalized elderly individuals. A cross-sectional study was carried out including 255 elderly adults living in nursing homes. The associations between plasma zinc and dietary zinc intake, sociodemographic indicators, and glycemic, lipid, and inflammatory biomarkers were evaluated. Independent variables were analyzed according to quartiles of plasma zinc concentrations (Q1: 93.7 μg/dL). The relationship between plasma zinc concentrations and predictor variables was also tested. In Q1, higher concentrations of the following variables were observed, compared with those in other quartiles: total cholesterol and low-density lipoprotein cholesterol (LDL-c; Q1 > Q2, Q3, Q4; all p  Q3, Q4; all p  Q3, Q4; p = 0.024 and p = 0.010, respectively); tumor necrosis factor (TNF)-α (Q1 > Q3, p = 0.003). A significant reduction in plasma zinc concentrations was observed with increasing age-adjusted institutionalization time (Δ = - 0.10; 95% confidence interval [CI]: -0.18 to -0.01). The concentrations of total cholesterol (Δ = - 0.19; 95% CI: -0.23 to -0.15), LDL-c (Δ = - 0.19; 95% CI: -0.23 to -0.15), triglycerides (Δ = - 0.11; 95% CI: -0.16 to -0.06), IL-6 (Δ = - 1.41; 95% CI: -2.64 to -0.18), and TNF-α (Δ = - 1.04; 95% CI: -1.71 to -0.36) were also significantly increased. In conclusion, decreased plasma zinc concentrations were associated with longer institutionalization time and worse lipid and inflammatory profiles in elderly institutionalized individuals. Published by Elsevier GmbH.

Deciding to institutionalize: caregiving crisis, intergenerational communication, and uncertainty management for elders and their children in Shanghai.

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Chen, Lin

2015-01-01

This phenomenological study integrated crisis theory, social identity theory, and uncertainty management theory to conceptualize the decision-making process around institutionalization among nursing home residents and their children in Shanghai. I conducted face-to-face, semistructured interviews with 12 dyads of matched elders and their children (N = 24). The findings suggest that caregiving crises triggered intergenerational communication about caregiving alternatives and new arrangements, although each generation had different stances and motivations. Children finalized the decision by helping their parents to manage the uncertainties pertaining to institutionalization. This study sheds light on caregiving decision-making dynamics for the increasing aging population across cultures.

Educational Support Group in Changing Caregivers' Psychological Elder Abuse Behavior toward Caring for Institutionalized Elders

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Hsieh, Hsiu-Fang; Wang, Jing-Jy; Yen, Maiofen; Liu, Tzu-Ti

2009-01-01

Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver's…

Missing Teeth and Prosthodontic Replacement in an Institutionalized Dentate Population of 60 Years and Older in Qingdao, China

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Zhang, Q.; Li, T.T.; Gerritsen, A.E.; Witter, D.J.; Bronkhorst, E.M.; Creugers, N.H.J.

2016-01-01

PURPOSE: The aim of this study was to investigate missing teeth and prosthodontic replacements in an institutionalized elderly population in China, and to assess dental functionality before and after the prosthodontic replacements based on a hierarchical dental functional classification (HDFC)

[Chronic pain and associated factors amongst institutionalized elderly with arthritis].

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Lin, Jyy-I; Wang, Jing-Jy; Chiu, Hui-Ju; Lee, Chiung-Ying; Cheng, Su-Fen

2011-02-01

The World Health Organization has predicted that arthritis will rise to become the fourth ranked global disability among the elderly. Arthritis is already a main cause of chronic pain, depression, and institutionalization in this group. Chronic pain resulting from arthritis is a serious threat to the elderly population. Study purposes were to: (1) explore chronic pain in elderly residents with arthritis residing at long-term care facilities and to understand the relationship between associated chronic pain and associated factors, and (2) identify the predictive factors of chronic pain. This study used a cross-sectional, descriptive correlational research design. A sample of 114 elderly residents, 65 years of age and older, were recruited from five long-term care facilities in Kaohsiung and Pingtung, Taiwan. Findings showed that the average pain intensity resulting from chronic arthritis during the three months of study was medium (4.51 ± 1.75). There were positive relationships amongst average pain intensity, previous pain intensity, self-perception of arthritis severity and depression status. Negative correlations were found amongst age, self-perception of arthritis severity, number of chronic illnesses experienced, function of daily activity and social support. Previous pain intensity, self-perception of arthritis severity, number of chronic illnesses experienced, function of daily activity and depression status were all found to predict chronic pain. Together, these factors explained 40.4% of total variance. Study results provide information for nurses to consider the physical, psychological, and social aspects of chronic pain when caring for the elderly. Healthcare providers should design individualized health care interventions for elderly people to promote their quality of life.

Degree of cognitive impairment of older adults institutionalized in two homes for the elderly in the metropolitan area of Bucaramanga-Santander, Colombia

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Katherine del Consuelo Camargo Hernández

2017-08-01

Full Text Available Introduction: Cognitive impairment is one of the most frequent occurring problems in the older adult population as a result of ageing. Objective: To determine the degree of cognitive impairment of older adults institutionalized in two homes for the elderly in the metropolitan area of Bucaramanga, Santander in Colombia. Materials and methods: A quantitative study was made by using a cross-sectional descriptive design with a population of 165 and a sample of 60 older adults from two homes for the elderly, whose inclusion criteria were: age between 65 to 95 or more and presence or absence of chronic pathology. A non-probabilistic sampling was used for convenience, and the instrument MMSE (Mini-Mental cognitive exam was applied. Results: The older adult population who participated in the study is between the ages of 75 to 94. Most of them were male, had a primary school level, had family contact and the time for institutionalization was 1 to 5 years. Conclusions: 41.7% of older adults studied showed severe cognitive impairment and require nursing interventions focused on cognitive therapy.

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

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

2008-01-01

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

Systematization of nursing care to institutionalized elderly based on Virginia Henderson

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Jorge Wilker Bezerra Clares

2013-07-01

Full Text Available This is an experience report that aims to describe the application of the nursing process to an institutionalized elderly, based on Virginia Henderson’s theory. The case study was developed in a long-stay institution for the elderly in Fortaleza, Ceará, Brazil, from May to August 2010, by filling out a form, physical examination and observation. Identifying the needs of elimination, communication, recreation and learning allowed to raise the nursing diagnoses, respectively: urge urinary incontinence; impaired social interaction; diversional activity deficit; and impaired memory. The nursing interventions were directed to the health and independence of the elderly. The application of systematic nursing care impacted positively on the health of the elderly, demonstrating the applicability of the nursing systematization based on Henderson’s theory in the scenery in which the study was developed.

Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders

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Alberto Carlos CRUZ GONZALEZ

2016-01-01

Full Text Available Abstract The aim of this study was to compare the clinical performance of root caries restorations after a six-month period using two methods, a conventional technique with rotary instruments and an atraumatic restorative technique (ART, in an institutionalized elderly population in the city of Bogotá, Colombia. Root caries represents a multifactorial, progressive, chronic lesion with softened, irregular and darkened tissue involving the radicular surface; it is highly prevalent in the elderly, especially in those who are physically or cognitively impaired. A quasi-experimental, double-blind, longitudinal study was carried out after cluster randomization of the sample. Two different experienced dentists, previously trained, performed the restorations using each technique. After six months, two new investigators performed a blind evaluation of the condition of the restorations. The results showed a significantly higher rate of success (92.9% using the conventional technique (p < 0.03. However, we concluded that ART may have been the preferred technique in the study population because 81% of those restorations survived or were successful during the observation period.

Educational workshops for health promotion of institutionalized elderly women

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Roberta Grangeiro de Oliveira

2014-09-01

Full Text Available Objective: To describe the experience of participation in workshops on health education for institutionalized elderly women. Data Synthesis: Actions of health education were performed through the development of educational workshops on lifestyle for 20 elderly women in a philanthropic institution of a municipality, during the month of October 2011. The workshops were divided into three meetings over 2 days. Empathic communication and interaction among the participants were sought through dynamics, aiming to motivate them to talk about the feelings aroused by figures. The healthy lifestyle was then approached, with explanation on diet and physical activity. Conclusion: The implementation of educational measures is effective for the health promotion, the development of critical thinking and the reduction of risk behaviors doi:http://dx.doi.org/10.5020/18061230.2013.p595

Chemical Induced Xerostomia Among Institutionalized Eldery

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Petrovski, Mihajlo; Minovska, Ana; Ivanovski, Kiro; Forna, Doriana Agop; Forna, Consuela Norna

2015-01-01

Subjective presence of dry mouth is most common oral problem among the institutionalized elderly. To assess the subjective presence of xerostomia among institutionalized elderly. Total numbers of 70 subjects older than 65 years institutionalized in one nursing home were evaluated. The subjective presence of xerstomia was determinated. To determine the level of expressiveness of xerostomia is used questionnaire recommended by Carda et al. 62.8% from the subjects believed that they ...

Oral health care activities performed by caregivers for institutionalized elderly in Barcelona-Spain.

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Cornejo-Ovalle, Marco; Costa-de-Lima, Kenio; Pérez, Glória; Borrell, Carme; Casals-Peidro, Elías

2013-07-01

To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95% 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons.

The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia.

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Mohammadi, Fatemeh; Momtaz, Yadollah Abolfathi; Motallebi, Seyedeh Ameneh; Boosepasi, Shahnaz

2017-01-01

There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, psocial skills of elderly patients with schizophrenia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Impacto da saúde bucal no cotidiano de idosos institucionalizados e não institucionalizados da cidade do Recife (PE, Brasil Impact of oral health in the daily life of institutionalized and non institutionalized elder in the city of Recife (PE, Brazil

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Eliane Helena Alvim de Souza

2010-09-01

Full Text Available Este artigo tem como objetivo avaliar a influência da saúde bucal no cotidiano de idosos institucionalizados e não institucionalizados da cidade do Recife (PE, bem como verificar se a saúde bucal tem a mesma relevância para os dois grupos estudados. Para avaliar a percepção de saúde bucal, utilizou-se o índice Geriatric Oral Health Assessment Index (GOHAI. As faixas do GOHAI foram categorizadas em baixa percepção (The objective of the study is to assess the influence of oral health in the daily routine of both institutionalized and non-institutionalized elders living in the city of Recife-PE, as well as to come to conclusions concerning the relevance level of oral health in both groups. In order to assess the perception of oral health, it was used the Geriatric Oral Health Assessment Index (GOHAI. The GOHAI levels, concerning the perception, were categorized in: low (<= 50, average (51 to 60 and high (57 to 60. Oral health conditions were represented by the DMFT index (with cavity, lost and repaired teeth. It was observed that the percentage of elderly with a GOHAI not higher than 50 (low perception of oral health was rather higher in the non-institutionalized group than in the institutionalized (92,2% x 64,9%. The average DMFT and the number of lost teeth were higher in the institutionalized group (96,01% x 87,87%. The perception of oral health was lower for more than half of the examined elderly population, but there being a meaningful difference between the two groups concerning the GOHAI, with lower levels for the non-institutionalized group. The result of the perception of oral health was compatible with the high number of decayed and lost teeth.

The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people.

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Manders, M; De Groot, L C P G M; Hoefnagels, W H L; Dhonukshe-Rutten, R A M; Wouters-Wesseling, W; Mulders, A J M J; Van Staveren, W A

2009-11-01

To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Homes for the elderly and nursing homes in the Netherlands. Institutionalized elderly people older than 60 years, with a BMI Mental State Examination score of at least 10 points. In addition to their usual diet the participants (n=176) received either a nutrient dense drink or a placebo drink twice a day during 24 weeks. The functionality measures included cognitive function, mood, physical performance and the ability to perform activities of daily living. In the supplement group a favorable effect of the intervention drink on body weight (1.6 kg difference in change; P = .035), calf circumference (0.9 cm difference in change; P = .048), and blood values (e.g. Hcy decreased from 16.8 to 11.2 mumol/L in the supplement group) was found. In the total group no significant effect was found on functionality outcomes. However, a subgroup of participants with BMI at baseline below 24.4 kg/m2 performed better on the cognitive subscale of Alzheimer's Disease Assessment Scale (P = .09), and its language sub score (P = .01) after 24 weeks of intervention. The results in the total group of this trial suggest that the nutritional supplement used in this study improves nutritional status. Furthermore, the results of this trial suggest that it is effective as treatment for decreasing function in a subgroup of institutionalized elderly people with low BMI.

Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors

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Lílian Varanda Pereira

2015-10-01

Full Text Available AbstractOBJECTIVECorrelating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales.METHODA study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS of 11 points and a Verbal Descriptor Scale (VDS of five points were compared in three evaluations: overall, at rest and during movement.RESULTSWomen were more representative (61.4% and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales.CONCLUSIONPain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.

Prediction of Risk of Falling among Institutionalized Elderly People in Iran

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Ahmad Ali Akbari Kamrani

2005-09-01

Full Text Available Aging declines abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly. In order to accomplish this aim, two functional assessment methods, Berg Scale and Tinetti Scale, were used and the validity indices of these methods were calculated. Prospective non-interventional methodological discriminative-validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using/without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use/nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases; independent variable was history of falling; and dependent variables were the results of the two functional assessment methods. Independent t-test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (P=0.0001 and Tinetti Scale (P=0.0001. The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

Prediction of Risk of Falling Among Institutionalized Elderly People in Iran

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Ahmad Ali Akbari-Kamrani

2003-07-01

Full Text Available Objective: Aging decline abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly people. Materials & Methods: Prospective non–interventional methodological discriminative–validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/ without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using / without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use / nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases independent variable was history of falling and dependent variables were the results of the two functional assessment methods. In order to accomplish the aim of study, two functional assessment methods, Berg scale and Tinetti scale, were used and the validity indices of these methods were calculated. Results: Independent t test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (p=0.00l and Tinetti Scale (p=0.00l. Conclusion: The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

Protein enrichment of familiar foods as an innovative strategy to increase protein intake in institutionalized elderly

NARCIS (Netherlands)

Beelen, J.; Roos, de N.M.; Groot, de C.P.G.M.

2017-01-01

Objective
To increase the protein intake of older adults, protein enrichment of familiar foods and drinks might be an effective and attractive alternative for oral nutritional supplements (ONS). We performed a pilot study to test whether these products could help institutionalized elderly to

The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people

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Manders, M.; Groot, de C.P.G.M.; Hoefnagels, W.H.L.; Dhonukshe-Rutten, R.A.M.; Wouters-Wesseling, W.; Mulders, A.J.M.J.; Staveren, van W.A.

2009-01-01

Objectives To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. Design A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Setting Homes for

An Even Distribution of Protein Intake Daily Promotes Protein Adequacy but Does Not Influence Nutritional Status in Institutionalized Elderly.

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Tieland, Michael; Beelen, Janne; Laan, Anna C M; Poon, Shirley; de Groot, Lisette C P G M; Seeman, Ego; Wang, Xiaofang; Iuliano, Sandra

2018-01-01

Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of malnutrition. Therefore, we aim to determine the association between protein intake distribution and nutritional status in institutionalized elderly people. Cross-sectional study among 481 institutionalized older adults. Dietary data from 481 ambulant elderly people (68.8% female, mean age 87.5 ± 6.3 years) residing in 52 aged-care facilities in Victoria, Australia, were assessed over 2 days using plate waste analysis. Nutritional status was determined using the Mini-Nutritional Assessment tool and serum (n = 208) analyzed for albumin, hemoglobin, and IGF-1. Protein intake distribution was classified as: spread (even distribution across 3 meals, n = 65), pulse (most protein consumed in one meal, n = 72) or intermediate (n = 344). Regression analysis was used to investigate associations. Mean protein intakes were higher in the spread (60.5 ± 2.0 g/d) than intermediate group (56.0 ± 0.8 g/d, P = .037), and tended to be higher than those in the pulse group (55.9 ± 1.9 g/d, P = .097). Residents with an even distribution of protein intake achieved a higher level of the recommended daily intake for protein (96.2 ± 30.0%) than the intermediate (86.3 ± 26.2%, P = .008) and pulse (87.4 ± 30.5%, P = .06) groups, and also achieved a greater level of their estimated energy requirements (intermediate; P = .039, pulse; P = .001). Nutritional status (Mini-Nutritional Assessment score) did not differ between groups (pulse; 20.5 ± 4.5, intermediate; 21.0 ± 2.5, spread; 20.5 ± 3.5), nor did any other indices of nutritional status. Meeting protein requirements is required before protein distribution may influence nutritional status in institutionalized

Urinary incontinence and indwelling urinary catheters in acutely admitted elderly patients: relationship with mortality, institutionalization, and functional decline

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Bootsma, A. M. Jikke; Buurman, Bianca M.; Geerlings, Suzanne E.; de Rooij, Sophia E.

2013-01-01

To study differences in functional status at admission in acutely hospitalized elderly patients with urinary incontinence, a catheter, or without a catheter or incontinence (controls) and to determine whether incontinence or a catheter are independent risk factors for death, institutionalization, or

Factors associated with negative self-perception of oral health among institutionalized elderly.

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Melo, Laércio Almeida de; Sousa, Meily de Mello; Medeiros, Annie Karoline Bezerra de; Carreiro, Adriana da Fonte Porto; Lima, Kenio Costa de

2016-11-01

The aim of this study was to determine self-perception of oral-health in institutionalized elderly, and look into the sociodemographic and clinical aspects associated with negative self-perception. One hundred and sixty-six elderly were assessed by answering a self-perception question that predicts the GOHAI (Geriatric Oral Health Assessment Index). Sociodemographic data was obtained from a previously validated questionnaire and clinical data taken from the WHO file and QST-TMD used to check the existence of TMD (temporomandibular disturbance). The data gathered was submitted to Mann-Whitney, Fisher's Exact and Chi-squared tests with a 5% significance level. The average age of the study population was 80.5, and 75.9% were women. The mean DMFT (decayed, missing, and filled teeth in permanent teeth) was 28.9, the majority of the sample subject (65%) reported good to excellent teeth, gums and prostheses (dentures and bridges). Three questions in the TMD questionnaire (QST-DTM) were associated with negative self-perception. Those claiming that their jaws "lock" when they open or close their mouth, who always have pain at the front or side of their jaw, or whose jaws get tired during the course of the day are less satisfied with their oral health. We conclude that clinical and sociodemographic conditions have little influence on self-perception of oral health, possibly because pain is the main factor associated with negative self-perception in these individuals.

Effectiveness of group reminiscence for improving wellbeing of institutionalized elderly adults: study protocol for a randomized controlled trial.

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Gaggioli, Andrea; Scaratti, Chiara; Morganti, Luca; Stramba-Badiale, Marco; Agostoni, Monica; Spatola, Chiara A M; Molinari, Enrico; Cipresso, Pietro; Riva, Giuseppe

2014-10-25

Group reminiscence therapy is a brief and structured intervention in which participants share personal past events with peers. This approach has been shown to be promising for improving wellbeing and reducing depressive symptoms among institutionalized older adults. However, despite the considerable interest in reminiscence group therapy, controlled studies to determine its specific benefits as compared to generic social interactions with peers (group conversations about everyday subjects) are still lacking. We have designed a randomized controlled trial aimed at comparing the effects of group reminiscence therapy with those of group recreational activity on the psychological wellbeing of an institutionalized sample of older adults. The study includes two groups of 20 hospitalized elderly participants: the experimental group and the control group. Participants included in the experimental group will receive six sessions of group reminiscence therapy, while the control group will participate in a recreational group discussion. A repeated-measures design will be used post-intervention and three months post-intervention to evaluate changes in self-reported outcome measures of depressive symptoms, self-esteem, life satisfaction, and quality of life from baseline. The protocol of a study aimed at examining the specific effects of group reminiscence therapy on psychological wellbeing, depression, and quality of life among institutionalized elderly people is described. It is expected that the outcomes of this trial will contribute to our knowledge about the process of group reminiscence, evaluate its effectiveness in improving psychological wellbeing of institutionalized individuals, and identify the best conditions for optimizing this approach. This trial was registered with ClinicalTrials.gov (registration number: NCT02077153) on 31 January 2014.

Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature.

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Mahieu, Lieslot; Gastmans, Chris

2012-03-01

Admission to a nursing home might challenge the way in which individuals experience their own sexuality, but it does not automatically diminish their need and desire for sexual fulfillment. Despite the fact that sexuality proves to be an intrinsic part of human existence, the sexual expression of geriatric residents remains a sensitive subject for many caregivers and family members. It evokes a variety of ethical issues and concerns, especially when dementia patients are involved. The overall objective of this review was to examine the ethical arguments and concepts about the debate on sexuality within a nursing home environment. We conducted a systematic search for argument-based ethics literature focusing on sexuality in institutionalized elderly people. Twenty-five appropriate studies were identified. A thematic analysis of the included literature led us to distinguish two major groups of ethical arguments: (i) principles and (ii) care. Ethics arguments on sexuality in institutionalized elderly are particularly guided by the principle of respect for autonomy and the concomitant notion of informed consent. Arguments related to care were also apparent within the research literature although they received considerably less attention than the arguments related to the principles of respect for autonomy, beneficence, nonmaleficence and justice. The lack of clarity in the conceptualization of the arguments referred to in the research literature indicates that there is a pressing need for a better defined, more fundamental philosophical-ethical analysis of the values at stake.

An Even Distribution of Protein Intake Daily Promotes Protein Adequacy but Does Not Influence Nutritional Status in Institutionalized Elderly

NARCIS (Netherlands)

Tieland, Michael; Beelen, Janne; Laan, Anna C.M.; Poon, Shirley; Groot, de Lisette C.P.G.M.; Seeman, Ego; Wang, Xiaofang; Iuliano, Sandra

2018-01-01

Objective: Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of

Older residents' perspectives on aged sexuality in institutionalized elderly care: a systematic literature review.

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Mahieu, Lieslot; Gastmans, Chris

2015-12-01

The aim of this systematic literature review is to investigate older residents' thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Systematic literature review. We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential

Protein Enrichment of Familiar Foods as an Innovative Strategy to Increase Protein Intake in Institutionalized Elderly.

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Beelen, J; de Roos, N M; de Groot, L C P G M

2017-01-01

To increase the protein intake of older adults, protein enrichment of familiar foods and drinks might be an effective and attractive alternative for oral nutritional supplements (ONS). We performed a pilot study to test whether these products could help institutionalized elderly to reach a protein intake of 1.2 gram per kg body weight per day (g/kg/d). Intervention study with one treatment group (no control group). Dietary assessment was done before and at the end of a 10-day intervention. Two care facilities in Gelderland, the Netherlands: a residential care home and a rehabilitation center. 22 elderly subjects (13 women, 9 men; mean age 83.0±9.4 years). We used a variety of newly developed protein enriched regular foods and drinks, including bread, soups, fruit juices, and instant mashed potatoes. Dietary intake was assessed on two consecutive days before and at the end of the intervention, using food records filled out by research assistants. Energy and macronutrient intake was calculated using the 2013 Dutch food composition database. Changes in protein intake were evaluated using paired t-tests. Protein intake increased by 11.8 g/d (P=0.003); from 0.96 to 1.14 g/kg/d (P=0.002). This increase is comparable to protein provided by one standard portion of ONS. The intake of energy and other macronutrients did not change significantly. At the end of the intervention more elderly reached a protein intake level of 1.2 g/kg/d than before (9 vs 4). Protein intake significantly increased during breakfast (+3.7 g) and during the evening (+2.2 g). Including familiar protein enriched foods and drinks in the menu helped to meet protein recommendations in institutionalized elderly.

Relationship between cardiometabolic profile, vitamin D status and BsmI polymorphism of the VDR gene in non-institutionalized elderly subjects: Cardiometabolic profile, vitamin D status and BsmI polymorphism of the VDR gene in non-institutionalized elderly subjects.

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Issa, Chahira Taha Mahd Ibrahim; Silva, Alexandre Sérgio; Toscano, Luciana Tavares; Medeiros, Marcia Silva; Persuhn, Darlene Camati; da Silva Diniz, Alcides; de Carvalho Costa, Maria José; Rodrigues Gonçalves, Maria da Conceição

2016-08-01

This study aimed to evaluate the relationship between the cardiometabolic profile, vitamin D status and BsmI polymorphism of the VDR gene in non-institutionalized elderly subjects. A cross-sectional study was conducted with a random and representative sample of 142 elderly subjects selected by cluster and recruited from a municipal assistance program. Clinical, nutritional, biochemical and inflammatory profiles, oxidative stress and genotyping for the BsmI polymorphism were evaluated. Participants had mean age of 69.9 (7.0) years, BMI of 28.3 (4.4) kg/m(2) and 80.3% were women. The prevalence of a 25-hydroxyvitamin D [25(OH)D] status vitamin D levelDD≥75nmol/L]; this relationship was maintained only for women in the analysis by sex. The BsmI polymorphism showed allelic frequencies in the SUF group of B 49% and b 51% and in the INSUF/DEF group B 38% and b 62%. The frequency of bb homozygosity was significantly associated with lower serum total cholesterol and LDL cholesterol concentrations compared to Bb, both in the general population and in the SUF group. Among individuals with bb, the INSUF/DEF group showed higher levels of triglycerides and VLDL cholesterol. Blood glucose levels and oxidative stress were increased in elderly subjects with 25(OH)Dvitamin D status resulted in lower total and LDL cholesterol, but the benefit was lost when vitamin D insufficiency or deficiency was present. Copyright © 2016 Elsevier Inc. All rights reserved.

Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people.

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Curcio, Francesco; Basile, Claudia; Liguori, Ilaria; Della-Morte, David; Gargiulo, Gaetano; Galizia, Gianluigi; Testa, Gianluca; Langellotto, Assunta; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

2016-12-01

Elderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m 2 ; p for trend strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg; p for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (y = 4.5x + 0.4, r = 0.61; p strength (y = 14.0x + 0.8, r = 0.53; p strength (r = 0.39, p = 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls.

Resting energy expenditure and body composition in bedridden institutionalized elderly women with advanced-stage pressure sores.

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Sergi, Giuseppe; Coin, Alessandra; Mulone, Silvana; Castegnaro, Eugenio; Giantin, Valter; Manzato, Enzo; Busetto, Luca; Inelmen, Emine Meral; Marin, Sara; Enzi, Giuliano

2007-03-01

Our study investigated nutritional status, body composition, and resting energy expenditure (REE) in elderly patients with advanced-stage pressure sores (PS), in addition to researching any hypermetabolic condition and its relationship with PS size. The study involved 52 institutionalized bedridden elderly women (aged 83.7 +/- 6.3 years), divided into two groups: 23 with advanced-stage (stage 3 and 4) PS and 29 without PS. Albumin, prealbumin, and retinol-binding protein were measured in all patients, and fat-free mass (FFM) and fat mass (FM) were obtained by dual-energy x-ray absorptiometry (DEXA). REE was measured by indirect calorimetry and predicted with the Harris-Benedict formula. PS area and volume were also measured. The elderly women with and without PS were comparable in age, FFM, and FM. Mean albumin, prealbumin, and retinol-binding protein values were lower in cases with PS. Unadjusted mean REE was significantly higher in patients with PS (1212.3 +/- 236.7 vs 1085.5 +/- 161.3 kcal/d; p 110% of the predicted REE, was seen in 74% of patients with PS and 38% of controls. The difference between measured and predicted REE (DeltaREE) correlated with PS volume (r = 0.58; p elderly women are associated with a hypermetabolic state that is influenced by the volume of the PS.

Preventive Care Use among the Belgian Elderly Population: Does Socio-Economic Status Matter?

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Sarah Hoeck

2013-12-01

Full Text Available Objective: To analyze the association between influenza and pneumococcus vaccination and blood cholesterol and blood sugar measurement by Belgian elderly respondents (≥65 years and socio-demographic characteristics, risk factors, health status and socio-economic status (SES. Methods: A cross-sectional study based on 4,544 non-institutionalized elderly participants of the Belgian Health Interview Surveys 2004 and 2008. Multivariate logistic regression models were constructed to examine the independent effect of socio-demographic characteristics, risk factors, health status and SES on the four preventive services. Results: After adjustment for age, sex, region, survey year, living situation, risk factors (body mass index, smoking status, physical activity and health status (self-assessed health and longstanding illness lower educated elderly were significantly less likely to report a blood cholesterol and blood sugar measurement. For instance, elderly participants with no degree or only primary education were less likely to have had a cholesterol and blood sugar measurement compared with those with higher education. Pneumococcus vaccination was not related to educational level, but lower income groups were more likely to have had a pneumococcus immunization. Influenza vaccination was not significantly related to SES. Conclusion: The results highlight the need to promote cholesterol and blood sugar measurement for lower SE groups, and pneumococcus immunization for the entire elderly population. Influenza immunization seems to be equally spread among different SE groups.

Knee flexion contractures in institutionalized elderly: prevalence, severity, stability, and related variables.

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Mollinger, L A; Steffen, T M

1993-07-01

The purpose of this study was to document the prevalence, severity, and progression of knee flexion contractures (KFCs) in a population of institutionalized elderly and to identify relationships between knee extension and other variables. The subjects were 112 nursing home residents who exhibited a broad range of ambulation and cognitive function abilities. Data were collected initially (T1) and after a 10-month period (T2). Only 25% of the population had extension in the 0- to 5-degree (lacking full extension) range bilaterally at T1 and T2, leaving the majority of subjects with some degree of unilateral KFC. Most of the subjects with a KFC greater than 20 degrees were nonambulatory and had a significantly higher occurrence of resistance to motion than did nonambulators with a KFC of less than 20 degrees. Knee extension measurements did not change in most subjects between T1 and T2. The knees that did show a change in KFC (either an increase or a decrease) had a significantly higher occurrence of resistance to passive motion than did other knees. Compared with the subjects who gained extension, the subjects who lost extension over the study period more frequently had minimal KFC at T1, were ambulatory at T1, showed a regression in ambulation at T2, and developed resistance to motion at T2. The data confirmed significant positive correlations between degree of KFC and presence of resistance to passive knee motion, cognitive impairment, impaired ambulation, and presence of knee pain. Physical therapy assessment and intervention may be appropriate in nonambulatory nursing home residents with resistance to passive motion, residents with KFC approaching 20 degrees, and ambulatory residents with minimal KFC who develop resistance and begin to regress in ambulation. Several areas for future study are suggested.

Prevalencia del deterioro cognitivo leve en mayores institucionalizados Prevalencia of the mild cognitive impairment in institutionalized elders

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Jesús Manuel Vallejo Sánchez

2010-12-01

become institutionalized with absence of neurological pathology or severe cognitive impairment of the home care nursing Jose Matía Calvo of Cádiz. It was sifted to the subjects by the mini cognitive test in the version of Wolf during January, 2008, there being obtained a sample of which were studied social, demography and of control variables. Results: it is clear that DCL's prevalencia in the elders become institutionalized in our center is 27 %, number higher than the contributed one like average for some authors for the general population (15-20 %, but minor that the established one in other home care nursing, that range between 38,7 and 44 %. Conclusions: the increase stated of the prevalencia of the cognitive impairment in the older population and his repercussion in the level of independence and quality of life of major become institutionalized, justifies the need to identify prematurely such alteration to initiate, as soon as possible, you programme of intervention directed to delaying the dependence, promoting the residual capacities and improving the quality of life of these elders.

Socio-demographic, behavioral and functional characteristics of groups of community and institutionalized elderly Quechua Indians of Peru, and their association with nutritional status.

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Fortunato, Laura; Drusini, Andrea G

2005-06-01

Socio-demographic, behavioral, functional and anthropometric data for groups of elderly Quechua Indians of Peru were used to investigate the effects of gender and lifestyle patterns on nutritional status. Two community-dwelling samples were selected for study, representative of divergent lifestyles in terms of their combination of socio-economic, demographic and cultural contexts, plus an ad-hoc sample of institutionalized individuals with controlled food intake and reduced physical activity. Results suggest that differences in socio-demographic, behavioral and functional characteristics exist between the sexes and across settings (low- vs. highland) and lifestyles (institutionalized vs. community-dwelling; semi-urban vs. rural). These factors are likely to be related to diverging dietary and physical activity patterns, and have considerable effects on the nutritional status of the respondents.

Depressive symptoms in institutionalized older adults

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Lívia Maria Santiago

2014-04-01

Full Text Available OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals.

Technologies for participatory medicine and health promotion in the elderly population

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Nieto-Riveiro, Laura; Groba, Betania; Miranda, M. Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-01-01

Abstract Introduction: The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called “geriatric syndromes” frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. Objective: The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. Methods and Analysis: The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a “quasi-experimental” type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group. The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants’ occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. Ethics and Dissemination: The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles

Dietary Protein Intake in Dutch Elderly People: A Focus on Protein Sources

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Michael Tieland

2015-11-01

Full Text Available Introduction: Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people. Objectives: to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people. Methods: Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people. Results: Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60% with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source. Conclusion: Daily protein intake in these older populations is mainly (>80% provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from

Developing effective animal-assisted intervention programs involving visiting dogs for institutionalized geriatric patients: a pilot study.

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Berry, Alessandra; Borgi, Marta; Terranova, Livia; Chiarotti, Flavia; Alleva, Enrico; Cirulli, Francesca

2012-09-01

An ever increasing interest in the therapeutic aspects of the human-animal bond has led to a proliferation of animal-assisted interventions (AAI) involving dogs. However, most of these programs lack a solid methodological structure, and basic evaluative research is needed. The purpose of this study was to test the value of dog-assisted interventions as an innovative tool to increase quality of life in the geriatric population. Nineteen patients (men and women) with a mean age of 85 years participated in the study. Interactions between patients and visiting dogs occurred either in a social situation (socialization sessions) or in a therapeutic context (physical therapy sessions). We derived and characterized a specific ethogram of elderly-dog interactions aimed at evaluating the effectiveness of visiting dogs in improving mood, catalyzing social interactions and reducing their everyday apathetic state. Cortisol levels were also measured in the saliva, and depressive state was evaluated. Overall, results show a time-dependent increase in social behaviour and spontaneous interactions with the dogs. Dog-mediated interactions affected the daily increase in cortisol levels, thus having an 'activational effect', in contrast to the apathetic state of institutionalized elderly. Dog-mediated intervention programs appear to be promising tools to improve the social skills and enrich the daily activities of the institutionalized elderly. © 2012 The Authors. Psychogeriatrics © 2012 Japanese Psychogeriatric Society.

Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India.

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Kshetrimayum, Nandita; Reddy, Chavva Venkata Konda; Siddhana, Sunitha; Manjunath, Maurya; Rudraswamy, Sushma; Sulavai, Sibyl

2013-06-01

To assess whether oral health-related quality of life (OHRQoL) is associated with nutritional status in the institutionalised elderly population of Mysore. Malnutrition in the elderly has an evident impact on their general health and quality of life. Analysis of data of the Geriatric Oral Health Assessment Index (GOHAI) and their association with the Mini Nutritional Assessment (MNA) results improves our understanding of the complex relationship between oral health and malnutrition. The study was conducted among the institutionalised elderly population in Mysore city, Karnataka. Data on socio-demographic, oral health status were gathered. OHRQoL was evaluated using GOHAI, and malnutrition risk using MNA. Out of 141 elderly, 41.1% were men and 58.9% were women with mean age of 72.2 ±7.5 years. Mean GOHAI score was 47.03 ± 9.2, with 69.5% had low perception of oral health. Mean MNA score was 9.91 ± 2.4, 15.6% were malnourished, 52.5% were at risk of malnutrition and 31.9% were adequately nourished. A strong association was found between the mean GOHAI and MNA scores.  Oral health-related quality of life was associated with nutritional deficit, and it requires a greater integration between dentistry and nutrition in the health promotion of older adults. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Physical strength is associated with Mini-Mental State Examination scores in Spanish institutionalized elderly.

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Pedrero-Chamizo, Raquel; Albers, Ulrike; Tobaruela, José L; Meléndez, Agustín; Castillo, Manuel J; González-Gross, Marcela

2013-10-01

The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5-100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini-Mental State Examination (MMSE). The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 (MMSE score). All parameters were significantly higher for men (P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age. © 2013 Japan Geriatrics Society.

Elder abuse in Chinese populations: a global review.

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Dong, XinQi

2015-01-01

This review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse. Evidence revealed that elder abuse and its subtypes are common among the global Chinese population with prevalence ranging from 0.2% to 64%. Younger age, lower income levels, depression, cognitive impairment, and lack of social support were consistently associated with self-reported elder abuse. Caregiver burden was a constant risk factor for the proclivity to elder abuse by caregivers. The adverse health outcomes of elder abuse included suicidal ideation and psychological stress. Some primary research gaps exist: such as, lack of consistency in measurements and recall periods, insufficient studies on the causal relationships between potential risk factors and elder abuse, consequences of elder abuse, and possible interventions. In order to reduce the risk of elder abuse in the global Chinese population, collaboration is encouraged among researchers, health care professionals, social service providers, and policy makers.

Depressive symptoms and cognitive performance of the elderly: relationship between institutionalization and activity programs Sintomas depressivos e desempenho cognitivo nos idosos: relações entre institucionalização e realização de atividades

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Mara Cristina F Plati

2006-06-01

Full Text Available OBJECTIVE: The aim of this study was to assess the frequency of depressive symptoms and to evaluate cognitive performance of institutionalized versus non-institutionalized elderly subjects and to compare the effect of institutionalization and participation in the institution's activity programs on their cognitive performance. METHOD: A group of 120 elderly subjects with a mean age of 71 years and average schooling of 4.2 years was evaluated. The participants were divided into 3 groups: non-institutionalized (n = 37; institutionalized with activities (n = 37; institutionalized without activities (n = 46. The groups were matched for age, gender and educational level. The following assessment instruments were used: the Geriatric Depression Scale, the Mini-Mental State Examination, the Verbal Fluency Test and the computerized versions of the Hooper Visual Organization Test and the Boston Naming Test. The data were analyzed using one-way ANOVA and the Pearson's correlation test. RESULTS: The two groups of institutionalized elderly showed higher frequency of depressive symptoms when compared to non-institutionalized subjects and worse performance on the Verbal Fluency Test. The institutionalized group without activities had lower scores on Mental State Examination, Boston Naming Test and Hooper Visual Organization Test when compared to the other two groups (p OBJETIVO: Avaliar a freqüência de sintomas depressivos e o desempenho cognitivo de idosos institucionalizados e não institucionalizados. Comparar os escores nos testes em função da institucionalização e da realização de atividades oferecidas pela instituição. MÉTODO: Foram avaliados 120 idosos com idade média de 71 anos e escolaridade média de 4,2 anos, divididos em três grupos: Não institucionalizados (n = 37; Institucionalizados com atividade (n = 37; Institucionalizados sem atividade (n = 46. Os grupos foram pareados em função da idade, sexo e escolaridade. Foram aplicados os

Seasonal Variation in Mortality, Medical Care Expenditure and Institutionalization in Older People

DEFF Research Database (Denmark)

Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David

2015-01-01

. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality. METHODS: Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer...... in mortality is similar for both institutionalized and community-dwelling elderly. Policy-makers, epidemiologists and health economists are urged to acknowledge and include the impact of the seasons in future policy and research....

Tc-99m ECD brain SPET in the evaluation of dementia for institutionalized elderly patients

International Nuclear Information System (INIS)

Lee, Myoung Hoon; Park, Chan H.; Yoon, Seok Na.; Hwang, Kyung Hoon

2001-01-01

Dementia is one of the clinically recognized indications of regional cerebral blood flow (rCBF) measurement by Tc-99m ECD brain SPET (Single Photon Emission Tomography). There is only limited number of institutions for elderly demented patients who are institutionalized in Korea and SPET is nor available at these institutions. The aim of the study is to evaluate rCBF SPET findings of the patients from such an institution. Thirty-one patients were reffered for rCBF SPET from Yongin Hyoja Hospital, Yongin. They were screened using NINCDS-ADRDA criteria for probable Alzheimers disease (AD) and dementia severity was assumed by the Mini-Mental State examination. In a quite, dim light room, patients were injected with 740 mBq (20mCi) Tc-99m ethyl cysteinate dimmer (ECD), Neurolite R, Dupont Pharmaceuticals, Billerica, MA, USA). SPET was acquired using fanbeam collimators and triple-head gamma camera (MultiSPECT III, Siemens medical systems. Inc. Hoffman Estates, III.USA). SPET was done one hour after the tracer injection and most of the patients needed sedation 30 minutes before the scan. SPET was evaluated visually by 2 nuclear medicine physicians blinded to clinical information. The SPET scans of 31 patients revealed 3 typical AD, 9 atypical AD patterns. Other dementia patterns were 4 cases of frontotemporal lobe dementia, 5 cases of frontal lobe dementia and 2 multifocal infarctions. Only cerebral atrophy is depicted in 8 patients and normal SPECT findings was noted in one patient. Patients who are institutionalized for dementia have varying SPET patterns as expected and SPET findings are useful in the management of these patients with more clearer clinical insight

Antiepileptic drug use and the occurrence of pressure ulcers among bedridden institutionalized elderly patients: a retrospective chart review.

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Arinzon, Zeev; Zeilig, Gabriel; Berner, Yitshal N; Adunsky, Abraham

2005-09-01

Phenytoin (PH) is indicated primarily for the control of grand mal and psychomotor seizures. However, topical PH has been used for the treatment of various types of ulcers, including pressure ulcers. The aim of this study was to investigate the possibility of a relationship between the use of oral PH and the prevalence of pressure ulcers among bedridden institutionalized elderly patients. This retrospective chart review was conducted in a state-run urban geriatric medical center in Israel and involved long-term bedridden institutionalized patients who were receiving chronic antiepileptic medication during the 7-year period between January 1996 and December 2003. The prevalence of pressure ulcers in patients who received treatment with PH alone or in combination with other antiepileptic drugs was compared with that in patients who received antiepileptic agents other than PH. The study analyzed data from the medical charts of 153 patients, 72 of whom received PH alone or in combination with other antiepileptic drugs, and 81 of whom received antiepileptic agents other than PH. Patients' mean (SD) age was 78.5 (7.2) years; 106 (69.3%) were women. All patients were totally dependent with respect to activities of daily living (mean Katz score, 2.0 [2.0]) and had severe cognitive decline (mean Mini-Mental State Examination score, 3.5 [3.3]). Pressure ulcers occurred in 9.7% of PH recipients and 27.2% of non-PH recipients (P = 0.006; chi2 = 7.55). In PH recipients, 85.7% of pressure ulcers were of mild to moderate severity (stage I or II), compared with 59.1% of ulcers in non-PH recipients; the difference between groups was not statistically significant. Four (18.2%) non-PH recipients and no PH recipients had stage IV pressure ulcers. In the PH group, 71.4% of patients had a pressure ulcer in only 1 anatomic location, compared with 22.7% of the non-PH group (P = 0.023; chi2 = 5.13); 28.6% of PH recipients and 63.6% of non-PH recipients had pressure ulcers in 2 or 3

Use of health care resources and associated costs in non-institutionalized vulnerable elders with overactive bladder treated with antimuscarinic agents in the usual medical practice.

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Sicras-Mainar, A; Rejas-Gutiérrez, J; Navarro-Artieda, R; Aguado-Jodar, A; Ruíz-Torrejón, A

2014-10-01

To evaluate the use of resources and health costs in vulnerable elderly institutionalized patients with overactive bladder (OAB) treated with fesoterodine, tolterodine or solifenacin in routine medical practice. A multicenter retrospective study, from the records of patients treated during 2008-2010 in three geographical locations and starting treatment with antimuscarinic (fesoterodine, solifenacin and tolterodine) for OAB. The attribute of vulnerability was based on collecting at least 3 of the Vulnerable Elders Survey criteria-13, age>75 years, poor/average age for health and difficulty in at least one daily physical activity. morbidity, persistence and resource use and costs. Monitoring of patients was conducted over 52 weeks. A general linear model with covariates and bootstraping (1000) at random was used to construct the 95% CI of the cost differences between drugs. Records of 552 patients (50.8% women, mean age: 80.2 years) were analyzed. Treated with fesoterodine (N=58), solifenacin (N=252) or tolterodine (N=212). The use of absorbent was 20.7%, 29.4% and 33.0% (P=.186), respectively. Persistence to treatment was slightly greater with fesoterodine. The patient healthcare costs/year were lower with fesoterodine, €1,775 (1550-2014) vs. solifenacin €2,062 (1911-2223) and tolterodine €2,149 (1,978-2,307), P=.042, as a result of lower utilization visits and concomitant medication. Despite the potential limitations of the study, the vulnerable elderly non institutionalized patients with OAB treated with fesoterodine, compared to solifenacin or tolterodine were associated with lower resource utilization and healthcare costs. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement

NARCIS (Netherlands)

Tieland, C.A.B.; Borgonjen-van den Berg, K.J.; Loon, van L.C.; Groot, de C.P.G.M.

2012-01-01

Adequate dietary protein intake is required to postpone and treat sarcopenia in elderly people. Insight into dietary protein intake in this heterogeneous population segment is needed to locate dietary inadequacies and to identify target populations and feeding strategies for dietary interventions.

Identification of fungi species in the onychomycosis of institutionalized elderly Identificação de espécies fúngicas nas onicomicoses do idoso institucionalizado

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Cidia Vasconcellos

2013-06-01

Full Text Available BACKGROUND: Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue. OBJECTIVE: The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +. METHODS: The identification of the fungi relied upon the combined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails. Both groups were institutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil. RESULTS: The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii, 11.11% Candida parapsilosis, 5.56% Candida glabrata, and 5.56% Trichosporon asahii. A third group displayed 16.70% filamentous fungi, like Fusarium sp, Aspergillus sp and Neoscytalidium sp (5.56% each. The interdigital scrapings presented a positivity rate of 14.29%. The agents were coincident with the fungi that caused the onychomycosis. In the control group, Candida guilliermondii was found at interdigital space in one person. CONCLUSION: Employing a combination of those identification methods, we found no difference between the etiology of the institutionalized elderly onychomycosis from that reported in the literature for the general population. FUNDAMENTOS: As infecções fúngicas superficiais se correlacionam com o agente etiológico, a resposta imune do hospedeiro, o local da lesão e o

IDENTIFYING DEMENTIA IN ELDERLY POPULATION : A CAMP APPROACH

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Anand P

2015-06-01

Full Text Available BACKGROUND: Dementia is an emerging medico social problem affecting elderly, and poses a challenge to clinician and caregivers. It is usually identified in late stage where management becomes difficult. AIM: The aim of camp was to identify dementia in elderly population participating in screening camp. MATERIAL AND METHODS : The geriatric clinic and department of psychiatry jointly organised screening camp to detect dementia in elderly for five days in September 2014 to commemorate world Alzheimer’s day. The invitation regarding camp was sent to all senio r citizen forums and also published in leading Kannada daily newspaper. Mini Mental Status Examination and Diagnostic and Statistical Manual of Mental Disorders, 4 th edition criteria (DSM IV was used to identify dementia. RESULTS: Elderly male participate d in camp in more number than females and dementia was identified in 36% elderly with education less than 9 th standard. Dementia was found in 18% in our study population. CONCLUSION: The camp help identify elderly suffering from dementia and also created a wareness about it. Hypertension and diabetes mellitus were common co morbidity in study population. Our study suggested organising screening camp will help identify elderly living with dementia.

Elder Abuse and Neglect in Israel: A Comparison between the General Elderly Population and Elderly New Immigrants

Science.gov (United States)

Iecovich, Esther

2005-01-01

The present study investigated differences between the general elderly population and elderly new immigrants from former Soviet Union countries in regard to the incidence of elder abuse and neglect, victims' characteristics, and perpetrators' characteristics. In addition, the study sought to examine predictors of various types of abuse and…

Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level.

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Gálvez-Barrón, César; Narvaiza, Leire; Dapena, María D; Macho, Oscar; Rodríguez-Molinero, Alejandro

2016-04-01

In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population. To explore prevalence and considered pharmacological treatments for pain in this population. Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews. Pain's prevalence was 52.5 % (CI 95 % 48.28-56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93-1.02) in females and 0.99 (CI 95 % 0.92-1.06) in males]. The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline's recommendations are probably not being considered to select the analgesic therapy.

Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.

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Bogaerts, An; Delecluse, Christophe; Boonen, Steven; Claessens, Albrecht L; Milisen, Koen; Verschueren, Sabine M P

2011-03-01

Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity. Copyright © 2010 Elsevier B.V. All rights reserved.

Use of Medicines Among a Brazilian Elderly Sample: A Cross-sectional Study

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Adriana Mathias Pereira da Silva Marchini

2011-06-01

Conclusion: In this Brazilian elderly sample, the most widely used medicines were antihypertensives, diuretics, and nonsteroidal anti-inflammatory drugs, and institutionalized used more medications than community-dwelling elderly.

The effect of group exercise frequency on health related quality of life in institutionalized elderly.

Science.gov (United States)

Rugbeer, Nivash; Ramklass, Serela; Mckune, Andrew; van Heerden, Johan

2017-01-01

The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. A significant difference was noted in social function post training 2X/week (MD = -13.85, 95% CI [-24.66, -3.38], p = 0.017, d = 0.674) and 3X/week (MD = -13.30, 95% CI [-21.81, -5.59], p = 0.003, d = 0.712) a week. Training 3X/week a week provided an additional benefit in vitality (MD = -7.55, 95% CI [-13.16, -1.91], p = 0.018, d =0. 379). Improvements in mental component summary scale post training 2X/week (MD = -4.08, 95% CI [-7.67, -0.42], p = 0.033, d = 0.425) and 3X/week (MD = -6.67, 95% CI [-10.92, -2.33], p = 0.005, d = 0.567) a week was further noted. Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence.

Training model to institutionalize population education in the in-service education programme for elementary school teachers.

Science.gov (United States)

Dugenia, M E

1982-12-01

The goal of the Philippine Population Education Program (PEP) since its inception in 1972 is to institutionalize population education in the formal educational system. The PEP Training Section views institutionalization of population education in the inservice education program for elementary school teachers as part of the process of making it an integral part of that program. In practice elementary school teachers periodically attend training programs organized by division or district supervisors and school principals. This is the usual modality through which teachers are updated on or informed about new thrusts and recent developments in teaching content, strategies, and methodologies. In this context, the PEP Training Section convened a seminar workshop in December 1981 for 10 subject area supervisors from the 3 large geographic island groups of Luzon, Visayas, and Mindanao. They represented 10 school divisions and subject areas where population education is integrated. The specific objectives of the 5 day activity were to: discuss existing inservice training programs in the school divisions; prepare a training model incorporating population education in the overall division inservice training program; and develop a content chart or a listing of topical areas on population education for the training model. 1 of the outputs of the seminar workshop was a training model incorporating population education in the regular inservice training programs using 3 delivery schemes, i.e., seminar workship on the teaching of specific subject areas; district staff meeting and/or echo seminars organized by district supervisors following division seminars; and regular teachers' meeting at the school level organized by school principals. Another output was a content chart listing suggested topics in population education classified according to subject areas into which they will be incorporated. The semninar workshop concluded with a plan to try out the model using the identified

[Use of new antidiabetics in the elderly population].

Science.gov (United States)

Besse, Sarah; Besse, Arun; Jornayvaz, François R

2016-06-01

Over the last few years, we have noticed the arrival on the market of new antidiabetic treatments. These represent an potential advantage because of the increase in the prevalence of type 2 diabetes, particularly in the elderly population. Nevertheless, elderly patients have a number of frailties that should be considered in the treatment of this condition. There is a lack of literature in this population as elderly are frequently excluded from randomized controlled trials. Therefore, guidelines were developed based on the consensus of experts in geriatrics and diabetology for this specific population. We have to consider the potential benefits and adverse effects of the new antidiabetics in older patients.

Estudo comparativo da classificação do grau de perda auditiva em idosos institucionalizados Comparative study for classifying the hearing loss degree in institutionalized elderly

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Cristhiane Emy Kano

2009-09-01

Full Text Available OBJETIVO: comparar os resultados audiológicos de idosos institucionalizados, levando-se em consideração duas classificações distintas. MÉTODOS: foram avaliados 40 idosos de ambos os sexos, com faixa etária superior a 60 anos. Após levantar a história clínica audiológica e de realizar otoscopia, foram obtidos os limares tonais (via aérea e via óssea dos indivíduos, com o uso de audiômetro Eymasa, dentro de cabina acústica. RESULTADOS: demonstraram que a classificação proposta pela Recomendação 02/1 do Bureau International d'Audio Phonologie, foi mais sensível quanto a caracterização da perda auditiva na população idosa. CONCLUSÃO: a classificação utilizada pela Recomentação 02/1 é a que melhor representa o grau de perda auditiva nesta população, uma vez que leva em consideração além das freqüências da fala (500, 1k e 2kHz, a freqüência de 4 kHz para o cálculo da média.PURPOSE: to compare the audiological results for institutionalized elderly, taking into consideration two distinct classifications. METHODS: we evaluated 40 elderly of both genders, over 60-year-old, after assessing the clinical history and conduct of audiological otoscopy, we obtained the pure tone (via air and bone of the individuals, by using the audiometer Eymasa within an acoustic cabin. RESULTS: the classification used by Recommendation 02/1 of Bureau International d'Audio Phonologie, was more sensitive about hearing loss characterization in the elderly population. CONCLUSION: the classification used by Recommendation 02/1, is the one that better represents hearing loss degree in this population, since it takes in consideration in addition to the speech frequencies (500, 1k and 2kHz, the frequency of 4kHz for calculating the mean value.

Physical exercise and functional fitness in independently living vs institutionalized elderly women: a comparison of 60- to 79-year-old city dwellers

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Furtado HL

2015-04-01

Full Text Available Hélio L Furtado,1 Nelson Sousa,2 Roberto Simão,3 Fabio Dutra Pereira,1 José Vilaça-Alves2 1Castelo Branco University, Rio de Janeiro, Brazil; 2Research Center for Sport, Health, and Human Development, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; 3School of Physical Education and Sports, Rio de Janeiro Federal University, Rio de Janeiro, Brazil Purpose: To compare functional fitness (FF levels among independent-living (IL and day care (DC elderly women of different age groups and to analyze changes in FF after 8 months of participation in an exercise program intervention for the IL elderly women. Materials and methods: A total of 674 elderly women were divided into four IL groups with age in the range of 60–64 years (IL60–64, n=149, 65–69 years (IL65–69, n=138, 70–74 years (IL70–74, n=135, and 75–79 years (IL75–79, n=83, and four DC groups with age in the range of 60–64 years (DC60–64, n=35, 65–69 years (DC65–69, n=34, 70–74 years (DC70–74, n=47, and 75–79 years (DC75–79, n=53. The intervention consisted of a multimodal exercise training, 3 days per week for 8 months. Senior Fitness Test battery performances were obtained at baseline and after 8-month intervention. Results: Significant differences were identified between all IL groups and DC groups in all FF tests (P<0.001, except between IL70–74 and DC70–74 in the chair sit-and-reach. Analysis of covariance (ANCOVA identified significant improvements in all FF tests between pre- and posttests in the IL groups (P<0.001, except in the chair sit-and-reach for the IL70–74. ANCOVA also showed a significant declining performance in all FF tests for DC groups (P<0.001, except in the chair sit-and-reach for the DC70–74 and DC75–79. Conclusion: IL women are more fit than institutionalized DC elderly women. The multimodal training was effective in improving all FF components related to daily living activities, in all age groups

Bacterial Pneumonia in Elderly Japanese Populations

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Naoya Miyashita

2018-01-01

Full Text Available Bacterial pneumonia is one of the most important infectious diseases in terms of incidence, effect on quality of life, mortality, and impact on society. Pneumonia was the third leading cause of death in Japan in 2011. In 2016, 119 650 Japanese people died of pneumonia, 96% of whom were aged 65 years and above. The symptoms of pneumonia in elderly people are often atypical. Aspiration pneumonia is seen more frequently than in young people because of swallowing dysfunction in the elderly. The mortality rate is also higher in the elderly than in young people. In Japan, the population is aging at an unprecedented rate, and pneumonia in the elderly will be increasingly important in medicine and medical economics in the future. To manage pneumonia in the elderly, it is important to accurately evaluate its severity, administer appropriate antibiotic treatment, and implement effective preventive measures.

Quality of care: from the perspective of elderly people: the QUOTE-Elderly instrument.

NARCIS (Netherlands)

Sixma, H.J.; Campen, C. van; Kerssens, J.J.; Peters, L.

2000-01-01

Background: patient views on the quality of care are usually assessed by means of patient satisfaction questionnaires. Aim: to develop an instrument that would: (i)produce data to the expectations and experiences of non-institutionalized elderly people, (ii) contain items that has been formulated in

Falls in institutionalized older adults: risks, consequences and antecedents

OpenAIRE

Araújo Neto, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

2017-01-01

ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova ...

The falls and the fear of falling among elderly institutionalized

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Patrícia Almeida

2013-06-01

Full Text Available In the present study it is intended to characterize the history of falls and to evaluate the fear to fall in aged institutionalized. The sample is composed for 113 institutionalized aged people, 32 men and 81 women with a average 82,96 ± 7,03 age of years. The data had been collected by means of a questionnaire and statistical analyzed (descriptive statistics, parametric tests - Test T and Anova - Test U-Mann Whitney, and Test of Kruskal-Wallis – and the Test of Tukey. The results point in the direction of that the women present a bigger number of falls (24.8% and greater fear to fall (Med=55. The falls had occurred in its majority in the context of the room of the institutions. It was verified that people who had at least a fall experience present greater fear to fall comparatively (Med=55 with that they had not the same had no incident of fall in period of time (Med=77. Our results come to strengthen the hypothesis of the changeable sex to be able to be considered a factor of fall risk. Aged that they present a history of falls seems to be more vulnerable to develop the fear to fall.

Restless Legs Syndrome in a Nigerian Elderly Population

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

2016-01-01

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

Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

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Herrmann, Nathan; Eryavec, Goran

1994-01-01

Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Estudo da hipotermia acidental em idosos institucionalizados Study on accidental hypothermia in institutionalized elderly

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António Palma Seman

2009-01-01

Full Text Available OBJETIVO: Analisar a prevalência, causas e evolução da hipotermia acidental em idosos institucionalizados. MÉTODOS: Estudo prospectivo realizado entre janeiro e dezembro de 2004, no Hospital Geriátrico e de Convalescentes D. Pedro II, com 483 internos. Hipotermia foi confirmada por termômetro esofágico, utilizado em todos os pacientes com temperatura axilar menor ou igual a 35ºC (95ºF. Tanto o diagnóstico etiológico quanto as complicações da hipotermia foram observados em exames clínico e subsidiários de urgência como eletrocardiograma, radiografia de tórax, hemograma, gasometria arterial, glicemia, metabólitos, amilase, função hepática e renal, sorologias para HIV, sífilis e hepatite B e urina tipo I. Foram adotadas medidas de reaquecimento entre outras do protocolo de tratamento. RESULTADOS: A prevalência de hipotermia foi de 7,2% especialmente em mulheres (65,7%, e a média de idade do grupo foi 76,4 anos. A maioria dos pacientes (77,1% apresentava elevado grau de dependência (Katz "F" e "G". Hipotermia leve foi identificada na maioria dos idosos (71,4%. A taxa de mortalidade foi de 62,8%, sendo 31,4% em vigência de hipotermia e 31,4% após sua reversão. Em 100,0% dos casos, a etiologia foi infecciosa: pneumonia em 80%, infecção urinária em 60,0%, e úlceras por pressão em 17,1%. Em 60% dos casos havia mais de um foco infeccioso. CONCLUSÃO: A hipotermia em idosos institucionalizados é uma grave condição clínica, com altos índices de mortalidade. A prevenção, o diagnóstico precoce e medidas de reaquecimento central corroboram para um melhor prognóstico.OBJECTIVE: To analyze the prevalence, causes and outcome of hypothermia in institutionalized elderly. METHODS: prospective study held from January to December, 2004 at the Hospital Geriátrico e de Convalescentes Dom Pedro II (Geriatric and Convalescent Hospital Dom Pedro II, with 483 long-term care beds. Hypothermia was diagnosed by esophageal thermometer

Are elderly dependency ratios associated with general population suicide rates?

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Shah, Ajit

2011-05-01

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

Religious well-being in noninstitutionalized elderly women.

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Zorn, C R; Johnson, M T

1997-01-01

Spirituality is recognized as an important component of health care practice with elderly people. Yet, discussion of the role it plays in elderly women on a day-to-day basis is minimal, and it is frequently not addressed in quality-of-life studies in this population. The purposes of this study were to describe the level of religious well-being and selected characteristics of religiosity in a sample of 114 non-institutionalized, largely rural elderly women (Mdn age = 75), as well as to identify the relationship between selected factors and the level of religious well-being. Descriptive research revealed a high level of religious well-being among the participants and significant positive correlation between religious well-being and the variables of social support and hope (p hope emerged as the single significant predictor of religious well-being (p religious activities, highly rated the value or influence of religious beliefs in their lives, and identified that religious beliefs become increasingly important with age. Conducting a comprehensive assessment and implementing focused interventions associated with religious well-being will strengthen the scope of health care practice for elderly women.

[The experience of adult Korean children caring for parents institutionalized with dementia].

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Kwon, Suhye; Tae, Young Sook

2014-02-01

The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.

Body Mass Index assessment of institutionalized aged people without cognitive impairment using clinical and nutritional factors

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María del Mar Ruperto López

2016-12-01

Full Text Available Introduction: Overweight and obesity are recognized mortality risk factors in the general population. The aim of the study was to analyse the phenotypic distribution of body mass index (BMI, and to identify the prevalence of malnutrition and clinical and nutritional factors related to BMI in autonomous institutionalized elders. Material and Methods: Cross-sectional and descriptive study in 104 institutionalized aged people (73% female, mean of age 86.4 [±6.2] years and time on institutionalization 25.7 [±21.7] months. Mini-Nutritional Assessment (MNA, anthropometric measures and laboratory parameters were used for nutritional assessment. Bioimpedance analysis (BIA-101; RJL-System was used for body composition analysis. The sample was classified into BMI tertiles (Tn: T1=<26.2kg/m2; T2=26.3-29.7kg/m2; and T3=≥29.8kg/m2. Results: The phenotypic distribution of BMI was: overweight 51% and, prevalence of obesity 29.8%. Mean of BMI: 28.3 (±4.6 kg/m2. Nutritional risk or malnutrition were 60.6% and 11.5%, respectively in the sample. The tertiles of BMI showed significant differences with: mid-arm muscle circumference, triceps-skinfold thickness, total body water (TBW (all, p<0.001. Subjects into T1 had significantly higher nutritional risk or malnutrition compared with T2 and T3 counterparts (p=0.015. Waist-circumference, calf-circumference (at least, p<0.01, and TBW (p<0.001 were independent predictors of BMI in the linear regression analysis (R2=0.52. Conclusions: Overweight and obesity measured by BMI is not an exclusion criterion of malnutrition in the geriatric population. Nutritional screening by MNA and the conjoint use of clinical-nutritional parameters are useful for identifying at nutritional risk or malnutrition. Further studies are needed to define the potential nutritional risk factors associated with BMI in autonomous institutionalized aged.

Does Population Aging Drive Up Pro-Elderly Social Spending?

DEFF Research Database (Denmark)

Vanhuysse, Pieter

-elderly biased. It then points out that population ageing actually cannot explain very much of this pro-elderly bias variance. For instance, countries such as Denmark, Finland and Sweden are demographically old societies, yet they boast among the lowest pro-elderly spending biases in the OECD world, due...... to their greater commitment to family-friendly policies, active labour market policies and similar pro-young policies. The essay reviews a series of similarly counter-intuitive findings about generational politics and policies as published in Ageing Populations in Post-Industrial Democracies (Vanhuysse and Goerres......, 2012) and makes a plea for institutionally and historically richly informed explanations of the political consequences and the policy feedback effects arising from population ageing....

Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

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Dong, XinQi; Simon, Melissa A.

2013-01-01

Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

IDENTIFYING DEMENTIA IN ELDERLY POPULATION : A CAMP APPROACH

OpenAIRE

Anand P; Chaukimath; Srikanth; Koli

2015-01-01

BACKGROUND: Dementia is an emerging medico social problem affecting elderly, and poses a challenge to clinician and caregivers. It is usually identified in late stage where management becomes difficult. AIM: The aim of camp was to identify dementia in elderly population participating in screening camp. MATERIAL AND METHODS : The geriatric clinic and department of psychiatry jointly organised screening camp to detect dementia in elderly for five days in Sept...

Malnutrition in elderly: social and economic determinants.

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Donini, L M; Scardella, P; Piombo, L; Neri, B; Asprino, R; Proietti, A R; Carcaterra, S; Cava, E; Cataldi, S; Cucinotta, D; Di Bella, G; Barbagallo, M; Morrone, A

2013-01-01

Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition. A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated. According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNAshop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.

Prevalência de quedas em idosos asilados do município de Rio Grande, RS Prevalence of falls in institutionalized elderly in Rio Grande, Southern Brazil

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Lílian Gatto Gonçalves

2008-10-01

(62.3% and mostly in the bedroom (23%. In the adjusted analysis, falls remained associated to white color skin, separated and divorced elderly, depression, and higher continuous use of medications. CONCLUSIONS: The study showed that the prevalence of falls among institutionalized elderly is high and that they can be disabling to this population. Although some of the associated factors are preventable, accidental falls still occur in settings that should be safe, such as the elderly's bedroom.

Introduktion. Islam & institutioner

DEFF Research Database (Denmark)

Jacobsen, Brian Arly

2008-01-01

Introduktion til Tidsskrift for Islamforskning temanummer Islam & institutioner Udgivelsesdato: 18-02......Introduktion til Tidsskrift for Islamforskning temanummer Islam & institutioner Udgivelsesdato: 18-02...

Normal lymphocyte immunophenotype in an elderly population

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Sâmia Macedo Queiroz Mota Castellão Tavares

2014-06-01

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

Fall risk in an active elderly population

DEFF Research Database (Denmark)

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

2007-01-01

risk can be assessed by testing balance performance. In this study a test battery of physiological parameters related to balance and falls was designed to address fall risk in a community dwelling elderly population. RESULTS: Ninety-four elderly males and females between 70 and 80 years of age were...... assessment in which the physiological performance is evaluated in relation to the activity profile of the individual. Udgivelsesdato: 2007-null...

Effect of Early Referral to Specialist in Dementia on Institutionalization and Functional Decline: Findings from a Population-Based Study.

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Pimouguet, Clément; Le-Goff, Mélanie; Rizzuto, Debora; Berr, Claudine; Leffondré, Karen; Pérès, Karine; Dartigues, Jean FranÇois; Helmer, Catherine

2016-01-01

Although early diagnosis has been hypothesized to benefit both patients and caregivers, until now studies evaluating the effect of early dementia diagnosis are lacking. To investigate the influence of early specialist referral for dementia on the risk of institutionalization and functional decline in Activity of Daily Living (ADL). Incident dementia cases were screened in a prospective population-based cohort, the Three-City Study, and initial specialist consultation for cognitive complaint was assessed at dementia diagnosis. Proportional hazard regression and illness-death models were used to test the association between specialist referral and, respectively, institutionalization and functional decline. Only one third of the incident individuals with dementia had consulted a specialist for cognitive problems early (36%). After adjustment on potential confounders (including cognitive and functional decline) and competing risk of death, participants who had consulted a specialist early in the disease course presented a higher rate of being institutionalized than those who did not (Hazard Ratio = 2.00, 95% Confidence Interval (CI): 1.09- 3.64). But early specialist referral was not associated with further functional decline (HR = 1.09, 95% CI: 0.71- 1.67). Early specialist referral in dementia is associated with increased risk of institutionalization but not with functional decline in ADL. These findings suggest that early care referral in dementia may be a marker of concern for patients and/or caregivers; subsequent medical and social care could be suboptimal or inappropriate to allow patients to stay longer at home.

A cross-sectional study on quality of life among the elderly in non-governmental organizations' elderly homes in Kuala Lumpur.

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Onunkwor, Obinna Francis; Al-Dubai, Sami Abdo Radman; George, Philip Parikial; Arokiasamy, John; Yadav, Hemetram; Barua, Ankur; Shuaibu, Hassana Ojonuba

2016-01-12

There is a rapid increase in the population of the elderly globally, and Malaysia is anticipated to become an ageing nation in 2030. Maintaining health, social participation, reducing institutionalization, and improving quality of life of the elderly are public health challenges of the 21(st) century. Quality of life among elderly in Elderly Homes in Malaysia is under researched. This study aims to determine the quality of life and its associated factors among the Elderly in Elderly Homes in Kuala Lumpur. This was a cross-sectional study among 203 residents aged 60 years or more in eight randomly selected Elderly Homes in Kuala Lumpur in September 2014. Stratified simple random sampling was used to select participants. Study instruments included World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF), Multidimensional Scale for Perceived Social Support, and a questionnaire for Socio-demographic variables. Data collection was by face to face interview. Univariate and Multivariate analysis were used to determine associations, and P-value leisure activity, physical activity, duration of residence, type of accommodation, co-morbidities, and social support. This study confirms that multiple factors are associated with quality of life among elderly in elderly homes. Social support, chronic co-morbidities, gender and outdoor leisure activity were significantly associated with all the domains of quality of life. Among the four domains of quality of life, the physical domain had the highest score while the social domain had the lowest score. This emphasizes the need for more social support-related interventions in these homes.

Negative aging stereotypes and their relation with psychosocial variables in the elderly population.

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Sánchez Palacios, C; Trianes Torres, M V; Blanca Mena, M J

2009-01-01

This study explores whether there is a relationship between the level of belief in negative aging stereotypes in 65-year-old people and their results concerning some psychosocial variables. These were selected for their relevance for health and well being in elderly people. These were: living situation, responsibilities toward others, subjective health, frequency of medical appointments, subjective age, participation in community social activities and regular physical activity. The sample consisted of 757 people of low educational level, ranged from 65 to 96 years. Age and gender were homogeneously distributed. Participants were non-institutionalized people. Firstly, the psychosocial variables under focus were assessed by means of seven questions. Secondly, a questionnaire about negative aging stereotypes (CENVE) was administered. It was composed of three factors: health, motivational-social and character-personality. Results show that a high score in negative stereotypes is significantly associated to the studied variables, except for living situation, showing a worse quality of life (QoL) profile. Results are discussed in terms of their utility for assessment and psychosocial intervention, which is meant to improve health in the elderly.

IBD in the elderly population: results from a population-based study in Western Hungary, 1977-2008.

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Lakatos, Peter Laszlo; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Kiss, Lajos S; Lakatos, Laszlo

2011-02-01

Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. Data of 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 SD 15.9 years; CD: 506, age at diagnosis: 31.5 SD 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. 106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60 years of age. In UC, the incidence increased from 1.09 to 10.8/10(5) in the elderly, while CD increased to 3.04/10(5) in 2002-2007. In CD, colonic location (elderly: 61.9% vs. pediatric: 24.3%, p=0.001, and adults: 36.8%, p=0.02) and stenosing disease (elderly: 42.9% vs. pediatric: 14.9%, p=0.005, and adults: 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5 years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR: 2.73, 95%CI: 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR: 6.58; 95%CI: 3.22-12.9) and adult (39.8%, p<0.001, OR: 3.24; 95%CI: 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10 years was 11.6%, but time to extension was not different according to the age at onset. Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Mood disorders in elderly population: neurostimulative treatment possibilities.

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Rosenberg, Oded; Shoenfeld, Netta; Kotler, Moshe; Dannon, Pinhas N

2009-06-01

Treatment of mood disorders is one of the most challenging territories in elderly. Effectiveness of different treatment strategies could be related to age, sex and physical conditions. The side effect profile in this population also affects pharmacological interventions. Our review includes the neurostimulative treatment strategies in elderly. However, possible treatment strategies such as electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were less studied in elderly. ECT was found to be an effective treatment procedure in mood disorders. Few double-blind sham controlled studies were conducted and demonstrated effectiveness of TMS. DBS has lack of double-blind studies. ECT seems to be the golden standard for the treatment resistant elderly patients, yet side effect profile of ECT in elderly will be discussed. Double -blind sham controlled studies with larger samples are necessary to confirm preliminary results with transcranial direct current stimulation (tDCS), magnetic seizure therapy (MST) and VNS, DBS.

Educational program in oral health for caregivers on the oral hygiene of dependent elders

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Jéssica Damares LAGO

Full Text Available Abstract Objective Due increased number of elders living in long-term care institutions, actions designs to improve their oral health are essential. Thus, the aim of this study was to evaluate the impact of an educational program for the caregivers through the assessment of the oral hygiene of institutionalized elders. Material and method The education program consisted in lectures to caregivers about oral health that were performed once a month. The subjects were 40 functionally dependent institutionalized elders and 14 caregivers. Hygiene habits, plaque index, and tongue coating/discoloration of the elders were measured before the educational program (baseline- T0 and after 6 (T1, 12 (T2, 18 (T3 and 24 months (T4. Caregivers answered questions about their knowledge, doubts and implementation of dental care (T0 to T4. Result After analyzing the data (Friedman, Chi-square and Spearman α = 0.05, a gradual improvement in the oral hygiene of the subjects was observed, with an increased frequency of brushing (p=0.0005, a change in the brush type (p=0.0065 and a reduction in the plaque index (p<0.05 and tongue coating (p<0.05. Caregivers showed a marked improvement in their dental care knowledge. Conclusion It was concluded that the educational program for caregivers had a positive impact in the oral health of institutionalized elderly observed by the increased in the effectiveness of oral hygiene parameters such as plaque index and tongue coating, contributing to the knowledge gain in hygiene by caregivers.

Institutionalized Stroke Patients: Status of Functioning of an Under Researched Population

NARCIS (Netherlands)

van Almenkerk, S.; Depla, M.F.I.A.; Smalbrugge, M.; Eefsting, J.A.; Hertogh, C.M.P.M.

2012-01-01

Objectives: In view of the development of an integrated care and treatment program for institutionalized stroke patients tailored to their needs, we aimed to explore their status of functioning in the physical, cognitive, emotional, communicative and social domains. In addition, we explored the

Depression in elderly women resident in a long-stay nursing home.

Science.gov (United States)

Lampert, Melissa Agostini; Rosso, Ana Luiza Pereira

2015-01-01

Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH). This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version) above 5. Other clinical and psychiatric diagnoses were obtained from medical files. Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3%) of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

Depression in elderly women resident in a long-stay nursing home

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Melissa Agostini Lampert

Full Text Available Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. OBJECTIVE: To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH. METHODS: This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version above 5. Other clinical and psychiatric diagnoses were obtained from medical files. RESULTS: Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3% of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. CONCLUSION: The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

Polypharmacy and falls in the middle age and elderly population

NARCIS (Netherlands)

G. Ziere; J.P. Dieleman (Jeanne); A. Hofman (Albert); H.A.P. Pols (Huib); T.J.M. van der Cammen (Tischa); B.H.Ch. Stricker (Bruno)

2006-01-01

textabstractAim: Falls in the elderly are common and often serious. We studied the association between multiple drug use (polypharmacy) and falls in the elderly. Methods: This was a population-based cross-sectional study, part of the Rotterdam Study. The participants were 6928 individuals aged ≥55

Does self-reported sleep quality predict poor cognitive performance among elderly living in elderly homes?

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Amer, Motassem S; Hamza, Sarah A; El Akkad, Rania M; Abdel Galeel, Yamen I I

2013-01-01

Sleep complaints are common among elderly, especially institutionalized elderly, as they experience poorer sleep quality and higher use of sedative hypnotics, when compared to community-dwelling elderly. Recent findings suggest that there may be a relationship between poor quality of sleep and cognitive deficits. This study aimed at studying the relation between sleep quality and cognitive performance in older adults living in elderly homes. 100 elderly living in an elderly home in El Mansoura, Egypt, were recruited in this study, 50 cases with subjective poor quality of sleep and 50 controls with subjective good quality of sleep as assessed by Pittsburgh sleep quality index (PSQI). Each participant went through comprehensive geriatric assessment (CGA), including geriatric depression scale (GDS), assessment of cognitive function by mini mental state examination (MMSE). 52% of poor sleepers showed impaired MMSE, while only 24% of good sleepers had impaired MMSE. Both orientation and (attention and calculation) were more affected (P = 0.027 and 0.035, respectively). Linear correlation coefficient between PSQI and different variables revealed significant negative correlation with total MMSE score, attention and calculation. Poor quality of sleep is related to cognitive impairment among elderly living in elderly homes and this problem should be taken in consideration among this group of elders.

Institutionalization and Organizational Long-term Success

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Denise L. Fleck

2007-05-01

Full Text Available Institutionalization processes have an ambivalent effect on organizational long-term success. Even though they foster organizational stability and permanence, they also bring about rigidity and resistance to change. As a result, successful organizations are likely to lose their competitive advantage over time. The paper addresses this issue through the investigation of the institutionalization processes of two long-lived companies: General Electric, a firm that has been a long-term success and its rival, Westinghouse, which was broken up after eleven decades of existence. The longitudinal, multilevel analysis of firms and industry has identified two different modes of organizational institutionalization. The reactive mode gives rise to rigidity and change resistance, much like institutional theory predicts; the proactive mode, on the other hand, neutralizes those negative effects of institutionalization processes. In the reactive mode, structure predominates. In the proactive mode, agency plays a major role in organizational institutionalization, and in managing the organization’s relations with the environment, clearly contributing to environmental institutionalization.

Migration patterns of the elderly: the case of the American Jewish population.

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Rosenwaike, I

1989-01-01

"This article examines the growing concentration of the elderly Jewish population of the U.S. in one metropolitan region of the Sun Belt. The principal data sources used are U.S. Census counts of the population with a Yiddish mother tongue or speaking Yiddish at home, as well as 1980 data on the population of Russian ancestry. The limitations of these measures are discussed and data from local community surveys also are presented. The data show that relocation of the elderly from the North, especially to South Florida, has been occurring since the 1950s and accelerated during the 1970s. The need for further study, which may document the migration patterns of elderly members of diverse religions and ethnic groups, is pointed out." excerpt

Strategic Communication Institutionalized

DEFF Research Database (Denmark)

Kjeldsen, Anna Karina

2013-01-01

of institutionalization when strategic communication is not yet visible as organizational practice, and how can such detections provide explanation for the later outcome of the process? (2) How can studies of strategic communication benefit from an institutional perspective? How can the virus metaphor generate a deeper...... understanding of the mechanisms that interact from the time an organization is exposed to a new organizational idea such as strategic communication until it surfaces in the form of symptoms such as mission and vision statements, communication manuals and communication positions? The first part of the article...... focuses on a discussion of the virus metaphor as an alternative to the widespread fashion metaphor for processes of institutionalization. The second part of the article provides empirical examples of the virus metaphor employed, examples that are drawn from a study of the institutionalization of strategic...

Future time perspective in institutionalized adolescents

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María Claudia Carcelén Velarde

2008-12-01

Full Text Available The study describes the future goals and concerns of institutionalized adolescents, and also identifies their attitudes towards the past, the present and the future, comparing them with a group of non-institutionalized adolescents with similar characteristics. It is a descriptive study with a transversal design, of 34 institutionalized and 41 non-institutionalized adolescents between 15 to 17 years old. The instruments were the Motivational Induction Method (MIM and the Time Attitude Scale (TAS (Nuttin, 1985. Goals are related to interpersonal contacts, the self-realization and the self. Institutionalized adolescents show more goals related to the development of aptitudes and a major necessity of interpersonal contacts associated with the fear of the damage caused by settling these relationships.

Validity and reliability of the European portuguese version of neuropsychiatric inventory in an institutionalized sample.

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Ferreira, Ana Rita; Martins, Sonia; Ribeiro, Orquidea; Fernandes, Lia

2015-01-01

Neuropsychiatric symptoms are very common in dementia and have been associated with patient and caregiver distress, increased risk of institutionalization and higher costs of care. In this context, the neuropsychiatric inventory (NPI) is the most widely used comprehensive tool designed to measure neuropsychiatric Symptoms in geriatric patients with dementia. The aim of this study was to present the validity and reliability of the European Portuguese version of NPI. A cross-sectional study was carried out with a convenience sample of institutionalized patients (≥ 50 years old) in three nursing homes in Portugal. All patients were also assessed with mini-mental state examination (MMSE) (cognition), geriatric depression scale (GDS) (depression) and adults and older adults functional assessment inventory (IAFAI) (functionality). NPI was administered to a formal caregiver, usually from the clinical staff. Inter-rater and test-retest reliability were assessed in a subsample of 25 randomly selected subjects. The sample included 166 elderly, with a mean age of 80.9 (standard deviation: 10.2) years. Three out of the NPI behavioral items had negative correlations with MMSE: delusions (rs = -0.177, P = 0.024), disinhibition (rs = -0.174, P = 0.026) and aberrant motor activity (rs = -0.182, P = 0.020). The NPI subsection of depression/dysphoria correlated positively with GDS total score (rs = 0.166, P = 0.038). NPI showed good internal consistency (overall α = 0.766; frequency α = 0.737; severity α = 0.734). The inter-rater reliability was excellent (intraclass correlation coefficient (ICC): 1.00, 95% confidence interval (CI) 1.00 - 1.00), as well as test-retest reliability (ICC: 0.91, 95% CI 0.80 - 0.96). The results found for convergent validity, inter-rater and test-retest reliability, showed that this version appears to be a valid and reliable instrument for evaluation of neuropsychiatric symptoms in institutionalized elderly.

Factors affecting institutionalization in older Hong Kong Chinese patients after recovery from acute medical illnesses.

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Luk, James Ka Hay; Chiu, Patrick Ka Chun; Chu, Leung Wing

2009-01-01

Older patients with medical illnesses are at risk of institutionalization. The purpose of this study is to investigate the factors leading to institutionalization in older patients after recovery from medical illnesses. We studied 535 older patients in two convalescence hospitals in Hong Kong. Of them, 116 patients (21.7%) needed to move to nursing homes upon discharge. Univariate analysis showed that age, single/divorced/widowed status, longer length of stay, pressure sores, urinary incontinence, urinary catheterization, falls, dementia, diabetes mellitus, Barthel index (100), Elderly Mobility Score (EMS), Chinese version of the mini-mental state examination (C-MMSE) and albumin levels were significant factors associated with institutionalization. Multivariate analysis showed that being single/divorced/widowed (odds ratio=OR=2.74, 95% confidence interval=CI=1.36-5.53, p=0.0048), having urinary incontinence on discharge (OR=5.13, CI=2.66-10.6, p<0.001) and admission due to falls (OR=2.4, CI=1.03-5.57, p=0.04) were independent risk factors for nursing home admission. Higher admission EMS (OR=0.91, CI=0.84-0.97, p=0.009), admission C-MMSE (OR=0.93, CI=0.87-0.98, p=0.019), and discharge albumin levels (OR=0.93, CI=0.88-0.99, p=0.02) were independent protecting factors against nursing home admission. Knowledge of these factors can allow us to predict accommodation outcome and develop intervention strategy to reduce institutionalization in the older patients.

Qualidade de vida em idosos institucionalizados submetidos a um programa de envelhecimento ativo

OpenAIRE

Magalhães, Carlos Pires; Anes, Eugénia; Rebelo, Flávia Marisa Ramalho

2017-01-01

Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. Objective: To evaluate the quality of life (QOL) of institutionalized elderly undergoing to an active aging pro...

Gender differences in the utilization of health-care services among the older adult population of Spain

OpenAIRE

Redondo-Sendino, Áurea; Guallar-Castillón, Pilar; Banegas, José Ramón; Rodríguez-Artalejo, Fernando

2006-01-01

Abstract Background Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly. Methods Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposin...

Saúde bucal de idosos residentes em instituições de longa permanência de Belo Horizonte, Minas Gerais, Brasil Oral health among institutionalized elderly in Belo Horizonte, Minas Gerais State, Brazil

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Raquel Conceição Ferreira

2009-11-01

Full Text Available Este estudo transversal descreveu a saúde bucal de idosos residentes em instituições de longa permanência de Belo Horizonte, Minas Gerais, Brasil. Uma amostra de 335 idosos acima de 60 anos de idade foi aleatoriamente selecionada. Os dados foram coletados dos registros das instituições, por entrevista e exame clínico da cavidade bucal. Avaliaram-se a higiene bucal, a cárie dentária coronária e radicular e a doença periodontal. Foi observada placa bacteriana em 76% das superfícies dentárias e 57% dos idosos usuários de prótese total superior apresentaram placa em pelo menos uma das superfícies. O CPOD foi de 30,8, com predomínio do componente perdido (94,2% e 57,1% dos idosos apresentaram experiência de cárie radicular. A maioria dos idosos (78,2% apresentou como pior condição periodontal sextante nulo e 64,5% dos sextantes válidos apresentaram bolsa periodontal de 4mm a 5mm e 47% perda inserção de 4mm a 5mm (47%. A saúde bucal dos idosos é precária, representada por higiene bucal deficiente, alta experiência de cárie, acentuada perda dentária e presença de bolsa periodontal.This study assessed the oral health of the institutionalized elderly in Belo Horizonte, Minas Gerais State, Brazil. A sample of 335 individuals over 60 years of age was randomly selected. Data were collected through interviews, review of medical records, and clinical examination by a single researcher. Oral health was evaluated in terms of oral hygiene, caries, and periodontal disease. Bacterial plaque was present on 76% of the dental surfaces, and 57% of the elderly using upper dentures presented plaque on at least one of its surfaces. DMF-T index was 30.8, with the missing component representing 94.2%. Missing sextant was the worst periodontal finding in 78.2% of the elderly. Among the valid sextants, there was a higher prevalence of 4 to 5mm periodontal pocket and attachment loss from 4 to 5mm (47%. According to the findings

Institutionalized elderly rehabilitation – improving balance ability with a platform technology

OpenAIRE

Pimentel, Maria Manuela da Silva; Mendes, Eugénia; Novo, André; Preto, Leonel

2015-01-01

Ageing is associated with a decrease in the functionality of all organic systems. One factor that affects the quality of life in the elderly is the decrease of balance that sometimes leads to falls and consequently the fear of falling. In this sense, it is essential to try to mitigate this progressive degeneration. Wii is a platform technology and method that can be used to improve balance in elderly and thus enable them a better quality of life and well-being. Objective: To investigate wheth...

Falls in the community-dwelling elderly with a history of cancer.

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Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles

2010-01-01

Falls place older adults at risk for injuries, resulting in functional decline, hospitalization, institutionalization, higher healthcare costs, and decreased quality of life. This study examined community-dwelling elderly to identify if individuals with a history of cancer fall at a higher rate than those without cancer, and if the occurrence of falls was influenced by individual characteristics, symptoms, or function. This was a retrospective, cross-sectional study, in 2007, examining 7,448 community-dwelling elderly 65 years or older in a state in the Midwest. Fallers were identified based on a diagnosis of cancer, age, sex, race and ethnicity, poor vision, reduced activities of daily living (ADLs), instrumental ADLs, cognition, incontinence, pain, or depression. Findings indicated that 2,125 (28.5%) had at least 1 fall. Of those who fell, 967 (13.0%) had cancer, and 363 (4.9%) with cancer had a fall. Predictors of falls in this population included race, sex, ADLs, incontinence, depression, and pain, all with P falls in this study. This study found a high frequency of falls and suggests a predictive model for fall risk in the vulnerable, community-dwelling elderly and will be used to inform future studies.

The profile of spinal injuries in the elderly population

OpenAIRE

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

2014-01-01

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

Leisure activities and attitude of institutionalized elderly people: a basis for nursing practice.

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de Castro, Vivian Carla; Carreira, Lígia

2015-01-01

to identify the leisure activities performed in Long-Stay Institutions for the Elderly (LSIEs), registered in the city of Maringá-PR, Brazil, and to analyze the attitude of the elderly people toward leisure promoted by the institutions. this was a descriptive and transversal study with a quantitative approach, carried out with 97 elderly people, through the establishment of the socio-demographic profile and the application of the Leisure Attitude Scale. The data was subjected to descriptive statistical analysis, association tests (chi-square or Fisher's) and Spearman's correlation. males, aged 80 or over, widowed, with one to eight years of study, who had a monthly income were predominant. Age group and income were significantly associated with the performance of leisure activities. The results reflected the positive attitude of the elderly people in relation to leisure activities, except in the behavioral component. the findings of this study indicate the need for further investigation into the difficulties linked to the attitude toward leisure in the behavioral component, considering aspects such as individual concepts of leisure and the health status of the elderly people.

Institutionalizing interactive governance for democracy

DEFF Research Database (Denmark)

Sørensen, Eva

2013-01-01

-institutional theory points out, however, the considerable regulatory impact of ‘soft’ forms of institutionalization such as incentives structures, sedimented normative codes, logics of appropriateness and routinized practices. The article explores the role that soft forms of institutionalization might play...

Factors Affecting Hypertension among the Malaysian Elderly

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Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Shahar, Suzana; Ng, Chee Kyun; Mun, Chan Yoke

2016-01-01

Hypertension is a common chronic disease in the elderly. This study aimed to determine the effects of age, ethnicity, gender, education, marital status, nutritional parameters, and blood elements on the risk of high blood pressure in the Malaysian elderly. This research was conducted on a group of 2322 non-institutionalized Malaysian elderly. The hierarchy binary logistic regression analysis was applied to estimate the risk of hypertension in respondents. Approximately, 45.61% of subjects had hypertension. The findings indicated that the female gender (Odds ratio (OR) = 1.54), an increase in body weight (OR = 1.61), and an increase in the blood levels of albumin (OR = 1.51), glucose (OR = 1.92), and triglycerides (OR = 1.27) significantly increased the risk of hypertension in subjects (p Malaysian elderly. In addition, an increase in both dietary carbohydrates and blood cholesterol level decreased hypertension in subjects. PMID:29367559

[Study of intrinsic risk factors for falls in institutionalized elderly people].

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de Menezes, Ruth Losada; Bachion, Maria Márcia

2008-01-01

The objective of this research was to identify intrinsic risk factors that predispose elderly people living in long-term institutions in the city of Goiânia (GO) to falls. The present descriptive transversal study was carried out in six long-term institutions for seniors in the city of Goiânia. The investigated sample consisted of 95 elderly that fitted the inclusion and exclusion criteria. A questionnaire was used for collecting clinical data related to health-disease conditions; cognitive data; capacity to develop basic daily life activities and equilibrium and gait. In general terms, as pointed out the literature, the examined elderly presented different fall risk factors such as: motor difficulty in lower limbs (90%), visual deficit (81,1%), use of 3 or more kinds of medicines (59,7%), suspected depression (37,9%), lack of equilibrium/unstable unipodal support (37,9%) abnormally decreased height in step (32,6%). The obtained data allow us to set indicators for the increase in falls among the studied sample, demonstrating the need for creating strategies for health promotion, prevention of injuries and rehabilitation.

Effectiveness of a physiotherapeutic protocol for equilibrium with institutionalized elderly people Eficácia de um protocolo fisioterapêutico para equilíbrio em idosos institucionalizados

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Mariane Negrão Serra dos Santos Lopes

2010-12-01

Full Text Available Equilibrium consists of keeping the gravity center within a support basis which provides more stability in the body segments during static and dynamic situations. The maintenance of body equilibrium in space is a complex phenomenon that depends on several structures, such as: motor system, proprioceptive sensitivity, vestibular system, visual system, cerebellum, among others. The fall is one of the main consequences of lack of equilibrium in the elderly. It is known that the physical therapy and the physical activity are important tools to prevent and/or reduce these deficits. The objective of this work was to verify the effectiveness of a physiotherapeutic program for institutionalized elderly people. Materials and methods: This is a prospective study of cohort, with seven institutionalized elderly people. The elderly who walked without orthosis, were obedient and understood verbal commands, were included. An initial evaluation of the respiratory, neurological and orthopedic systems was used, together with Tinetti’s Equilibrium and Mobility Scale. The treatment protocol consisted of 16 therapies. In each session, the warm up, stretching, strengthening, equilibrium training, walk training and relaxation were performed twice a week, with a 50-minute length each, for two months. The data were statistically evaluated through Wilcoxon test with a significance of p=0.03. Results showed an improvement in the equilibrium of the studied group. It will be suggested that the protocol used be implemented in the institution where it was conducted, what could reduce the risks inherent in the equilibrium deficit in the elderly. O equilíbrio consiste em manter o centro de gravidade dentro de uma base de suporte que proporcione maior estabilidade nos segmentos corporais durante situações estáticas e dinâmicas. A manutenção do equilíbrio do corpo no espaço é um fenômeno complexo que depende da integração de várias estruturas como: sistema motor

Leisure activities and attitude of institutionalized elderly people: a basis for nursing practice

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Vivian Carla de Castro

2015-04-01

Full Text Available Aim: to identify the leisure activities performed in Long-Stay Institutions for the Elderly (LSIEs, registered in the city of Maringá-PR, Brazil, and to analyze the attitude of the elderly people toward leisure promoted by the institutions. METHOD: this was a descriptive and transversal study with a quantitative approach, carried out with 97 elderly people, through the establishment of the socio-demographic profile and the application of the Leisure Attitude Scale. The data was subjected to descriptive statistical analysis, association tests (chi-square or Fisher's and Spearman's correlation. RESULTS: males, aged 80 or over, widowed, with one to eight years of study, who had a monthly income were predominant. Age group and income were significantly associated with the performance of leisure activities. The results reflected the positive attitude of the elderly people in relation to leisure activities, except in the behavioral component. CONCLUSION: the findings of this study indicate the need for further investigation into the difficulties linked to the attitude toward leisure in the behavioral component, considering aspects such as individual concepts of leisure and the health status of the elderly people.

Evaluation of Hepatitis B Infection Prevalence in Institutionalized Intellectually Disabled Children

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Foad Davoodbeglou

2016-04-01

Full Text Available Background: Hepatitis B virus (HBV infection causes chronic infection in human population, with high mortality. One of the high risk communities is mentally retarded children, who are institutionalized. Special conditions in these centers predispose children for HBV infection and transmission to healthy people. In this study our objective was to determine the prevalence of HBV infection among institutionalized mentally retarded children and study its associated risk factors.Materials and Methods: In this study, 250 mentally retarded children (younger than 14 years old were included. They were living in 5 nursing institutions, located in different parts of Tehran. Hepatitis B surface antigen (HBsAg was measured in the sera of these patients by ELISA method.Results: Among 250 children, 20 children (8% were HBsAg positive. HBV infection in girls was more than boys (11% to 5.6%. Among the types of mental retardation, children with cerebral palsy had the highest positive result for HBsAg. The most HBV infection (28.5% was seen in children with longest duration of being institutionalized (10 to 11 years. Vaccinated children were more HBsAg positive (8.7% than non-vaccinated children (5.3%. However, no significant relationship was observed between any of these factors and HBsAg positivity.Conclusion: Despite improvement of people’s health condition and implementation of HBV vaccination, the prevalence of HBV infection is increased in institutionalized mentally retarded children, which highlights the need for active measures to reduce this infection among this high risk population

Evaluation of diet quality of the elderly and associated factors.

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Pinto de Souza Fernandes, Dalila; Duarte, Maria Sônia Lopes; Pessoa, Milene Cristine; Franceschini, Sylvia do Carmo Castro; Ribeiro, Andréia Queiroz

2017-09-01

Observational studies suggest healthy dietary patterns are associated with risk reduction and better control of various chronic diseases. However, few Brazilian studies have focused on evaluating the quality of the elderly diet and its relationship with diseases. This study aimed to estimate the association between diet quality and socioeconomic factors, health and nutrition of the elderly. This is a cross-sectional population-based study whose target population were non-institutionalized elderly residents in the city of Viçosa, Brazil. Anthropometric, socioeconomic, health conditions, lifestyle and food consumption variables were obtained from a semi-structured questionnaire. The quality of the diet was assessed by the revised Healthy Eating Index classified into tertiles, considering the first tertile as "Poor diet quality," the second as 'Intermediate diet quality' and the third as "Better diet quality." To identify factors independently associated with diet quality model, the works used multinomial logistic regression. In the results of the multivariate analysis, the factors independently associated with "better diet quality" included female gender, higher education, history of one to five medical visits in the past year, history of diabetes mellitus, dyslipidemia and the use of polypharmacy. Our results show that most seniors need to improve the quality of their diet and those of male gender with no or little education, and those who do not seek medical services constitute the group that needs attention concerning the measures to improve the quality of their diet. Copyright © 2017 Elsevier B.V. All rights reserved.

Falls in institutionalized older adults: risks, consequences and antecedents

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Antonio Herculano de Araújo Neto

Full Text Available ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey, Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0. Results: A total of 66.7% (30 falls occurred, 20% (9 of them in the external area, with 66.7% (30 of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5. The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05. Conclusion: It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls.

Knowledge and Attitudes of Health-Care Providers toward Sexuality in the Institutionalized Elderly.

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Glass, J. Conrad, Jr.; And Others

1986-01-01

Examined the relationship between the knowledge and attitudes of nursing home caretakers toward elderly sexuality, looking at certain sociodemographic and institutional factors. The more knowledge providers possessed, the more restrictive their attitudes toward elderly sexuality. Education, religiosity, position, nursing education, time in current…

High consumption foods and their influence on energy and protein intake in institutionalized older adults.

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Mila, R; Abellana, R; Padro, L; Basulto, J; Farran, A

2012-02-01

The elderly, and especially those attending nursing homes, are at great risk from certain nutritional deficiencies. The aim of this study was to determine which food groups present the highest rates of consumption among the institutionalized elderly and study the energy density of each food group and the number of calories and amount of protein in the total diet of each resident. This was a multicentre observational study of a sample of the institutionalized population over the age of 65. The sample of patients was drawn from four Spanish nursing homes (Santa Coloma Gramanet, Barcelona, Madrid and Bilbao). Our final sample comprised a total of 62 individuals, of whom 22 were men and 40 women, aged between 68 and 96 years. Dietary data were collected using the double weight method for each main meal (breakfast, lunch, afternoon snack and dinner), including food type, the quantity of food served and the amount of plate waste for each of the main meals served during 21 days. The characteristics of the study population were compared by Student's t-test and χ2 test. The results are expressed in terms of their median values and the interquartile range. To analyse the overall differences between sites, gender and food groups we used Kruskall-Wallis test combined with the Mann-Whitney U-test with Bonferroni correction for multiple comparisons. The food group that was served most was milk products (376.25 g/day). A large amount of potatoes were also served (109.64 g/day) as were sweets and pastries (62.14 g/day). The daily serving of fruit (138.34 g/day) and vegetables (239.47 g/day) was equivalent to no more than that of a daily ration in each case. Milk was the food group with the highest consumption (311 g/day). Most of the energy was provided by groups with a higher energy density like as fats and sauces, sweets and pastries and bread. The mean protein consumption was 82,6 g/day (Table 5) and no significant differences were recorded in this consumption between men and

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

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Shradha Mathur

2015-01-01

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

Emotional intelligence and depressive symptoms in Spanish institutionalized elders: does emotional self-efficacy act as a mediator?

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Octavio Luque-Reca

2016-07-01

Full Text Available Background. This work examines the relationship between emotional intelligence (EI and depressive symptomatology in institutionalized older adults, delving into the mechanisms underlying this relationship. Considering that previous evidence of the variation of the EI-depression relationship depending on whether the emotional ability or the perception of that ability is evaluated, a model of multiple mediation was tested in which the dimensions of emotional self-efficacy (ESE act as mediators in the relationship between ability EI and depressive symptomatology. Methods. The sample consisted of 115 institutionalized older adults (47.82% women; 80.3 ± 7.9 years of age from the province of Jaén (Spain who completed a test of ESE, a measure of ability EI, and a self-administered questionnaire of depressive symptoms. Results. The results showed a positive association between older adults’ emotional performance and depressive symptomatology, finding stronger associations with ESE than with EI abilities. In addition, multiple mediation analyses showed that two of the four dimensions of ESE fully mediated the relationship between ability EI and depressive symptoms. Discussion. These findings suggest that older adults’ high levels of emotional competence generate a feeling of ESE which can protect them against depressive symptoms. This work supports the predictive validity of emotional abilities and ESE for the mental health of a group that is particularly vulnerable to depression, institutionalized older adults. The limitations of the work are discussed, and future lines of research were considered.

Locomotor problems among rural elderly population in a District of Aligarh, North India.

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Maroof, Mohd; Ahmad, Anees; Khalique, Najam; Ansari, M Athar

2017-01-01

Locomotor functions decline with the age along with other physiological changes. This results in deterioration of the quality of life with decreased social and economic role in the society, as well as increased dependency, for the health care and other basic services. The demographic transition resulting in increased proportion of elderly may pose a burden to the health system. To find the prevalence of locomotor problems among the elderly population, and related sociodemographic factors. The study was a community-based cross-sectional study done at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India. A sample of 225 was drawn from 1018 elderly population aged 60 years and above using systematic random sampling with probability proportionate to size. Sociodemographic characteristics were obtained using pretested and predesigned questionnaire. Locomotor problems were assessed using the criteria used by National Sample Survey Organization. Data were analyzed using SPSS version 20. Chi-square test was used to test relationship of locomotor problems with sociodemographic factors. P locomotor problems among the elderly population was 25.8%. Locomotor problems were significantly associated with age, gender, and working status whereas no significant association with literacy status and marital status was observed. The study concluded that approximately one-fourth of the elderly population suffered from locomotor problems. The sociodemographic factors related to locomotor problems needs to be addressed properly to help them lead an independent and economically productive life.

Prevalence and cost of hospital medical errors in the general and elderly United States populations.

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Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

2013-12-01

The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

Functional and cognitive decline in hospitalized elderly

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EUGÉNIA MENDES

2016-12-01

Full Text Available ABSTRACT Aim – Understand if functional and cognitive decline is accentuated during hospitalization in elderly patients. Method – It was design a descriptive and correlational study. The Functional Independence Measure (FIM and the Mini-Mental State Examination (MMSE were used. Results – Were evaluated at admission and discharge 51 elderly (75.53 ± 7.16 years, 53% women, admitted in an internal medicine unit with a length of stay of 14.27±6.45 days. For FIM and MMSE were found statistically significant differences with lower scores from admission to discharge. Negative correlations between age and length of stay and the scores of all measures were found. Except for the Cognitive FIM at admission, all elderly residents at home fared better than the institutionalized in all measures. Conclusions – The hospitalization contributes to a greater weakness/frailty of the elderly and is considered high risk for decline in physical fitness and cognitive function.

Tracheostomy Complications in Institutionalized Children with Long-term Tracheostomy and Ventilator Dependence.

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Wilcox, Lyndy J; Weber, Brittany C; Cunningham, Tina D; Baldassari, Cristina M

2016-04-01

(1) To identify tracheostomy complications in institutionalized children with chronic tracheostomy. (2) To determine factors that predispose to development of tracheostomy complications in institutionalized children with chronic tracheostomy. Case series with chart review over 10 years. Tertiary children's hospital. Children were included if they underwent tracheostomy before 21 years of age and resided at a pediatric nursing facility. Most children were ventilator dependent and had severe comorbid medical conditions, including developmental delay and cerebral palsy. The number of tracheostomy complications and unplanned hospital admissions were recorded. Interventions for tracheostomy complications were also reviewed. Thirty-two institutionalized children with chronic tracheostomy were included. The mean age at time of tracheostomy was 5.4 years, with a mean duration of institutionalization of 9.1 years. Twenty-seven children (84%) experienced tracheostomy complications. The total number of complications was 79. The most common tracheostomy complications identified were peristomal granulation (n = 13) and suprastomal granulation (n = 12). Age at time of tracheostomy, duration of institutionalization, and ventilator dependence did not predict the likelihood of developing a complication. Of 32 patients, 20 were evaluated in the emergency room during the study, and there were 48 unplanned admissions for tracheostomy-related complications during the study. Forty-five urgent direct laryngoscopy and bronchoscopy procedures were performed in a total of 20 children with tracheostomy complications. Tracheostomy complications are common in institutionalized children with chronic tracheostomy and are challenging to manage. Further research is necessary to determine novel ways to reduce tracheostomy complications in this population. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Institutionalized elderly people and malnutrition: research on the patients of a nursing home

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Francesco Rondoni

2013-09-01

Full Text Available Protein-energy malnutrition (PEM is a common finding in hospitalized or institutionalized elderly people. In the literature, PEM is not mentioned as being related to individual ability of the patient to feed him or herself correctly. This study analyzed the 56 patients of a nursing home divided into two groups: self-sufficient and non self-sufficient regarding feeding. Levels of serum albumin, transferrin, prealbumin and hemoglobin (Hb were examined and compared to body mass index (BMI calculated with bioelectrical impedance analysis. Fifty-three percent of patients were self-sufficient, while 47% were not self-sufficient for feeding of which 83.3% were women and 16.7% men. Levels below the average range were 49.1% for lymphocyte count, 52.9% for serum albumin, 13.7% for serum transferrin and 52.9% for serum prealbumin. No significant differences were found in terms of patient age, while the mean values of the parameters examined in the two groups, self-sufficient and not, were lower in the patients who were not self-sufficient, even if statistical significance was not reached. Serum albumin was in inverse proportion to age (P<0.05 and 46.1% of individuals with low levels of transferrin also showed low levels of Hb. Anemia was in direct proportion (P<0.05 to age. Measurement of BMI showed values below 22.5 (cut off for risk for malnutrition in 33.4% of the subjects examined. Of the three hematochemical parameters, analysis of a possible relationship with BMI showed only a significant and directly proportional correlation with prealbumin (P<0.05%. These data should be considered in the context of an epidemiological research study carried out in a conditioned and limited environment, where PEM, detected using hematochemical parameters, amounted to 50% of the patients, whereas BMI identified only approximately one-third of patients at risk of malnutrition. There were no statistically significant differences between men and women. Mean values of the

Estuary ecosystem restoration: implementing and institutionalizing adaptive management: Institutionalizing adaptive management

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Ebberts, Blaine D. [Portland District, U.S. Army Corps of Engineers, 333 SW 1st Avenue, Portland OR 97204 U.S.A.; Zelinsky, Ben D. [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Karnezis, Jason P. [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Studebaker, Cynthia A. [Portland District, U.S. Army Corps of Engineers, 333 SW 1st Avenue, Portland OR 97204 U.S.A.; Lopez-Johnston, Siena [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Creason, Anne M. [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Krasnow, Lynne [Columbia Hydropower Branch, National Marine Fisheries Service, 1201 NE Lloyd Boulevard Suite 1100, Portland OR 97232 U.S.A.; Johnson, Gary E. [Pacific Northwest National Laboratory, 620 SW 5th Avenue, Suite 810, Portland OR 97204 U.S.A.; Thom, Ronald M. [Pacific Northwest National Laboratory, Marine Science Laboratory, 1286 Washington Harbor Road, Sequim WA 98382 U.S.A.

2017-08-25

We successfully implemented and institutionalized an adaptive management (AM) process for the Columbia Estuary Ecosystem Restoration Program, which is a large-scale restoration program focused on improving ecosystem conditions in the 234-km lower Columbia River and estuary. For our purpose, “institutionalized” means the AM process and restoration program are embedded in the work flow of the implementing agencies and affected parties. While plans outlining frameworks, processes, or approaches to AM of ecosystem restoration programs are commonplace, establishment for the long term is not. This paper presents the basic AM framework and explains how AM was implemented and institutionalized. Starting with a common goal, we pursued included a well-understood governance and decision-making structure, routine coordination and communication activities, data and information sharing, commitment from partners and upper agency management to the AM process, and meaningful cooperation among program managers and partners. The overall approach and steps to implement and institutionalize AM for ecosystem restoration explained here are applicable to situations where it has been less than successful or, as in our case, the restoration program is just getting started.

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

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Rodrigues, Iara Guimarães; Fraga, Gustavo Pereira; Barros, Marilisa Berti de Azevedo

2014-01-01

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

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

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Iara Guimarães Rodrigues

2014-09-01

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

Prevalence and correlates of fear of falling among elderly population in urban area of Karnataka, India.

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Mane, Abhay B; Sanjana, T; Patil, Prabhakar R; Sriniwas, T

2014-07-01

Falls are a major public health problem in the elderly population. Fear of falling (FOF) among elderly persons can compromise quality of life by limiting mobility, diminished sense of well-being and reduced social interactions. India is undergoing a demographic transitional phase with urban elderly population of 6.72% in 2001. The major challenge would be on the prevention of falls among them. Hence there is a need to highlight the problems related to fall faced by the elderly in India. To study the prevalence of FOF and its correlates among the elderly population in urban area. 250 elderly subjects above 60 years were randomly selected from urban area and interviewed for FOF using Short Fall Efficacy Scale-I (FES-I), history of falls and risk factors. The prevalence of FOF among the elderly was 33.2%. The significant correlates of FOF were educational status, family type, associated health problems, history of fall in past 6 months, worried of fall again among fallers, fearfulness of fall again among fallers, restriction of daily activities and depression among them. The insignificant correlates were gender and socio-economic status. FOF is a health problem among the elderly living in urban India needs urgent attention. It represents a significant threat to socialization, independence and morbidity or mortality. Knowledge of correlates of FOF may be useful in developing multidimensional strategies to reduce it among elderly.

Increasing Prevalence of Metabolic Syndrome in a Chinese Elderly Population: 2001?2010

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

2013-01-01

Objective The information on the changes of prevalence of MetS in China is limited. Our objective was to assess a 10-year?s change of the prevalence of MetS in a Chinese elderly population between 2001 and 2010. Methods We conducted two cross-sectional surveys in a representative sample of elderly population aged 60 to 95 years in Beijing in 2001 and 2010 respectively. MetS was defined according to the 2009 harmonizing definition. Results A total of 2,334 participants (943 male, 1,391 female)...

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

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García-Peña Carmen

2011-03-01

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

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

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González-González, César; Sánchez-García, Sergio; Juárez-Cedillo, Teresa; Rosas-Carrasco, Oscar; Gutiérrez-Robledo, Luis M; García-Peña, Carmen

2011-03-29

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

“Exchange of letters between generations”: Gerontological intergenerational project, carried out in a elderly long-term institution of São Paulo

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Marcelo Piovezan

2015-12-01

Full Text Available The work promoted a gerontological action through anonymous letters that provided intergenerational link between institutionalized elderly and high school students. Allowed the inclusion of the elderly aiming positive impact on their depression and provided positive promotion on aging to the students. The intervention showed the possibility to establish links between the elderly and the young students, improving their sense of belonging, self-efficacy and better self-esteem.  

An evaluation of prosthetic status and treatment needs among institutionalized elderly individuals of Delhi, India

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Nisha Yadav; Roma Yadav; Meetika Pahuja; Sanchit Pardhan; Sahiba Miglani; Tamanna Malik

2017-01-01

Context: Oral health is essential for elderly person's general health and well-being. The most common oral problem in elderly is tooth loss which results due to periodontal diseases and caries. Prosthetic status is very important as it is related to dietary intake and maintaining nutritional status. Hence, to promote the oral health of the elderly, we need to know their prosthetic status and need. Aims: The aim of this study is to find the prosthetic status and need of 65–74 years old elderly...

The prevalence of undiagnosed pre-surgical cognitive impairment and its post-surgical clinical impact in elderly patients undergoing surgery for adult spinal deformity.

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Adogwa, Owoicho; Elsamadicy, Aladine A; Lydon, Emily; Vuong, Victoria D; Cheng, Joseph; Karikari, Isaac O; Bagley, Carlos A

2017-09-01

Pre-existing cognitive impairment (CI) is emerging as a predictor of poor post-operative outcomes in elderly patients. Little is known about impaired preoperative cognition and outcomes after elective spine surgery in this patient population. The purpose of this study was to assess the prevalence of neuro CI in elderly patients undergoing deformity surgery and its impact on postoperative outcomes. Elderly subjects undergoing elective spinal surgery for correction of adult degenerative scoliosis were enrolled in this study. Pre-operative baseline cognition was assessed using the Saint Louis Mental Status (SLUMS) test. SLUMS consists of 11 questions, which can give a maximum of 30 points. Mild CI was defined as a SLUMS score between 21-26 points, while severe CI was defined as a SLUMS score of ≤20 points. Normal cognition was defined as a SLUMS score of ≥27 points. Complication rates, duration of hospital stay, and 30-day readmission rates were compared between patients with and without baseline CI. Eighty-two subjects were included in this study, with mean age of 73.26±6.08 years. Fifty-seven patients (70%) had impaired cognition at baseline. The impaired cognition group had the following outcomes: increased incidence of one or more postoperative complications (39% vs. 20%), higher incidence of delirium (20% vs. 8%), and higher rate of discharge institutionalization at skilled nursing or acute rehab facilities (54% vs. 30%). The length of hospital stay and 30-day hospital readmission rates were similar between both cohorts (5.33 vs. 5.48 days and 12.28% vs. 12%, respectively). CI is highly prevalent in elderly patients undergoing surgery for adult degenerative scoliosis. Impaired cognition before surgery was associated with higher rates of post-operative delirium, complications, and discharge institutionalization. CI assessments should be considered in the pre-operative evaluations of elderly patients prior to surgery.

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

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K S Negi

2004-06-01

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

Prevalence of pressure ulcers among the elderly living in long-stay institutions in São Paulo

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Julieta Maria Ferreira Chacon

Full Text Available CONTEXT AND OBJECTIVE: The prevalence of pressure ulcers varies according to geographic region and population group, such as the institutionalized elderly. The aim of this study was to identify the prevalence of pressure ulcers among elderly people living in long-stay institutions. DESIGN AND SETTING: Cross-sectional study in six long-stay institutions for the elderly in São Paulo, Brazil. METHODS: Demographic and clinical data were collected in six long-stay institutions on two visits to each institution between May and August 2007, during which all elderly patients with pressure ulcers were evaluated. The Braden scale was used to identify the risk of developing pressure ulcers and the National Pressure Ulcer Advisory Panel (NPUAP stages for classifying the pressure ulcers. Statistical analysis was performed using the chi-square test, Student's t-test and Fisher's exact test. RESULTS: There was no significant difference in the results between visits. The population was 181 elderly people in May and 184 in August: 23 had pressure ulcers in May (prevalence of 12.7% and 17 in August (prevalence of 9.2%. The mean age at the two times was 84 years, and the average length of stay was 32 months. Pressure ulcers were found mainly in the sacral region (mean, 71.5%, and most commonly in stage II (mean, 41%. CONCLUSION: The prevalence of pressure ulcers was 10.95%. These data provide background information that may aid in developing protocols for applying best practices for prevention and treatment of pressure ulcers, consequently reducing the prevalence.

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

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Biehl M

2016-06-01

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

Zinc Absorption from Representative Diet in a Chinese Elderly Population Using Stable Isotope Technique.

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Li, Ya Jie; Li, Min; Liu, Xiao Bing; Ren, Tong Xiang; Li, Wei Dong; Yang, Chun; Wu, Meng; Yang, Lin Li; Ma, Yu Xia; Wang, Jun; Piao, Jian Hua; Yang, Li Chen; Yang, Xiao Guang

2017-06-01

To determine the dietary zinc absorption in a Chinese elderly population and provide the basic data for the setting of zinc (Zn) recommended nutrient intakes (RNI) for Chinese elderly people. A total of 24 elderly people were recruited for this study and were administered oral doses of 3 mg 67Zn and 1.2 mg dysprosium on the fourth day. The primary macronutrients, energy, and phytic acid in the representative diet were examined based on the Chinese National Standard Methods. Fecal samples were collected during the experimental period and analyzed for zinc content, 67Zn isotope ratio, and dysprosium content. The mean (± SD) zinc intake from the representative Chinese diet was 10.6 ± 1.5 mg/d. The phytic acid-to-zinc molar ratio in the diet was 6.4. The absorption rate of 67Zn was 27.9% ± 9.2%. The RNI of zinc, which were calculated by the absorption rate in elderly men and women, were 10.4 and 9.2 mg/d, respectively. This study got the dietary Zn absorption in a Chinese elderly population. We found that Zn absorption was higher in elderly men than in elderly women. The current RNI in elderly female is lower than our finding, which indicates that more attention is needed regarding elderly females' zinc status and health. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Mental status testing in the elderly nursing home population.

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Nadler, J D; Relkin, N R; Cohen, M S; Hodder, R A; Reingold, J; Plum, F

1995-07-01

The clinical utility of selected brief cognitive screening instruments in detecting dementia in an elderly nursing home population was examined. One hundred twenty nursing home residents (mean age 87.9) were administered the Mini-Mental State Exam (MMSE) and the Modified Mini-Mental State Exam (3MS). The majority of the subjects (75%) were also administered the Dementia Rating Scale (DRS). Both clinically diagnosed demented (n = 57) and non-demented (n = 63) subjects participated in the study. Dementia was diagnosed in accordance with DSM-III-R criteria by physicians specializing in geriatric medicine. Using standard cutoffs for impairment, the 3MS, MMSE, and DRS achieved high sensitivity (82% to 100%) but low specificity (33% to 52%) in the detection of dementia among nursing home residents. Positive predictive values ranged from 52% to 61%, and negative predictive values from 77% to 100%. Higher age, lower education, and history of depression were significantly associated with misclassification of non-demented elderly subjects. Receiver Operating Characteristic (ROC) curve analyses revealed optimal classification of dementia with cutoff values of 74 for the 3MS, 22 for the MMSE, and 110 for the DRS. The results suggest that the 3MS, MMSE, and DRS do not differ significantly with respect to classification accuracy of dementia in a nursing home population. Elderly individuals of advanced age (i.e., the oldest-old) with lower education and a history of depression appear at particular risk for dementia misclassification with these instruments. Revised cutoff values for impairment should be employed when these instruments are applied to elderly residents of nursing homes and the oldest-old.

Energy and B Vitamins Intake in Elderly Population under Health Care in Isfahan, Iran

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Sanaz Jamshidi

2017-09-01

Full Text Available Background: B vitamins are essential nutrients to maintain body health. These water soluble vitamins are critical co-enzymes in different cycles. Also, the intake of an adequate energy in elderly contributes to more ability to perform daily activities. This study aims at assessing the energy and water-soluble vitamins intake in elderly population under health care in Isfahan, Iran. Methods: One hundred and fifty two old men and women (82 were under health care in Ghadir Elderly Care Center, Isfahan, Iran and 70 without health care were enrolled in a case-control study. Food frequency questionnaire (168 items was used for dietary intake assessment and N4 software for analysis of food content of the used diet. Results: The intake of energy was significantly higher in the elderly population under health care than those without health care (p=0.038. Also, after adjustion of variables for energy and B vitamins, B1 and B9 vitamins were higher in case group when compared to the control group (p=0.032, p=0.012, respectively. Conclusion: Old population in elderly centers had desirable levels of vitamins B1 and B9 and also energy intake denoting to the high health cares in the health centers.

Leisure activities and attitude of institutionalized elderly people: a basis for nursing practice1

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de Castro, Vivian Carla; Carreira, Lígia

2015-01-01

Aim: to identify the leisure activities performed in Long-Stay Institutions for the Elderly (LSIEs), registered in the city of Maringá-PR, Brazil, and to analyze the attitude of the elderly people toward leisure promoted by the institutions. METHOD: this was a descriptive and transversal study with a quantitative approach, carried out with 97 elderly people, through the establishment of the socio-demographic profile and the application of the Leisure Attitude Scale. The data was subjected to descriptive statistical analysis, association tests (chi-square or Fisher's) and Spearman's correlation. RESULTS: males, aged 80 or over, widowed, with one to eight years of study, who had a monthly income were predominant. Age group and income were significantly associated with the performance of leisure activities. The results reflected the positive attitude of the elderly people in relation to leisure activities, except in the behavioral component. CONCLUSION: the findings of this study indicate the need for further investigation into the difficulties linked to the attitude toward leisure in the behavioral component, considering aspects such as individual concepts of leisure and the health status of the elderly people. PMID:26039302

Boligstandarden i plejehjem og andre institutioner

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Gottschalk, Georg

Boligstandarden i plejehjem og institutioner for handicappede diskuteres meget for tiden. Denne rapport er den første landsdækkende undersøgelse af boligstandarden i plejehjem, beskyttede boliger og institutioner for voksne med handicap. Den indeholder blandt andet oplysninger om, hvor store være...

Leisure travel distance of elderly population : the case of the Netherlands

NARCIS (Netherlands)

Dane, G.Z.; Feng, T.; Timmermans, H.J.P.

2012-01-01

The population of the Netherlands is getting older. These changes in population cause new challenges in understanding the needs of elderly such as mobility. Mobility is a significant aspect of the elderly’s quality of life since it provides them the means to reach the services, fulfilling their

PERCEPTIONS AND EXPERIENCES OF ELDERLY RESIDENTS IN A NURSING HOME

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Renata Alessandra Evangelista

2014-12-01

Full Text Available The objective of this study was to evaluate the perception of the elderly residents of a long-stay nursing home on the process of institutionalization. We interviewed 14 subjects, five women and nine men, aged between 60 and 92 years. Data collection was conducted with a semi-structured sociodemographic interview, which presented the guiding question: “Tell me about how is your life, what do you do and how did you come to live here”. From the analysis, we found topics related to feelings of abandonment, loneliness, anger, ingratitude, living with chronic pain, satisfaction of property in the nursing home, productivity and social relationship. Given the thematic analysis, it was possible to group them into three categories such as: what the elderly feel, what the elderly perceive and what the elderly desire. As a result, we need public policies that addresses to the service provided by institutions regarding elderly expectations.

Dysthymic disorder in the elderly population.

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Devanand, D P

2014-01-01

The diagnosis of dysthymic disorder was created in DSM-III and maintained in DSM-IV to describe a depressive syndrome of mild to moderate severity of at least two years' duration that did not meet criteria for major depressive disorder. The prevalence of dysthymic disorder is approximately 2% in the elderly population where subsyndromal depressions of lesser severity are more common. Dysthymic disorder was replaced in DSM-V by the diagnosis of "persistent depressive disorder" that includes chronic major depression and dysthymic disorder. In older adults, epidemiological and clinical evidence supports the use of the term "dysthymic disorder." In contrast to young adults with dysthymic disorder, older adults with dysthymic disorder commonly present with late age of onset, without major depression and other psychiatric disorders, and with a low rate of family history of mood disorders. They often have stressors such as loss of social support and bereavement, and some have cerebrovascular or neurodegenerative pathology. A minority has chronic depression dating from youth with psychiatric comorbidity similar to young adults with dysthymic disorder. In older adults, both dysthymic disorder and subsyndromal depression increase disability and lead to poor medical outcomes. Elderly patients with dysthymic disorder are seen mainly in primary care where identification and treatment are often inadequate. Treatment with antidepressant medication shows marginal superiority over placebo in controlled trials, and problem-solving therapy shows similar efficacy. Combined treatment and collaborative care models show slightly better results, but cost effectiveness is a concern. Further work is needed to clarify optimal approaches to the treatment of dysthymic disorder in elderly patients.

Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol.

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Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

2016-05-25

Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and

Institutional abuse toward the elderly: Perceptions of health care providers and older adult

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M. Guadalupe Ruelas-González

2014-11-01

Full Text Available Objective. To analyze the health care providers (HCP and elderly patients’ perceptions about abuse of the elderly by health personnel of public health services, in selected cities in Mexico. Materials and methods. A qualitative study and a strategy of data triangulation were performed during 2009 and 2012; 13 HCPs and 12 elders were interviewed, in order to obtain their experience regarding elder abuse. Grounded Theory proceedings were used for the analysis. Results. Elder abuse is a naturalized practice, from HCP and elderly people’s point of view; these perceptions are showed in different ways. Conclusion. Institutionalization, historical professionalization and lack of consciousness about needs of the elderly (sociocultural and economic, require changes in planning, organization and monitoring process in the Health System; training and educational interventions on staff and exchange attitudes and behavior are necessary in order to offer a health care that is comprehensive, decent, human and with respect for the human rights.

Which activities threaten independent living of elderly when becoming problematic: inspiration for meaningful service robot functionality.

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Bedaf, Sandra; Gelderblom, Gert Jan; Syrdal, Dag Sverre; Lehmann, Hagen; Michel, Hervé; Hewson, David; Amirabdollahian, Farshid; Dautenhahn, Kerstin; de Witte, Luc

2014-11-01

In light of the increasing elderly population and the growing demand for home care, the potential of robot support is given increasing attention. In this paper, an inventory of activities was made that threaten independent living of elderly when becoming problematic. Results will guide the further development of an existing service robot, the Care-O-bot®. A systematic literature search of PubMed was performed, focused on the risk factors for institutionalization. Additionally, focus group sessions were conducted in the Netherlands, United Kingdom and France. In these focus group sessions, problematic activities threatening the independence of elderly people were discussed. Three separate target groups were included in the focus group sessions: (1) elderly persons (n = 41), (2) formal caregivers (n = 40) and (3) informal caregivers (n = 32). Activities within the International Classification of Functioning domains mobility, self-care, and interpersonal interaction and relationships were found to be the most problematic. A distinct set of daily activities was identified that may threaten independent living, but no single activity could be selected as the main activity causing a loss of independence as it is often a combination of problematic activities that is person-specific. Supporting the problematic activities need not involve a robotic solution.

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

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Prasad, Shivangi

2017-09-18

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

Magnitude of depression and its correlates among elderly population in a rural area of Maharashtra: A cross-sectional study

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Sourav Goswami

2017-01-01

Full Text Available Background: Depression is the most common psychiatric disorder among elderly population in India, yet, it is commonly misdiagnosed and undertreated. The exact burden of depression among the elderly population in rural India was not known. Objectives: To study the magnitude of depression among the elderly masses in rural Maharashtra and to find its correlates. Material and Methods: This is a cross sectional study, carried out among the elderly (≥60 years population of both sexes residing in the field practice area of the department of community medicine. Geriatric depression scale was used for screening depression among the study population. Data collection was completed within 2 months using convenience sampling. Ethical approval was taken before beginning the study. Magnitude was expressed in percentage along with its 95% confidence interval (CI. Univariate and multivariate logistic regression was carried out to study associated correlates. Odds ratio and 95% CI was used to express association. Results: The magnitude of depression among the elderly population was found to be 41.7% (95% CI 36.1–47.4. We got the significant positive association of female sex, living without spouse, lacking in decision making capability, a victim of abuse or neglect, or suffering from chronic illnesses with depression among elderly population in univariate analysis that did not hold good in the multivariate logistic regression. Our study showed the prevalence of mild depression among elderly to be 26.72% and that of severe depression to be 15.17%. Conclusion: To deal with this huge social problem of depression among the elderly population, more enthusiastic steps should be undertaken.

Cohort study of institutionalized elderly people: fall risk factors from the nursing diagnosis

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Karine Marques Costa dos Reis

2015-12-01

Full Text Available Objective: to determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice. Method: this was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors. Results: the results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045, presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028, foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033 and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145. Conclusion: the taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice.

Physical and mental health aspects of elderly in social care in Poland

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Dobrzyn-Matusiak D

2014-10-01

Full Text Available Dorota Dobrzyn-Matusiak,1 Czeslaw Marcisz,2 Ewelina Bąk,3 Halina Kulik,1 Ewa Marcisz4 1Department of Nursing Propaedeutics, 2Department of Gerontology and Geriatric Nursing, School of Health Care, Medical University of Silesia, Katowice, Poland; 3Faculty of Health Sciences, University of Bielsko-Biała, Bielsko-Biała, Poland; 4Department of Anxiety Disorders, Hospital of Ministry of Internal Affairs, Katowice, Poland Background: The objective of the study was to evaluate health aspects in elderly individuals in social, institutional, and home care in Poland.Methods: A total of 300 elderly individuals in care in Poland were included in the study. The subjects were divided into three groups: residents of long-term care institutions (group I, residents of adult day-care homes (group II, and community-dwelling subjects (group III. Each group consisted of 100 subjects. Questionnaires evaluating the following physical and mental dimensions of health were used: SF-36 Health Survey, basic activities of daily living, instrumental activities of daily living, Geriatric Depression Scale, and Mini–mental state examination.Results: It was found that the health aspects of the elderly varied depending on whether care was provided in an institutionalized or a home environment, and the lowest health status was found in the elderly receiving in-home care. Furthermore, home-based elderly indicated significant limitations in performing basic activities of daily living and instrumental activities of daily living, as well as a higher prevalence of depression and cognitive impairment.Conclusion: The elderly in long-term institutionalized care, both in a residential home and adult day-care homes, were characterized by a better physical and mental health status than those receiving in-home care. It seemed that worse health status, including the more frequent depression occurrence and cognitive function disorders in the elderly using the nursing care at their homes

Excluding Institutionalized Elderly from Surveys: Consequences for Income and Poverty Statistics

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Peeters, Hans; Debels, Annelies; Verpoorten, Rika

2013-01-01

Growing life expectancy and changes in financial, marriage and labour markets have placed the income position of the elderly at the center of scientific and political discourse. As a consequence, the last decades witnessed the publication of various influential reports that contained comparative statistics on old age income inequalities on the…

Prevalence of Eye Disorders in Elderly Population of Tehran, Iran

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Afsun Nodehi- Moghadam

2015-12-01

Full Text Available Introduction: The decline of visual function with increasing age is a significant concern in elderly. Despite previous work on prevalence of specific ophthalmic pathologies, there has not been enough valid data about overall eye disorders in Tehran yet, and it is poorly defined and not underpinned by strong evidence. The purpose of this study was to investigate the common eye disorders in the elderly population of Tehran. Methods: A total of 392 elderly community residents aged 60 to 96 were enrolled. The 278 older adults referred to Tehran’s Polyclinic of 6th Region of municipality and 114 older adults referred to the health centers of 9th Region of municipality between 2013 and 2014 were examined. All participants underwent an extensive ophthalmologic screening examination including cataract, diabetic retinopathy of optic nerve, macular degeneration, and glaucoma. The prevalence of various eye disorders was calculated as percentages of the total study population and categorized by age and sex. Results: Of the 392 participants, 152 subjects (38.8% had no eye disease. Common visual impairments in elderly were cataract (39.3%, macular degeneration (11.5%, diabetic retinopathy of optic nerve (5.6% and glaucoma (4.8%. It has also showed cataract prevalence increased with age from (6.3% in the 60-64 age group to (47.6% for the patients 85years of age and older. Conclusion: Cataract is the most frequent eye disease in community dwelling older adults that should be considered at a younger age by health officials to provide preventive programs. Improving accessibility to surgery for the treatment of cataract among the old people will help diminish of untreated cataract that lead to visual impairment.

Bone lead levels in an environmentally exposed elderly population in shanghai, China.

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Specht, Aaron J; Lin, Yanfen; Xu, Jian; Weisskopf, Marc; Nie, Linda H

2018-06-01

This study looked at measurements of lead (Pb) in a pilot population of environmentally exposed elderly residents of Shanghai, China and presented the first set of bone Pb data on an elderly Chinese population. We found that with environmental exposures in this population using K-shell x-ray fluorescence (KXRF) bone Pb measurements 40% of the individuals had bone Pb levels above the nominal detection limit with an average bone lead level of 4.9 ± 3.6 μg/g. This bone lead level is lower than comparable values from previous studies of community dwelling adults in US cities. This population had a slightly higher geometric mean blood Pb of 2.6 μg/dL than the adult US population. The main conclusion of this data is that in Shanghai there is environmental exposure to Pb, measured through blood and bone, which should be further investigated to assess the health impact of this exposure. Copyright © 2018. Published by Elsevier B.V.

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

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

2013-01-01

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

Elderly population in the prison system: a look behind bars

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Hércules de Oliveira Carmo

2012-09-01

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

Life-style habits and homocysteine levels in an elderly population.

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Dankner, Rachel; Chetrit, Angela; Lubin, Flora; Sela, Ben-Ami

2004-12-01

Increased plasma total homocysteine (Hcy) is a known cardiovascular disease (CVD) risk factor, related to several components of the established CVD risk profile. Observational studies support the role of modifying life-style related risk factors such as diet, physical activity and alcohol consumption in CVD prevention. Regular physical activity protects against coronary artery disease, possibly through its role in controlling risk factors such as hypertension, diabetes mellitus and obesity, but also independently. The aim of our study was to test the hypothesis that there is an association between physical activity, life-style habits and plasma Hcy levels in an elderly population. In this cross-sectional study, 423 males and females aged 69.0 +/- 6.7 years completed an interview and laboratory examinations. Our main outcome measure was plasma levels of Hcy. Mean Hcy values were 10.5 +/- 5.5 micromol/L (11.4 +/- 6.1 for males and 9.3 +/- 4.5 for females; p sedentary life-style, 17% higher amongst males, 1% higher for each one-year increment in age, and 10% higher amongst participants who used no B vitamin supplements. Any level of physical activity was found to be an independent life-style habit associated with a lower Hcy level in an elderly population. This study supports existing recommendations for elderly persons to maintain a physically active life-style.

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

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

2017-01-23

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

A framework for institutionalizing quality assurance.

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Silimperi, Diana R; Franco, Lynne Miller; Veldhuyzen van Zanten, Tisna; MacAulay, Catherine

2002-12-01

To develop a framework to support the institutionalization of quality assurance (QA). The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.

Anorexia and eating patterns in the elderly.

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Lorenzo Maria Donini

Full Text Available To evaluate the change in eating habits occurring in community-dwelling and institutionalized elderly subjects with senile anorexia.Cross-sectional, observational.Community, nursing homes and rehabilitation or acute care facilities in four Italian regions.A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards.All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables.In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups ("meat, eggs and fish" and "fruit and vegetables" whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety.Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients.

The evaluation of disability and its related factors among the elderly population in Kashan, Iran

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Aghahoseini Shima

2007-09-01

Full Text Available Abstract Background Recent literature indicates that developing countries in Asia are aging faster than other countries in the world and disability has become one of the greater public health concern in these countries. Pausity of published data on the elderly disability in Iran signifies the importance of this study designed to evaluate the disability and its related factors among the elderly population in Kashan, Iran during 2006–2007. Methods/Design A cross-sectional study is conducting on a multy-stage random sample of elderly people in Kashan ages 65 years and older. Volunteer participants were included by age 65 and older and excluded if they had the medical diagnosis of Alzhimer disease. The WHO DAS II was used as the generic disability measure in this survey. The original version of WHO DAS II was translated into Farsi according to the standardized guidelines for cross-cultural adaptation of health-related measures. Upon completion of data collection the descriptive statistics will compute all the variables. Chi-square, t-test analysis and ANOVA will be used to examine significant differences between the subgroups. Discussion This is the first research protocol to study disability among the Iranian elderly population. Presently, 80% of eligible subjects have been selected. The results of this study will help to develop more effective protocols to assist Iranian elderly population with disabilities.

Mere kapital til systemisk vigtige finansielle institutioner

DEFF Research Database (Denmark)

Grosen, Anders

2011-01-01

. Basel-komiteen har endnu ikke udformet konkrete krav til systemisk vigtige finansielle institutioner, men rammerne for de samlede regulative Basel III-kapitalkrav er i dag så langt fremme, at de schweiziske myndigheders forslag til kapitalkrav for systemiske institutioner i det følgende sammenlignes med...... Basel III....

Dignity and Distress towards the End of Life across Four Non-Cancer Populations

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Chochinov, Harvey Max

2016-01-01

Objective The purpose of this study was to identify four non-cancer populations that might benefit from a palliative approach; and describe and compare the prevalence and patterns of dignity related distress across these diverse clinical populations. Design A prospective, multi-site approach was used. Setting Outpatient clinics, inpatient facilities or personal care homes, located in Winnipeg, Manitoba and Edmonton, Alberta, Canada. Participants Patients with advanced Amyotrophic Lateral Sclerosis (ALS), Chronic Obstructive Pulmonary Disease (COPD), End Stage Renal Disease (ESRD); and the institutionalized alert frail elderly. Main Outcome Measure In addition to standardized measures of physical, psychological and spiritual aspects of patient experience, the Patient Dignity Inventory (PDI). Results Between February 2009 and December 2012, 404 participants were recruited (ALS, 101; COPD, 100; ESRD, 101; and frail elderly, 102). Depending on group designation, 35% to 58% died within one year of taking part in the study. While moderate to severe loss of sense of dignity did not differ significantly across the four study populations (4–11%), the number of PDI items reported as problematic was significantly different i.e. ALS 6.2 (5.2), COPD 5.6 (5.9), frail elderly 3.0 (4.4) and ESRD 2.3 (3.9) [p < .0001]. Each of the study populations also revealed unique and distinct patterns of physical, psychological and existential distress. Conclusion People with ALS, COPD, ESRD and the frail elderly face unique challenges as they move towards the end of life. Knowing the intricacies of distress and how they differ across these groups broadens our understanding of end-of-life experience within non-cancer populations and how best to meet their palliative care needs. PMID:26808530

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

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Huikuan Chu

2014-01-01

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

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

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Surekha Kishore

2015-06-01

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

Is an increased elderly population related to decreased CO2 emissions from road transportation?

International Nuclear Information System (INIS)

Okada, Akira

2012-01-01

Few studies have focused on the potential effects of an increase in the share of aged population on the environmental impacts of road transportation. In order to fill this gap in the literature, this paper empirically analyzes whether there is a relationship between the share of aged population and carbon dioxide (CO 2 ) emissions from road transportation by applying a quadratic function. Using international panel data, it also addresses the level of the turning point in the relationships between the share of aged population and CO 2 emissions. The analysis in this paper uses a first-order differential equation to estimate an inverted U-shaped relationship between them in order to alleviate the unit roots issue. The results from 25 OECD countries, consisting mainly of European countries and Japan, indicate that there is a quadratic relationship between CO 2 emissions per capita and the share of aged population, and that the turning point is around 16 percent. The results also imply that a relative increase in the number of elderly people is associated with a decrease in CO 2 emissions per capita from the road sector when the share of aged population reaches more than 16 percent. - Highlights: ► I estimate the relationship between a country's share of elderly population and CO 2 emissions from road transport. ► In order to alleviate the unit roots issue, the analysis uses a first-order differential equation to estimate models. ► There is a quadratic relationship between CO 2 emissions per capita and the share of elderly. ► The level of the turning point in terms of the share of elderly in OECD European countries and Japan is around 16 percent.

[Self-esteem in formal care providers and quality of life indexes in users of support facilities for the institutionalized elderly, in Portalegre].

Science.gov (United States)

Graça, Ana; Melo, Ana; Gaspar, Ana; Cunha, Ana; Gomes, Anatilde; Cruz, Andreia; Galveias, Bruna; Gomes, Carina; Costa, Carlos; Bastos, Cátia; Ramos, Célsia; Ramalho, Cristina; Paz, Cristina; Carpinteiro, David; Lourenço, Edite

2006-01-01

It is a transversal and descriptive study, and the main meaning was to measure the Self-concept of formal caregivers in elderly institutions, and also the life quality of internally users in the same institutions. To the development of the study were selected two of the elderly institutions of Portalegre, Portugal. The population was composed by internally users (N=113) and formal caregivers (N=81) of both elderly institutions, being used respectively the WOHQOL-bref Questionnaire and the Self-concept Inventory (Vaz Serra, 1986). Based on the distribution of the self-concept of formal caregivers by mean point, we verify that 97.67% (n=42) have a high self-concept and 2.33% (n=1) have a low self-concept. We can conclude that generally formal caregivers have a high self-concept. About life quality value, we verify that most of internally users have values above the average point that identify the life quality. That suggests the internally users have a life quality above the medium point.

Prevalence and correlates of dental caries in an elderly population in northeast China.

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

2013-01-01

The present study aimed to investigate the prevalence and correlates of dental caries in elderly population in northeast China. A community-based, cross-sectional study among 2376 elderly subjects (age: 65-74 years) from nine urban areas and nine rural areas in three provinces of northeast China was conducted using multistage stratified random sampling per the World Health Organization oral health survey methodology. Decayed-missing-filled teeth (DMFT) and decayed-filled teeth (DFT) indices were used to evaluate the prevalence of dental caries. Face-to-face questionnaire survey on oral health was performed in a randomly selected subset (n = 1197). T test and chi square test were employed to compare groups for continuous and categorical variables, respectively. Multivariate logistic regression was used to estimate odds ratios (ORs) and corresponding confidence intervals (CIs). 67.5% of elderly subjects reported dental caries (average DFT = 2.68±3.40), and the prevalence was higher in urban areas (Ppopulation in urban areas (OR 1.713; 95% CI 1.337-2.195), smoking (OR 1.779; 95% CI 1.384-2.288), and individuals without dental insurance (OR 2.050; 95% CI 1.120-3.754) with dental caries. The prevalence of dental caries in the elderly population in northeast China is high. The elderly from urban areas who smoke and who do not have a dental insurance are at a higher risk to develop dental caries.

Mortality associated with traumatic injuries in the elderly: a population based study.

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O'Neill, Stephen; Brady, Richard R; Kerssens, Jan J; Parks, Rowan W

2012-01-01

Elderly trauma is increasing in incidence and is associated with significant morbidity and mortality. The primary objective of the study was to identify factors associated with survival or mortality in the elderly following trauma. The secondary objective was to compare the epidemiology of trauma in the elderly with younger patients. A retrospective analysis was performed of data that was obtained from a prospectively collected multi-centre trauma database maintained by The Scottish Trauma Audit Group (STAG) containing details of 52,887 trauma patients admitted to 25 participating Scottish Hospitals over an 11-year period. Elderly trauma patients (aged >80 years) were separately analyzed and compared to younger trauma patients (aged 13-80). Of 52,887 trauma patients identified, 4791 were elderly (9.1%). Elderly patients had a higher absolute mortality rate following traumatic injury (9.9% versus 4%, pelderly was higher in males, following a high fall, with lower Glasgow Coma Scale (GCS), in those with higher Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS), in those with concomitant injuries, hemodynamic compromise and following delayed presentation. Multiple logistic regression analysis confirmed an independent relationship between mortality and low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) in the elderly. In conclusion, trauma in elderly patients is associated with significantly higher mortality. Low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) have the strongest independent relationships with mortality after trauma in the elderly population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

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

2016-01-01

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

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

Science.gov (United States)

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

2016-01-01

Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia. PMID:27877126

The Characteristics of the Danish population in the Elderly-study

DEFF Research Database (Denmark)

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

the characteristics of the Danish population in the Elderly-study. Methods The study is a randomized controlled study and has so far enrolled 716 participants from Germany, USA, and Denmark and 341 are from Denmark. Participants are 60+ years old and fulfil the DSM-5 criteria for alcohol use disorder. The exclusions...

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

NARCIS (Netherlands)

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

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

[Salivary flow and psychoactive drug consumption in elderly people].

Science.gov (United States)

Cabrera, Marcos Aparecido Sarria; Mesas, Arthur Eumann; Rossato, Luiz Angelo; Andrade, Selma Maffei de

2007-01-01

To analyze the association between low saliva flow rates and the use of psychoactive drugs among the elderly. A cross-sectional study was carried out with 267 elderly people from 60 to 74 years of age who lived in a borough of the city of Londrina, Paraná State, Brazil. Individuals with high functional dependence or restricted to bed were excluded. Saliva flow rate was the dependent variable with values under the first tercile being considered as low flow rates (less than 0.44 ml/min). The continuous use of psychoactive drugs (antidepressant, antiepileptic, sedative, antipsychotic, hypnotic or sedative-hypnotic drugs) was the independent variable. Multivariate analysis was performed taking into account gender, age and smoking status. The majority of the elderly were women (80.5%), with a mean age of 66.5 years. Use of psychoactive drugs was observed among 31 elderly (11.6%). Mean saliva flow rate was 0.76 ml/min, lower among users of psychoactive drugs (0.67 ml/min). In the multivariate analysis, use of psychoactive drugs was associated with low saliva flow rates (psychoactive drugs and low saliva flow rates in this group of independent and non-institutionalized elderly. These conclusions stress the need of a rational use of these drugs, particularly among the elderly.

Formal home help services and institutionalization

DEFF Research Database (Denmark)

Yamada, Yukari; Siersma, Volkert; Avlund, Kirsten

2012-01-01

The effect of home help services has been inconsistent. Raising the hypothesis that receiving small amounts of home help may postpone or prevent institutionalization, the aim of the present study is to analyze how light and heavy use of home help services was related to the risk...... for institutionalization. The study was a secondary analysis of a Danish intervention study on preventive home visits in 34 municipalities from 1999 to 2003, including 2642 home-dwelling older people who were nondisabled and did not receive public home help services at baseline in 1999 and who lived at home 18 months...... after baseline. Cox regression analysis showed that those who received home help services during the first 18 months after baseline were at higher risk of being institutionalized during the subsequent three years than those who did not receive such services. However, receiving home help for less than 1h...

The Avahan Transition: Effects of Transition Readiness on Program Institutionalization and Sustained Outcomes.

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Sachiko Ozawa

Full Text Available With declines in development assistance for health and growing interest in country ownership, donors are increasingly faced with the task of transitioning health programs to local actors towards a path to sustainability. Yet there is little available guidance on how to measure and evaluate the success of a transition and its subsequent effects. This study assesses the transition of the Avahan HIV/AIDS prevention program in India to investigate how preparations for transition affected continuation of program activities post-transition.Two rounds of two surveys were conducted and supplemented by data from government and Avahan Computerized Management Information Systems (CMIS. Exploratory factor analysis was used to develop two measures: 1 transition readiness pre-transition, and 2 institutionalization (i.e. integration of initial program systems into organizational procedures and behaviors post-transition. A fixed effects model was built to examine changes in key program delivery outcomes over time. An ordinary least square regression was used to assess the relationship between transition readiness and sustainability of service outcomes both directly, and indirectly through institutionalization.Transition readiness data revealed 3 factors (capacity, alignment and communication, on a 15-item scale with adequate internal consistency (alpha 0.73. Institutionalization was modeled as a unidimensional construct, and a 12-item scale demonstrated moderate internal consistency (alpha 0.60. Coverage of key populations and condom distribution were sustained compared to pre-transition levels (p<0.01. Transition readiness, but not institutionalization, predicted sustained outcomes post-transition. Transition readiness did not necessarily lead to institutionalization of key program elements one year after transition.Greater preparedness prior to transition is important to achieve better service delivery outcomes post-transition. This paper illustrates a

Dental state and subjective chewing ability of institutionalized elderly people.

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Ekelund, R

1989-02-01

The purpose of the present study was to investigate the dental state of the elderly, to provide a subjective appraisal of their chewing ability and their inability to eat certain foods because of their poor dental state. The subjects were 480 residents of 24 municipal old people's homes in different parts of Finland. Of the subjects, 153 were men and 327 women, and their ages ranged from 65 to 100 years. The methods used were clinical examination and interview. The clinical examination revealed that 68% of the subjects had no natural teeth, and 22% had neither natural nor artificial teeth. The number of teeth in dentate subjects was small (average 7.6), and the condition mostly poor. Only 2% had any serviceable counterparts. 51% of the subjects wore dentures: 57 subjects in the maxilla alone, three in the mandible alone and 186 in both maxilla and mandible. 41% said that because of their teeth they were unable to eat some foods they would have liked to eat, crisp bread being mentioned most often as such a food (85% of those with chewing difficulties). Edentulous subjects and dentate subjects wearing both maxillary and mandibular dentures said more often than those without dentures that they could eat everything; those without any teeth had most often (59%) to avoid some foods. More attention should be given to the dental condition and the masticatory function of the elderly, especially of those living in institutions, to ensure that they are comfortable physically, psychologically, and socially for the rest of their lives.

Nutritional and oral health status of an elderly population in Nairobi.

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Ngatia, E M; Gathece, L W; Macigo, F G; Mulli, T K; Mutara, L N; Wagaiyu, E G

2008-08-01

To determine the nutrition and oral health status of elderly persons in Nairobi, Kenya. A cross-sectional study. Households in Dagoretti Division of Nairobi. Two hundred and eighty nine persons (29.8% males and 70.2% females) aged 45 years and above were assessed. The level of malnutrition using the mid upper arm circumference was 18.8% while by body mass index was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, with more females (48.0%) than males (25.9%) being overweight. The study established that many of the elderly persons suffered from dental problems, especially periodontitis with 89.9% having dental plaque, calculus 85.6%, gingival recession 82.5% and bleeding gums 77.4%. The decayed index missing and filled teeth, was 7.173 with 19.7% caries free, 51.9% reported tooth mobility and edentulousness was common. Under-nutrition, obesity and dental problems are issues of concern among the elderly. There is need to develop policies that will look into the nutrition and dental health of the elderly in order to improve their welfare.

Veterans Experiencing Elder Abuse: Improving Care of a High-Risk Population About Which Little Is Known.

Science.gov (United States)

Makaroun, Lena K; Taylor, Laura; Rosen, Tony

2018-02-01

At least 10% of older adults experience abuse, neglect, or exploitation annually in the United States, and this problem is expected to grow as our population ages. Little is known about the prevalence and characteristics of elder abuse of veterans, but it is likely that this population is at high risk based on established elder abuse risk factors. Veterans who receive their care through the Veterans Health Administration (VHA) have a higher prevalence of poor psychological health, poor physical health, functional impairment, cognitive impairment, and social isolation than the general population. As the largest integrated healthcare system in the United States, the VHA has long been a leader in the development of innovative, integrated care programs for older adults. The VHA has another opportunity to lead by promoting research, clinical care, and education on elder abuse, furthering their mission of serving those who served. This article outlines the rationale for developing a research agenda for elder abuse in the VHA, as well as potential first steps toward understanding more about this complex problem affecting veterans. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Evaluation of dental care and the prevalence of tooth decay among middle-aged and elderly population of Kaunas city.

Science.gov (United States)

Zubiene, Jurate; Milciuviene, Simona; Klumbiene, Jurate

2009-01-01

The aim of the study was to evaluate the prevalence and the intensity of tooth decay among the middle-aged and elderly population of Kaunas, city, and to assess the need for prostheses as well as the possibilities for oral care. During 2006-2008, we studied 1,141 inhabitants of Kaunas city; the subjects' age was 45-72 years. Oral evaluation technique proposed by the WHO was used in the investigation. We evaluated the prevalence of tooth decay, and its intensity was evaluated using the DMF-T index. We also evaluated dental prostheses, the need for prosthetics, and asked the subjects how they took care of their oral health. The prevalence of tooth decay among middle-aged and elderly population of Kaunas city was 99.9%. The DMF-T index was 21.01+/-0.3 in the age group of 45-54 years, 23.52+/-0.4 - in the age group of 55-64 years, and 25.63+/-0.3 - in the elderly subjects. Full removable dentures were found in 14.0% of the elderly subjects, while 1.0% of the middle-aged subjects and 1.2% of the elderly subjects required full dentures. 57.7% of the subjects aged 45-54 years, 53.1% of the subjects aged 55-64 years, and 43.4% of the elderly subjects brushed their teeth twice daily. The intensity of tooth decay in middle-aged and elderly population of Kaunas city significantly increased with age (21.01-25.63). A relationship was found between oral hygiene status and the DMF-T index. In the middle-aged and elderly population of Kaunas city, the intensity of tooth decay was significantly lower (DMF-T 23.04%) among those who brushed their teeth twice daily than among those who brushed their teeth once daily or less frequently (DMF-T 24.01%). Reduction of the prevalence of tooth decay among middle-aged and elderly population of Kaunas city necessitates alterations in people's attitudes towards dental care, implementation of suitable hygiene habits, and creation and implementation of the dental disease prevention program for adults and the elderly, based on the strategy

Predictors of institutionalization in patients with dementia in Korea.

Science.gov (United States)

Kim, Jae-Min; Shin, Il-Seon; Jeong, Seong-Joo; Gormley, Niall; Yoon, Jin-Sang

2002-02-01

Many studies have sought to determine the predictors of institutionalization of patients with dementia. Such studies, performed in developed western societies, have come to various conclusions which may not be supported in an East Asian culture such as that found in Korea. This study aimed to determine the factors that predict institutionalization of patients in Korea diagnosed with dementia. Seventy-nine cases (37 institutionalized, 42 community-dwelling) in the Kwangju area were evaluated for patient characteristics, severity of dementia symptoms, caregiver characteristics, burden and distress. Logistic regression was performed to determine predictors of actual institutionalization. Six predictors of institutionalization were identified. Of these, three were patient-related factors: higher score on the Clinical Dementia Rating, higher score on the Brief Psychiatric Rating Scale, and shorter duration of dementia. The other three were caregiver-related factors: younger age, higher education (formal schooling), and higher cost of home care. As seen in previous western studies, institutionalization of dementia sufferers was influenced by both patient and caregiver factors. But, the specific predictors and their relative influences might be explained best by the particular social, cultural and economic situation in Korea. This study was the first of its kind in Korea and, as such, could serve as a reference for future intra-cultural and cross-cultural comparisons. Copyright 2002 John Wiley & Sons, Ltd.

An evaluation of prosthetic status and treatment needs among institutionalized elderly individuals of Delhi, India

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Nisha Yadav

2017-01-01

Full Text Available Context: Oral health is essential for elderly person's general health and well-being. The most common oral problem in elderly is tooth loss which results due to periodontal diseases and caries. Prosthetic status is very important as it is related to dietary intake and maintaining nutritional status. Hence, to promote the oral health of the elderly, we need to know their prosthetic status and need. Aims: The aim of this study is to find the prosthetic status and need of 65–74 years old elderly residing in old age homes of Delhi, India. Settings and Design: A cross-sectional study was conducted among a total of 464 residents of 20 old age homes of Delhi, India. Material and Methods: Residents with age group of 64–75 were included in the study. The prosthetic status with treatment need was recorded using the World Health Organization Oral Health Assessment Form (1997. Statistical Analysis Used: Chi-square test and t-test were used to find significance of variables. P < 0.05 was considered significant. Results: Full removable dentures were worn by 7.30% of participants with predominance in upper arch, and one bridge was seen in 9.10% of participants with predominance in lower arch. Full removable denture was required in 25.20% of participants. Most of participants required multiunit prosthesis in both upper as well as lower arch (42.20% and 36.20%, respectively. Conclusion: The present study underlines a considerable need for dental treatment in elderly as the prosthetic status of participants was poor, and prosthetic needs were high.

Institutionalizing Strong Sustainability: A Rawlsian Perspective

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Konrad Ott

2014-02-01

Full Text Available The article aims to provide some ethical orientation on how sustainability might be actualized by institutions. Since institutionalization is about rules and organization, it presupposes ideas and concepts by which institutions can be substantiated. After outlining terminology, the article deals with underlying ethical and conceptual problems which are highly relevant for any suggestions concerning institutionalization. These problems are: (a the ethical scope of the sustainability perspective (natural capital, poverty, sentient animals, (b the theory of justice on which ideas about sustainability are built (capability approach, Rawlsianism, and (c the favored concept of sustainability (weak, intermediate, and strong sustainability. These problems are analyzed in turn. As a result, a Rawlsian concept of rule-based strong sustainability is proposed. The specific problems of institutionalization are addressed by applying Rawls’s concept of branches. The article concludes with arguments in favor of three transnational duties which hold for states that have adopted Rawlsian strong sustainability.

Prevalence of vitamin D deficiency and its associated factors among the urban elderly population in Hyderabad metropolitan city, South India.

Science.gov (United States)

Suryanarayana, Palla; Arlappa, Nimmathota; Sai Santhosh, Vadakattu; Balakrishna, Nagalla; Lakshmi Rajkumar, Pondey; Prasad, Undrajavarapu; Raju, Banavath Bhoja; Shivakeseva, Kommula; Divya Shoshanni, Kondru; Seshacharyulu, Madabushi; Geddam, Jagjeevan Babu; Prasanthi, Prabhakaran Sobhana; Ananthan, Rajendran

2018-03-01

Deficiency of vitamin D has been associated with various health conditions. However, vitamin D deficiency (VDD) and factors associated with VDD are not well studied, especially among the urban elderly population of India. To assess the prevalence of VDD and its associated factors among the urban free-living elderly population in Hyderabad. A community-based cross-sectional study was conducted among 298 urban elderly (≥60 years) by adapting a random sampling procedure. Demographic particulars were collected. Blood pressure and anthropometric measurements were recorded using standard equipment. Fasting glucose, lipid profile and 25-hydroxy vitamin D [25(OH) D] were estimated in plasma samples. The mean ± SE plasma vitamin D and the prevalence of VDD among the urban elderly population were 19.3 ± 0.54 (ng/ml) and 56.3%, respectively. The prevalence of VDD was significantly associated with education, high body mass index (BMI), hypertension (HT) and metabolic syndrome (MS). Multiple logistic regression analysis revealed HT as a significant predictor of vitamin D deficiency and the risk of VDD was double among the elderly with hypertension. The prevalence of VDD was high among the urban elderly population in the south Indian city of Hyderabad. High BMI, MS, HT and education are significant associated factors of VDD.

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

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Pallavi Kwan

2016-01-01

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

Anorexia and Eating Patterns in the Elderly

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Donini, Lorenzo Maria; Poggiogalle, Eleonora; Piredda, Maria; Pinto, Alessandro; Barbagallo, Mario; Cucinotta, Domenico; Sergi, Giuseppe

2013-01-01

Objectives To evaluate the change in eating habits occurring in community- dwelling and institutionalized elderly subjects with senile anorexia. Design Cross- sectional, observational. Setting Community, nursing homes and rehabilitation or acute care facilities in four Italian regions. Participants A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards). Measurements All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables). Results In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups (“meat, eggs and fish” and “fruit and vegetables”) whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety. Conclusion Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients. PMID:23658838

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

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

2013-01-01

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

Why is the age-standardized incidence of low-trauma fractures rising in many elderly populations?

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Kannus, Pekka; Niemi, Seppo; Parkkari, Jari; Palvanen, Mika; Heinonen, Ari; Sievänen, Harri; Järvinen, Teppo; Khan, Karim; Järvinen, Markku

2002-08-01

Low-trauma fractures of elderly people are a major public health burden worldwide, and as the number and mean age of older adults in the population continue to increase, the number of fractures is also likely to increase. Epidemiologically, however, an additional concern is that, for unknown reasons, the age-standardized incidence (average individual risk) of fracture has also risen in many populations during the recent decades. Possible reasons for this rise include a birth cohort effect, deterioration in the average bone strength by time, and increased average risk of (serious) falls. Literature provides evidence that the rise is not due to a birth cohort effect, whereas no study shows whether bone fragility has increased during this relatively short period of time. This osteoporosis hypothesis could, however, be tested if researchers would now repeat the population measurements of bone mass and density that were made in the late 1980s and the 1990s. If such studies proved that women's and men's age-standardized mean values of bone mass and density have declined over time, the osteoporosis hypothesis would receive scientific support. The third explanation is based on the hypothesis that the number and/or severity of falls has risen in elderly populations during the recent decades. Although no study has directly tested this hypothesis, a great deal of indirect epidemiologic evidence supports this contention. For example, the age-standardized incidence of fall-induced severe head injuries, bruises and contusions, and joint distortions and dislocations has increased among elderly people similarly to the low-trauma fractures. The fall hypothesis could also be tested in the coming years because the 1990s saw many research teams reporting age- and sex-specific incidences of falling for elderly populations, and the same could be done now to provide data comparing the current incidence rates of falls with the earlier ones.

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

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Baldev, Vibha Florence; Chopra, Rupali; Batra, Nitin; Singh, Shavinder

2017-08-01

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

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

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Guohua Zheng

2015-01-01

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

Understanding micro-processes of institutionalization: stewardship contracting and national forest management

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Cassandra Moseley; Susan Charnley

2014-01-01

This paper examines micro-processes of institutionalization, using the case of stewardship contracting within the US Forest Service. Our basic premise is that, until a new policy becomes an everyday practice among local actors, it will not become institutionalized at the macro-scale. We find that micro-processes of institutionalization are driven by a mixture of large-...

The effect of loneliness on malnutrition in elderly population.

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Ramic, Enisa; Pranjic, Nurka; Batic-Mujanovic, Olivera; Karic, Enisa; Alibasic, Esad; Alic, Alma

2011-01-01

The clinical and epidemiological data show that proper nutrition plays an important role in maintaining health and combating the danger of developing some chronic diseases in the elderly population. Nutrition is an important factor in many physiological and pathological changes that accompany the aging process. More than 50% of elderly patients are suffering from malnutrition which is information that concerns. Due to various factors, older people are potentially vulnerable groups at risk of malnutrition. Loneliness, isolation from society and neglect of parents by children is a big problem to many people in old age. To determine differences in nutritional status of elderly people living alone compared to those who live in family surroundings. The study was conducted in the municipality of Tuzla in 2009-2010, in outpatient family medicine Simin Han. The survey covered a total of 200 elderly subjects (age >65 years). Subject group consisted of 45% of people living alone, and 55% control group consisted of elderly patients who live in traditional family surroundings. Questionnaires used in this study are General geriatric assessment questionnaire and Mini nutritional status. The average age (+/- SD) was 75.4 +/- 6.2 years in subject group, while the same in the control group was 74.9 +/- 5.6 years. In subject group significantly more patients are on the verge of poverty. There are significant differences in the classification of financial status, according to the groups (p = 0.043). Members of subject groups have significantly lower BMI categories (p = 0.03) compared with the control group. In our study, people who live alone are at increased risk of malnutrition (p = 0030), have reduced the number of daily meals, significantly lower daily intake of protein, fruits and vegetables in the diet in relation to persons living in a family environment. Significantly more patients with loss of appetite live alone. According to the existence of self-reported food problems

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

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M. Avolio

2013-01-01

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

Institutionalizing New Ideas Through Visualization

DEFF Research Database (Denmark)

Meyer, Renate; Jancsary, Dennis; Höllerer, Markus A.

How do visualization and visual forms of communication influence the process of transforming a novel idea into established organizational practice? In this paper, we build theory with regard to the role of visuals in manifesting and giving form to an innovative idea as it proceeds through various...... stages of institutionalization. Ideas become institutionalized not merely through widespread diffusion in a cognitive-discursive form but eventually through their translation into concrete activities and transformation into specific patterns of organizational practice. We argue that visualization plays...... a pivotal and unique role in this process. Visualization bridges the ideational with the practical realm by providing representations of ideas, connecting them to existing knowledge, and illustrating the specific actions that instantiate them. Similar to verbal discourse, and often in tandem, visual...

Psychotropic drug use among persons with mental distress symptoms: a population-based study in Norway.

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Hausken, Anne M; Skurtveit, Svetlana; Rosvold, Elin O; Bramness, Jørgen G; Furu, Kari

2007-01-01

To explore psychotropic drug use in the general population and in particular among non-institutionalized persons with mental distress symptoms. A total of 14,139 women and 11,665 men participating in the Oslo Health Study or the Oppland/Hedmark Study 2000-2001 submitted a self-administered questionnaire on health status and drug use, lifestyle, and socioeconomic factors. Respondents using antidepressants, hypnotics, and/or anxiolytics during the last four weeks were defined as users. A high Hopkins Symptoms Checklist-10 score indicated mental distress. The 15% with the highest score in each gender and age group (adults: 30/40/45 years; elderly: 60 years) were studied. The prevalence of antidepressant use among those with mental distress was, for women: adults 21%; elderly 30%; and for men, adults 15%; elderly 15%. These figures were nearly four times higher than in the general population. Not participating in the labour market was the main factor associated with use of antidepressants for subjects with mental distress: adult women (odds ratio (OR) 3.5; 95% confidence interval (CI) 2.5-5.0); elderly women (OR 5.2; CI 2.7-10.2); adult men (OR 4.7; CI 3.0-7.3); and elderly men (OR 2.9; CI 1.4-6.0). Use of analgesics was the main factor associated with use of anxiolytics/hypnotics: adult women (OR 2.4; CI 1.7-3.4); elderly women (OR 2.3; CI 1.4-3.8); adult men (OR 2.1; CI 1.3-3.3); and elderly men (OR 3.4; CI 1.9-6.0). Among individuals with mental distress, not participating in the labour market and regular use of analgesics were the main factors associated with use of psychotropics in both genders regardless of age.

HIGH PREVALENCE OF Strongyloides stercoralis INFECTION AMONG THE ELDERLY IN BRAZIL

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Maria Margarida Naves

2013-09-01

Full Text Available SUMMARY Little is known about the frequency of intestinal parasites in the elderly due to a lack of attention given to the occurrence of these infections among older adults. This study compares the frequency of Strongyloides stercoralis and other enteroparasites between elderly living in nursing homes (n = 100 and those noninstitutionalized (n = 100 from Uberlândia, state of Minas Gerais, southeastern Brazil, associated with data of epidemiological and socio-demographic conditions. Through coproparasitological examination of both groups, enteroparasites were detected in 15 of 200 individuals examined (7.5%; CI: 5.1- 9.9. S. stercoralis was the most frequent parasite 10/200 (5%; CI: 4.2-5.8, being significantly higher in males and in individuals with autonomy for daily living activities. There were no statistical differences in the prevalence of parasites between the two groups compared. In conclusion, S. stercoralis infection was highly prevalent in elderly patients and it does not depend on whether the individual was institutionalized or not.

Non-leisure time physical activity is an independent predictor of longevity for a Taiwanese elderly population: an eight-year follow-up study.

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Lin, Yu-Pei; Huang, Ying-Hsiang; Lu, Feng-Hwa; Wu, Jin-Shang; Chang, Chih-Jen; Yang, Yi-Ching

2011-06-03

The aim of this study is to determine the relationship between leisure time physical activity (LTPA) and non-leisure time physical activity (NLTPA) on mortality among the elderly in Taiwan. This is a prospective observational cohort study. We analyzed the mortality data from a cohort of 876 non-institutionalized community-dwelling men and women aged 65 years or over, who were recruited by stratified clustering random sampling from Tainan city and participated in the 1996 Elderly Medication Survey. Information about activities and other variables were collected by structured interviews at baseline in the participants' home. The Cox proportional hazards model and crude death rate were applied to estimate mortality risk. Among the 876 participants, 312 died during the follow-up period (1996-2004). In the unadjusted Cox regression model, subjects aged over 75, having difficulty in carrying out activities of daily living (ADLs), a BMI less than 18.5, a history of diabetes mellitus or stroke, without LTPA or being inactive in NLTPA, were found to have a higher risk of eight-year mortality. With the adjustment for age, gender, education level, habitual smoking and drinking, living status, BMI and medical history, the mortality was found to be higher among the sedentary subjects, either defined by lack of LTPA or NLTPA, with the hazard ratio of 1.27 (95% confidence interval [CI] = 0.97-1.66) and 1.45 (95% CI = 1.07-1.97), respectively. Furthermore, when both LTPA and NLTPA were put into the model simultaneously, NLTPA (HR = 1.40; 95% CI = 1.03-1.91) but not LTPA (HR = 1.21, 95% CI = 0.92-1.59) significantly predicted mortality during eight-year follow-up. In addition, subjects who were actively engaged in NLTPA had a lower mortality risk especially in subjects without performing LTPA. NLTPA is an independent predictor of longevity among older people in Taiwan. A physically active lifestyle, especially engaged in NLTPA, is associated with lower mortality risk in the elderly

Non-leisure time physical activity is an independent predictor of longevity for a Taiwanese elderly population: an eight-year follow-up study

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Wu Jin-Shang

2011-06-01

Full Text Available Abstract Background The aim of this study is to determine the relationship between leisure time physical activity (LTPA and non-leisure time physical activity (NLTPA on mortality among the elderly in Taiwan. Methods This is a prospective observational cohort study. We analyzed the mortality data from a cohort of 876 non-institutionalized community-dwelling men and women aged 65 years or over, who were recruited by stratified clustering random sampling from Tainan city and participated in the 1996 Elderly Medication Survey. Information about activities and other variables were collected by structured interviews at baseline in the participants' home. The Cox proportional hazards model and crude death rate were applied to estimate mortality risk. Results Among the 876 participants, 312 died during the follow-up period (1996-2004. In the unadjusted Cox regression model, subjects aged over 75, having difficulty in carrying out activities of daily living (ADLs, a BMI less than 18.5, a history of diabetes mellitus or stroke, without LTPA or being inactive in NLTPA, were found to have a higher risk of eight-year mortality. With the adjustment for age, gender, education level, habitual smoking and drinking, living status, BMI and medical history, the mortality was found to be higher among the sedentary subjects, either defined by lack of LTPA or NLTPA, with the hazard ratio of 1.27 (95% confidence interval [CI] = 0.97-1.66 and 1.45 (95% CI = 1.07-1.97, respectively. Furthermore, when both LTPA and NLTPA were put into the model simultaneously, NLTPA (HR = 1.40; 95% CI = 1.03-1.91 but not LTPA (HR = 1.21, 95% CI = 0.92-1.59 significantly predicted mortality during eight-year follow-up. In addition, subjects who were actively engaged in NLTPA had a lower mortality risk especially in subjects without performing LTPA. Conclusions NLTPA is an independent predictor of longevity among older people in Taiwan. A physically active lifestyle, especially engaged in

Factors Affecting Hypertension among the Malaysian Elderly

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Sima Ataollahi Eshkoor

2016-03-01

Full Text Available Hypertension is a common chronic disease in the elderly. This study aimed to determine the effects of age, ethnicity, gender, education, marital status, nutritional parameters, and blood elements on the risk of high blood pressure in the Malaysian elderly. This research was conducted on a group of 2322 non-institutionalized Malaysian elderly. The hierarchy binary logistic regression analysis was applied to estimate the risk of hypertension in respondents. Approximately, 45.61% of subjects had hypertension. The findings indicated that the female gender (Odds ratio (OR = 1.54, an increase in body weight (OR = 1.61, and an increase in the blood levels of albumin (OR = 1.51, glucose (OR = 1.92, and triglycerides (OR = 1.27 significantly increased the risk of hypertension in subjects (p < 0.05. Conversely, an increase in both dietary carbohydrates (OR = 0.74, and blood cholesterol level (OR = 0.42 significantly reduced the risk of hypertension in samples (p < 0.05. Furthermore, the results showed that ethnicity was a non-relevant factor to increase the risk of hypertension in subjects. It was concluded that female gender, an increase in body weight, and an increase in the blood levels of glucose, triglycerides, and albumin enhanced the risk of high blood pressure in the Malaysian elderly. In addition, an increase in both dietary carbohydrates and blood cholesterol level decreased hypertension in subjects.

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

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Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

2010-01-01

Abstract Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by...

Biopsychosocial Characteristics, Using a New Functional Measure of Balance, of an Elderly Population with CLBP

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Ryan Hulla

2016-08-01

Full Text Available This study examined the biopsychosocial characteristics of chronic low back pain (CLBP in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older. A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH-developed Patient-Reported Outcome Measurement Information System (PROMIS was also part of this comprehensive evaluation. Two demographically-matched groups of elderly participants were evaluated: one with CLBP (n = 24; and the other without (NCLBP, n = 24. Results revealed significant differences in most of these measures between the two groups, further confirming the importance of using a biopsychosocial approach for future studies of pain and postural control in the elderly.

Chronic pain and pattern of health care utilization among Malaysian elderly population: National Health and Morbidity Survey III (NHMS III, 2006).

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Mohamed Zaki, Lily R; Hairi, Noran N

2014-12-01

The aims of this study were to report prevalence of chronic pain and to examine whether chronic pain influence healthcare usage among elderly Malaysian population. This was a sub-population analysis of the elderly sample in the Malaysia's Third National Health and Morbidity Survey (NHMS III) 2006, a nation-wide population based survey. A subset of 4954 elderly aged 60 years and above was used in the analysis. Chronic pain, pain's interference and outcome variables of healthcare utilization (hospital admission and ambulatory care service) were all measured and determined by self-report. Prevalence of chronic pain among elderly Malaysian was 15.2% (95% CI: 14.5, 16.8). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across young-old and old-old groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no educational background. Our study showed that chronic pain alone increased hospitalization but not visits to ambulatory facilities. Presence of chronic pain was significantly associated with the frequency of hospitalization (aIRR 1.11; 95% CI 1.02, 1.38) but not ambulatory care service. Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher hospitalization rate among the elderly population. This study provides insight into the distribution of chronic pain among the elderly and its relationship with the patterns of healthcare utilization. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prótesis totales y lesiones bucales en adultos mayores institucionalizados Total Prosthetics and Oral Lesions in Institutionalized Elderly

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Beatriz García Alpízar

2012-03-01

characteristics of patients with dentures and its relation to oral lesions. Methods: A descriptive study was conducted with 93 institutionalized elderly using total prosthetics. We used chi square tests and relative risk to determine the association between variables: patient’s age, sex and oral hygiene; denture’s preservation, time and frequency of use and needs of rehabilitation; type and location of lesion, smoking habit, systemic diseases and medication used. Results: 78.5% of elderly presented lesions related to the use of prosthetics. Stomatitis sub-prosthesis was the most frequent injury. The presence of oral lesions was significant in those aged 80 and over (100%. 95.8% of dentures were deteriorated and all of them had 21 or more years of use. The risk of injury was 2.98 times higher in those with poor oral hygiene. 100% of diabetic and anemic elderly presented lesions. Conclusions: Oral lesions were closely related to local factors: denture’s preservation, oral hygiene, time of use of the prosthesis, and general factors such as increased age, systemic diseases and the medication used for their treatment.

Social participation and perceived depression among elderly population in South Africa

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Hao G

2017-06-01

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

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established.

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Jacopo M Legramante

Full Text Available The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users".A retrospective study was performed during the calendar year 2014 (1st January 2014 - 31st December 2014 analyzing all ED admissions to the University Hospital of Rome Tor Vergata. Variables collected included age, triage code, arrival data, discharge diagnosis, and visit outcome. We performed a risk analysis using univariate binary logistic regression models.A total number of 38,016 patients accessed the ED, generating 46,820 accesses during the study period, with an average of 1.23 accesses for patient. The elderly population represented a quarter of the total ED population and had an increased risk of frequent use (OR 1.5: CI 1.4-1.7 and hospitalization (OR 3.8: CI 3.7-4. Moreover, they showed a greater diagnostic complexity, as demonstrated by the higher incidence of yellow and red priority codes compared to other ED populations (OR 3.1: CI 2.9-3.2.Older patients presented clinical and social characteristics related to the definition of "elderly frail frequent users". The fact that a larger number of hospitalizations occurred in such patients is indirect evidence of frailty in this specific population, suggesting that hospital admissions may be an inappropriate response to frailty, especially when continued care is not established.Enhancement of continuity of care, establishment of a tracking system for those who are at greater risk of visiting the ED and evaluating

Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established.

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Legramante, Jacopo M; Morciano, Laura; Lucaroni, Francesca; Gilardi, Francesco; Caredda, Emanuele; Pesaresi, Alessia; Coscia, Massimo; Orlando, Stefano; Brandi, Antonella; Giovagnoli, Germano; Di Lecce, Vito N; Visconti, Giuseppe; Palombi, Leonardo

2016-01-01

The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users". A retrospective study was performed during the calendar year 2014 (1st January 2014 - 31st December 2014) analyzing all ED admissions to the University Hospital of Rome Tor Vergata. Variables collected included age, triage code, arrival data, discharge diagnosis, and visit outcome. We performed a risk analysis using univariate binary logistic regression models. A total number of 38,016 patients accessed the ED, generating 46,820 accesses during the study period, with an average of 1.23 accesses for patient. The elderly population represented a quarter of the total ED population and had an increased risk of frequent use (OR 1.5: CI 1.4-1.7) and hospitalization (OR 3.8: CI 3.7-4). Moreover, they showed a greater diagnostic complexity, as demonstrated by the higher incidence of yellow and red priority codes compared to other ED populations (OR 3.1: CI 2.9-3.2). Older patients presented clinical and social characteristics related to the definition of "elderly frail frequent users". The fact that a larger number of hospitalizations occurred in such patients is indirect evidence of frailty in this specific population, suggesting that hospital admissions may be an inappropriate response to frailty, especially when continued care is not established. Enhancement of continuity of care, establishment of a tracking system for those who are at greater risk of visiting the ED and evaluating fragile

Elderly Suicide

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

Effectiveness of the mHealth technology in improvement of healthy behaviors in an elderly population-a systematic review.

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Changizi, Maryam; Kaveh, Mohammad H

2017-01-01

Demographic changes in the 21st century, increased population of the elderly and high prevalence of related diseases call for new healthcare strategies that can change the behavior and lifestyle of elderly individuals. Innovative information and communication technology, such as mobile health (mHealth), can play a significant role. The present study was conducted aiming to assess the effectiveness of mHealth in improving health behaviors among an elderly population. This paper presents a systematic review involving a search of PubMed, Web of Science (ISI), Scopus, Science Direct and Embase databases from [2012-2016]. Our search resulted after initial evaluations 12 articles. Inclusion criteria mostly revolved around interventional studies, other studies were excluded because of their methodology, non-elderly target groups and irrelevant to the subject. Findings showed that mHealth can improve care, self-management, self-efficacy, behavior promotion (quality of sleep, diet, physical activity mental health) and medication adherence. The mHealth technology has proven effective for disease prevention, lifestyle changes, management of cardiovascular disease and diabetes, and is a suitable tool for elderly people. In conclusion, it seems that mHealth can facilitate behavioral changes; although, further research is necessary in this regard.

Significados atribuídos por profissionais de saúde ao processo de envelhecimento de idosos institucionalizados

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Camila Aparecida Pinheiro Landim Almeida

2017-01-01

Full Text Available Objective: to analyze the meanings attributed by health professionals to the process of aging of institutionalized elderly. Methods: qualitative study carried out with ten health professionals in two long stay institutions for the elderly. A semistructured interview script was used with questions related to the aging process of institutionalized elderly. The data were analyzed according to the symbol, referent and thought proposed by the Representational Theory of Meaning. Results: the meanings obtained resulted in aspects related to being an elderly; fragile elderly; social exclusion and cultural values (symbol; elements related to the aging process (referent; and the recognition of institutional aspects (thought. Conclusion: the meanings attributed by health professionals to the aging process were related to the fragility of being elderly, in view of social exclusion, cultural aspects and institutionalization. These meanings allow us to reflect on the daily practice of integrality in the care of institutionalized elderly.

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

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Luallen, Jeremy; Kling, Ryan

2014-12-01

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

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

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Miao Liu

Full Text Available The information on the changes of prevalence of MetS in China is limited. Our objective was to assess a 10-year's change of the prevalence of MetS in a Chinese elderly population between 2001 and 2010.We conducted two cross-sectional surveys in a representative sample of elderly population aged 60 to 95 years in Beijing in 2001 and 2010 respectively. MetS was defined according to the 2009 harmonizing definition.A total of 2,334 participants (943 male, 1,391 female in 2001 and 2,102 participants (848 male, 1,254 female in 2010 completed the survey. The prevalence of MetS was 50.4% (95%CI: 48.4%-52.4% in 2001 and 58.1% (95%CI: 56.0%-60.2% in 2010. The absolute change of prevalence of MetS was 7.7% over the 10-year's period (p<0.001. The syndrome was more common in female than male in both survey years. Among the five components, hypertriglyceridemia and low HDL-C had increased most, with an increase of 14.8% (from 29.4% to 44.2% and 9.9% (from 28.3% to 38.2% respectively. The adjusted ORs of MetS for CHD, stroke and CVD were 1.67(95%CI: 1.39-1.99, 1.50(95%CI: 1.19-1.88 and 1.70(95%CI: 1.43-2.01 respectively in 2001, and were 1.74(95%CI: 1.40-2.17, 1.25(95%CI: 0.95-1.63 and 1.52(95%CI: 1.25-1.86 respectively in 2010.The prevalence of MetS is high and increasing rapidly in this Chinese elderly population. Participants with Mets and its individual components are at significantly elevated ORs for CVD. Urgent public health actions are needed to control MetS and its components, especially for dislipidemia.

Institutionalization of Gerontological Curricular Change in Schools of Social Work

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Wernet, Stephen P.; Singleton, Judy L.

2010-01-01

This study addresses factors associated with sustainability and institutionalization of change in the 67 Geriatric Enrichment in Social Work Education (GeroRich) projects, and the ways innovations introduced became institutionalized at the respective colleges and universities. An unobtrusive qualitative-descriptive research design was used to…

Association between functional performance and executive cognitive functions in an elderly population including patients with low ankle–brachial index

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Ferreira, Naomi Vidal; Cunha, Paulo Jannuzzi; da Costa, Danielle Irigoyen; dos Santos, Fernando; Costa, Fernando Oliveira; Consolim-Colombo, Fernanda; Irigoyen, Maria Cláudia

2015-01-01

Introduction Peripheral arterial disease, as measured by the ankle–brachial index (ABI), is prevalent among the elderly, and is associated with functional performance, assessed by the 6-minute walk test (6MWT). Executive cognitive function (ECF) impairments are also prevalent in this population, but no existing study has investigated the association between ECF and functional performance in an elderly population including individuals with low ABI. Aim To investigate the association between functional performance, as measured by the 6MWT, and loss in ECF, in an elderly sample including individuals with low ABI. Method The ABI group was formed by 26 elderly individuals with low ABI (mean ABI: 0.63±0.19), and the control group was formed by 40 elderly individuals with normal ABI (mean ABI: 1.08±0.07). We analyzed functional performance using the 6MWT, global cognition using the Mini-Mental State Examination (MMSE), and ECF using the Digit Span for assessing attention span and working memory, the Stroop Color Word Test (SCWT) for assessing information processing speed and inhibitory control/impulsivity, and the Controlled Oral Word Association Test (COWAT) for assessing semantic verbal fluency and phonemic verbal fluency. We also used a factor analysis on all of the ECF tests (global ECF). Results Before adjustment, the ABI group performed worse on global cognition, attention span, working memory, inhibitory control/impulsivity, semantic verbal fluency, and phonemic verbal fluency. After adjustment, the ABI group performance remained worse for working memory and semantic verbal fluency. In a simple correlation analysis including all of the subjects, the 6MWT was associated with global cognition, attention span, working memory, information processing speed, inhibitory control/impulsivity, semantic verbal fluency, and global ECF. After adjustment, all the associations remained statistically significant. Conclusion This study found an independent association between

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

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

2013-01-01

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

Efectos de una intervención cognitivo-conductual para disminuir el burnout en cuidadores de ancianos institucionalizados (Effects of a Cognitive Behavioural Intervention to reduce burnout in caregivers of institutionalized elderly individuals

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Karina Reyes Jarquín

2016-04-01

Full Text Available Burnout is a dysfunctional response to chronic job stress in professionals (e.g., doctors, nurses, and caregivers who are in constant contact with service users. Burnout has negative affects at the physiological, personal, familial, and work levels. The aim of this study was to evaluate the effect of a cognitive behavioural intervention (CBI to reduce burnout in professional caregivers. The intervention was implemented and evaluated in 15 professional caregivers of institutionalized elderly individuals, and comprised relaxation, cognitive restructuring, social skills, positive reinforcement, and shaping and modelling modules. Following the intervention, statistically significant decreases were found in burnout scores and the dimensions of physical and psychological exhaustion, disappointment at work, and guilt; statistically significant increases were found in the variable quality of life scores and the dimensions of physical health, psychological health, and social relationships. In addition, a reduction was observed in clinical burnout scores in all the caregivers, and 60% of them improved their clinical quality of life scores. The results suggest that CBI is effective in the management of burnout and improving the quality of life of caregivers.

The institutionalization of benchmarking in the Danish construction industry

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Rasmussen, Grane Mikael Gregaard; Gottlieb, Stefan Christoffer

, the chapter accounts for the data collection methods used to conduct the empirical data collection and the appertaining choices that are made, based on the account for analyzing institutionalization processes. The analysis unfolds over seven chapters, starting with an exposition of the political foundation...... and disseminated to the construction industry. The fourth chapter demonstrates how benchmarking was concretized into a benchmarking system and articulated to address several political focus areas for the construction industry. BEC accordingly became a political arena where many local perspectives and strategic...... emerged as actors expressed diverse political interests in the institutionalization of benchmarking. The political struggles accounted for in chapter five constituted a powerful political pressure and called for transformations of the institutionalization in order for benchmarking to attain institutional...

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

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

2016-03-01

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

Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study.

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Yang, Zhi-Qi; Zhao, Qi; Jiang, Ping; Zheng, Song-Bai; Xu, Biao

2017-12-28

Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m 2 ). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.

Postural balance and falls in elderly nursing home residents enrolled in a ballroom dancing program.

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da Silva Borges, Eliane Gomes; de Souza Vale, Rodrigo Gomes; Cader, Samária Ali; Leal, Silvania; Miguel, Francisco; Pernambuco, Carlos Soares; Dantas, Estélio H M

2014-01-01

The aim of this study was to investigate the influence of a ballroom dancing program on the postural balance of institutionalized elderly residents. The sample consisted of 59 sedentary elderly residents of long-stay institutions who were randomly assigned to a ballroom dancing experimental group (EG, n=30) or a control group (CG, n=29). The ballroom dancing program consisted of three 50-min sessions each week on alternate days over a 12-week period. The dances included the foxtrot, waltz, rumba, swing, samba and bolero. The medical records of the subjects were reviewed to determine the number of falls they experienced in the three months prior to the intervention. Postural static balance was assessed using a Lizard (Med. EU., Italy, 2010) stabilometric and posturometric platform. Only patients in the EG lost a significant amount of weight (Δ=-2.85 kg) when comparing the pre- and post-test postural balance assessments. The intergroup comparison revealed a reduced lower limb weight distribution difference in the EG post-test compared to the CG post-test (p=0.012). In the intragroup comparison, the EG patients experienced significantly fewer falls post-test relative to pre-test (pfalls in the EG post-test compared to the CG post-test (pbalance via a ballroom dancing program. This activity improved balance and reduced the number of falls in this elderly population. Copyright © 2014. Published by Elsevier Ireland Ltd.

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

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Alejandra Contreras-Manzano

2015-09-01

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

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

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

2015-01-01

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

Institutionalization of Organized Industrial Estates in Turkey, Problems Encountered and Proposed Solutions

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Hasan DAĞLAR

2015-12-01

Full Text Available In the aim of the study is to determine the institutionalization degree of organized industrial estates and to identify the faced problems and to develop solutions for these problems. By using survey method, information about problems and institutionalization status of organized industrial estates were obtained from managers of the active organized industrial estates. The problems of organized industrial estates are related to the management structure, qualified staff, energy, transportation, regulation and public improvements. Formalization, professionalism, accountability, transparency and social responsibility have been identified as the factors about the institutionalization of organized industrial estates in Turkey according to factor analysis. It could be argued that organized industrial estates in Turkey have an institutional structure and they have institutionalized. However, it could be said that organized industrial estates which operate in 80 cities of Turkey and more than one are in some cities are not at the same level of institutionalization.

Quality of life in elderly patients with an ostomy - a study from the population-based PROFILES registry.

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Verweij, N M; Bonhof, C S; Schiphorst, A H W; Maas, H A; Mols, F; Pronk, A; Hamaker, M E

2018-04-01

Ostomies are being placed frequently in surgically treated elderly patients with colorectal cancer (CRC). An insight into the (potential) impact of ostomies on quality of life (QoL) could be useful in patient counselling as well as in the challenging shared treatment decision-making. Patients with CRC diagnosed between 2000 and 2009 and registered in the population-based Eindhoven Cancer Registry received a QoL questionnaire (EORTC QLQ-C30) in 2010. In addition, QoL was compared with an age- and sex-matched normative population. The study included 2299 CRC patients, of whom 494 had an ostomy. No differences were found in reported ostomy-related problems between patients aged ≤65, 66-75 and ≥76 years. Ostomy patients aged 66-75 and ≥76 years reported significantly lower physical functioning compared with those without an ostomy. In the elderly (those aged ≥76 years) ostomates reported a worse physical and social functioning compared with the normative population. All these differences were of small clinical relevance. The impact of an ostomy seems to be more prominent in younger (≤75 years old) ostomates, as they experience more functional limitations and a decrease in global health status compared with younger nonostomy patients and the normative population. Although elderly (≥76 years old) patients with an ostomy report significantly more limitations in functioning compared with a normative population and elderly CRC patients without an ostomy, the clinical relevance of this finding is limited. In contrast, the impact of an ostomy is more prominent in younger patients. Thus, age itself is not a reason for withholding an ostomy. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review.

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Hardeman, Rachel R; Murphy, Katy A; Karbeah, J'Mag; Kozhimannil, Katy Backes

Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being.

Profile of mental disorders among the elderly United Arab Emirates population: sociodemographic correlates.

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Ghubash, Rafia; El-Rufaie, Omer; Zoubeidi, Taoufik; Al-Shboul, Qasim M; Sabri, Sufyan M

2004-04-01

To investigate the prevalence, nature and sociodemographic correlates of mental disorders among the elderly United Arab Emirates (UAE) population. STUDY SUBJECTS AND SAMPLE: UAE nationals aged 60 years or more, were recruited from within a random sample of households representing the UAE national population, irrespective of the age of individuals in each household. RESEARCH INSTRUMENTS: (i) Geriatric Mental State Interview (GMS-A3): an Arabic version, using the AGECAT for analysis; (ii) A short questionnaire for relevant sociodemographic data. Purposely trained, Arabic speaking interviewers visited the targeted sample households to interview study subjects at their homes. The total number of screened subjects was 610: 166 (27.2%) in Al-Ain; 286 (46.9%) in Dubai and 158 (25.9%) in Ras Al-Khaimah. There were 347 (56.9%) male subjects and 263 (43.1%) female subjects. The mean age of the interviewed subjects was 68.6 (SD 8.3). The commonest diagnostic entities at the AGECAT syndrome case level were depression (20.2%), anxiety (5.6%), hypochondriasis (4.4%) and organic, mostly cognitive impairment with or without dementia (3.6%). Organic syndrome caseness, as an independent entity, showed significant correlation only to older age, while the rest of the mental disorders showed significant correlation with female gender, insufficient income and being single, separated, divorced or widowed. The GMS-AGECAT package proved to be a useful tool for psychiatric assessment among the elderly in this Arabian culture. The prevalence rates of mental disorders among the elderly UAE population were, more or less, within the same range reported by other comparable worldwide studies. Copyright 2004 John Wiley & Sons, Ltd.

Suicidal Ideation among the Chinese Elderly and Its Correlates: A Comparison between the Rural and Urban Populations

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Jianwen Wei

2018-02-01

Full Text Available Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were taken from the Sample Survey of the Aged Population in Urban/Rural China (SSAPUR accomplished in 2010 by the China Ministry of Civil Affairs. The valid sample for this study was composed of 18,683 individuals, including 9416 urban residents and 9267 rural residents both aged 60 or more years; Results: Logistic regression analyses showed that household income and expenditure, the number of children, chronic diseases, disability of daily living, depression, the frequency of visiting neighbors and having friends or relatives who can help or not had remarkable effects on the suicidal ideation among urban and rural old people. Gender, education, political affiliation, marital status and self-rated health status did not work on the dependent variable. However, some risk factors for suicidal ideation among the Chinese elderly were different between rural and urban regions; Conclusions: We should take different measures when facing the different groups of the elderly.

Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

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Lochner, Kimberly A; Wynne, Marc

2011-12-21

no co-pay on the part of the beneficiary (Centers for Medicare and Medicaid Services, 2011), for the 2008 flu season, only 73% of non-institutionalized Medicare beneficiaries, aged 65 years and older, reported receiving one. This report presents the most recent data on flu vaccination rates among non-institutionalized elderly Medicare beneficiaries and their association with socio-demographic and personal health characteristics. The report also describes the places beneficiaries received their flu shot and, for those not getting vaccinated, the reasons reported for not doing so. Public Domain.

A instituição asilar segundo o cuidador familiar do idoso The nursing home as seen by the elderly family caretaker

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Márcia Maria Porto Rossetto Mazza

2004-12-01

elderly from being depressed, the family resorts to institutionalization when lacking a member to look after the elderly and when he is especially dependent and in need of special care. The institutionalization is seen as malignant for it would lead to the death of the elderly, not being accepted by either the elderly or the caretaker. For many of the caretakers, institutionalization is rejected but for others, it represents a possibility in case the care cannot be provided for some reason.

Approach to Fall in Elderly Population

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Mehmet Ilkin Naharci

2009-10-01

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

Changes in the provision of institutionalized mental health care in post-communist countries.

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Adrian P Mundt

Full Text Available General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that

Changes in the provision of institutionalized mental health care in post-communist countries.

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Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as

Quality of life, perceptions of change, and psychological well-being of the elderly population in small rural towns in the Midwest.

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Cantarero, Rodrigo; Potter, James

2014-01-01

This study examines the quality of life of the elderly residents of two rural Nebraska towns, both having experienced a large increase in population. The study examines how the residents' perception of changes in the community affect their view of quality of life, and identifies determinants of psychological well-being for these elderly residents. The results are compared to the non-elderly residents of these two communities for purposes of contrast. A face-to-face survey of the residents addressed physical, social/cultural, economic, and service issues. Both correlation and regression were used to analyze the data. The quality of life of the elderly residents in our study, in terms of satisfaction with the various components of general well-being--home and neighborhood, accessibility and adequacy of services (including transportation), health and safety--were very positive or satisfactory; this applies equally to the non-elderly population, with the exception of access to public transportation.

The Relationship of Health Locus of Control, Perceived Health Status and Activity Levels of Non-Institutionalized Elderly Clients.

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Speake, Dianne L.

Individuals of all ages need to maintain an active lifestyle to promote health. The physiological changes associated with aging, however, make the elderly especially vulnerable to disuse atrophy associated with inactivity. Exercise programs for the elderly are being established in increasing numbers, but high dropout rates from these programs…

Reminiscence Therapy Improves Cognitive Functions and Reduces Depressive Symptoms in Elderly People With Dementia: A Meta-Analysis of Randomized Controlled Trials.

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Huang, Hui-Chuan; Chen, Yu-Ting; Chen, Pin-Yuan; Huey-Lan Hu, Sophia; Liu, Fang; Kuo, Ying-Ling; Chiu, Hsiao-Yean

2015-12-01

Cognitive function impairments and depressive symptoms are common in elderly people with dementia. Previous meta-analyses of outdated and small-scale studies have reported inconsistent results regarding the effects of reminiscence therapy on cognitive functions and depressive symptoms; therefore, we conducted a meta-analysis by including more recent randomized controlled trials (RCTs) with large sample sizes to investigate the immediate and long-term (6-10 months) effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia. Electronic databases, including PubMed, Medline, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, ProQuest, Google Scholar, and Chinese databases were searched to select eligible articles. Primary outcome measures included the scores of cognitive functions and depressive symptoms. In total, 12 RCT studies investigating the effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia were included. Two reviewers independently extracted data. All analyses were performed using a random-effects model. Reminiscence therapy had a small-size effect on cognitive functions (g = 0.18, 95% confidence interval [CI] 0.05-0.30) and a moderate-size effect on depressive symptoms (g = -0.49, 95% CI -0.70 to -0.28) in elderly people with dementia. Long-term effects of reminiscence therapy on cognitive functions and depressive symptoms were not confirmed. Moderator analysis revealed that institutionalized elderly people with dementia exhibited greater improvement in depressive symptoms than community-dwelling people with dementia did (g = -0.59 vs. -0.16, P = .003). This meta-analysis confirms that reminiscence therapy is effective in improving cognitive functions and depressive symptoms in elderly people with dementia. Our findings suggest that regular reminiscence therapy should be considered for inclusion as routine care for the improvement

Institutionalization of evidence-informed practices in healthcare settings.

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Novotná, Gabriela; Dobbins, Maureen; Henderson, Joanna

2012-11-21

The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs.

Quedas em idosos institucionalizados: características gerais, fatores determinantes e relações com a força de preensão manual Falls in institutionalized elderly people: general characteristics, determinant factors and relationship with handgrip strength

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José Rubens Rebelatto

2007-01-01

Full Text Available OBJETIVO: Identificar a ocorrência de quedas em idosos institucionalizados no Município de São Carlos (SP, descrever os fatores determinantes e verificar sua associação com a força de preensão manual. MÉTODOS: Participaram do estudo 61 idosos institucionalizados (31 homens e 30 mulheres que foram avaliados quanto à força de preensão manual e entrevistados quanto a eventos de queda e possíveis fatores determinantes. RESULTADOS: Verificou-se que 54,1% haviam sofrido pelo menos uma queda no ano que antecedeu a entrevista e que a incapacidade de assistir televisão possui correlação significativa com o índice de quedas (p=0,05, ao contrário das demais atividades funcionais estudadas (deambular, tomar banho e sentar sem auxílio, dor e doenças. Foram encontradas diferenças estatisticamente significantes entre as médias de idade dos idosos que já haviam caído (76,76 anos, ±9,17 e dos que não haviam caído (71,05 anos, ±8,67; e entre as médias de força de preensão manual de idosos que já haviam caído (19,37 kgf, ±8,92 e dos que não haviam caído (25,45 kgf, ±12,14. A análise de variância não mostrou diferença no número de quedas sofridas entre homens e mulheres. CONCLUSÕES: Houve alta incidência de quedas em idosos institucionalizados no município estudado, sendo que os idosos com menor força de preensão manual, os mais velhos e os incapazes de assistir televisão se mostraram mais propensos a sofrer quedas.OBJECTIVE: To identify the occurrence of falls among institutionalized elderly in São Carlos City, to describe its determining factors and to verify its relationship with handgrip strength. METHODS: 61 elderly subjects (31 men and 30 women took part of the study, being assessed regarding handgrip strength and interviewed regarding falls and possible factors for its occurrence. RESULTS: It was found that 54.1% of the elderly had fallen at least once in the 12 months preceding the study. The disability of

Population at high-risk of indoor heatstroke: the usage of cooling appliances among urban elderlies in Japan.

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Kondo, Masahide; Ono, Masaji; Nakazawa, Kouichi; Kayaba, Momoko; Minakuchi, Emiko; Sugimoto, Kazutoshi; Honda, Yasushi

2013-05-01

Heatstroke due to a heat wave during the summer is one of the commonly known health impacts of climate change in Japan. The elderly are particularly at high-risk of developing indoor heatstroke with poor prognosis. This study aims to describe the population among elderlies at high-risk of indoor heatstroke by focusing on the usage of cooling appliances. We conducted a web-based household survey in eight urban areas during the winter season of 2011. Households with a person aged 65 and over were selected as samples from panel members of a research firm, and the oldest member of the household was queried about his/her usage of cooling appliances. The population at high-risk of indoor heatstroke is defined as the elderly staying in a room without cooling appliances, or not using the installed cooling appliances, or turning the cooling appliances on only when the room temperature is above 28 °C. 15.4 and 19.1 % of the elderlies living in urban areas of Japan are identified as at high-risk of indoor heatstroke during activity time and sleeping time, respectively, according to the definition of high-risk of indoor heatstroke in this study. These figures are not negligible since the consequences of heatstroke are grave, but its risk can be eliminated by an appropriate usage of cooling appliances. The preventive interventions are needed to protect the elderlies at high-risk of heatstroke.

Idea Generation in Highly Institutionalized Fields

DEFF Research Database (Denmark)

Agoguè, Marine; Boxenbaum, Eva

innovation. An important question facing innovation research is thus how actors can generate ideas that break with the field frame in highly institutionalized fields? To answer this question, we draw on insights into dual process modeling from cognitive sciences. Dual process modeling emphasizes...... the different nature of the conscious (deliberate) and subconscious (implicit) systems involved in ideation. We further elaborate on how these two systems relate to four streams of research that management scholars evoke to model microprocesses of generating new ideas, namely metaphors, conceptual blending......The early phase of innovation processes in highly institutionalized fields relies on the capabilities of actors to generate new ideas that break with the field frame. Informed by a dominant logic, a field frame shapes collective cognition and can thus prevent the generation of new ideas and block...

Cluster Management Institutionalization

DEFF Research Database (Denmark)

Normann, Leo; Agger Nielsen, Jeppe

2015-01-01

of how it was legitimized as a “ready-to-use” management model. Further, our account reveals how cluster management translated into considerably different local variants as it travelled into specific organizations. However, these processes have not occurred sequentially with cluster management first...... legitimized at the field level, then spread, and finally translated into action in the adopting organizations. Instead, we observed entangled field and organizational-level processes. Accordingly, we argue that cluster management institutionalization is most readily understood by simultaneously investigating...

Institutionalization of Social Media in Large Danish Firms

DEFF Research Database (Denmark)

Haahr, Lars; Svejvig, Per

2014-01-01

of the first stages of institutionalization as well as it points to critical issues related to the progression of this process. The paper adds to the emerging literature on social media by an industry level longitudinal study of how organizational use of social media can be understood as a process......Although social media research has accelerated dramatically in the last few years, few studies have addressed organizational use of social media as a process of institutionalization at industry level and over a longer time period. Against this backdrop, we present the findings from an industry...

Diffuse Large B-Cell Lymphoma in the Elderly: Real World Outcomes of Immunochemotherapy in Asian Population.

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Byun, Ja Min; Lee, Jeong-Ok; Kang, Beodeul; Kim, Ji-Won; Kim, Se Hyun; Kim, Jin Won; Kim, Yu Jung; Lee, Keun-Wook; Bang, Soo-Mee; Lee, Jong Seok

2016-09-01

We evaluated the real-life treatment outcomes of elderly patients with diffuse large B-cell lymphoma from a homogenous Asian population and defined the cutoff age for "elderly." The medical records of 192 DLBCL patients aged > 60 years who had received first-line immunochemotherapy were retrospectively evaluated. The treatment schedule, adverse events, and survival outcomes were analyzed overall and stratified by 4 age groups (> 60-64, 65-69, 70-74, and ≥ 75 years). Patient age of ≥ 75 years was associated with a significantly lower complete remission rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P population, 75 years seems to be a judicious cutoff for predicting treatment outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Viral hepatitis in the elderly.

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Carrion, Andres F; Martin, Paul

2012-05-01

As life expectancy continues to rise, elderly adults represent a rapidly growing proportion of the population. The likelihood of complications of acute and chronic liver disease and overall mortality are higher in elderly populations. Several physiological changes associated with aging, greater prevalence of co-morbid conditions, and cumulative exposure to hepatotropic viruses and environmental hepatotoxins may contribute to worse outcomes of viral hepatitis in the elderly. Although pharmacotherapy for hepatitis B and C continues to evolve, the efficacy, tolerability, and side effects of these agents have not been studied extensively in elderly adults. Immunization against hepatitis A and B in naïve elderly adults is an important public health intervention that needs to be revised and broadened.

Estratégias de enfrentamento, dificuldades funcionais e fatores associados em idosos institucionalizados Coping strategies, functional difficulties, and associated factors in institutionalized elderly

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Analise de Souza Vivan

2009-02-01

Full Text Available O objetivo deste estudo é verificar as estratégias de enfrentamento utilizadas pelos idosos em face das dificuldades funcionais e a existência de associação entre o uso das estratégias e variáveis como sintomas depressivos, sexo, escolaridade, idade, estado civil e percepção da saúde. Participaram do estudo 103 idosos institucionalizados, que apresentavam necessidade de assistência em no mínimo uma atividade de vida diária. O delineamento foi transversal, com a utilização dos seguintes instrumentos: Ficha de Dados Pessoais, Escala de Atividades da Vida Diária, Breve Entrevista Internacional de Neuropsiquiatria Modificada, Mini-Exame do Estado Mental, Inventário de Estratégias de Coping e Escala de Depressão Geriátrica. As estratégias de enfrentamento mais utilizadas pela amostra foram a de autocontrole e resolução de problemas. Encontraram-se associações significativas entre as variáveis escolaridade e depressão. Os resultados da pesquisa sugerem que a avaliação das estratégias utilizadas em face de eventos estressores pode auxiliar na análise da situação e na adequação das estratégias escolhidas, ajudando também em processos de mudança no contexto clínico.The aim of this study was to analyze the strategies used by elderly people to cope with functional difficulties, and to investigate a possible association between such strategies and variables like depressive symptoms, gender, schooling, marital status, and self-perceived health. 103 institutionalized elderly individuals participated in the study. They required assistance for at least one activity of daily living. The study was cross-sectional and used the following indicators: Personal Data Chart, Activities of Daily Living Scale, Modified Mini International Neuropsychiatric Interview, Mini-Mental Examination, Coping Strategies Inventory, and Geriatric Depression Scale. The most widely used coping strategies in the sample were self-control and problem

Use of telemedicine-based care for the aging and elderly: promises and pitfalls

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Bujnowska-Fedak MM

2015-05-01

Full Text Available Maria Magdalena Bujnowska-Fedak, Urszula Grata-Borkowska Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland Abstract: Telemedicine-based care provides remote health and social care to maintain people's autonomy and increase their quality of life. The rapidly aging population has come with a significant increase in the prevalence of chronic diseases and their effects, and thus the need for increased care and welfare. The elderly have become one of the main target groups for telecare technologies. Smart home systems allow older adults to live in the environment of their choice and protect them against institutionalization or placement in a nursing home. It gives the elderly person a feeling of reassurance and safety, and appears to be one of the most promising approaches to facilitate independent living in a community-dwelling situation. Telecare solutions give a new opportunity for diagnosis, treatment, education, and rehabilitation, and make it possible to monitor patients with a number of chronic diseases. It also reduces socioeconomic disparity with regard to access to care and gives equal chances to patients from urban and rural areas. However, although telecare has undisputed benefits, it also has some limitations. Older people are often resistant to use of new technology, in particular acquiring the knowledge and skills necessary for use of electronic devices and computer systems. Further, privacy and security are important elements when building confidence in telemedicine systems. Leaking of sensitive information, such as health or test results, may have a negative and far-reaching impact on the personal and professional life of the patient. Telemedicine-based care should now be personalized for the needs, capabilities, and preferences of the elderly, with adaptation over time as care needs evolve. If technologies are introduced that are familiar, usable, desirable, and cost-effective, and able to be adapted to

Mini-Mental State Examination in Elderly Chinese: A Population-Based Normative Study.

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Li, Hanzhi; Jia, Jianping; Yang, Zhiqiang

2016-05-07

Chinese nationwide norms of the Mini-Mental State Examination (MMSE) have not been established despite its wide use. To obtain norms for the MMSE based on age, gender, education, and rural or urban residences and to determine the optimal cut-off points of the MMSE in elderly Chinese. A cross-sectional study was conducted in Chinese community residents aged 65 years or over selected by cluster random sampling. The MMSE was administered to 9,629 subjects (7,110 cognitively normal, 2,024 with mild cognitive impairment, and 495 with dementia). The demographic influences on MMSE scores were investigated and the norms were established considering those factors. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off points. Years of education (standardized β= 0.399), rural residence (standardized β= -0.261), age (standardized β= -0.198), and being female (standardized β= -0.101) had significant effects on MMSE scores (p < 0.001). Accordingly, we presented the demographic-stratified normative data for the MMSE. The optimal cut-off points for dementia screening were 16/17 for illiterate (sensitivity 87.6% and specificity 80.8%), 19/20 for individuals with 1-6 years of education (sensitivity 93.6% and specificity 92.7%), and 23/24 for individuals with 7 or more years of education (sensitivity 94.3% and specificity 94.3%). We provide the age-, gender-, education-, and residence-specific reference norms for the MMSE derived from an investigation of a large-scale, multicenter, nationwide representative Chinese elderly population. It could be of great improvement for the use of the MMSE in dementia screening in Chinese elderly population.

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

NARCIS (Netherlands)

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

2009-01-01

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

Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly: the EXERNET multi-center study.

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Pedrero-Chamizo, R; Gómez-Cabello, A; Meléndez, A; Vila-Maldonado, S; Espino, L; Gusi, N; Villa, G; Casajús, J A; González-Gross, M; Ara, I

2015-02-01

To evaluate the associations between physical fitness levels, health related quality of life (HRQoL) and sarcopenic obesity (SO) and to analyze the usefulness of several physical fitness tests as a screening tool for detecting elderly people with an increased risk of suffering SO. Cross-sectional analysis of a population-based sample. Non-institutionalized Spanish elderly participating in the EXERNET multi-centre study. 2747 elderly subjects aged 65 and older. Body weight, height and body mass index were evaluated in each subject. Body composition was measured by bioelectrical impedance. Four SO groups were created based on percentage of body fat and relative muscle mass; 1) normal group, 2) sarcopenic group, 3) obesity group and 4) SO group. Physical fitness was evaluated using 8 tests (balance, lower and upper body strength, lower and upper body flexibility, agility, walking speed and aerobic capacity). Three tertiles were created for each test based on the calculated scores. HRQoL was assessed using the EuroQol visual analogue scale. Participants with SO showed lower physical fitness levels compared with normal subjects. Better balance, agility, and aerobic capacity were associated to a lower risk of suffering SO in the fittest men (odds ratio health was associated with better physical fitness performance. Higher levels of physical fitness were associated with a reduced risk of suffering SO and better perceived health among elderly. SO elderly people have lower physical functional levels than healthy counterparts.

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

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Sunil Kumar Raina

2013-01-01

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

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

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Vancea, Mihaela; Solé-Casals, Jordi

2016-08-01

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

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

Science.gov (United States)

Vancea, Mihaela; Solé-Casals, Jordi

2016-01-01

Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people’s daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis. PMID:27493837

Clinical epidemiology of reduced kidney function among elderly male fishing and agricultural population in Taipei, Taiwan.

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Kuo, Chi-Mei; Chien, Wu-Hsiung; Shen, Hsi-Che; Hu, Yi-Chun; Chen, Yu-Fen; Tung, Tao-Hsin

2013-01-01

To quantify the prevalence of and associated factors for chronic kidney disease (CKD) among male elderly fishing and agricultural population in Taipei, Taiwan. Subjects (n = 2,766) aged 65 years and over voluntarily admitted to a teaching hospital for a physical checkup were collected in 2010. CKD was defined as an estimated glomerular filtration rate agricultural population.

Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care

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Gisélia Santana Souza

2017-11-01

Full Text Available ABSTRACT OBJECTIVE To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines, a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%, partial (35.0%-69.0%, and advanced (70.0%-100%, estimated based on the interviewees’ answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05. RESULTS Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the “organization, structure, and financing” dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. CONCLUSION The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional

Theorization and Translation in IT Institutionalization

DEFF Research Database (Denmark)

Agger Nielsen, Jeppe; Mathiassen, Lars; Newell, Sue

2014-01-01

Although institutional theory has become a more dominant perspective in information systems research, studies have only paid scant attention to how field dynamics and organizational processes coevolve during information technology institutionalization. Against this backdrop, we present a new...

Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study.

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Vilppula, Anitta; Kaukinen, Katri; Luostarinen, Liisa; Krekelä, Ilkka; Patrikainen, Heikki; Valve, Raisa; Mäki, Markku; Collin, Pekka

2009-06-29

Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s). The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002-2005 was 0.23%, giving an annual incidence of 0.08% in this population. The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital.

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Salam, Asma Abdus; Afshan, Gauhar

2016-01-01

Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information.

Social communication difficulties and autism in previously institutionalized children.

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Levin, April R; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A

2015-02-01

To determine the risk of difficulties with social communication and restricted/repetitive behaviors as well as the rate of autism in children institutionalized in early infancy and to assess the impact of a foster care intervention on ameliorating this risk. Children abandoned at birth and raised in institutions in Bucharest, Romania were randomly assigned to a care-as-usual group (institutional care, CAUG), or placed in family-centered foster care (FCG) as part of the Bucharest Early Intervention Project (BEIP). At approximately 10 years of age, the Social Communication Questionnaire (SCQ) was administered to caregivers of children in both groups as well as to parents of a typically developing community sample (Never-Institutionalized group [NIG]) residing in Bucharest, Romania. Children scoring ≥12 on the SCQ underwent clinical evaluation for autism spectrum disorder (ASD). Caregivers of children with a history of institutionalization reported that these children had significantly more deviant behavior than never-institutionalized children on all subdomains of the SCQ (all p communication. Three of 60 CAUG children, 2 of 57 FCG children, and none of the NIG children received a formal ASD diagnosis. Early institutional rearing was associated with an increased risk of social communication difficulties and ASD. A family-centered foster care intervention improved social communication skills. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Study on institutionalization of risk-informed performance-based regulation

Energy Technology Data Exchange (ETDEWEB)

Kim, M. G.; Hong, S. Y.; Seo, M. R. [Korea Electric Power Research Institute, Taejon (Korea, Republic of)

2003-02-15

In this study, for the institutionalization of risk informed and performance based regulation in Korea, the latest technical movements of overseas countries are examined and reviewed. And the issues that was found when license change petition using risk information was submitted in Korean regulatory body are reviewed. Based on these review, the applicable areas to domestic situation will be found and proposed. This study can contribute to setting up the proper direction for the institutionalization of risk informed and performance based regulation.

Exploring the Institutionalization of Corporate Responsibility

DEFF Research Database (Denmark)

Haack, Patrick; Schoeneborn, Dennis

2015-01-01

by drawing on the prominent management practice of corporate responsibility. Our paper contributes to the development of a general theory of decoupling and institutionalization by examining the boundary conditions under which organizations adopt ceremonially or implement substantively a policy. We discuss...

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

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Hao, Gang; Bishwajit, Ghose; Tang, Shangfeng; Nie, Changping; Ji, Lu; Huang, Rui

2017-01-01

There is a growing consensus regarding the influence of various psychosocial factors such as degree of social participation on health and disease outcomes, quality of life, and general well-being. Older individuals with diminished motor and physical functionality suffer a heightened risk of social exclusion and loneliness. Previous studies have demonstrated the association between social exclusion and loneliness with mental health among the older population. In the present study, we aimed to investigate whether or not difficulty in social participation has any relationship with perceived depression among older individuals in South Africa. We collected cross-sectional data from the SAGE Well-Being of Older People Study 2010 on 422 men and women aged 50 years and above. Perceived depression and loss of interest in things (eg, personal relationships, hobbies) during the last 12 months were used as outcome variables with difficulty in joining community activities, relationships/community participation, friendships, and visiting family/friends as the main explanatory variables. Findings indicated that the prevalence of self-reported depression and the feeling of reduced interest in most things were respectively 51.9% and 43.8%. In the multivariate analysis, those who reported difficulty in joining community activities had respectively 64% (OR =1.639; 95% CI =1.081-2.583) and 69% (OR =1.685; 95% CI) higher odds of depression and loss of interest in things compared with those who did not report any difficulty. The study concludes that addressing the barriers to engaging in community activities may help minimize burden of depression among the elderly population in South Africa. Furthermore, large-scale studies are warranted to explore the social and structural barriers which constrain community participation among the elderly population.

Fatores associados ao uso de psicofármacos em idosos asilados Factors associated with the use of psychoactive drugs in institutionalized elderly

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Giancarlo Lucchetti

2010-01-01

psychoactive drugs for the control of behavioral disorders. Few Brazilian studies have so far focused on this aspect of elderly care. OBJECTIVE: To evaluate the factors associated with use of psychoactive drugs in institutionalized elderly patients. METHODS: A cross-sectional, retrospective study was carried out based on medical charts of all elderly patients (60 years and over treated in a nursing home, independently of their diseases. Logistic regression analysis was performed to assess factors associated with the use of psychoactive drugs in the institution. RESULTS: Two hundred and nine patients were evaluated (73.2% females, suffering predominantly of dementia syndromes, sequelae of stroke or cranial trauma, and hypertension. Of these, 123 patients (58.9% were using some type of psychoactive drug, mainly antipsychotics and antidepressants. Logistic regression analysis revealed an association between antipsychotic drug use and dementia (p = 0.000, whereas antidepressant drug use was associated with a higher number of drugs (p = 0.004 and depression (p = 0.000. In general, the use of psychoactive drugs was strongly associated with depression (p = 0.000, dementia (p = 0.006, and psychiatric disorders (p = 0.02. There were no associations with sex, functional status or age. CONCLUSION: There is a high consumption of psychoactive drugs in nursing homes. The association between polypharmacy and depression is evident, and patients with dementia were shown to receive more antipsychotics than other patients. Factors such as age or sex, usually relevant among outpatients, did not present association with psychoactive drug use in nursing home patients.

Quality of life and its contributing factors in an elderly community-dwelling population in Shanghai, China.

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Shou, Juan; Du, Zhaohui; Wang, Haitang; Ren, Limin; Liu, Yao; Zhu, Shanzhu

2018-03-01

We aimed to investigate the relationship between quality of life and the factors that may influence it in an elderly community-dwelling population in Shanghai. From August to October 2014, elderly individuals were enrolled from three randomly selected communities in Shanghai. Participant information was collected from responses to a general questionnaire and to the Lubben Social Network Scale-6, Cumulative Illness Rating Scale for Geriatrics, Patient Health Questionnaire, and the 12-item Short Form Health Survey. The factors influencing quality of life were explored in a multivariate stepwise linear regression model. Physical and mental component summary scores for the elderly in Shanghai communities were 50.1 ± 10.1 and 47.3 ± 7.9, respectively. Physical component summary scores in the rural area were higher than those in the urban-rural intersection area (a place where urban and rural transitions are taking place) (52.32 ± 9.81 vs 49.63 ± 9.33, P < 0.05) and the urban area (52.32 ± 9.81 vs 47.34 ± 10.18, P < 0.05). Additionally, mental component summary scores in the rural area were higher than those in the urban-rural intersection area (52.63 ± 9.28 vs 48.43 ± 9.42, P < 0.05) and the urban area (52.63 ± 9.28 vs 48.13 ± 10.69, P < 0.05). Depression, self-care ability, and medical care burden were found to be significantly associated with the quality of life of elderly individuals in Shanghai, China. Therefore, more attention should be paid to the mental health of this elderly population. © 2018 Japanese Psychogeriatric Society.

Adaptation of oral medication in people institutionalized in nursing homes for whom medication is crushed: The ADECUA Study

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Francisco Apolo Carvajal

2016-12-01

Full Text Available Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention. Moreover, health professionals received a training course. Results: Medication was being crushed for 33% (618/1875 of residents (mean: 5 drugs susceptible of crushing. 220 pharmaceutical interventions were performed, mostly in extended release or gastro-resistant drugs (48% were accepted. Switch was the type of intervention more frequent (79%, mainly to Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention. Moreover, health professionals received a training course. Results

Institutionalizing Peer-Mediated Instruction and Interventions in Schools: Beyond "Train and Hope."

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King-Sears, Margaret E.

2001-01-01

This article provides guidelines for knowing when to institutionalize peer-mediated instruction and interventions (PMII), and generalization techniques familiar to special educators are linked specifically to institutionalization of PMII. Barriers and promoters of sustained PMII in schools are identified, with implications for how stakeholders…

Contribuições de um treino cognitivo para a memória de idosos institucionalizados Contribuciones de un entreno cognitivo para la memoria de ancianos institucionalizados Contributions of a cognitive training for the memory of institutionalized elderly

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Isabelle Patriciá Freitas Chariglione

2013-04-01

Full Text Available Este estudo investigou a influência de diferentes treinos cognitivos na memória de idosos institucionalizados e em medidas neuropsicológicas e de humor. Dezesseis idosos participaram do programa que incluiu dois tipos de treinamentos que variavam quanto à semelhança com as atividades e o ambiente dos idosos na instituição. Os treinos tinham a duração de 60 minutos e ocorreram duas vezes por semana durante quase quatro semanas. Os resultados mostraram que ARFC foi influenciado pelo tipo de treinamento, e que a recordação livre para palavras foi melhor após o treinamento somente para o grupo de idosos alfabetizados, independentemente do tipo de treinamento. Não foram detectados efeitos no teste de reconhecimento de imagem e as sessões de treinamento afetaram positivamente os escores EDG.Este estudio investigó la influencia de diferentes entrenos cognitivos en la memoria de ancianos institucionalizados y en medidas neuropsicológicas y del humor. Dieciséis ancianos participaron del programa que incluyó dos tipos de entrenamientos que variaban cuanto a la semejanza con las actividades y el ambiente de ancianos en la institución. Los entrenos tenían la duración de 60 minutos y ocurrieron dos veces por semana durante casi cuatro semanas. Los resultados mostraron que ARFC fue influenciado por el tipo de entrenamiento, y que el recuerdo libre para palabras fue mejor pasado el entrenamiento solamente para el grupo de ancianos alfabetizados, independientemente del tipo de entrenamiento. No fueron detectados efectos en el teste de reconocimiento de imagen y las sesiones de entrenamiento afectaron positivamente los escores EDG.This study investigated the influence of different cognitive training procedures in memory, neuropsychological measures and mood of institutionalized elderly. Sixteen seniors attended the program which included two types of procedures that varied in terms of the similarity to the daily activities and environment of

Interest and limits of glomerular filtration rate (GFR) estimation with formulae using creatinine or cystatin C in the malnourished elderly population.

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Fabre, Emmanuelle E; Raynaud-Simon, Agathe; Golmard, Jean-Louis; Gourgouillon, Nadège; Beaudeux, Jean-Louis; Nivet-Antoine, Valérie

2010-01-01

Renal function is often altered in elderly patients. A lot of formulae are proposed to estimate GFR to adjust drug posology. French guidelines recommend the Cockcroft-Gault formula corrected with the body surface area (cCG), but the initially described unadjusted Cockcroft-Gault equation (CG) is mainly used in geriatric clinical practice. International recommendations have proposed the modification of diet in renal disease (MDRD) formula, since several authors recommended the Rule formula using cystatin C (cystC) in particular population. To appreciate the most accurate GFR estimation for posology adaptation in an elderly polypathological population, a cross-sectional study with prospective inclusion was carried out in Charles Foix Hospital. Plasma glucose levels (PGL), creatinine (CREA) levels and serum cystC, albumin (ALB), transthyretin (TTR), C-reactive protein (CRP), orosomucoid (ORO) total cholesterol (tCHOL) levels were determined among 193 elderly patients aged 70 and older. The results showed that in a malnourished, inflamed old population, CG, MDRD and Rule formulae resulted in different estimations of GFR, depending on nutritional and inflammatory parameters. Only cCG estimation was shown to be independent from these parameters. To conclude, cCG seems to be the most accurate and appropriate formula in a polypathological elderly population to evaluate renal function in order to adapt drug posology. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Gerontological contributions to the care of elderly people in long-term care facilities

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Vanessa da Silva Antonio Coimbra

Full Text Available ABSTRACT Objective: To analyze Brazilian scientific productions from the last 11 years which show the contributions of nursing to elderly people in long-term care facilities. Method: This is an integrative literature review. The search took place in the Virtual Health Library (VHL in the BDENF and LILACS databases and the SCIELO virtual library, between June and October 2016, using the keyword long-term care facility and the descriptors nursing and geriatrics. Results: Eleven studies were selected, published 2005 and 2016, with various methodological approaches that enabled discussion of the proposed objective. Conclusion: The contributions of nursing to institutionalized elderly people were linked to health promotion measures, as well as simple interventions, such as listening, interacting, offering recreation and helping in psychoaffective relationships. These activities contributed to raising the self-esteem of the individuals.

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

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Mundt, Adrian P.; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

Background General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. Methodology/Principal Findings General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. Conclusions/Significance After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent

Health-related and socio-demographic factors associated with frailty in the elderly: a systematic literature review

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Amanda de Carvalho Mello

2014-06-01

Full Text Available Frailty is a syndrome that leads to practical harm in the lives of elders, since it is related to increased risk of dependency, falls, hospitalization, institutionalization, and death. The objective of this systematic review was to identify the socio-demographic, psycho-behavioral, health-related, nutritional, and lifestyle factors associated with frailty in the elderly. A total of 4,183 studies published from 2001 to 2013 were detected in the databases, and 182 complete articles were selected. After a comprehensive reading and application of selection criteria, 35 eligible articles remained for analysis. The main factors associated with frailty were: age, female gender, black race/color, schooling, income, cardiovascular diseases, number of comorbidities/diseases, functional incapacity, poor self-rated health, depressive symptoms, cognitive function, body mass index, smoking, and alcohol use. Knowledge of the complexity of determinants of frailty can assist the formulation of measures for prevention and early intervention, thereby contributing to better quality of life for the elderly.

Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study

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Vilppula Anitta

2009-06-01

Full Text Available Abstract Background Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s. Methods The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Results Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002–2005 was 0.23%, giving an annual incidence of 0.08% in this population. Conclusion The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

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

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Mathews, Mathew

2016-09-01

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

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

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Narges Sotuneh

2014-01-01

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

The State of Alaska's early experience with institutionalization of health impact assessment

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Paul J. Anderson

2013-08-01

Full Text Available Background . Many nations routinely include health impact assessments (HIA in public policy decisions. Institutionalization of HIA formally integrates health considerations into a governmental decision-making process. We describe an example of institutionalization in the United States through Alaska's early experience with institutionalization of HIA. Literature review . HIA arose from a series of health conferences in the 1970s that affirmed the importance of “health for all.” A number of key milestones eventually defined HIA as a unique field of impact assessment. There are several approaches to institutionalization, and one common approach in the United States is through the National Environmental Policy Act (NEPA. NEPA formed the basis for the earliest HIAs in Alaska. Program description . Early HIAs in Alaska led to conferences, working groups, a state guidance document and the institutionalization of a HIA program within the Department of Health and Social Services in 2010. A medical epidemiologist staffs the program, which utilizes contractors to meet rising demand for HIA. The HIA program has sustainable funding from the state budget and from the state's natural resource permitting process. The HIA document is the main deliverable, but the program performs other tasks, including fieldwork and technical reviews. The HIA program works closely with a host of collaborative partners. Conclusion . Alaska's institutionalized HIA program benefits from sustainable funding that promotes continuous quality improvement and involves the program in the entire life cycle of a development project. The program structure adapts well to variations in workflow and supports a host of quality control activities. Currently, the program focuses on HIAs for natural resource development projects.

Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

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Dong, XinQi; Simon, Melissa; Evans, Denis

2012-01-01

Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

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

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Antonio Giulio de Belvis

2004-12-01

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

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

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

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

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

Prevalence of and Risk Factors for Elder Abuse and Neglect in the Community: A Population-Based Study.

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Burnes, David; Pillemer, Karl; Caccamise, Paul L; Mason, Art; Henderson, Charles R; Berman, Jacquelin; Cook, Ann Marie; Shukoff, Denise; Brownell, Patricia; Powell, Mebane; Salamone, Aurora; Lachs, Mark S

2015-09-01

To estimate past-year prevalence and identify risk and protective factors of elder emotional abuse, physical abuse, and neglect. Cross-sectional, population-based study using random-digit-dial sampling and direct telephone interviews. New York State households. Representative (race, ethnicity, sex) sample (N = 4,156) of English- or Spanish-speaking, community-dwelling, cognitively intact individuals aged 60 and older. The Conflict Tactics Scale was adapted to assess elder emotional and physical abuse. Elder neglect was evaluated according to failure of a responsible caregiver to meet an older adult's needs using the Duke Older Americans Resources and Services (OARS) scale. Caseness thresholds were based on mistreatment behavior frequencies and elder perceptions of problem seriousness. Past-year prevalence of elder emotional abuse was 1.9%, of physical abuse was 1.8%, and of neglect was 1.8%, with an aggregate prevalence of 4.6%. Emotional and physical abuse were associated with being separated or divorced, living in a lower-income household, functional impairment, and younger age. Neglect was associated with poor health, being separated or divorced, living below the poverty line, and younger age. Neglect was less likely in older adults of Hispanic ethnicity. Elder abuse and neglect are common problems, with divergent risk and protective factor profiles. These findings have direct implications for public screening and education and awareness efforts designed to prevent elder mistreatment. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Descrição da dinâmica de alimentação de idosas institucionalizadas Description of the feeding dynamics of institutionalized elderly women

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Francelise Pivetta Roque

2010-01-01

Full Text Available OBJETIVO: Descrever a dinâmica alimentar de idosas institucionalizadas no que se refere aos aspectos clínicos de deglutição, cognitivos, comportamentais e ambientais ligados à alimentação. MÉTODOS: Realizou-se um estudo observacional transversal prospectivo, que descreveu a dinâmica de alimentação de 30 idosas residentes numa instituição de longa permanência. Alguns dos aspectos analisados foram registrados por observadores no momento da alimentação e outros em filmagem da refeição de cada idosa. Os dados foram apresentados de forma descritiva e comparados à literatura. RESULTADOS: A média de idade foi 83,7 anos. Os diagnósticos médicos mais prevalentes foram síndrome demencial e hipertensão arterial sistêmica. Foram observados: ingestão oral pobre em 73,3% das idosas, tempo médio de alimentação de 10,1 minutos, posicionamento inadequado em 46,7% das refeições, alterações atitudinais em 16,7% e comportamentais em 40% das idosas. A assistência foi requerida por 56,6% das idosas, tendo sido provida a 70,6% desses casos, e julgada inadequada em 66,6% deles. Eram edêntulas 44,4% das idosas, das quais 46,1% utilizavam prótese dentária total, sendo predominante a inadequação da adaptação, do estado de conservação e da higiene (83,4%. A prevalência de alterações de deglutição foi igual a 23,3%, sendo as mais prevalentes os resíduos alimentares após a deglutição, tosse durante a alimentação e alteração vocal após a deglutição. CONCLUSÃO: Verificou-se presença significativa de fatores ambientais, cognitivos e comportamentais ligados à alimentação que podem oferecer risco à deglutição. Também se identificaram outras alterações específicas da deglutição, cujo gerenciamento é importante para evitar complicações da saúde destas idosas.PURPOSE: To describe the feeding dynamics of institutionalized elderly women regarding the clinical aspects of deglutition, cognition, behavioral and

Reducing SMEs informal economy through institutionalization.

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Alfonso Lopez Lira Arjona

2014-01-01

Full Text Available The informal sector has been growing throughout the last century in emerging economies. Particularly in Latin America, both a long-term instability in economic and political environments, and a continuous migration from rural to urban areas; have triggered the appearance of unregulated businesses and employments. Small and Medium-sized Enterprises (SMEs operate informally in one or more business processes, in order to reduce costs and maximize profits. Leaving aside tax evasion and illegal labor, such SMEs often have low technology and an unskilled work force; which threatens its survival in highly competitive environments. The purpose of this paper is to highlight the impact of the Multi National Corporation (MNC and the Academia in the formalization of SMEs. This is aimed through a collaborative model for the institutionalization of operational and managerial knowledge within SMEs. Qualitative results indicate that improvements are triggered by a self-conscious awareness of the value derived from institutionalizing best business practices.

Traumatic events involving elderly patients treated with anticoagulants for atrial fibrillation: the downside of stroke prevention

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Alessandro Riccardi

2016-08-01

Full Text Available A group of oral anticoagulant-treated patients affected by permanent atrial fibrillation was evaluated after their access to the emergency room as a result of a traumatic accident. In these patients, the re-evaluation of their risk of thromboembolism and bleeding was performed together with the evaluation of their risk of falling and institutionalization. Results show that the emergency department identifies a cohort of very elderly frail patients, who should be carefully reconsidered for anticoagulant therapy after a traumatic event.

Demographic profile and health conditions of the elderly in a community in an urban area of Southeastern Brazil

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Telarolli Junior Rodolpho

1996-01-01

Full Text Available Some specific characteristics of the aging of the Brazilian population in different areas, states and communities all over the country, have shown significant variations. Historical series of demographic and health indicators for the population in their sixties and over in Brazil, state of S. Paulo and in the municipal district of Araraquara are listed as follows: level of education and urban population growth rate, income distribution, mortality rates and main causes of death. In 1991 the aged constituled were 7,8% of the Brazilian population and 9,7% in Araraquara community. The elderly population (of 70 years of aged and above as a proportion of the whole, has increased and already stands for 40%. The same trend holds good for both the proportion of aged within the urban population and their level of education wich increased to 90% in 1991. The main causes of death are chronic degenerative diseases which have replaced the infectious illness: firts, the diseases of the circulatory sistem (which account for more than 40% of all deaths and the neoplasms (which let to 15% of the deaths. On the basis of these health and demographic data relating to people of 60 years of age and over, this study suggests some procedures for the improvement of the quality of the assistance given to the target population: a the assistance give to the aged should be improved by providing gerontological training for general physicians and nurses, both of public and private clinics; b the already exixting educational activities for the aged, for health workers and for teachers of secundary education should be further developed; c the number of day-hospitals should be increased for the purpose of avoiding unnecessary confinement so as maintain the low rate of institutionalization in homes for the elderly (0,7% in Araraquara. It is reported that at least 35% of the aged population in this area is entitled to private health assistance, wich brings out the importance of

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

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Marc Garcia

2016-12-01

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

America's Families and Living Arrangements: 2003. Population Characteristics. Current Population Reports. P20-553

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Fields, Jason

2004-01-01

The data in this report is from the Annual Social and Economic Supplement (ASEC) to the 2003 Current Population Survey (CPS). The population represented (the population universe) in the ASEC is the civilian non institutionalized population living in the United States. Members of the Armed Forces living off post or with their families on post are…

HEALTH STATUS OF ELDERLY A COMMUNITY BASED STUDY

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Vartika Saxena

2013-01-01

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

Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care.

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Souza, Gisélia Santana; Costa, Ediná Alves; Barros, Rafael Damasceno de; Pereira, Marcelo Tavares; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Álvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

2017-11-13

To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees' answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of pautonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services' finalistic activities.

Spatiotemporal characteristics of elderly population's traffic accidents in Seoul using space-time cube and space-time kernel density estimation.

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Kang, Youngok; Cho, Nahye; Son, Serin

2018-01-01

The purpose of this study is to analyze how the spatiotemporal characteristics of traffic accidents involving the elderly population in Seoul are changing by time period. We applied kernel density estimation and hotspot analyses to analyze the spatial characteristics of elderly people's traffic accidents, and the space-time cube, emerging hotspot, and space-time kernel density estimation analyses to analyze the spatiotemporal characteristics. In addition, we analyzed elderly people's traffic accidents by dividing cases into those in which the drivers were elderly people and those in which elderly people were victims of traffic accidents, and used the traffic accidents data in Seoul for 2013 for analysis. The main findings were as follows: (1) the hotspots for elderly people's traffic accidents differed according to whether they were drivers or victims. (2) The hourly analysis showed that the hotspots for elderly drivers' traffic accidents are in specific areas north of the Han River during the period from morning to afternoon, whereas the hotspots for elderly victims are distributed over a wide area from daytime to evening. (3) Monthly analysis showed that the hotspots are weak during winter and summer, whereas they are strong in the hiking and climbing areas in Seoul during spring and fall. Further, elderly victims' hotspots are more sporadic than elderly drivers' hotspots. (4) The analysis for the entire period of 2013 indicates that traffic accidents involving elderly people are increasing in specific areas on the north side of the Han River. We expect the results of this study to aid in reducing the number of traffic accidents involving elderly people in the future.

A social work study on the effect of gender on mental ability and depression among institutionalized elderly versus nursing home residents

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Mohammad Reza Iravani

2013-04-01

Full Text Available This paper studies the level of depression and mental ability among elderly people who live in institutional elderly versus nursing home residents. The investigation designs a questionnaire and distributes it among 345 elderly people who are residences of both places. The study implements Wechsler Memory Scale (WMS test where mental ability includes seven factors including “general information”, “orientation”, “mind control”, “logical memory” and “repeated figures”, “visual memory” and “learn association”. The study performs some statistical tests and the results show that gender has no impact on two groups of elderly people in terms of mental utilization as well as depression level when the level of significance is five percent.

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

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Shin Young Ahn

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

Prevalence of possible Alzheimer′s disease in an urban elderly population of Ludhiana: A pilot study

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Neena Bhatti

2014-01-01

Full Text Available Background : Dementias in the elderly, of which Alzheimer′s disease (AD is the most common form, may emerge as important public health problems in the elderly in low-resource developing countries whose populations are ageing rapidly. Aims: 1. To find out the prevalence of possible AD in the elderly population of an urban area of Ludhiana. 2. To identify major socio-demographic risk factors for "possible AD" in the population under study. Materials and Methods: A cross-sectional study was conducted on >60 year old residents of an urban area of Ludhiana. Data was collected from 200 consenting individuals chosen by simple random sampling, using a pre-tested questionnaire with standardized batteries, "10 Warning Signs of Alzheimer′s Disease" to screen for possible AD, Everyday Abilities Scale for India (EASI to assess physical impairment and the Hindi version of the Mini-Mental State Examination (MMSE to assess cognitive impairment. The presence of >1 warning signs was considered as "possible AD", EASI score >3 as "functional impairment" and MMSE score 80-years-old was observed to be a significant risk factor for "possible AD" [odd ratio (OR = 3.93, confidence interval (CI = 1.10-13.26. Gender, educational status, marital status, family type, employment status, and addictions were not found to be statistically significant risk factors (P > 0.05. One-third of those with "possible AD" had "probable AD". Those with "possible AD" were at high risk of having functional impairment (OR = 17.10, 95%, CI = 5.00-58.46.

Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

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Dong, XinQi; Simon, Melissa; Rajan, Kumar; Evans, Denis A.

2011-01-01

Aim This study aimed to examine the cross-sectional association between cognitive function and elder abuse. Methods The Chicago Health and Aging Project (CHAP) is a population-based study conducted in a geographically defined community (n = 8,932). We identified 238 CHAP participants who had elder abuse reported to a social services agency. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (perceptual speed), and both immediate and delayed recall of the East Boston Memory Test (episodic memory). An index of global cognitive function scores was derived by averaging the z-scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk of elder abuse. Results After adjusting for confounders, lowest tertiles of global cognition (odd's ratio, OR 4.18, 95% confidence interval, 95% CI 2.44–7.15), MMSE (OR 2.97, 95% CI 1.93–4.57), episodic memory (OR 2.27, 95% CI 1.49–3.43) and perceptual speed (OR 2.37, 95% CI 1.51–3.73) were associated with increased risk of elder abuse. The lowest levels of global cognitive function were associated with an increased risk of physical abuse (OR 3.56, 95% CI 1.08–11.67), emotional abuse (OR 3.02, 95% CI 1.41–6.44), caregiver neglect (OR 6.24, 95% CI 2.68–14.54), and financial exploitation (OR 3.71, 95% CI 1.88–7.32). Conclusion Lower levels of global cognitive function, MMSE, episodic memory and perceptual speed are associated with an increased risk of elder abuse. PMID:22095098

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

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Ione Jayce Ceola Schneider

2013-12-01

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

Assessing the functional disability of rural elderly population from North-West India using activity of daily living scale: A cross-sectional survey

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Parveen Singh

2017-01-01

Full Text Available Background: Aging is associated with both physical impairment and functional disability. One of the areas of concerns is a derangement in the activities of daily living (ADL where the elderly people are unable to perform their basic personal care tasks. The present study was planned with the aim to evaluate functional impairment among rural elderly using ADL scale. Materials and Methods: The study was conducted as a cross-sectional population-based survey using multistage randomized sampling technique from August 2015 to October 2015 in Miran Sahib Health Zone of R S Pura health block in Jammu District in North-West India. The study involved 418 elderly individuals above 60 years of age. Results: A higher proportion of elderly (378/418; 90.43% were classified as functionally independent. Among the study participants 9.54% (40/418 were found to have some had some impairment. Among the elderly impaired individuals, 5.26% (22/418 were moderately impaired while 2.64% (11/418 were severely impaired. However, importantly only a small proportion (7/418; 1.67% of elderly individuals was completely dependent on others. Conclusion: The total impairment prevalence reported among the geriatrics in the current study was 9.5%. With the increase in the geriatric population expected in near future, this number will be significant. Policies with a clear focus on geriatric health-care need to be developed to reduce the dependency among elderly.

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

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Alhasan H

2017-03-01

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

Institutionalizing and sustaining social change in health systems: the case of Uganda.

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Hage, Jerald; Valadez, Joseph J

2017-11-01

The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used

Metabolic syndrome and physical activity in southern Brazilian community-dwelling elders: a population-based, cross-sectional study

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Reichert César L

2009-01-01

Full Text Available Abstract Background - The association between a sedentary lifestyle and obesity is well documented, and is linked to an increased prevalence of metabolic syndrome (MS. There is some evidence that information regarding the health benefits of physical activity is beginning to impact on the elderly people and is beginning to change their behavior. We aimed to investigate the level of physical activity undertaken by elderly people with MS and those without this condition. Methods - We evaluated 362 community-dwelling elders of Novo Hamburgo, southern Brazil. Diagnosis of MS was based on the International Diabetes Federation criteria and the physical activity (PA level was estimated by the International Physical Activity Questionnaire. Analysis of covariance was carried out to verify associations between MS risk factors and the level of PA. Logistic regression was used to estimate the MS odds ratio for each level of PA. Results - No significant association was found between MS and the level of physical activity, irrespective of sex. The odds ratio for the presence of MS adjusted for sex and age and using insufficiently active elderly people as reference was 1.04 (95% CI, 0.6 to 1.7 in sufficiently active elderly people and 1.15 (95% CI, 0.7 to 2.0 in very active elderly people. Conclusion - The elderly citizens of a southern Brazilian community who were diagnosed with MS presented the same levels of PA as the individuals who did not have this diagnosis. This may imply that information on the importance of physical activity has already reached this higher risk population.

Prolonged Cardiopulmonary Resuscitation Process and Lower Frequency of Medical Staff Visit Predicts Independently In-hospital Resuscitation Success in the Elderly Population

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Jui-Chen Tsai

2012-09-01

Conclusion: Although the initial resuscitation success rate was not affected by age, a longer time interval between the last medical staffs’ visit and the onset of resuscitation did result in a worse success rate in elderly patients. Our data suggest that more frequent staff visits to the elderly population during hospitalization could alter initial resuscitation results.

Association between Reported Elder Abuse and Rates of Admission to the Skilled Nursing Facilities: Findings from a Longitudinal Population-Based Cohort Study

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Dong, XinQi; Simon, Melissa A.

2013-01-01

Background Elder abuse is common and is a frank violation of an older adult’s fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). Methods A prospective population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse reported to social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of SNF for those without elder abuse was 0.14(0.58) and for those with elder abuse was 0.66(1.63). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR, 4.60 (2.85–7.42)). Psychological abuse (RR, 2.31(1.17–4.56)), physical abuse (RR, 2.36(1.19–4.66)), financial exploitation (RR, 2.81(1.53–5.17)) and caregiver neglect (RR, 4.73(3.03–7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with higher rate of SNF stay of great than 30 days (RR, 6.27(3.68–10.69). Conclusion Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had differential association with increased rate of admission to SNF. PMID:23816799

Elder abuse telephone screen reliability and validity.

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Buri, Hilary M; Daly, Jeanette M; Jogerst, Gerald J

2009-01-01

(a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.

Vaccines for the elderly.

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Del Giudice, Giuseppe; Weinberger, Birgit; Grubeck-Loebenstein, Beatrix

2015-01-01

The aging of the human population is posing serious challenges to research and to public health authorities in order to prevent diseases that more frequently affect the elderly, a portion of the population that will increase more and more in the coming years. While some vaccines exist and are used in the elderly to effectively fight against some infections (e.g. influenza, pneumococci, varicella-zoster virus, diphtheria, and tetanus), still a lot of work remains to be done to better adapt these vaccines and to develop new ones for this age group. The prevention of infectious diseases affecting the elderly can be successful only through a holistic approach. This approach will aim at the following: (1) a deeper understanding of the mechanisms leading to the senescence of the immune system, (2) a better and broader use of vaccines recommended for the elderly, (3) the use of vaccines currently considered only for other age groups and (4) actively priming the population when they are immunological competent, before the physiological waning of immune responsiveness may affect the beneficial effects of vaccination. © 2014 S. Karger AG, Basel

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

LENUS (Irish Health Repository)

Ryan, Cristín

2009-12-01

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

Cognitive functioning in elderly people and the influence of the socio-educative variables - Results from the ELES Study

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Mª Feli González

2013-12-01

Full Text Available Cognitive functioning changes in elderly people. The degree of decline varies across different cognitive abilities and other variables, such as educational level and life-time professional activity, can slow down this process. This study investigates the pattern of cognitive performance in people over 50 years old, taking into account the influence of educational level and profession. Research data were collected during the pilot study of the Longitudinal Aging Study in Spain (ELES in which a representative sample of non-institutionalized Spanish older people was assessed. The following cognitive variables were evaluated: general cognitive functioning, verbal memory, working memory span, visuomotor speed, and language. Differences were found in all cognitive variables in the different age groups, and according to educational level and profession. These differences remained after controlling for the age variable. Population studies provide a global perspective of cognitive performance in older people and help to identify the role of the different associated factors.

Does cognitive/physical screening in an outpatient setting predict institutionalization after hip fracture?

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Hongisto, Markus T; Nuotio, Maria; Luukkaala, Tiina; Väistö, Olli; Pihlajamäki, Harri K

2016-10-22

Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively. A telephone interview with a structured inquiry was performed at 1, 4, and 12 months after hip fracture. Age-adjusted univariate logistic regression analysis revealed that IADL and MMSE scores measured at the outpatient clinic were significantly associated with living arrangements 1 year after hip fracture. Multivariate logistic regression analysis established that institutionalization 1 year after hip fracture was significantly predicted by institutionalization at 4 months (odds ratio [OR] 16.26, 95 % confidence interval [CI] 7.37-35.86), IADL <5 (OR 12.96, 95 % CI 1.62-103.9), and MMSE <20 (OR 4.19, 95 % CI 1.82-9.66). A cut-off value of 5 was established for IADL with 100 % (95 % CI 96 %-100 %) sensitivity and 38 % (95 % CI 33 %-43 %) specificity and for MMSE, a cut-off value of 20 had 83 % (95 % CI 74 %-91 %) sensitivity and 65 % (95 % CI 60 %-70 %) specificity for institutionalization. During the time period from 4 to 12 months, 66 (11 %) patients changed living arrangements, and 36 (55 %) of these patients required more supportive accommodations. IADL and MMSE scores obtained 4 to 6 months after hospital discharge may be applicable for predicting institutionalization among fragility hip fracture patients ≥65 years of age at 1 year after hip fracture. An IADL score of ≥5 predicted the ability to remain in the community. Changes in living arrangements also often occur after 4 months.

The Institutionalization of Entrepreneurship

DEFF Research Database (Denmark)

Fayolle, Alain; Landström, Hans; Gartner, Bill

2016-01-01

In this article, we briefly identify three main challenges/issues that should be taken into consideration in the institutionalization of entrepreneurship research: (1) recognizing the complexity of the phenomenon under study; (2) producing interesting, relevant and useful research results for all...... stakeholders; and (3) developing a critical posture in research. Following the discussion of these challenges/issues we introduce the five contributions to the Special Issue that, in different ways, problematize and challenge mainstream research and approaches. These articles use ‘dissensus discourses’, apply...

Injuries and outcomes associated with traumatic falls in the elderly population on oral anticoagulant therapy.

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Boltz, Melissa M; Podany, Abigail B; Hollenbeak, Christopher S; Armen, Scott B

2015-09-01

Fall risk for older adults is a multi-factorial public health problem as 90% of geriatric injuries are caused by traumatic falls. The CDC estimated 33% of adults >65 years incurred a fall in 2011, with 30% resulting in moderate injury. While much has been written about overall risk to trauma patients on oral anticoagulant (OAC) therapy, less has been reported on outcomes in the elderly trauma population. We used data from the National Trauma Data Bank (NTDB) to identify the types of injury and complications incurred, length of stay, and mortality associated with OACs in elderly patients sustaining a fall. Using standard NTDB practices, data were collected on elderly patients (≥65 years) on OACs with diagnosis of fall as the primary mechanism of injury from 2007 to 2010. Univariate analysis was used to determine patient variables influencing risk of fall on OACs. Odds ratios were calculated for types of injury sustained and post-trauma complications. Logistic regression was used to determine mortality associated with type of injury incurred. Of 118,467 elderly patients sampled, OAC use was observed in 444. Predisposing risk factors for fall on OACs were >1 comorbidity (p3 complications (p<0.0001); the most significant being ARDS and ARF (p<0.0001). The mortality rate on OACs was 16%. Injuries to the GI tract, liver, spleen, and kidney (p<0.0002) were more likely to occur. However, if patients suffered a mortality, the most significant injuries were skull fractures and intracranial haemorrhage (p<0.0001). Risks of anticoagulation in elderly trauma patients are complex. While OAC use is a predictor of 30-day mortality after fall, the injuries sustained are markedly different between the elderly who die and those who do not. As a result there is a greater need for healthcare providers to identify preventable and non-preventable risks factors indicative of falls in the anti-coagulated elderly patient. Copyright © 2015 Elsevier Ltd. All rights reserved.

Religiousness, social support and the use of antidepressants among the elderly: a population-based study.

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Vicente, Adriano Roberto Tarifa; Castro-Costa, Érico; Firmo, Josélia de Oliveira Araújo; Lima-Costa, Maria Fernanda; Loyola Filho, Antônio Ignácio de

2018-03-01

The purpose of the study was to investigate whether religiousness and social support were associated with the use of antidepressants among community-dwelling elders. The research involved 1,606 older adults who make up the cohort of Bambuí Project, a study on ageing and health. The dependent variable was the use of antidepressants in the last 90 days, and the exposures of interest were social support and religiousness. Logistic regression was used to test the associations and to estimate crude and adjusted Odds Ratio and their 95% confidence intervals. The chances of use of antidepressants were significantly lower among older people with higher level of religiosity (OR = 0.45; 95% CI: 0.29 to 0.70), but none of the descriptors social support was associated with the event. In this population, it is possible that religion occupies a prominent role in the arsenal of health problems coping strategies, especially mental. Health professionals attending this particular segment of the population (elderly people with depressive disorders) should consider religiousness of patients when the proposed guidelines and treatment in coping with their mental suffering.

Sustainable institutionalized punishment requires elimination of second-order free-riders

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Perc, Matjaž

2012-03-01

Although empirical and theoretical studies affirm that punishment can elevate collaborative efforts, its emergence and stability remain elusive. By peer-punishment the sanctioning is something an individual elects to do depending on the strategies in its neighborhood. The consequences of unsustainable efforts are therefore local. By pool-punishment, on the other hand, where resources for sanctioning are committed in advance and at large, the notion of sustainability has greater significance. In a population with free-riders, punishers must be strong in numbers to keep the ``punishment pool'' from emptying. Failure to do so renders the concept of institutionalized sanctioning futile. We show that pool-punishment in structured populations is sustainable, but only if second-order free-riders are sanctioned as well, and to a such degree that they cannot prevail. A discontinuous phase transition leads to an outbreak of sustainability when punishers subvert second-order free-riders in the competition against defectors.

Elder physical abuse.

Science.gov (United States)

Young, Lisa M

2014-11-01

Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

INSTITUTION FOR THE AGED: ASSESSING THE CONDITIONS OF ACCESSIBILITY AND FUNCTIONALITY OF THE ELDERLY.

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Raphaella Lomanto Santos de Almeida

2015-04-01

Full Text Available The study aim was to assess the capacity to undertake the Basic Activities of Daily Living (BADL of elderly residents of an Institution for the Aged (IA and their level of accessibility. This is an observational, descriptive, cross-sectional study. The level of independence for BADL was assessed by the Barthel Index and the degree of accessibility of IA was verified through a check-list, based on the Brazilian Standard (NBR 9050/2004, the Brazilian Association of Technical Standards (ABNT. Of the 62 seniors who participated in the study, 64.5% had some degree of functional dependence. Noteworthy the level of functional dependency for activities undertaken in the bathroom among elderly on wheelchair. The assessed physical structure does not fully follow the technical standards established by NBR 9050, with differences mainly in the parameters of bedrooms, bathrooms and stairs. Although much of the institutionalized elderly presenting advanced and most functional vulnerability ages, level of IA architectural accessibility is still insufficient. Rooms and bathrooms are the places with the highest deficit of accessibility and also higher prevalence of falls among the elderly residents. A good level of accessibility in IA, can be an important factor in improving the level of independence for everyday activities and to prevent the risk of falls.

Cardiovascular risk assessment in elderly adults using SCORE OP model in a Latin American population: The experience from Ecuador.

Science.gov (United States)

Sisa, Ivan

2018-02-09

Cardiovascular disease (CVD) mortality is predicted to increase in Latin America countries due to their rapidly aging population. However, there is very little information about CVD risk assessment as a primary preventive measure in this high-risk population. We predicted the national risk of developing CVD in Ecuadorian elderly population using the Systematic COronary Risk Evaluation in Older Persons (SCORE OP) High and Low models by risk categories/CVD risk region in 2009. Data on national cardiovascular risk factors were obtained from the Encuesta sobre Salud, Bienestar y Envejecimiento. We computed the predicted 5-year risk of CVD risk and compared the extent of agreement and reclassification in stratifying high-risk individuals between SCORE OP High and Low models. Analyses were done by risk categories, CVD risk region, and sex. In 2009, based on SCORE OP Low model almost 42% of elderly adults living in Ecuador were at high risk of suffering CVD over a 5-year period. The extent of agreement between SCORE OP High and Low risk prediction models was moderate (Cohen's kappa test of 0.5), 34% of individuals approximately were reclassified into different risk categories and a third of the population would benefit from a pharmacologic intervention to reduce the CVD risk. Forty-two percent of elderly Ecuadorians were at high risk of suffering CVD over a 5-year period, indicating an urgent need to tailor primary preventive measures for this vulnerable and high-risk population. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Optimization of impedance spectroscopy techniques for measuring cutaneous micropore formation after microneedle treatment in an elderly population.

Science.gov (United States)

Kelchen, Megan N; Holdren, Grant O; Farley, Matthew J; Zimmerman, M Bridget; Fairley, Janet A; Brogden, Nicole K

2014-12-01

The objective of this study was to optimize a reproducible impedance spectroscopy method in elderly subjects as a means to evaluate the effects of microneedles on aging skin. Human volunteers were treated with microneedles at six sites on the upper arm. Repeated impedance measurements were taken pre- and post-microneedle insertion. Two electrode types were evaluated (dry vs. gel), using either light or direct pressure to maintain contact between the electrode and skin surface. Transepidermal water loss (TEWL) was measured as a complementary technique. Five control subjects and nine elderly subjects completed the study. Microneedle insertion produced a significant decrease in impedance from baseline in all subjects (p micropore formation. This was supported by a complementary significant increase in TEWL (p micropore formation in elderly subjects, which will be essential for future studies describing microneedle-assisted transdermal delivery in aging populations.

Potential contribution of the neurodegenerative disorders risk loci to cognitive performance in an elderly male gout population.

Science.gov (United States)

Han, Lin; Jia, Zhaotong; Cao, Chunwei; Liu, Zhen; Liu, Fuqiang; Wang, Lin; Ren, Wei; Sun, Mingxia; Wang, Baoping; Li, Changgui; Chen, Li

2017-09-01

Cognitive impairment has been described in elderly subjects with high normal concentrations of serum uric acid. However, it remains unclear if gout confers an increased poorer cognition than those in individuals with asymptomatic hyperuricemia. The present study aimed at evaluating cognitive function in patients suffering from gout in an elderly male population, and further investigating the genetic contributions to the risk of cognitive function.This study examined the cognitive function as assessed by Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in 205 male gout patients and 204 controls. The genetic basis of these cognitive measures was evaluated by genome-wide association study (GWAS) data in 102 male gout patients. Furthermore, 7 loci associated with cognition in GWAS were studied for correlation with gout in 1179 male gout patients and 1848 healthy male controls.Compared with controls, gout patients had significantly lower MoCA scores [22.78 ± 3.01 vs 23.42 ± 2.95, P = .023, adjusted by age, body mass index (BMI), education, and emotional disorder]. GWAS revealed 7 single-nucleotide polymorphisms (SNPs) associations with MoCA test at a level of conventional genome-wide significance (P gout in further analysis (all P > .05).Elderly male subjects with gout exhibit accelerated decline in cognition performance. Several neurodegenerative disorders risk loci were identified for genetic contributors to cognitive performance in our Chinese elderly male gout population. Larger prospective studies of the cognitive performance and genetic analysis in gout subjects are recommended.

Identifying risk for dementia across populations: A study on the prevalence of dementia in tribal elderly population of Himalayan region in Northern India

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Sunil Kumar Raina

2013-01-01

Full Text Available Introduction: Studies have suggested that dementia is differentially distributed across populations with a lower prevalence in developing regions than the developed ones. A comparison in the prevalence of dementia across populations may provide an insight into its risk factors. Keeping this in view, a study was planned to evaluate the prevalence of dementia in tribal elderly population. Materials and Methods: A cross-sectional comprehensive two-phase survey of all residents aged 60 years and older was conducted. Phase one involved screening of all individuals aged 60 and above with the help of a cognitive screen specifically developed for the tribal population. Phase two involved clinical examination of individuals who were suspected of dementia as per the developed cognitive screening test. Results: The results revealed that no individual above 60 years of age in the studied population was diagnosed as a case of dementia. Thereby, pointing out at some unknown factors, which are responsible for prevention of dementia. Discussion: The differences between the prevalence rate in this study and other studies in India appear to be a function of a valid regional difference. Environmental, phenotypic and genetic factors may contribute to regional and racial variations in dementia. Societies living in isolated hilly and tribal areas seem less predisposed to dementia, particularly age related neurodegenerative and vascular dementia, which are the most common causes for dementia in elderly. This may be because some environmental risk factors are much less prevalent in these settings.

Perfil epidemiológico da cárie dentária, doença periodontal, uso e necessidade de prótese em idosos residentes em uma instituição na cidade de Fortaleza, Ceará Epidemiology of tooth decay, periodontal diseases, use and need of prostheses in the elderly living in a nursing home in the city of Fortaleza, State of Ceará (Brazil

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Luciene Ribeiro Gaião

2005-09-01

of that, studies on the oral health of institutionalized elderly in northeast Brazil are virtually non-existent. The objective of the present study was to analyze the dental and periodontal conditions and the use and need for prostheses in the institutionalized elderly in a northeastern Brazilian city. A cross-sectional study was conducted with 160 individuals (95.2% of the target population, 65 years old or older, living in a nursing home in the city of Fortaleza/CE - Brazil, consisting of the analysis of patient records and oral examination. Their mean age was 76.6 years. The DMFT index of the institutionalized elderly was high: 29.73. Lost teeth represented the highest proportion (28.42; 109 (68.1% elderly did not have any healthy teeth. Of the 160 elderly, 93 (58.1% were total edentates and 56 (35.0% had teeth with exposed roots. Of the exposed roots, 16% were decayed or filled. Of the 67 dentate elderly, 54 (80.6% required dental extraction. Of the total 573 teeth present, 256 (44.6% required some kind of treatment, and 194 (75.8% of them dental extraction. Of the study population, 112 (70% did not use any upper prosthesis, and 130 (81.3% did not use any lower prosthesis. The need of an upper prosthesis was detected in 135 elderly (84.4%, and 142 (88.7% elderly needed a lower prosthesis. Of 117 sextants present in 160 elderly, the majority (838% had dental calculus. These data show that most of the elderly had poor oral health. Interventional measures focused on these populations, such as health education and preventive treatment, are, therefore, necessary.

Association between serum 25-hydroxyvitamin D level and ...

African Journals Online (AJOL)

Elderly people in institutionalized home care might have the risk of getting certain nutrient deficiencies due to lack of food intake and comorbidities. This study was intended to investigate the prevalence of vitamin D deficiency among institutionalized elderly people and association between anthropometric indices with serum ...

Conflicting views on elder care responsibility in Japan.

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Lee, Kristen Schultz

2016-05-01

I examine the attitudinal ambivalence created by conflicting social expectations regarding parent-child devotion, filial obligation and family membership, and gender norms in a national population of Japanese adults. I ask: in a context of rapidly changing family and elder care norms, how do different beliefs and attitudes overlap and conflict and how are they related to elder care preferences? I analyze data from the 2006 Japanese General Social Survey and use Latent Class Analysis to identify latent groups in the population defined by their beliefs and examine the relationship between class membership and elder care preferences. I found variation in the population with respect to the measured beliefs as well as a relationship between patterns of beliefs and choice of elder caregiver. I found conflicting expectations regarding elder care responsibility in one latent class and this class also expressed elder care preferences that conflict with at least some of their strongly held beliefs. Copyright © 2016 Elsevier Inc. All rights reserved.

A Korean version of the Oral Impacts on Daily Performances (OIDP scale in elderly populations: Validity, reliability and prevalence

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Tsakos Georgios

2008-02-01

Full Text Available Abstract Background This study aimed to develop a Korean version of the OIDP index for elderly people and to assess the levels of sociodental impacts in an older Korean population. Methods The OIDP index for elderly people was cross-culturally adapted from English into Korean and then the derived instrument was tested for reliability and validity. The study population was elderly (65+ year-old residents of Gangneung City, South Korea. Twenty two of the 222 senior day centres were randomly selected. Results 687 people were invited and 668 participated in the study (response rate: 97.2%. The standardized Cronbach's alpha coefficient was 0.85. The OIDP related significantly with different subjective measures of oral and general health (p Conclusion The Korean OIDP index showed satisfactory validity and internal consistency reliability, confirming its appropriateness for use among older Korean people. The prevalence of oral health related impacts was high. Future studies should focus on the test-retest reliability and the sensitivity to change of the Korean OIDP.

Oral health disparities in older adults: oral bacteria, inflammation, and aspiration pneumonia.

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Scannapieco, Frank A; Shay, Kenneth

2014-10-01

Poor oral hygiene has been suggested to be a risk factor for aspiration pneumonia in the institutionalized and disabled elderly. Control of oral biofilm formation in these populations reduces the numbers of potential respiratory pathogens in the oral secretions, which in turn reduces the risk for pneumonia. Together with other preventive measures, improved oral hygiene helps to control lower respiratory infections in frail elderly hospital and nursing home patients. Copyright © 2014 Elsevier Inc. All rights reserved.

The elderly and general anesthesia

DEFF Research Database (Denmark)

Steinmetz, J; Rasmussen, L S

2010-01-01

Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

Benzodiazepine abuse among the elderly

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Shalini Singh

2016-01-01

Full Text Available Benzodiazepines belong to the hypnotic-sedative class of drugs which have anxiolytic, sedative, and hypnotic properties. These drugs have been in clinical use for at least half a century. The propensity for development of dependence, especially on prescription benzodiazepines, coupled with the risk of falls and cognitive impairment due to benzodiazepines makes the elderly population susceptible to adverse outcomes with the use of benzodiazepines, and hence, cautious use is desired in this population. This review discusses the various aspects pertaining to benzodiazepine abuse in the elderly including pharmacology, prevalence of abuse, adverse consequences of benzodiazepine abuse, and subsequently assessment and management of elderly patients with benzodiazepine abuse.

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

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

2017-08-26

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

Predicting hemorrhage and obstruction in the elderly population using thromboelastographic indices

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Zheng Q

2013-10-01

Full Text Available Qiwen Zheng,1,* Shuhong Fu,2,* Dafang Chen,1 Xiaoxia Li,2 Yuru Li,2 Yanyan Li,2 Jihong Yu,2 Meiliang Gong,2 Jie Bai2 1Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; 2Nanlou Clinical Lab, Chinese PLA General Hospital, Beijing, People's Republic of China *These authors contributed equally to this work Objective: To estimate the value of the different thromboelastogram indices for predicting hemorrhage and vascular obstruction in an elderly population. Methods: This was a prospective cohort study of patients 65 years and older without hematologic disorders who received thromboelastography (TEG examination at the Chinese People's Liberation Army General Hospital from January 2007 to December 2010. Detailed information was collected at recruitment including their TEG test results. Subjects were then followed during outpatient visits and hospitalization. The primary outcome measures were hemorrhage and vascular obstruction. Receiver-operating characteristics (ROC curves were used to compare the predictive value of the four TEG indices, reaction time (R, clot formation time (K, maximal amplitude (MA, alpha angle (ANGLE and their combination for predicting hemorrhage and vascular obstruction. The maximal Youden's index was used to estimate optimal cut-off values for the indices. Areas under the ROC curves were used to estimate overall predictive accuracies. Results: A total of 403 elderly patients met inclusion criteria and were included: 373 male and 30 females with mean age 83.0 ± 7.3 years and range of 65–103 years. Hemorrhage occurred in 25 (6.2% patients and vascular obstruction in 78 (19.4% patients during the 2-year follow up. The currently recommended TEG cut-off values were poorly predictive of vascular obstruction and modestly predictive of hemorrhage. Based on maximal Youden's, the optimal cutoffs of the TEG indices for predicting vascular

Age and education adjusted normative data and discriminative validity for Rey's Auditory Verbal Learning Test in the elderly Greek population.

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Messinis, Lambros; Nasios, Grigorios; Mougias, Antonios; Politis, Antonis; Zampakis, Petros; Tsiamaki, Eirini; Malefaki, Sonia; Gourzis, Phillipos; Papathanasopoulos, Panagiotis

2016-01-01

Rey's Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological test to assess episodic memory. In the present study we sought to establish normative and discriminative validity data for the RAVLT in the elderly population using previously adapted learning lists for the Greek adult population. We administered the test to 258 cognitively healthy elderly participants, aged 60-89 years, and two patient groups (192 with amnestic mild cognitive impairment, aMCI, and 65 with Alzheimer's disease, AD). From the statistical analyses, we found that age and education contributed significantly to most trials of the RAVLT, whereas the influence of gender was not significant. Younger elderly participants with higher education outperformed the older elderly with lower education levels. Moreover, both clinical groups performed significantly worse on most RAVLT trials and composite measures than matched cognitively healthy controls. Furthermore, the AD group performed more poorly than the aMCI group on most RAVLT variables. Receiver operating characteristic (ROC) analysis was used to examine the utility of the RAVLT trials to discriminate cognitively healthy controls from aMCI and AD patients. Area under the curve (AUC), an index of effect size, showed that most of the RAVLT measures (individual and composite) included in this study adequately differentiated between the performance of healthy elders and aMCI/AD patients. We also provide cutoff scores in discriminating cognitively healthy controls from aMCI and AD patients, based on the sensitivity and specificity of the prescribed scores. Moreover, we present age- and education-specific normative data for individual and composite scores for the Greek adapted RAVLT in elderly subjects aged between 60 and 89 years for use in clinical and research settings.

Lower Urinary Tract Symptoms in Elderly Population With Multiple Sclerosis

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Camille Chesnel

2018-03-01

Full Text Available Purpose The aim of this study is to compare the clinical and urodynamic characteristics of urinary disorders in multiple sclerosis (MS patients in a geriatric population with a nongeriatric population. Methods This study was conducted retrospectively between 2010 and 2016. Each patient with MS aged 65 and older was matched with 2 patients with MS aged less than 65 in sex, form of MS, and Expended Disability Status Scale (EDSS. Demographic data, urinary symptoms, treatment, quality of life, repercussion of lower urinary tract symptoms on daily life activities and psychological state and urodynamic parameters were collected. Differences between the 2 populations were evaluated using Student test, chi-square, or Fischer tests. Results Twenty-four patients with MS aged 65 and older (mean age, 69.8 years were matched with 48 patients aged less than 65 years (mean age, 49.4 years. Maximum urethral closure pressure was lower in the elderly population than in the nongeriatric population (mean±standard deviation [SD]: 35.6±18.5 cm H2O vs. 78.2±52.3 cm H2O, P<0.001. In the male population, there was no statistical difference in any other clinical or urodynamic endpoints. In the female population, voiding symptoms was more described in the nongeriatric population (Urinary Symptom Profile low stream: 3.4±3.5 vs. 1.7±2.4, P=0.04, geriatric population had less urinary treatment (P=0.05. LUTS had less impact on quality of life (Qualiveen: 1.4±1.0 vs. 2.1±0.9, P=0.02 on the geriatric population than in the nongeriatric of female MS patients. Conclusions Geriatric population of MS has few differences of urinary disorders compared to a nongeriatric population with EDSS, sex, and MS form equal. However, the psychological impact of these urinary disorders is less important in female geriatric population.

[Trauma in the elderly].

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de Souza, José Antonio Gomes; Iglesias, Antonio Carlos R G

2002-01-01

The populational growth of the elderly, associated to a healthier and more active life, make this group of people more exposed to accidents. In some countries, trauma in the elderly is responsible for a high mortality rate, disproportionately higher than in the adults. This fact consumes a great portion of health care resources and implies in a high social cost. The distinct physiologic characteristics of the elderly and the frequent presence of associated diseases make that these patients behave differently and in a more complex way than patients of other ages. These particularities make that health care to the elderly victims of trauma have to be different. The present revision is about aspects of epidemiology, prevention, physiology, health care and rehabilitation of the elderly victims of trauma.

Nutritional Status and Its Related Factors in Elderly in Kashmar

OpenAIRE

Hashem Heshmati; Nasser Behnampour; Rasoul Asnaashari; Aliasghar Ayatollahi

2014-01-01

Aging population and its consequences is one of the most issues in a lot of countries. Iranian population is in the transition in young population to the aging population and elderly population growth is higher than total population growth, therefore programming for control and solving elderly population issues is necessary in the future.

Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly.

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Shinkov, Alexander; Borissova, Anna-Maria; Dakovska, Lilia; Vlahov, Jordan; Kassabova, Lidia; Svinarov, Dobrin; Krivoshiev, Stefan

2016-02-23

To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

Spatial practices and the institutionalization of water sanitation services in southern metropolises

DEFF Research Database (Denmark)

Putri, Prathiwi Widyatmi; Moulaert, Frank

2017-01-01

the city as a multi-scalar socio-ecological system in which different forms of human–water relations and their institutionalization are found. Particular attention is given to informality in this system and how it interacts with ‘regular’ state and corporate market sector practices. Within...... these interactive dynamics, informality is not only understood as a survival strategy but also as a creative practice connecting various social-ecological opportunities, traditional and contemporary technologies and modes of institutionalization to each other. Ongoing institutionalization processes in the formal...... and informal economy, as well as between them, are analysed. Opportunities to integrate and regularize the diverse water sanitation services into community-led closed water–wastewater cycles capable of ensuring public health and sustaining a bio-hydrological balance at the local level are explored....

Pro-Elderly Welfare States within Child-Oriented Societies

DEFF Research Database (Denmark)

Gal, Robert Ivan; Vanhuysse, Pieter; Vargha, Lili

Households and policies are the main vehicles of intergenerational transfers. Working-age people are net contributors; children and older persons net beneficiaries. However, there is an asymmetry in socialization. Working-age people pay taxes and social security contributions to institutionalize...... care for older persons as a generation, but invest private resources to raise their own children, often with large social returns. This results in asymmetric statistical visibility. Elderly transfers are near-fully observed in National Accounts; those to children much less. Analysing ten European...... societies, we employ National Transfer Accounts to include public and private transfers and National Time Transfer Accounts to value unpaid household labour. All three channels combined, children receive more per capita resources (73 percent of prime-age labour income) than older persons (31 percent...

Pro-Elderly Welfare States within Child-Oriented Societies

DEFF Research Database (Denmark)

Gal, Robert Ivan; Vanhuysse, Pieter; Vargha, Lili

2018-01-01

Families and policies both are main vehicles of intergenerational transfers. Working-age people are net contributors; children and older persons net beneficiaries. However, there is an asymmetry in socialization. Working-age people pay taxes and social security contributions to institutionalize...... care for older persons as a generation, but invest private resources to raise their own children, often with large social returns. This results in asymmetric statistical visibility. Elderly transfers are near-fully observed in National Accounts; those to children much less. Analysing ten European...... societies, we employ National Transfer Accounts to include public and private transfers, and National Time Transfer Accounts to value unpaid household labour. All three transfer channels combined, children receive more than twice as many per-capita resources as older persons. Europe is a continent...

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

Science.gov (United States)

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

2017-08-01

Vitamin D deficiency has been reported to be associated with the risk of cardiovascular disease. We investigated the relationship between vitamin D status and asymmetric dimethylarginine (ADMA) concentration, a marker of endothelial dysfunction, in the Korean elderly population. A cross-sectional study was conducted on 269 men and 382 women (mean age, 71.6 years) enrolled in the Korean Social Life, Health, and Aging Project (KSHAP), a population-based longitudinal study of health determinants in elderly Koreans. We stratified patients by vitamin D status into three groups according to serum 25-hydroxyvitamin D [25(OH)D] level: sufficient (≥30ng/mL, n=25), insufficient (10-D status and ADMA concentration was analyzed by multiple linear regression models. The mean ADMA concentration was significantly higher in the insufficient 25(OH)D group (0.665μmol/L, p=0.001) and the deficient 25(OH)D group (0.734μmol/L, pD group (0.589μmol/L). Even after adjusting for sex, age, body mass index, blood pressure, diabetes mellitus, total and HDL cholesterol, estimated glomerular filtration rate (eGFR), smoking status, and drinking status, ADMA concentrations were higher in the insufficient group (β=0.0742μmol/L, p=0.001) and the deficient group (β=0.1417μmol/L, pD deficiency was associated with higher ADMA levels in both women (pD deficiency was associated with higher ADMA levels in women (pD level may be associated with endothelial dysfunction in elderly Korean people. Copyright © 2017 Elsevier B.V. All rights reserved.

Screening and detection of elder abuse: Research opportunities and lessons learned from emergency geriatric care, intimate partner violence, and child abuse.

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Beach, Scott R; Carpenter, Christopher R; Rosen, Tony; Sharps, Phyllis; Gelles, Richard

2016-01-01

This article provides an overview of elder abuse screening and detection methods for community-dwelling and institutionalized older adults, including general issues and challenges for the field. Then, discussions of applications in emergency geriatric care, intimate partner violence (IPV), and child abuse are presented to inform research opportunities in elder abuse screening. The article provides descriptions of emerging screening and detection methods and technologies from the emergency geriatric care and IPV fields. We also discuss the variety of potential barriers to effective screening and detection from the viewpoint of the older adult, caregivers, providers, and the health care system, and we highlight the potential harms and unintended negative consequences of increased screening and mandatory reporting. We argue that research should continue on the development of valid screening methods and tools, but that studies of perceived barriers and potential harms of elder abuse screening among key stakeholders should also be conducted.

Access to medicines: relations with the institutionalization of pharmaceutical services

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Rafael Damasceno de Barros

2017-11-01

Full Text Available ABSTRACT OBJETIVE To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services 2015, a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3; there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1; there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0; those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5; there is computerized system for pharmaceutical services management, OR

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

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

2017-05-01

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

Associations between plasma insulin-like growth factor-I and the markers of inflammation interleukin 6, C-reactive protein and YKL-40 in an elderly background population

DEFF Research Database (Denmark)

Andreassen, Mikkel; Raymond, Ilan; Hildebrandt, Per

2010-01-01

The objective of the present study was to test the hypothesis that circulating levels of insulin-like growth factor-I (IGF-I) are inversely associated with inflammatory processes in an elderly background population.......The objective of the present study was to test the hypothesis that circulating levels of insulin-like growth factor-I (IGF-I) are inversely associated with inflammatory processes in an elderly background population....

Community acquired pneumonia in the elderly: the Pneumonia in Italian Acute Care for Elderly units (PIACE study protocol by the Italian Society of Hospital and Community Geriatrics (SIGOT

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Filippo Luca Fimognari

2017-01-01

Full Text Available Pneumonia is a frequent cause of hospital admission in elderly patients. Diagnosis of pneumonia in elderly persons with comorbidity may be challenging, due to atypical presentation and complex clinical scenarios. Community-acquired pneumonia (CAP arises out-of-hospital in subjects without previous contact with the healthcare system. Healthcare associated pneumonia (HCAP occurs in patients who have frequent contacts with the healthcare system and should be treated with empiric broad spectrum antibiotic therapy also covering multi-drug resistant (MDR pathogens. Recent findings, however, have questioned this approach, because the worse prognosis of HCAP compared to CAP may better reflect increased level of comorbidity and frailty (poor functional status, older age of HCAP patients, as well as poorer quality of hospital care provided to such patients, rather than pneumonia etiology by MDR pathogens. The Pneumonia in Italian Acute Care for Elderly units (PIACE Study, promoted by the Società Italiana di Geriatria Ospedale e Territorio (SIGOT, is an observational prospective cohort study of patients consecutively admitted because of pneumonia to hospital acute care units of Geriatrics throughout Italy. Detailed information regarding clinical presentation, diagnosis, etiology, comprehensive geriatric assessment, antibiotic therapy, possible complications and comorbidities was recorded to identify factors potentially predicting in-hospital mortality (primary endpoint, 3-month mortality, length of hospital stay, postdischarge rate of institutionalization and other secondary endpoints. This paper describes the rationale and method of PIACE Study and reviews the main evidence on pneumonia in the elderly.

[Articles on elderly in Serbian medical journals].

Science.gov (United States)

Despotović, Nebojsa; Milosević, Dragoslav P; Erceg, Predrag; Davidović, Mladen

2009-01-01

Population aging is a feature of all countries in the world. According to statistics, the Republic of Serbia is one of the countries with the majority of the elderly. Taking this into account, are articles on the elderly well represented in domestic medical journals? The aim of the paper was to determine whether there was a sufficient number of articles on the elderly in domestic medical journals. The articles on the elderly were searched using search engines in domestic and foreign medical journals for the last 5 years compared with the number of articles on children in the same publications for the same period. In the Serbian Citation Index, 11 articles on the topic of the elderly, and 487 on children were registered. In Srpski arhivza celokupno lekarstvo, there was registered only one article on the topic of the elderly, and 30 on children. In Vojnosanitetskipregled, 2 articles on the elderly and 13 on children were registered (p articles on the elderly and 759 articles on children; in the JAMA, there were 63 articles on the elderly and 303 articles on children; and in The Lancet, in the last five years, 46 articles on the elderly and 148 articles on children were published. The themes of the elderly were rarely represented in Serbian medical journals.This has reduced the interest of physicians in medical problems of this growing population of patients and further sent them away from making standards in the diagnosis and treatment of the elderly.

Association between functional performance and executive cognitive functions in an elderly population including patients with low ankle–brachial index

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Ferreira NV

2015-05-01

Full Text Available Naomi Vidal Ferreira,1 Paulo Jannuzzi Cunha,2 Danielle Irigoyen da Costa,3 Fernando dos Santos,1 Fernando Oliveira Costa,1 Fernanda Consolim-Colombo,4 Maria Cláudia Irigoyen1 1Heart Institute, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil; 2Neuroimaging in Psychiatry Laboratory, Department of Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil; 3Rio Grande do Sul Cardiology Institute, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil; 4Medical School, Universidade Nove de Julho, São Paulo, SP, Brazil Introduction: Peripheral arterial disease, as measured by the ankle–brachial index (ABI, is prevalent among the elderly, and is associated with functional performance, assessed by the 6-minute walk test (6MWT. Executive cognitive function (ECF impairments are also prevalent in this population, but no existing study has investigated the association between ECF and functional performance in an elderly population including individuals with low ABI.Aim: To investigate the association between functional performance, as measured by the 6MWT, and loss in ECF, in an elderly sample including individuals with low ABI.Method: The ABI group was formed by 26 elderly individuals with low ABI (mean ABI: 0.63±0.19, and the control group was formed by 40 elderly individuals with normal ABI (mean ABI: 1.08±0.07. We analyzed functional performance using the 6MWT, global cognition using the Mini-Mental State Examination (MMSE, and ECF using the Digit Span for assessing attention span and working memory, the Stroop Color Word Test (SCWT for assessing information processing speed and inhibitory control/impulsivity, and the Controlled Oral Word Association Test (COWAT for assessing semantic verbal fluency and phonemic verbal fluency. We also used a factor analysis on all of the ECF tests (global ECF.Results: Before adjustment, the ABI group performed worse on global cognition, attention span, working

The Effects of Early Experience on Face Recognition: An Event-Related Potential Study of Institutionalized Children in Romania

Science.gov (United States)

Moulson, Margaret C.; Westerlund, Alissa; Fox, Nathan A.; Zeanah, Charles H.; Nelson, Charles A.

2009-01-01

Data are reported from 3 groups of children residing in Bucharest, Romania. Face recognition in currently institutionalized, previously institutionalized, and never-institutionalized children was assessed at 3 time points: preintervention (n = 121), 30 months of age (n = 99), and 42 months of age (n = 77). Children watched photographs of caregiver…

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

OpenAIRE

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

2017-01-01

Background Alcohol consumption is considered a risk factor for sarcopenia, but the association between alcohol consumption and the prevalence of sarcopenia has not been evaluated in detail. This study was to identify the relationship between alcohol drinking patterns and the prevalence of sarcopenia in the elderly Korean population. Methods The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Participants were excluded if they wer...

Psychosocial Status and Economic Dependence for Healthcare and Nonhealthcare among Elderly Population in Rural Coastal Karnataka.

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Rent, Priyanka Dsouza; Kumar, Sudeep; Dmello, Mackwin Kenwood; Purushotham, Jagannath

2017-01-01

The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS) among elderly patients. The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September-December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent. Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%), whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them. The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.

Factors Influencing Title VII Bilingual Program Institutionalization.

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Lewis, Gerald R.; And Others

1985-01-01

This study of the primary restraining and driving forces that influence Title VII bilingual education programs found the external environment, the local community, to be the main factor influencing institutionalization and self-renewal. The internal environment--the local school, and the local school's organization or central office, school board,…

How Does Ethics Institutionalization Reduce Academic Cheating?

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Popoola, Ifeoluwa; Garner, Bart; Ammeter, Anthony; Krey, Nina; Beu Ammeter, Danielle; Schafer, Stuart

2017-01-01

Extant research on academic cheating primarily focuses on the impact of honor codes on academic cheating. However, the influence of ethics institutionalization is curiously missing in past research. The authors developed and validated a structural equations model in the R programming language to examine the impact of formal (explicit) and informal…

Effectiveness of light paths coupled with personal emergency response systems in preventing functional decline among the elderly

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Florent Lachal

2016-08-01

Full Text Available Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0 and at the end of the study (T12-month. Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5 at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54, p = 0.002. Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies.

Institutionalizing Gender and Women's Rights and Citizenship at ...

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

Institutionalizing Gender and Women's Rights and Citizenship at Cheikh Anta Diop ... The results will provide an information base for other teaching and research ... aux problèmes auxquels l'Inde est confrontée, comme le stress thermique, ...

Advances in treating psoriasis in the elderly with small molecule inhibitors.

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Cline, Abigail; Cardwell, Leah A; Feldman, Steven R

2017-12-01

Due to the chronic nature of psoriasis, the population of elderly psoriasis patients is increasing. However, many elderly psoriatic patients are not adequately treated because management is challenging as a result of comorbidities, polypharmacy, and progressive impairment of organ systems. Physicians may hesitate to use systemic or biologic agents in elderly psoriasis patients because of an increased risk of adverse events in this patient population. Small molecule medications are emerging as promising options for elderly patients with psoriasis and other inflammatory conditions. Areas covered: Here we review the efficacy, safety and tolerability of small molecule inhibitors apremilast, tofacitinib, ruxolitinib, baricitinib, and peficitinib in the treatment of psoriasis, with focus on their use in the elderly population. Expert opinion: Although small molecule inhibitors demonstrate efficacy in elderly patients with psoriasis, they will require larger head-to-head studies and post-marketing registries to evaluate their effectiveness and safety in specific patient populations. Apremilast, ruxolitinib, and peficitinib are effective agents with favorable side effect profiles; however, physicians should exercise caution when prescribing tofacitinib or baricitinib in elderly populations due to adverse events. The high cost of these drugs in the U.S. is likely to limit their use.

Study of Health and Social Indicators of Elderly Women in Iran

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Marzieh Shirazi Khah

2012-03-01

Full Text Available Objectives: by reducing the fertility rate and Improve health& social conditions in Iran, increases the statistics of population older women also follow the whole population of seniors. So that in two decades than has increased the population of elderly women to total female population of 3 percent to 4.1 percent in the recent census in 2006 to 7 percent and is expected that increasing continues this trend the next decades. Global statistics show that significantly more elderly woman than elderly men in most countries, developed and developing, But according to the Statistical Center of Iran shows that during 1976-2006 has increased in every decade the number of elderly women in Iran Due to improved health services, social and economic, but has reduced the population of elderly women than elderly men This happened while usually Is less life expectancy in men than women .therefore In this paper we study the population status, health, education, family status, employment, quality of life and isolation of elderly women in Iran and We review different reasons than elderly women than elderly men in gender. Methods & Materials: This study is a descriptive-analytical study and a library that was used in the Statistics Center of Iran as the country's census is the most documented. In addition, we search for related database in English and Persian, including pubmed, medline, ISI and Web site World Health Organization and Scientific Information Database To obtain demographic and social information about the Iranian elderly population. Also took advantage of the views of experts to analyze the findings gerontology, epidemiology and sociology on gender differences in the elderly population in Iran. Result: With a deep look at the situation of elderly women from different dimensions, including physical health, psychological-psychological, familial, social and... Understand that Despite the efforts and improvements in health status, social and economic in

The prevalence and treatment of hypertension in the elderly population of the Mexican Institute of Social Security.

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García-Peña, C; Thorogood, M; Reyes, S; Salmerón-Castro, J; Durán, C

2001-01-01

To assess the prevalence and treatment of high blood pressure among elderly people in Mexico. A cross-sectional study was conducted from February to July 1998 among the elderly people covered by the Instituto Mexicano del Seguro Social (IMSS) healthcare services in Mexico City. The study population consisted of 4,777 subjects aged 60 years and over, selected from a cohort of 5,433 people, representative of the population of Mexico City. Trained nurses carried out three blood pressure measurements at home. Diagnosis of high blood pressure was established if systolic pressure was equal to or higher than 160 mmHg, and/or diastolic pressure was equal or higher than 90 mmHg, or by self-report of a medical diagnosis of hypertension. Demographic and risk factor information was also collected. A total of 4,777 subjects were screened; 2,036 (43%) of them reported that they had been previously diagnosed as hypertensive. Of these, 1,954 (96%) were already on pharmacological treatment. A further 273 (5.7%) subjects were found to be hypertensive at screening. Among those receiving treatment, 1,399 (68.5%) had a blood pressure reading of less than 160/90 mmHg, and this was also the case for 59 (72%) of the known hypertensives not on treatment. A single drug was used by 1,556 (79.6%) of those on treatment. Risk factors for hypertension were more frequent in the hypertensive group (p 0.05 Pound). Almost half of the elderly population is hypertensive, most of them are already on treatment, but about one third of those on treatment do not have an adequate control of high blood pressure.

Institutionalized Technological Foresight

DEFF Research Database (Denmark)

Koch, Christian; Hansen, Hans Henrik; Stissing Jensen, Jens

2008-01-01

, and they become dependent of national and other institutional foresights. Since 2000 the Danish ministry of Science, Technology and Innovation has tendered nine technology foresights. These could be used by SMEs as supplementary to internal decision making. One also expects to see these foresights placed firmly...... in the national strategy of coordinating and strengthening policy on research, technology and innovation in one superministry. The paper evaluates the methods, impact and role in policy making of these technological foresights. The particular role of institutionalized public foresight in relation to enterprise......Technology and knowledge monitoring is a continual challenge especially for small and medium size enterprises. Technological foresight seemingly offers important parts of this crucial monitoring. The SMEs rarely possess sufficient resources to do systematic foresights, or forecasts however...

Comprehensive Comparison between Empty Nest and Non-Empty Nest Elderly: A Cross-Sectional Study among Rural Populations in Northeast China

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Ye Chang

2016-08-01

Full Text Available This study aimed to comprehensively compare the general characteristics, lifestyles, serum parameters, ultrasonic cardiogram (UCG parameters, depression, quality of life, and various comorbidities between empty nest and non-empty nest elderly among rural populations in northeast China. This analysis was based on our previous study which was conducted from January 2012 to August 2013, using a multistage, stratified, random cluster sampling scheme. The final analyzed sample consisted of 3208 participants aged no less than 60 years, which was further classified into three groups: non-empty nest group, empty nest group (living as a couple, and empty nest group (living alone. More than half of the participants were empty nest elderly (60.5%. There were no significant statistical differences for serum parameters, UCG parameters, lifestyles, dietary pattern, and scores of Patient Health Questionnaire-9 (PHQ-9 and World Health Organization Quality of Life questionnaire, abbreviated version (WHOQOL-BREF among the three groups. Empty nest elderly showed no more risk for comorbidities such as general obesity, abdominal obesity, hyperuricemia, hyperhomocysteinemia, diabetes, dyslipidemia, left atrial enlargement (LAE, and stroke. Our study indicated that empty nest elderly showed no more risk for depression, low quality of life and comorbidities such as general obesity, abdominal obesity, hyperuricemia, hyperhomocysteinemia, diabetes, dyslipidemia, LAE, and stroke among rural populations in northeast China.

Pharmacological Management of Anxiety Disorders in the Elderly

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Crocco, Elizabeth A.; Jaramillo, Sindy; Cruz-Ortiz, Caroline; Camfield, Katherine

2017-01-01

Opinion Statement Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction. Those antidepressants with more favorable pharmacokinetic profiles should be considered first-line in the treatment of anxiety. Mirtazapine and vortioxetine are also considered safe treatment options. Buspirone may have benefit, but lacks studies in elderly populations. Although tricyclic/tetracyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may be effective in the elderly, their side effect and safety profiles are suboptimal and thus are not recommended in late-life. Benzodiazepines and beta blockers should generally be avoided when treating anxiety in the elderly. There is not enough evidence to support the use of antipsychotics or mood stabilizers given their risk of problems in both the long and short term. In addition, antipsychotics have a black box warning for increased mortality in elderly patients with dementia. PMID:28948135

The Crossing Speed of Elderly Pedestrians

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Ana Trpković

2017-04-01

Full Text Available The population of elderly people is rapidly growing and in terms of safety, senior pedestrians represent one of the most vulnerable group. The pedestrian crossing speed is a significant input parameter in traffic engineering, which can have effect on pedestrians’ safety, especially of older population. The objective of this study was to determine the value of the crossing speed of elderly pedestrians (65+ for different types of urban crossings. The research was conducted at ten intersections in the city of Belgrade, Serbia, using the method of direct observation and a questionnaire for collecting data. The data were analysed in the statistical software package IBM SPSS Statistics. The results showed that elderly pedestrians walk slower and the crossing type significantly influenced the speed of older population. The order of crossing types in relation to the measured speed is ranked as follows, from the lowest to the highest speed value: unsignalized, signalized, signalized with pedestrian countdown display, signalized with pedestrian island and pedestrian countdown display and finally signalized crossing with pedestrian island. According to the questionnaire results, the elderly recognize the importance of implementing pedestrian counters. This indicates the necessity to provide safe street crossing for the elderly using the corresponding engineering measures.

Feminisms and Challenges to Institutionalized Philosophy of Religion

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Nathan Eric Dickman

2018-04-01

Full Text Available For my invited contribution to this special issue of Religions on “Feminisms and the Study of ‘Religions,’” I focus on philosophy of religion and contestations over its relevance to the academic field of Religious Studies. I amplify some feminist philosophers’ voices—especially Pamela Sue Anderson—in corroboration with recent calls from Religious Studies scholars to diversify philosophy of religions in the direction of locating it properly within the current state of Religious Studies. I want to do this by thinking through two proposals in productive tension: first, any philosophy of religions worthy of the name is intrinsically feminist; second, any philosophy of religions worthy of the name is intrinsically traditional. I want to use the productive tension between these two to illuminate ways calls for broadening the field can be enhanced when such calls are seen as both feminist and traditional. I proceed as follows. First, I note three instances of explicitly feminist work in philosophy of religions that do not suffer from the same narrowness as so-called “traditional” philosophy of religion. Religious Studies critics of philosophy of religion overstate the case in claiming feminist philosophy of religion is too narrow. Second, I develop a useful distinction between the concepts of “tradition” and “institution” to locate forces of oppression more precisely in dynamics of institutionalization so that we might rehabilitate tradition as a resource for combating institutionalized oppressiveness. I do this in response to the hegemony of current philosophers of religion who claim to speak about “the traditional god.” And third, I briefly coordinate four topics in religions from diverse feminist perspectives to help refine paths of inquiry for future philosophy of religions that is both feminist and traditional. My hope is that these clarify a philosophy of religions renewed through feminisms—moving from fringe to

DeFF programområdet Nye Institutioner

DEFF Research Database (Denmark)

Aggerbeck, Mai

2009-01-01

Tietgenskolen i Odense dannede den 24. oktober 2008 rammen om den workshop Nye Institutioner afholdt som led i udviklingen af en kommunikationsstrategi. Dagens tema var: Tidens udfordringer–nye roller og relationer for bibliotek og uddannelse, og formålet var at kaste lys over følgende spørgsmål...

Examination of validity of fall risk assessment items for screening high fall risk elderly among the healthy community-dwelling Japanese population

OpenAIRE

DEMURA, Shinichi; SATO, Susumu; YAMAJI, Shunsuke; KASUGA, Kosho; NAGASAWA, Yoshinori

2010-01-01

We aimed to examine the validity of fall risk assessment items for the healthy community-dwelling elderly Japanese population. Participants were 1122 healthy elderly individuals aged 60 years and over (380 males and 742 females). The percentage who had experienced a fall was 15.8%. This study used fall experience and 50 fall risk assessment items representing the five risk factors (symptoms of falling, physical function, disease and physical symptom, environment, and behavior and character), ...

A normative study of lexical verbal fluency in an educationally-diverse elderly population.

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Kim, Bong Jo; Lee, Cheol Soon; Oh, Byoung Hoon; Hong, Chang Hyung; Lee, Kang Soo; Son, Sang Joon; Han, Changsu; Park, Moon Ho; Jeong, Hyun-Ghang; Kim, Tae Hui; Park, Joon Hyuk; Kim, Ki Woong

2013-12-01

Lexical fluency tests are frequently used to assess language and executive function in clinical practice. We investigated the influences of age, gender, and education on lexical verbal fluency in an educationally-diverse, elderly Korean population and provided its' normative information. We administered the lexical verbal fluency test (LVFT) to 1676 community-dwelling, cognitively normal subjects aged 60 years or over. In a stepwise linear regression analysis, education (B=0.40, SE=0.02, standardized B=0.506) and age (B=-0.10, SE=0.01, standardized B=-0.15) had significant effects on LVFT scores (p0.05). Education explained 28.5% of the total variance in LVFT scores, which was much larger than the variance explained by age (5.42%). Accordingly, we presented normative data of the LVFT stratified by age (60-69, 70-74, 75-79, and ≥80 years) and education (0-3, 4-6, 7-9, 10-12, and ≥13 years). The LVFT norms should provide clinically useful data for evaluating elderly people and help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy.

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

DEFF Research Database (Denmark)

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

2014-01-01

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

Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country.

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Sinha, Preeti; Yohannan, Sherin; Thirumoorthy, A; Sivakumar, Palanimuthu Thangaraju

2017-08-01

Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn't affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.

THE STUDY OF CLINICO-AETIOLOGICAL PROFILE OF PANCYTOPENIA IN ELDERLY POPULATION

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Vijayashree Thyagaraj

2017-06-01

deficiency. We found that mean MCV was 88 fL (p=0.2 in all these patients. CONCLUSION Vitamin B12 deficiency is the most common cause of pancytopenia in elderly population. Symptoms of vitamin B12 deficiency maybe vague in elderly. High index of suspicion is required for the diagnosis. Mean corpuscular volume may not be raised in all cases. Hence, all patients in geriatric population presenting with must be tested for vitamin B12 deficiency.

Frontiers in the Education of the Elderly.

Science.gov (United States)

Peterson, James A.

Demographic trends indicate a continued population rise among the elderly, suggesting an expanded market for adult education efforts. Early retirement, unemployment due to technological change, as well as the need for older workers to stay current in their fields all point in the direction of education of the elderly. The elderly report great…

Individual and social determinants of self-rated health and well-being in the elderly population of Portugal

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Pedro Alcântara da Silva

2014-11-01

Full Text Available This article aims to identify the main determinants of self-rated health and well-being in the elderly Portuguese population, using a set of dimensions including demographic and socioeconomic indicators, characteristics of interpersonal networks and social activities, health, sexual activity, representations of aging, and feeling of happiness. Taking socioeconomic, behavioral, and attitudinal predictors into account to analyze the explanatory value of the interrelated dimensions and weights for each factor, the author argues that social capital, activities associated with active aging, and greater optimism towards aging can contribute greatly to better self-rated health and wellbeing among the elderly, partially offsetting the effect of socioeconomic factors and illness associated with age.

Falls in institutionalized older adults: risks, consequences and antecedents.

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Araújo, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias Dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

2017-01-01

To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey), Chi-square, Mann Whitney. Statistically significance was p falls occurred, 20% (9) of them in the external area, with 66.7% (30) of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5). The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p risks of falls. Analisar a ocorrência de quedas em idosos institucionalizados quanto aos riscos, consequências e antecedentes. Estudo transversal, realizado com 45 idosos em Instituições de Longa Permanência para Idosos em João Pessoa/PB, Brasil, em junho e julho de 2016. Aplicou-se questionário sociodemográfico e Escala de Equilíbrio de Berg classificando risco de quedas quando escore inferior a 45. Realizou-se estatística descritiva e testes: t independente, Anova (Tukey), Qui-quadrado, Mann Whitney. Considerado significativamente estatístico p < 0,05 e processados no SPSS versão 19.0. As quedas ocorreram em 66,7% (30), sendo 20% (9) na área externa, 66,7% (30) com doença prévia hipertensão e como consequência destacou-se fratura com 11,2% (5). A Escala de Berg avaliou pontuações diferentes (p < 0,05) quando comparadas às quedas sofridas pelos idosos, e as doenças prévias influenciaram ocorrência de quedas (p < 0,05). Necessita-se implementar políticas públicas de financiamento ou parcerias que possibilitem adaptação dos ambientes visando a redução dos riscos de quedas.

Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries.

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Rivera, César; Droguett, Daniel; Arenas-Márquez, María-Jesús

2017-02-01

The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words: Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review.

The quality of life of older people from the influence of religiosity and spirituality: care for the institutionalized elderly in Caetité (BA

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Rosemeire Moreira de Oliveira

2015-02-01

Full Text Available This article illustrates how elderly caretakers from a Long-Term Care Institution (LTCI perform the care of the body, mind and spirit, and how it affects the life quality of the elderly. Emphasizes the importance of a better preparation for the caretakers to deal and supply the needs of these elderly, in order to provide cares involving the body, mind and the spirit. Uses observational research, with a cross-sectional, descriptive and quantitative qualitative approach.  

Psychosocial status and economic dependence for healthcare and nonhealthcare among elderly population in rural coastal Karnataka

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Priyanka Dsouza Rent

2017-01-01

Full Text Available Introduction: The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS among elderly patients. Materials and Methods: The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September–December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent. Results: Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%, whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them. Conclusion: The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.

BARRIERS TO PHYSICAL ACTIVITY IN THE ELDERLY

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Paulo Matias

2015-04-01

Full Text Available The population awareness of the physical exercise’s benefits is widely diffused. These benefits are particularly important in the elderly because, with increasing age, there is a decline of the musculoskeletal system and the maximum oxygen consumption which reduces the functional fitness of the elderly and can often lead to a significant decline in the quality of life. Despite this awareness, a large part of the population remains sedentary. It is important to know what the barriers are, so they can be circumvented in order to increase the engagement of the elderly population in existing physical activity programs.Objectives: This study aims to identify some of the personal, behavioral and environmental barriers that prevent older adults to be physically active.

Optimal Vitamin D Status in a Middle-Aged and Elderly Population Residing in Shanghai, China.

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Aleteng, Qiqige; Zhao, Lin; Lin, Huandong; Xia, Mingfeng; Ma, Hui; Gao, Jian; Pan, Baishen; Gao, Xin

2017-12-19

BACKGROUND The aim of this study was to investigate the optimal vitamin D status in the middle-aged and elderly population residing in Shanghai, China. MATERIAL AND METHODS A total of 1,829 males and postmenopausal females older than 45 years of age in the Changfeng community of Shanghai were included in this study. The optimal vitamin D level was determined according to the suppression of parathyroid hormone (PTH) and the highest bone mineral density (BMD). Locally weighted scatter plot smoothing (LOWESS) was performed to study the correlations of 25(OH)D with PTH and BMD in the lumbar spine and total hip, adjusting for gender, age, weight, use of calcium and vitamin D supplements, eGFR, smoking status, and alcohol consumption. RESULTS The mean serum 25(OH)D concentration was 48.0±19.2 nmol/L for the whole study population. The circulating PTH was maximally suppressed by the serum 25(OH)D of 55 nmol/L in the total population (60 nmol/L for males and 50 nmol/L for females). The 25(OH)D concentrations corresponding to the highest BMD at lumbar spine (L1-L4) and total hip were 53 nmol/L and 75 nmol/L, respectively, for the whole population. These values were also higher in males than females. CONCLUSIONS The optimal 25(OH)D concentration of 55 nmol/L is sufficient to maintain the bone health and metabolic status in middle-aged and elderly individuals living in Shanghai. Males probably need higher vitamin D concentration than females. There are differences between vitamin D status based on lumbar spine BMD and total hip BMD.

Direct costs associated with the appropriateness of hospital stay in elderly population

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Sánchez-García Sergio

2009-08-01

Full Text Available Abstract Background Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. Methods Appropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP. Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS, in Mexico City. Results The sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8 of hospital stay, of which 12.4% (n = 90 were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7. The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89. The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2 – US$4,931.4, while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7 – US$6,198.3, (p Conclusion Elderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.

Lymphocytic hypophysitis in the elderly: A case presentation and review of the literature

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Teresa Brown, DO

2017-06-01

Full Text Available Lymphocytic hypophysitis (LH, an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.

The ED use and non-urgent visits of elderly patients.

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Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

2016-12-01

To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p elderly age groups (p elderly population (17.5%, CI: 17.1-17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

The Role of Visual Communication in the Process of Institutionalization

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Meyer, Renate; Jancsary, Dennis; Boxenbaum, Eva

How does visual communication contribute to the emergence and consolidation of new institutions? Previous research on institutionalization has primarily focused on verbal text and neglected its interaction with visual forms of communication. We propose that a more thorough and systematic engagement...... of unique affordances (i.e., particular opportunities for meaning construction) of visual communication. First, we argue that the visual mode has certain ‘constitutive features’ that enable affordances different from those of verbal text. Second, we systematically discuss a set of affordances of visual...... communication and how it may extend, speed up, or strengthen the effect of verbal communication. Essentially, we argue that visual communication plays a crucial role in shaping the trajectory of institutionalization....

PA5 Elderly population in bangladesh: coping with society in transition.

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Chanda, Sanchoy Kumar; Wara, Kahful; Das, Sankar Narayan

2015-04-01

Bangladesh has a long tradition of looking after the elderly by offspring or family. But rapid socio-economic transformations, changing social values have broken down the traditional extended family system. Many elderly people now stay in old age homes, mainly based in Dhaka, run by non-government organisations or as a charity. This paper explores the scenario of the elderly's reasons for living in old age homes, coping with new environments and satisfaction about old age homes, and to sensitise the policy makers for designing and implementing appropriate programs for the elderly in Bangladesh. Elderly (65+ years) living in two old age homes (n = 56) in Dhaka were interviewed. Reasons for staying in home and satisfaction etc. along with socio-demographic information were collected. Almost all came from better off families, 47% male and 53% female. 68% of men and 36% of women were retired mid and high level officials. Reasons for coming to elderly home were problems with kin (63%) or with children (9%), children living in abroad (5%), no one to take care of them at home (67%), burden on the family (24%), properties occupied by others (27%). Children or relatives visit them (87%). 92% are satisfied with overall management of old age home. Elderly people living in old age homes are mainly from better off urban middle-class and rich families. It does not reflect the real situation of the elderly in the society. The old age home is a new idea or one answer of the elderly in a society in transition. It demands further wide ranged research; however findings reflect the indication of the growing rift between generations. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Asymptomatic bacteriuria among elderly and middle-aged rural community-dwellers in South-Western Nigeria

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Olowe OA

2013-07-01

Full Text Available OA Olowe,1 OB Makanjuola,1 KO Olabiyi,1 PO Akinwusi,2 CO Alebiosu,2 MA Isawumi,3 MB Hassan,3 EO Asekun-Olarinmoye,4 WO Adebimpe,4 TA Adewole5 1Department of Medical Microbiology and Parasitology, 2Department of Medicine, 3Department of Ophthalmology, 4Department of Community Medicine, 5Department of Biochemistry, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria Abstract: Asymptomatic bacteriuria in elderly individuals has been well described in institutionalized settings, but to a lesser extent in the community. The purpose of this study was to determine the pathogens responsible for asymptomatic bacteriuria in elderly and middle-aged individuals in Alajue-Ede, South-Western Nigeria, and to identify any associated factors. Mid-stream urine samples were collected from apparently healthy elderly and middle-aged volunteers who were participating in community health screening. Samples were processed and bacterial isolates were identified following standard procedures. In total, 128 volunteers (48 men, 76 women participated in the study. Twenty-eight (22.6% urinary pathogens were isolated, comprising Klebsiella species in five (17.9%, Pseudomonas aeruginosa in one (3.6%, Escherichia coli in 19 (67.9%, and Proteus species in three (10.7% cases. Women were identified as being at higher risk of asymptomatic bacteriuria, and the prevalence also increased with increasing age in men. The elderly in this community have a high prevalence of asymptomatic bacteriuria, and screening for comorbid medical conditions may be of benefit. Keywords: asymptomatic bacteriuria, urinary pathogens, elderly, urinary tract infection

Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence.

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Collamati, Agnese; Martone, Anna Maria; Poscia, Andrea; Brandi, Vincenzo; Celi, Michela; Marzetti, Emanuele; Cherubini, Antonio; Landi, Francesco

2016-02-01

The use of medication with anticholinergic properties is widespread among older subjects. Many drugs of common use such as antispasmodics, bronchodilators, antiarrhythmics, antihistamines, anti-hypertensive drugs, antiparkinson agents, skeletal muscle relaxants, and psychotropic drugs have been demonstrated to have an anticholinergic activity. The most frequent adverse effects are dry mouth, nausea, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment such as confusion, agitation and coma. A growing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment in the elderly population. However, the morbidity and management issues associated with unwanted anticholinergic activity are underestimated and frequently overlooked. Moreover, their possible relation with specific negative outcome in the elderly population is still not firmly established. The aim of the present review was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older persons. We searched PubMed and Cochrane combining the search terms "anticholinergic", "delirium", "cognitive impairment", "falls", "mortality" and "discontinuation". Medicines with anticholinergic properties may increase the risks of functional and cognitive decline, morbidity, institutionalization and mortality in older people. However, such evidences are still not conclusive probably due to possible confounding factors. In particular, more studies are needed to investigate the effects of discontinuation of drug with anticholinergic properties. Overall, minimizing anticholinergic burden should always be encouraged in clinical practice to improve short-term memory, confusion and delirium, quality of life and daily functioning.

Long-Term Adaptation to Institutionalization in Dementia Caregivers

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Gaugler, Joseph E.; Pot, Anne Margriet; Zarit, Steven H.

2007-01-01

Purpose: Longitudinal research in dementia has acknowledged the importance of transitions during the course of family caregiving. However, long-term adaptation to institutionalization has received little attention. This study attempts to describe caregivers' adaptation (changes in stress, well-being, and psychosocial resources) to placement up to…

Prader-Willi Syndrome in Two Institutionalized Older Adults.

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Goldman, Jeri J.

1988-01-01

Two case reports are presented of institutionalized women who were diagnosed as having Prader-Willi syndrome at the ages of 54 and 69. Implications are discussed for management of such persons and for program planning/funding for a much longer life expectancy than earlier realized. (Author/JDD)

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

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Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

2010-06-01

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

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

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Yaegashi Nobuo

2010-06-01

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

A multicomponent exercise program for institutionalized older adults.

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Justine, Maria; Hamid, Tengku Aizan

2010-10-01

This study examined the effects of a multicomponent exercise program on depression and quality of life in institutionalized older adults. A quasi-experimental pretest-posttest design was used. Participants were recruited from a publicly funded shelter home in Seremban, Negeri Sembilan Malaysia. The experimental group consisted of 23 volunteers 60 or older who performed 60 minutes of supervised exercise three times per week for 12 weeks. The control group consisted of 20 volunteers who continued with a sedentary lifestyle. At 12 weeks, the exercise group demonstrated an improvement in quality of life by 10.74% (p > 0.05) but not depression (-1.6%, p > 0.05). The control group demonstrated a decrease in both quality of life by 11.26% (p > 0.05) and level of depression by 17.7% (p > 0.05). This study suggests a multicomponent exercise program is a feasible intervention to improve quality of life in institutionalized older adults. Copyright 2010, SLACK Incorporated.

Morbidity pattern and health seeking behavior in elderly population of Raipur City, Chhattisgarh, India

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Md. Alam Naushad

2016-09-01

Full Text Available Background: Epidemiological transition across globe is considered as the net result of the demographic transition. The shape of the population pyramid is gradually changing from a wide-based and narrow topped form to a barrel-shaped form in recent future (1. Aims & Objectives: 1. To determine morbidity pattern in elderly population, 2. To assess their health care seeking behavior. Material & Methods: Study design- A Community based cross sectional observational study. Study setting - Pt J.N.M. Medical College, Raipur, Chhattisgarh. Study Duration: July 2013 to June 2014. Sampling method: - Multi stage simple random sampling. Sample size: 640. Sample Size were calculated by using statistical formula, n= Z21-α/2 P(1-P/d. Study tool: Pre-designed, Pre-tested Performa. Ethical consideration-Written document from institutional ethical Committee and Informed Consent from subject. Inclusion criteria: 1. All elderly persons in the age group of 60 years and above who were residing in the study area for at least one year, and willing to Participate in study without compulsion. Exclusion Criteria: 1. Those who were not willing to participate in study. Results & Conclusions: Prevalence of morbidity was 95.31%. Morbidity was positively associated with advancement of age and predominant in females (98.92% and those belong to slum (98.43% and lower (98.14% socio-economic status while inversely associated with Physical activity. Out of total morbid population 70.49% had chronic illness. Most common system involvement was Gastro intestinal system (82.62%. Perception about illness was increased with advancement of age. Majority were seeking therapy from private registered practitioner (35.52%.

Disability and handicap among elderly Singaporeans.

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Yadav, S S

2001-08-01

Singapore's elderly population has been growing rapidly and is expected to constitute more than 25 percent of the total population by the year 2030. The ageing process brings with it a host of health problems. Here the question arises--Are the increasing years of life going to create a high proportion of sick and disabled elderly people, or a rich human resource of healthy senior citizens? Since more women are living longer than men, who would face a higher risk of disability and handicap? These questions are yet to be answered in Singapore. This paper seeks answers to these questions. The study is based on a sample survey of 1209 elderly Singaporeans living in Kampong Glam, Kreta Ayer and Bukit Merah parliamentary constituencies which have some of the highest proportions of the aged population. The results revealed that more than half of the aged had a disability and the rate of disability was significantly higher among the women as compared to the men. More than one-third of the elderly had a handicap and the rate of handicap among the women was twice as much as that among the men. Severity of handicap was directly correlated with age.

Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010-2013 China national nutrition and health survey (CNNHS).

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Chen, Jing; Yun, Chunfeng; He, Yuna; Piao, Jianhua; Yang, Lichen; Yang, Xiaoguang

2017-01-14

Vitamin D inadequacy is common among the elderly, especially within the Asian population. The vitamin D status among healthy adults in the elderly Chinese population was evaluated. A total of 6014 healthy adults aged 60 years or older (2948 men, 3066 women) participated in this descriptive cross-sectional analysis. Possible predictors of vitamin D inadequacy were evaluated via multiple logistic regression analyses. The median serum 25-hydroxyvitamin D (25(OH)D) levels were 61.0 nmol/l (interquartile range (IQR) 44.3-80.6, range 5.1-154.5) for men and 53.7 nmol/l (IQR 38.8-71.0, range 6.0-190.0) for women, with 34.1% (95% confidence interval (CI) 32.4-35.8) of men and 44.0% (95% CI 42.2-45.8) of women presenting vitamin D inadequacy (25(OH)D vitamin D inadequacy was positively correlated with female gender (P vitamin D inadequacy was positively correlated with the spring season (P = 0.0015), low ambient UVB levels (P vitamin D inadequacy was positively correlated with the spring season (P = 0.0005) and low ambient UVB levels (P Vitamin D inadequacy is prevalent among the elderly population in China. Because residing in regions with low ambient UVB levels increases the risk of vitamin D inadequacy both for men and women, vitamin D supplementation and sensible sun exposure should be encouraged, especially during the cooler seasons. Further studies are required to determine the optimal vitamin D intake and sun exposure levels to maintain sufficient vitamin D levels in the elderly Chinese population.

Design of Eco-Smart Homes For Elderly Independent Living

OpenAIRE

Zhang, Yiran; Liu, Xiaohui

2015-01-01

The aging of the world population has increased dramatically during the past century. The rapid increase of elderly population is putting a heavy strain on healthcare and social welfare. Living conditions and service provision for elderly people have thus become an increasingly hot topic worldwide. In this paper, we address this problem by presenting a conceptual model of an integrated and personalized system for an eco-smart home for elderly independent living. This approach was inspired by ...

Elderly Onset Celiac Disease: A Narrative Review

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Maria Cappello

2016-09-01

Full Text Available Celiac sprue is a chronic disease, which usually occurs in children and young adults. However, it can develop in any age group, and the prevalence is increasing even in the elderly population. The atypical patterns of clinical presentation in this age group sometimes can cause a delay in diagnosis. Given the lower sensitivity and specificity of serological tests in the aged population, clinical suspect often arises in the presence of complications (autoimmune disorders, fractures, and finally, malignancy and must be supported by endoscopic and imaging tools. In this review, we highlight the incidence and prevalence of celiac disease in the elderly, the patterns of clinical presentation, diagnosis, and the most frequent complications, with the aim of increasing awareness and reducing the diagnostic delay of celiac disease even in the elderly population.

Relationship between obesity, metabolic syndrome, and nonalcoholic fatty liver disease in the elderly agricultural and fishing population of Taiwan.

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Shen, Hsi-Che; Zhao, Zi-Hao; Hu, Yi-Chun; Chen, Yu-Fen; Tung, Tao-Hsin

2014-01-01

The purpose of this study was to explore the relationship between obesity, the metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) in the elderly agricultural and fishing population of Taipei, Taiwan. The study participants comprised 6,511 (3,971 male and 2,540 female) healthy elderly subjects voluntarily attending a teaching hospital for a physical check-up in 2010. Blood samples and real-time ultrasound-proven fatty liver sonography results were collected. The prevalence of NAFLD in this elderly population was 27.2%, including mild NAFLD (16.0%), moderate NAFLD (10.3%), and severe NAFLD (0.9%). The prevalence of moderate or severe NAFLD for metabolic syndrome proved to be substantially greater (P<0.0001, χ(2) test) for one or two metabolic factors. Using multinomial logistic regression analysis, age, sex, metabolic syndrome, and higher body mass index had a statistically significant association with mild NAFLD. Age, sex, metabolic syndrome, higher body mass index, and higher alanine aminotransferase were significantly related to moderate NAFLD. In addition, higher body mass index, higher uric acid, and higher alanine aminotransferase levels were significantly related to severe NAFLD. The sensitivity and specificity of body mass index and waist circumference as markers of NAFLD were estimated to be 81% and 84%, respectively, and 77% and 69%, respectively. The prevalence of mild or moderate NAFLD was related to obesity and metabolic syndrome. Higher body mass index was also related to severe NAFLD but not to metabolic syndrome. Targeting this population for control of obesity and improved metabolic function is important.

The Effect of Individual Reminiscence Therapy on Self-Esteem and Depression Among Institutionalized Elderly in India.

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Poorneselvan, Catherine; Steefel, Lorraine

2018-04-01

Nurses often elicit patients' stories as a means to an end-for example, getting to know patients better and providing better care or treatments. However, the act of listening in itself can be therapeutic. Through the use of reminiscence therapy (RT), eliciting stories from elderly residents of a nursing home in India improved their sense of well-being. This article describes a study of the use of RT and presents one resident's story.

Travel Patterns and Characteristics of Elderly Subpopulation in New York State

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Hwang, Ho-Ling [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilson, Daniel W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reuscher, Tim [Macrosys, Arlington, VA (United States); Yang, Jianjiang [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Taylor, Rob D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Chin, Shih-Miao [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-03-01

With the increasing demographic shift towards a larger population of elderly (individuals 65 years and older), it is essential for policy makers and planners to have an understanding of transportation issues that affect the elderly. These issues include livability of the community, factors impacting travel behavior and mobility, transportation safety, etc. In this study, Oak Ridge National Laboratory was tasked by the New York State (NYS) Department of Transportation to conduct a detailed examination of travel behaviors, and identify patterns and trends of the elderly within NYS. The National Household Travel Survey (NHTS) was used as the primary data source to analyze subjects and address questions such as: Are there differences in traveler demographics between the elderly population and those of younger age groups who live in various NYS regions; e.g., New York City, other urban areas of NYS, or other parts of the country? How do they compare with the population at large? Are there any regional differences (e.g., urban versus rural)? Gender differences? Do any unique travel characteristics or patterns exist within the elderly group? In addition to analysis of NHTS data, roadway travel safety concerns associated with elderly travelers were also investigated in this study. Specifically, data on accidents involving the elderly (including drivers, passengers, and others) as captured in the Fatal Analysis Reporting System (FARS) database was analyzed to examine elderly driver and elderly pedestrian travel safety issues in NYS. The analyses of these data sets provide a greater understanding of the elderly within NYS and their associated transportation issues. Through this study, various key findings on elderly population size, household characteristics, and travel patterns were produced and are report herein this report.

Dental status, oral prosthesis and chewing ability in an adult and elderly population in southern Brazil.

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Baumgarten, Alexandre; Schmidt, Jeanne Gabriele; Rech, Rafaela Soares; Hilgert, Juliana Balbinot; Goulart, Bárbara Niegia Garcia de

2017-11-01

The objective of this study was to explore the factors associated with inadequate chewing in an adult and elderly population of a city in the southern region of Brazil. This was a cross-sectional study based on a population home-based inquiry (DCH-POP) in southern Brazil. Individuals were interviewed by trained interviewers to create a standardized procedure. In a pilot study, the Questionnaire of Human Communication Disorders (DCH-POP) was created and validated to identify self-reported speech and language, swallowing and hearing disorders. The outcome was dichotomized into either having adequate chewing or not, as assessed by a series of questions about chewing ability. Analyses of absolute and relative frequencies were measured according to the studied variables. A Poisson regression was applied at a significance level of 5%. A total of 1,246 people were interviewed. Inadequate chewing was found in 52 (5.6%) individuals, with a higher prevalence in the elderly (11.8%) than in adults (5.2%). In the final model, the following factors were associated with inadequate chewing: being 61 years of age or older (prevalence ratio or PR=9.03; 95% CI: 1.20-67.91), loss of teeth and use of unadjusted prosthesis (PR=3.50; 95% CI: 1.54-7.95), preference for foods of soft consistency (PR=9.34; 95% CI:4.66-8.70) and difficulty in nasal breathing (PR=2.82; 95% CI: 1.31-6.06). Age, oral health status through dental prosthesis, preference for foods of soft consistency and difficulty breathing through the nose were factors associated with chewing inability in adults and the elderly.

Avaliação nutricional de idosos em uma instituição por diferentes instrumentos Nutritional assessment of institutionalized elderly with different instruments

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Luciana Nabuco Félix

2009-08-01

.OBJECTIVE: The objective of this study was to assess the nutritional risk of institutionalized elderly with different nutritional assessment tools. METHODS: This was a cross-sectional study with 37 seniors aged 60 to 100 year living in a long-stay Institution of the Federal District. The assessment included different anthropometric measurements such as body mass index, arm circumference, calf circumference, waist-to-hip ratio and weight gain, total lymphocyte count and administration of the Mini Nutritional Assessment. RESULTS: Arm circumference revealed that 36.1% of the elderly were undernourished, 16.7% were overweight and obese and 47.2% were normal weight. Body mass index revealed 47.9% to be normal weight, a smaller proportion (27.0% to be underweight and another 27.0% to be overweight. Most of the females (86.4% and the majority of the males (57.1% were at risk of cardiovascular diseases according to their waist circumferences. However, when this same risk was assessed by the waist-to-hip ratio, the proportion of females at risk was significantly higher (95.5%. The percentage of the males at risk according to the same parameter was 42.9%. Immunedepletion was found in 46.7% of the males and 66.7% of the females. The nutritional status determined by the Mini Nutritional Assessment showed that 50.0% of the women and 40.0% of the men were at risk of malnutrition. If nutritional risk was determined by having at least one anthropometric indicator below the normal range, most of the elderly (83.8% were at risk. The Mini Nutritional Assessment showed a similar trend: 75.7% of subjects were at nutritional risk. CONCLUSION: In the institution under study, a significant majority of the elderly of both genders were at nutritional risk according to anthropometric indicators or the Mini Nutritional Assessment.

The Beneficial Effects of Cognitive Training With Simple Calculation and Reading Aloud (SCRA) in the Elderly Postoperative Population: A Pilot Randomized Controlled Trial.

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Kulason, Kay; Nouchi, Rui; Hoshikawa, Yasushi; Noda, Masafumi; Okada, Yoshinori; Kawashima, Ryuta

2018-01-01

Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA) cognitive training in elderly Japanese postsurgical patients. Methods: Elderly patients undergoing non-cardiovascular thoracic surgery under general anesthesia were recruited ( n = 12). Subjects were randomly divided into two groups-one that receives 12 weeks of SCRA intervention, and a waitlisted control group. Before and after the intervention, we measured cognitive function [Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), computerized Cogstate Brief Battery (CBB)] and emotional state [General Health Questionnaire-12 (GHQ-12), Geriatric Depression Scale (GDS), Quality of Life Scale-5 (QOL-5)]. Results: Group difference analyses using ANCOVA with permutation test showed that the intervention SCRA group had a significant improvement in FAB motor programming sub-score, GDS, and QOL-5 compared to the control group. Within-group analyses using Wilcoxon signed-rank test to compare baseline and follow-up showed that the SCRA intervention group total FAB scores, FAB motor programming sub-scores, and QOL-5 scores were significantly improved. Discussion: This pilot study showed that there are important implications for the beneficial effects of SCRA intervention on cognitive function and emotional state in the postoperative elderly population; however, further investigations are necessary to reach any conclusions. Trial registration: This study was registered with

The Beneficial Effects of Cognitive Training With Simple Calculation and Reading Aloud (SCRA in the Elderly Postoperative Population: A Pilot Randomized Controlled Trial

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Kay Kulason

2018-03-01

Full Text Available Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA cognitive training in elderly Japanese postsurgical patients.Methods: Elderly patients undergoing non-cardiovascular thoracic surgery under general anesthesia were recruited (n = 12. Subjects were randomly divided into two groups—one that receives 12 weeks of SCRA intervention, and a waitlisted control group. Before and after the intervention, we measured cognitive function [Mini-Mental Status Exam-Japanese (MMSE-J, Frontal Assessment Battery (FAB, computerized Cogstate Brief Battery (CBB] and emotional state [General Health Questionnaire-12 (GHQ-12, Geriatric Depression Scale (GDS, Quality of Life Scale-5 (QOL-5].Results: Group difference analyses using ANCOVA with permutation test showed that the intervention SCRA group had a significant improvement in FAB motor programming sub-score, GDS, and QOL-5 compared to the control group. Within-group analyses using Wilcoxon signed-rank test to compare baseline and follow-up showed that the SCRA intervention group total FAB scores, FAB motor programming sub-scores, and QOL-5 scores were significantly improved.Discussion: This pilot study showed that there are important implications for the beneficial effects of SCRA intervention on cognitive function and emotional state in the postoperative elderly population; however, further investigations are necessary to reach any conclusions.Trial registration: This study was

Challenges in anaesthesia for elderly

DEFF Research Database (Denmark)

Strøm, Camilla; Rasmussen, L S

2014-01-01

The segment of elderly individuals comprises a growing proportion of the global population. Health care systems and health care providers worldwide need to understand the specific challenges related to treatment of this heterogeneous patient population. The process of ageing is complex and under...... constant influence by numerous factors, for which reason the way human age is extremely individual. It is important to understand and acknowledge how elderly differ from younger adults, and how management needs to be modified and tailored to the individual patient in order to improve outcomes. The goal...... of treatment of an elderly patient is not necessarily to increase human longevity regardless of the consequences, but to increase active longevity free from disability and functional dependence. For older people, deterioration in function can be devastating and is often precipitated by a stressful event...

Prevalence of metabolic syndrome among elderly Mexicans.

Science.gov (United States)

Ortiz-Rodríguez, María Araceli; Yáñez-Velasco, Lucía; Carnevale, Alessandra; Romero-Hidalgo, Sandra; Bernal, Demetrio; Aguilar-Salinas, Carlos; Rojas, Rosalba; Villa, Antonio; Tur, Josep A

2017-11-01

One of the most prevalent chronic diseases among elderly population is the Metabolic Syndrome (MetS). The aim of this study was to assess the prevalence of MetS and associated factors among Mexican elderly people. Cross-sectional survey carried out in Mexico (2007). A random sample (n=516) of the elderly population (≥65years; 277 female, 239 male) was interviewed. Anthropometric and analytical measurements, and a general questionnaire incorporating questions related to socio-demographic and life-style factors were used. MetS definition AHA/NHLBI/IDF was applied. The prevalence of MetS in the elderly (≥65years) was of 72.9% (75.7% men; 70.4% women). Participants with values above MetS cut-off points were 92.4% (hypertension), 77.8% (hypertriglyceridemia), 77.1% (low HDL-cholesterol), 71.1% (hyperglycaemia), and 65.4% (central obesity). People with MetS showed higher values of anthropometric and biochemical variables than those without MetS, except for the height, cholesterol and creatinine. Mid-high education level (9-12 years), no smokers and former smokers, and Central-Western inhabitants of Mexico were associated with MetS components. BMI status was the main determinant of MetS prevalence and MetS components. The reported prevalence of MetS among the elderly Mexican population was higher than those previously obtained in the geographical area, showing a major public health problem in Mexican elders. Copyright © 2017 Elsevier B.V. All rights reserved.

A Model of Active Ageing through Elder Learning: The Elder Academy Network in Hong Kong

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Tam, Maureen

2013-01-01

This article presents the Elder Academy (EA) Network as the policy and practice in promoting active ageing through elder learning in Hong Kong. First, the article examines how the change in demographics and the prevalent trend of an ageing population have propelled the government in Hong Kong to tackle issues and challenges brought about by an…

The process of institutionalization of hygiene: the State, healt and hygiene

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María Teresa Gutiérrez

2010-06-01

Full Text Available This paper seeks to set out the process by which national elites made major efforts to the hygiene apparatus in Colombia a responsibility of the national state. The motivations behind this were a mix of racial, medical and social reasons. During this period, Colombian doctors, thanks to a racial ideology, built a pro-hygiene narrative in which they argued for the importance of institutionalizing the hygiene apparatus. The paper’s analysis is based upon legislation, reports to the National Congress and medical conferences. The sources have been studied from the perspective of discourse analysis. Key words: hygienism, institutionalization, racial theories. I

Equilibrium disorders in elderly: diagnostic classification and differential diagnosis

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Alessandro Castiglione

2013-04-01

Full Text Available Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs and vestibular rehabilitation (physiotherapy and vestibular exercises.

Deepening the Institutionalization of Service-Learning: The Added Value of Assessing the Social Return of Investment

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Stanton-Nichols, Kathleen; Hatcher, Julie; Cecil, Amanda

2015-01-01

Strategies to institutionalize service-learning are well documented (Furco 1996; Holland, 2000). Using Kecskes (2009) Community-Engaged Department Rubric we evaluated service-learning institutionalization within a school at a metropolitan campus. As a result, we propose adding an additional dimension, social return on investment. This added…

Prevalence of sarcopenia in elderly maintenance hemodialysis patients: the impact of different diagnostic criteria.

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Lamarca, F; Carrero, J J; Rodrigues, J C D; Bigogno, F G; Fetter, R L; Avesani, C M

2014-07-01

The prevalence of sarcopenia on elderly maintenance hemodialysis (MHD) has been scarcely investigated. To investigate the prevalence of decreased muscle mass and strength alone or combined (true sarcopenia) in elderly patients on MHD according to different methods and cutoff limits. Additionally, we evaluated the agreement between dual energy x-ray absorptiometry (DXA) and surrogate methods for the assessment of muscle mass. Observational and cross-sectional study. Non-institutionalized 102 elderly (age > 60 years) patients on MHD. Sarcopenia was considered when the patient fit one criteria for low muscle mass assessed by DXA, bioelectrical impedance (BIA), sum of skinfold thicknesses (SKF), calf circumference and mid-arm muscle circumference (MAMC) and one for low muscle strength evaluated by handgrip dynamometer. Decreased muscle strength was found in 85% of the patients. The prevalence of decreased muscle mass varied from 4 to 73.5% and of sarcopenia (decreased muscle mass and strength combined) from 4 to 63%, depending on the method and cutoff limit applied. A small percentage of patients (2 to 15%) were classified as sarcopenic by more than one diagnostic criteria. The agreement between DXA and the surrogate methods to assess muscle mass showed better kappa coefficients with BIA (r=0.36; Psarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study

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Lilian Varanda Pereira

2014-08-01

Full Text Available OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status.METHOD: cross-sectional study with a populational sample (n=934, conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more was measured using a numerical scale (0-10 and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor. For the statistical analysis, the absolute frequency and percentage, CI (95%, Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%.RESULTS: The prevalence of chronic pain was 52.8% [CI (95%:49.4-56.1]; most frequently located in the lower limbs (34.5% and lumbar region (29.5%; with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001 a worse self-perception of health (OR=4.2:2.5-7.0, a greater number of chronic diseases (OR=1.8:1.2-2.7, joint disease (OR=3.5:2.4-5.1 and the female gender (OR=2.3:1.7-3.0. A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001.CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population.

Trail Making Test: normative data for Turkish elderly population by age, sex and education.

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Cangoz, Banu; Karakoc, Ebru; Selekler, Kaynak

2009-08-15

Trail Making Test (TMT) is a neuropsychological test, which has parts A and B that can precisely measure executive functions, like complex visual-motor conceptual screening, planning, organization, abstract thinking and response inhibition. The main purpose of this study is to standardize TMT for Turkish adults and/or elderly population. This study primarily consists of two main parts; norm determination study and reliability/validity studies, respectively. The standardization study was carried on 484 participants (238 female and 246 male). Participants at the age of 50 years and older were selected from a pool of people employed in or retired from governmental and/or private institutions. The research design of this study involves the following variables mainly; age (7 subgroups), sex (2 subgroups) and education (3 subgroups). Age, sex and education variables have significant influence on eight different kinds of TMT scores. Statistical analysis by ANOVA revealed a major effect of age (pKruskal-Wallis Test was performed and chi-square (chi(2)) values revealed that, correction scores for Part A and B were found to be influenced by age groups (pTest-retest reliability and inter-rater reliability coefficients for time scores of Parts A and B were estimated as 0.78, 0.99 and 0.73, 0.93, respectively. This study provides normative data for a psychometric tool that reliably measures the executive functions in Turkish elderly population at the age of 50 and over.

What are key factors influencing malnutrition screening in community-dwelling elderly populations by general practitioners? A large cross-sectional survey in two areas of France.

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Gaboreau, Y; Imbert, P; Jacquet, J-P; Marchand, O; Couturier, P; Gavazzi, G

2013-11-01

Malnutrition is associated with a high morbi-mortality in elderly populations and their institutionalization at an early stage. The incidence is well known despite being often under-diagnosed in primary care. General practitioners (GPs) have a key role in home care. What are the factors affecting malnutrition-screening implementation by French GPs? We conducted a cross-sectional survey in two areas in the southeast of France (Savoie and Isère). In May 2008, an anonymized survey was sent by e-mail and/or post to all GPs with a large clinical practice. Two months later, reminder letters were sent. Potential barriers were measured by dichotomous scale. On GPs' characteristics (socio-demographic, medical training, geriatric practice and knowledge), multiple regression logistic was performed to identify others factors affecting malnutrition screening. In all, 493 GPs (26.85%) answered and 72.2% felt that malnutrition screening was useful although only 26.6% implemented it each year and 11.9% every 2-5 years. The main barriers to the implementation were patient selection (60.4%) and forgetting to screen (26.6%). Minor barriers were lack of knowledge (19.5%) or time (15%). New factors were identified: unsuitable working conditions (19.1%), insufficient motivation (6.8%) or technical support (7.2%). The quality of malnutrition information received was found to be the only promoter of annual screening (odds ratio=1.44 (1.087-1.919); P=0.011). This survey is the first in France to reveal GPs' factors affecting malnutrition implementation. New obstacles were identified in this survey. The hope of implementing regular malnutrition screening by GPs seems to lie with the quality of malnutrition information received.

Cultural challenges to oral healthcare implementation in elders.

Science.gov (United States)

Lo, Edward C M; Tan, Hai P

2014-02-01

For successful implementation of oral healthcare services for elders, there is a need to understand and respond to their oral health beliefs, perceived needs and preferred type of care services, all of which are shaped by their cultural beliefs and values. This poses challenges to oral healthcare providers, especially when serving a diverse elderly population with people coming from different cultural backgrounds. The general principles of oral healthcare provision and their adaptation to serve culturally diverse elderly populations are discussed. The oral health beliefs and behaviours of Chinese, an ethnic group that can be found in many countries across the world, are highlighted and used as examples. Chinese elders generally attach a higher value to the physical functions than to the appearance of their dentition and prefer to use traditional self-care methods to deal with their oral health problems rather than to seek professional services. There is need to incorporate into the training of oral healthcare providers the competence to adapt their services to the beliefs and practices of culturally diverse elderly population groups in different settings. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Ageing and Non-Formal Care for Elderly Persons in Croatia

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Sonja Podgorelec

2007-06-01

Full Text Available Ageing and depopulation are the fundamental demographic processes in the development of the population of Croatia. In the total population in 2001 the age group encompassing persons 65 years of age and older made up 15.7% of the total population. The age structure of the population is one of the essential determinants of the quality of lives of individuals, especially within the family. Based on an analysis of demographic indicators (the population structure, the ratio of females, the ageing index, the age coefficient, average age, age-dependency ratios, marital status, and a brief review of migration history in the second half of the 20th century, the goal of this paper is to evaluate the quality of non-formal care of the elderly in relation to potential care providers. Due to ageing in the total population of Croatia, due to a reduction in the number of children per family and separate residences of adult children and their elderly parents, the circle of main care providers for the elderly has diminished. With the decrease in the number of family members, increasingly frequent forms of single-parent families and the employment of women, who were traditionally the most important providers of all forms of non-formal care, insufficient care for the elderly within families has become a problem. Despite changes in the way of life, the family is still the basic source of emotional, informational and instrumental support for elderly people. The help and support that the elderly receive from friends is roughly equal in the city and in villages, although neighbourly help is somewhat greater in non-urban areas (for example in Istria and on the islands. However, researches confirm that the social network of support and help among the rural population has changed since the nineties of the last century. To a certain extent the support of friends and neighbours may substitute the lack of care by children, but a weaker network of homes for the elderly and

Durability of Effects of Group Counseling with Institutionalized Delinquent Females

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Redfering, David L.

1973-01-01

The current study is a one-year follow-up of an earlier report that group counseling with institutionalized delinquent females resulted in significant gains in the connotative meanings of several concepts. (Author)

Process of Institutionalization of Azerbaijan-Israeli Relations

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E A Yakimova

2014-12-01

Full Text Available The article dwells upon the process of formation and work peculiarities of the key structures of the Azerbaijani-Israeli cooperation. The author pinpoints achievements in the institutionalization of economic contacts, the main of which is the creation of a bilateral chamber of commerce. However the interaction potential is not fully exploited due to the absence of the Azerbaijani embassy in Israel.

[Dietary approach to improving the nutritional status in institutionalized elderly hemodialysis patients with a poor dietary intake: a single-arm pilot study].

Science.gov (United States)

Yamashita, Makiko; Komatsu, Rieko; Maruyama, Yuko; Takaki, Tomoyuki; Ichinose, Hiroshi; Sasaki, Osamu; Sawase, Kenji; Harada, Takashi; Funakoshi, Satoshi

2018-01-01

The hemodialysis (HD) diet, which is a high-calorie and high-fat regimen, may inadvertently lead to an inadequate dietary intake, resulting in undernutrition among elderly HD patients. Therefore, an attempt was made to improve the dietary intake by implementing a modified diet regimen in eligible elderly HD patients. Elderly HD patients who had ingested nutritional index [GNRI], 83.5±8.3; normalized protein catabolic ratio [nPCR], 0.78±0.14). The modified diet regimen, which involved reducing food portion sizes and incorporating a liquid diet, led to a significant increase in their dietary intake from 48.1% at baseline to 97.1% of the meals provided 3 months after the start of the modified HD diet regimen. Their GNRI also significantly increased from 83.5±8.3 to 86.1±10.2, and their serum albumin levels significantly increased from 3.2±0.2 g/dL to 3.4±0.4 g/dL, suggesting improvements in their nutritional status. The attempted dietary approach for elderly HD patients was shown to potentially increase their dietary intake and improve their nutritional status without affecting the efficiency of HD being implemented.

[Consumption of nutrients among the elderly living in Porto Alegre in the State of Rio Grande do Sul, Brazil: a population-based study].

Science.gov (United States)

Venturini, Carina Duarte; Engroff, Paula; Sgnaolin, Vanessa; El Kik, Raquel Milani; Morrone, Fernanda Bueno; da Silva Filho, Irenio Gomes; De Carli, Geraldo Attilio

2015-12-01

A cross-sectional, population-based study was conducted on a random sample of 427 elderly individuals living in Porto Alegre, Brazil, to establish the nutrient consumption profile and verify its association with sociodemographic and health variables. Dietary intake was assessed using the 24-hour Food Recall Survey and the Dietetic Research Investigation technique. Seventy percent of the elderly respondents were women: 48.5% were between 60 and 69 years old; 68.8% had less than 8 years of schooling; 39% had a family income of between 2 and 5 minimum wages and 58.4% took no physical exercise. Hypertension was the most prevalent disease among the elderly and 54.9% were underweight. Men consumed more calories, protein, fiber, minerals and vitamins than women. Carbohydrate and calcium intake increases with advancing age, while zinc intake decreases. Physical exercise increased the intake of calories, magnesium, potassium and phosphorus. The higher the schooling the greater the intake of vitamins B6 and B12; the higher the family income, the greater the consumption of vitamin B6 and folic acid. The results show that there are nutritional deficiencies in the daily diet of the Brazilian elderly population, especially among women and individuals over 80 years of age.

Erythrocyte seditnentation rate in elderly blacks

African Journals Online (AJOL)

Abstract This study inv~tigated the erythrocyte sedimen- tation rate (ESR) in an elderly population with the objective of establishing reference ranges and the diagnostic value of the ESR. Elderly blacks were randomly selected frOIn conununities in the. Orange Free State. ESR determinations were done according to the ...

Bangladesh. Population education programme reviewed.

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1995-01-01

The UNFPA (UN Population Fund)-funded population education program was reviewed last November 1994 in order to identify the emerging needs and requirements as well as chart the future directions of the program. The review was undertaken with the assistance of the CST SAWA Adviser on Population Education, Dr. D.M. de Rebello. Comprehensive literature review, and intensive discussions with government functionaries, educationists, teachers, students, UNFPA country director and staff and concerned officials of the World Bank and other UN agencies involved in the program served as the modalities for the review. The review looked into the current status of the school education sector and assessed the present progress of the population education program vis-a-vis its objectives and achievements. It also analyzed the issues and constraints in relation to institutionalization of the program, capacity building and integration of population education in curriculum and textbooks. Among the many recommendations, the review proposed further building up of national capacities at various levels; development of teaching/learning materials and textbooks for the new sectors; and intensification of good quality teacher education. Institutionalization of population education in the formal school system up to grade 12 and in technical and vocational education as well as the madrasah system and the introduction of population education in the Mass Non-formal Education Program were also proposed. full text

Falls in long-term care institutions for elderly people: protocol validation.

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Baixinho, Cristina Rosa Soares Lavareda; Dixe, Maria Dos Anjos Coelho Rodrigues; Henriques, Maria Adriana Pereira

2017-01-01

To validate the content of a fall management risk protocol in long-term institutions for elderly people. Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defined inclusion criteria. The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item. The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people. Validar o conteúdo de um protocolo para a gestão do risco de queda em Instituições de Longa Permanência para Idosos. Estudo metodológico, de abordagem quantiqualitativa, utilizando a técnica de Delphi. O instrumento, construído com base na literatura, foi enviado por via electrónica, para obter consenso entre os 14 peritos que respeitam os critérios de inclusão definidos. Os 27 indicadores do protocolo estão organizados em três dimensões: Preparar a Institucionalização (IRA=,88); Gerir o Risco de Queda ao longo da Institucionalização (IRA=,9) e Liderar a comunicação e formação (IRA=1), com um CVI=,91. Foram efetuadas duas rodadas para se obter consenso superior a 80% em todos os itens. Os valores obtidos no teste de fidedignidade (>0,8) atestam que o protocolo pode ser utilizado para atingir o fim que se pretende. A próxima etapa é a validação clínica do protocolo com idosos residentes em Instituições de Longa Permanência para Idosos.

Difference in the relation between daily mortality and air pollution among elderly and all-ages populations in southwestern France

International Nuclear Information System (INIS)

Filleul, Laurent; Le Tertre, A.L.; Baldi, Isabelle; Tessier, J.-F.

2004-01-01

Numerous time series studies around the world have reported an association between mortality and particulate air pollution. We investigated the distribution over time of effect of air pollution on short-term mortality among subjects aged 65 years and older and of all ages in Bordeaux, France. Statistical analysis was based on generalized additive models using either loess or penalized spline smoothing. Our study found a significant positive association between air pollution and all nonaccidental mortality and specific mortality in both group of population (all ages and elderly) with a greater effect among the elderly, particularly for respiratory mortality. For this case, we observed a greater effect according to distributed lag models (0-5 days) among the elderly, with an estimated increase of 9.2% in the daily number of deaths for 10 μg/m 3 of daily black smoke [95% CI, 3.4-15.3]. These results contribute to the efforts made to understand how air pollution promotes adverse health effects and to identify susceptible subgroups

Alterações na funcionalidade/cognição e depressão em idosos institucionalizados que sofreram quedas Alteraciones en la funcionalidad/cognición y depresión en ancianos institucionalizados que sufrieron caídas Changes in function/cognition and depression in institutionalized elderly who have suffered falls

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Rafaela Vivian Valcarenghi

2011-01-01

sugestivo para déficit cognitivo, diez sufrieron caídas. No hubo influencia significativa entre depresión y caídas en los investigados. CONCLUSIÓN: Se verificó la importancia de determinarse la influencia de alteraciones funcionales/cognitivas y la presencia de depresión, en episodios de caídas em los ancianos institucionalizados.OBJETIVE: To analyze the influence of changes in function/cognition and the presence of depression in institutionalized elderly who have suffered falls, in order to prevent these accidents. METHODS: Quantitative exploratory and descriptive research, conducted with 30 elderly individuals in Rio Grande do Sul (Brazil, using five data collection instruments. The analysis was conducted using SPSS 13.0. RESULTS: We found that: the majority were women; had low levels of education; the risk of falls increased with age; older people with less time in an institution had fallen more. We identified the influence of medication use on falls. In relation to functional capacity, the elderly who had fallen, had independence for activities of daily living; of 20 elderly with scores suggestive of cognitive impairment, ten suffered falls. There was no significant influence between depression and falls in our investigation. CONCLUSION: Results show the importance of determining the influence of functional / cognitive changes and the presence of depression, and in episodes of falls in institutionalized elderly.