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Sample records for frail elderly persons

  1. Dietary supplements and physical exercise affecting bone and body composition in frail elderly persons

    NARCIS (Netherlands)

    Jong, de N.; Chin A Paw, M.; Groot, de C.P.G.M.; Hiddink, G.J.; Staveren, van W.A.

    2000-01-01

    This study determined the effect of enriched foods and all-around physical exercise on bone and body composition in frail elderly persons. Methods. A 17-week randomized, controlled intervention trial, following a 2 x 2 factorial design—(1) enriched foods, (2) exercise, (3) both, or (4) neither— was

  2. Urinary incontinence in frail elderly persons: Report from the 5th International Consultation on Incontinence.

    Science.gov (United States)

    Wagg, Adrian; Gibson, William; Ostaszkiewicz, Joan; Johnson, Theodore; Markland, Alayne; Palmer, Mary H; Kuchel, George; Szonyi, George; Kirschner-Hermanns, Ruth

    2015-06-01

    Evidence based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management. To update the recommendations of the 4th ICI. A series of systematic reviews and evidence updates were performed by members of the working group in order to update the 2009 recommendations. The resulting guidelines were presented at the 2012 meeting of the European Associatioon of Urology. Along with the revision of the treatment algorithm and accompanying text. There have been significant advances in several areas including pharmacological treatment of overactive bladder. The committee continue to notes the relative paucity of data concerning frail older persons and draw attention to knowledge gaps in this area. © 2014 Wiley Periodicals, Inc.

  3. Art therapy with the frail elderly.

    Science.gov (United States)

    Callanan, B O

    1994-01-01

    The use of art engages frail oder persons in a unique way. Art therapists recognize the creative source in the elderly and strive to involve them in the creative process. The art therapist combines the media of the visual artist with assistance in art skills to enable the older person to make meaningful expressions of emotion despite deteriorating functional ability. Supportive and therapeutic art interventions augment the skills and assets that many older persons retain. Effective art therapy sessions may be brought to older persons in their homes or in the day programs they attend. Through art therapy, the frail elderly learn new ways to express and interpret life situations, to communicate perspectives and respond to the difficulties before them.

  4. Barium enema in frail elderly patients.

    Science.gov (United States)

    Segal, R; Khahil, A; Leibovitz, A; Gil, I; Annuar, M; Habot, B

    2000-01-01

    Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients. The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients. Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed. One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient's functional status (p < 0.001) and the presence of dementia (p < 0.001). The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly. Copyright 2000 S. Karger AG, Basel

  5. Oral health in frail elderly

    NARCIS (Netherlands)

    Hoeksema, Albert

    2016-01-01

    Ageing points towards increasing health problems and rising costs for the society. One of these health problems is the deteriorating oral health in care dependent elderly. The latter is related to the high need for care on many levels in these elderly. The lack of attention for oral care can be

  6. [An oral function improvement program utilizing health behavior theories ameliorates oral functions and oral hygienic conditions of pre-frail elderly persons].

    Science.gov (United States)

    Sakaguchi, Hideo

    2014-06-01

    Oral function improvement programs utilizing health behavior theories are considered to be effective in preventing the need for long-term social care. In the present study, an oral function improvement program based upon health behavior theories was designed, and its utility was assessed in 102 pre-frail elderly persons (33 males, 69 females, mean age: 76.9 +/- 5.7) considered to be in potential need of long-term social care and attending a long-term care prevention class in Sayama City, Saitama Prefecture, Japan. The degree of improvement in oral functions (7 items) and oral hygienic conditions (3 items) was assessed by comparing oral health before and after participation in the program. The results showed statistically significant improvements in the following oral functions: (1) lip functions (oral diadochokinesis, measured by the regularity of the repetition of the syllable "Pa"), (2) tongue functions, (3) tongue root motor skills (oral diadochokinesis, measured by the regularity of the repetition of the syllables "Ta" and "Ka"), (4) tongue extension/retraction, (5) side-to-side tongue movement functions, (6) cheek motor skills, and (7) repetitive saliva swallowing test (RSST). The following measures of oral hygiene also showed a statistically significant improvement: (1) debris on dentures or teeth, (2) coated tongue, and (3) frequency of oral cleaning. These findings demonstrated that an improvement program informed by health behavior theories is useful in improving oral functions and oral hygiene conditions.

  7. The golden opportunities for physiotherapists in frail elderly

    NARCIS (Netherlands)

    Hobbelen, Hans

    2018-01-01

    Frailty is a complex phenomenon which is a result of a decline in reserve capacity. Although it is generally known that movement has a positive influence on a diversity of health outcomes in relatively healthy elderly, the effect on frail elderly is less known. Key elements in the clinical

  8. Preoperative therapeutic exercise in frail elderly scheduled for total hip replacement: A randomized pilot trial

    NARCIS (Netherlands)

    Hoogeboom, T.J.; Dronkers, J.J.; Ende, C.H.M. van den; Oosting, E.; Meeteren, N.L.U. van

    2010-01-01

    Objective: To evaluate the feasibility and preliminary effectiveness of therapeutic exercise before total hip replacement in frail elderly. Design: A single-blind, randomized clinical pilot trial. Setting: Outpatient physiotherapy department. Subjects: Frail elderly with hip osteoarthritis awaiting

  9.  A CROSS-SECTIONAL STUDY OF ORAL HEALTH AND ORAL-HEALTH-RELATED QUALITY OF LIFE AMONG FRAIL ELDERLY PERSONS ON ADMISSION TO A SPECIAL ORAL-HEALTHCARE PROGRAM IN COPENHAGEN CITY,

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Borge; Nielsen, Ellen

    2012-01-01

    A cross-sectional study of oral health and oral health-related quality of life among frail elderly persons on admission to a special oral health care programme in Copenhagen City, Denmark Aim: To describe the oral health and the oral-health-related quality of life (OHRQoL) of citizens in Copenhagen...... City on admission to a specific oral health-care programme for disabled elderly persons. Further, to analyse how various factors influence the oral health and the OHRQoL among these patients. Methods: A cross-sectional study of 189 persons (average 85 years) consecutively admitted to a special oral...... health-care programme. Clinical data and data from interviews comprising social factors, life-style, dental visit habits, oral hygiene practices and self-perceived oral health were collected. A modified index on perceived dysfunction, discomfort and disability due to oral disorders was used. Results...

  10. Relation between functional mobility and dynapenia in institutionalized frail elderly

    OpenAIRE

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

    2017-01-01

    ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods 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 (sho...

  11. Relation between functional mobility and dynapenia in institutionalized frail elderly

    OpenAIRE

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

    2017-01-01

    ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods 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 ...

  12. Handgrip strength and physical activity in frail elderly

    Directory of Open Access Journals (Sweden)

    Maria Helena Lenardt

    2016-02-01

    Full Text Available Abstract OBJECTIVE To investigate the association between handgrip strength (HS and physical activity in physical frailty elderly. METHOD Cross-sectional quantitative study with a sample of 203 elderly calculated based on the population estimated proportion. Tests were applied to detect cognitive impairment and assessment of physical frailty. Descriptive statistics and multivariate analysis by binary logistic regression were used, and also Student's t-test and Fisher's exact test. RESULTS A total of 99 (64.3% elderly showed decreased handgrip strength and 90 (58.4% elderly presented decrease in physical activity levels. There was a statistically significant difference between these two components (p=0.019, in which elderly who have decreased HS have lower levels of physical activity. For low levels of physical activity and decreased HS, there was no evidence of significant difference in the probability of the classification as frail elderly (p<0.001. CONCLUSION The components handgrip strength and physical activity are associated with the frail elderly. The joint presence of low levels of physical activity and decreased handgrip strength leads to a significantly higher probability of the elderly to be categorized as frailty.

  13. Needs of frail elderly people in informal settlements

    Directory of Open Access Journals (Sweden)

    P du Rand

    2001-09-01

    Full Text Available The frail elderly in informal settlements find themselves in an extremely vulnerable position due to a number of factors, namely, their increasing dependency status, limited resources and adverse physical environment. Various aspects that influence the aged in their present environment will be highlighted. A survey method was used to explore and to describe the world in which they live in informal areas. The attitude, expectation and needs of the elderly in respect of their care was also determined. A random cluster sample was taken. Data was collected by means of interviews in terms of a semi-structured questionnaire. It appears that the frail elderly were happy in the environment in which they received care in spite of their unfavourable physical environment and limited resources. The communities where the frail elderly lived were largely unaware of the valuable inputs they can make regarding the care of the aged. This necessitates the development of programs in the heart of communities, owned by communities, where all role players in the care of the aged participate.

  14. [Nutrition and frail elderly at risk].

    Science.gov (United States)

    Barrière-Arnoux, Cécile

    2015-01-01

    Good health for elderly people depends on some extent on their nutritional status. During the completion of a master's degree in nursing sciences, a study highlighted the need to develop measuring tools for screening for undernutrition in the elderly in community nursing practice. A programme for raising awareness of the consequences of undernutrition in elderly people is an area to develop through broader frailty screening in primary care.

  15. [Physical exercise in the frail elderly: an update].

    Science.gov (United States)

    Casas Herrero, Álvaro; Cadore, Eduardo L; Martínez Velilla, Nicolás; Izquierdo Redin, Mikel

    2015-01-01

    Frailty is a state of vulnerability that involves an increased risk of adverse events and disability in older adults. It is a condition with a complex etiology and pathophysiology. Skeletal muscle power decreases earlier than muscle strength with advancing age and is more strongly associated with functional capacity than muscle strength in frail elderly populations. Multicomponent exercise programs, and especially resistance exercise that includes muscle power training, are currently the most relevant interventions to slow down disability and other adverse outcomes, even in the oldest-old. Moreover, these programs are valuable interventions in other frailty domains, such as falls and cognitive decline. Physical exercise, in the frail elderly, should be prescribed with a progressive individualized plan and just like other medical treatments. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  16. Relation between functional mobility and dynapenia in institutionalized frail elderly.

    Science.gov (United States)

    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.

  17. Evaluating an integrated neighbourhood approach to improve well-being of frail elderly in a Dutch community: a study protocol

    Directory of Open Access Journals (Sweden)

    Cramm Jane M

    2011-12-01

    Full Text Available Abstract Background An important condition for independent living is having a well-functioning social network to provide support. An Integrated Neighbourhood Approach (INA creates a supportive environment for the frail elderly, offering them tailored care in their local context that allows them to improve self-management abilities and well-being. The purpose of our research is to investigate how an INA can contribute to outcomes of frail elderly and the cost-effectiveness of such a program. The first central study question is: To what extent does INA contribute to (a continuous, demand-driven, coordinated care and support for the independently- living frail elderly; (b improvement of their well-being and self-management abilities; and (c reinforcement of their neighbourhood networks. The second central research question is: is the INA a cost-effective method to support the frail, independently- living elderly? Methods We investigate a Dutch INA. This transition experiment aims to facilitate the independently-living frail elderly (70+ to live the life they wish to live and improve their well-being. The study population consists of independently-living frail elderly persons in Rotterdam. The transition experiment starts in two Rotterdam districts and is later extended to two other districts. We propose a concurrent mixed methods design, that is, a combination of qualitative and quantitative research methods to evaluate processes, effects and costs of INA. Such a design will provide insight into an on-going INA and demonstrate which of its elements are potentially (cost-effective for the frail elderly. Discussion We embrace a wide range of scientific methodologies to evaluate the INA project and obtain information on mechanisms and contexts that will be valuable for decision making on local and national levels. The study will lead to a better understanding of how to provide support via social networks for the frail elderly and add to the knowledge

  18. Orthostatic Hypotension and Mortality in Elderly Frail Patients

    Science.gov (United States)

    Freud, Tamar; Punchik, Boris; Yan, Press

    2015-01-01

    Abstract Orthostatic hypotension (OH) is a common problem in the elderly age group, and some studies have reported an association between OH and increased mortality. We evaluated possible associations between OH and mortality in a retrospective study of frail elderly patients who came for a comprehensive geriatric assessment. The study included all patients ≥65 years who were assessed in the outpatient Comprehensive Geriatric Assessment Unit. Data were collected from the computerized medical record, including blood pressure, sociodemographic data, lifestyle, falls, pulse rate, body mass index, functional and cognitive status, and comorbidity. Data on mortlaity were also collected. The study population consisted of 571 patients who underwent assessment over a 9-year study period. The mean age was 83.7 ± 6.1, 35.9% were males, and 183 (32.1%) were diagnosed with OH. Systolic OH (OHS) was more common than diastolic OH (25.2% vs 15.6%). In univariate analyses, OHS was associated with increased overall mortality. Over the follow-up period, 30.2% of the OHS patients died compared with 22.3% (P = 0.037), but in the Cox models there was no statistically significant associations between OHS and overall mortality. In contrast, age, burden of comorbidity, a low high-density lipoprotein level, and low creatinine clearance were independent predictors of increased overall mortality. In a population of frail elderly patients with a high burden of comorbidity, OH was not an independent risk factor for overall mortality. PMID:26091470

  19. Effect of Probiotic Bacteria on Oral Candida in Frail Elderly

    DEFF Research Database (Denmark)

    Kraft-Bodi, E; Jørgensen, M R; Keller, M K

    2015-01-01

    The aim of this study was to investigate the effect of a daily intake of probiotic lactobacilli on the prevalence and counts of oral Candida in frail elderly patients living in nursing homes. The study had a double-blind randomized placebo-controlled design with 2 parallel arms. The study group...... consisted of 215 older adults (range, 60 to 102 y) who were enrolled after informed consent. After baseline examination and randomization, the subjects were given 1 lozenge containing 2 strains of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo twice daily (morning...... balanced at baseline. The attrition rate to follow-up was 19%. There was a statistically significant reduction in the prevalence of high Candida counts in the probiotic group but not in the placebo group, and the difference was statistically significant in both saliva and plaque (P

  20. Pharmacotherapy in frail elderly : pharmacy data as a tool for improvement

    NARCIS (Netherlands)

    Dijk, Karen Nanette van

    2002-01-01

    This thesis focuses on drug use in the elderly, in particular those residing in Dutch nursing homes: the frail elderly. These elderly are especially prone to drug-related problems because of their age, frequently occurring co-morbidity and polypharmacy. Relatively little is known of drug use and

  1. Bowel preparation in CT colonography: electrolyte and renal function disturbances in the frail and elderly patient.

    LENUS (Irish Health Repository)

    Mc Laughlin, Patrick

    2010-03-01

    Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients.

  2. Limited-preparation CT colonography in frail elderly patients: a feasibility study.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2010-05-01

    Full colonic preparation can be onerous and may be poorly tolerated in frail elderly patients. The purpose of this study was to prospectively assess the image quality and diagnostic yield of limited-preparation CT colonography (CTC) in elderly patients with suspected colorectal cancer who were deemed medically unfit or unsuitable for colonoscopy.

  3. Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people

    NARCIS (Netherlands)

    Tieland, C.A.B.; Brouwer, E.M.; Nienaber-Rousseau, C.; Loon, van L.J.C.; Groot, de C.P.G.M.

    2013-01-01

    Background/Objectives: Serum 25-hydroxyvitamin D (25(OH)D) status has been associated with muscle mass, strength and physical performance in healthy elderly people. Yet, in pre-frail and frail elderly people this association has not been studied. The objective of this study was to explore the

  4. Content validation of the Tilburg Frailty Indicator from the perspective of frail elderly

    DEFF Research Database (Denmark)

    Andreasen, Jane; Lund, Hans; Aadahl, Mette

    2015-01-01

    validation. AIM: To validate the Tilburg Frailty Indicator on content in relation to the physical, psychological and social domain by exploring the experience of daily life of community dwelling frail elderly. METHODS: The design was a qualitative content validation study. The participants were acutely...... admitted frail elderly discharged to home and interviewed one week after discharge. A deductive content analysis, with categories structured in advance, was performed. RESULTS: A total of 422 meaning units were extracted from the transcriptions; 131 units related to the physical domain, 106 units...

  5. Influence of fall related factors and bone strength on fracture risk in the frail elderly.

    Science.gov (United States)

    Sambrook, P N; Cameron, I D; Chen, J S; Cumming, R G; Lord, S R; March, L M; Schwarz, J; Seibel, M J; Simpson, J M

    2007-05-01

    When subjects are selected on the basis of fall risk alone, therapies for osteoporosis have not been effective. In a prospective study of elderly subjects at high risk of falls, we investigated the influence of bone strength and fall risk on fracture. At baseline we assessed calcaneal bone ultrasound attenuation (BUA) as well as quantitative measures of fall risk in 2005 subjects in residential care. Incident falls and fractures were recorded (median follow-up 705 days). A total of 6646 fall events and 375 low trauma fracture events occurred. The fall rate was 214 per 100 person years and the fracture rate 12.1 per 100 person years. 82% of the fractures could be attributed to falls. Although fracture rates increased with decreasing BUA (incidence rate ratio 1.94 for lowest vs. highest BUA tertile, pfalls also affected fracture incidence. Subjects who fell frequently (>3.15 falls/per person year) were 3.35 times more likely to suffer a fracture than those who did not fall. Some fall risk factors such as balance were associated with the lowest fracture risk lowest in the worst performing group. Multivariate analysis revealed higher fall rate, history of previous fracture, lower BUA, lower body weight, cognitive impairment and better balance as significant independent risk factors for fracture. In the frail elderly, both skeletal fragility and fall risk including the frequency of exposure to falls are important determinants of fracture risk.

  6. [Predictive value of the VMS theme 'Frail elderly': delirium, falling and mortality in elderly hospital patients].

    Science.gov (United States)

    Oud, Frederike M M; de Rooij, Sophia E J A; Schuurman, Truus; Duijvelaar, Karlijn M; van Munster, Barbara C

    2015-01-01

    To determine the predictive value of safety management system (VMS) screening questions for falling, delirium, and mortality, as punt down in the VMS theme 'Frail elderly'. Retrospective observational study. We selected all patients ≥ 70 years who were admitted to non-ICU wards at the Deventer Hospital, the Netherlands, for at least 24 hours between 28 March 2011 and 10 June 2011. On admission, patients were screened with the VMS instrument by a researcher. Delirium and falls were recorded during hospitalisation. Six months after hospitalisation, data on mortality were collected. We included 688 patients with a median age of 78.7 (range: 70.0-97.1); 50.7% was male. The sensitivity of the screening for delirium risk was 82%, the specificity 62%. The sensitivity of the screening for risk of falling was 63%, the specificity 65%. Independent predictors for mortality within 6 months were delirium risk (odds ratio (OR): 2.3; 95% CI 1.1-3.2), malnutrition (OR: 2.1; 95% CI 1.3-3.5), admission to a non-surgical ward (OR: 3.0; 95% CI 1.8-5.1), and older age (OR: 1.1; 95%CI 1.0-1.1). Patients classified by the VMS theme 'Frail elderly' as having more risk factors had a higher risk of dying (p instrument for identifying those elderly people with a high risk of developing this condition; the VMS sensitivity for fall risk is moderate. The number of positive VMS risk factors correlates with mortality and may therefore be regarded as a measure of frailty.

  7. Delivering integrated care to the frail elderly: The impact on professionals’ objective burden and job satisfaction

    NARCIS (Netherlands)

    B. Janse (Benjamin); R. Huijsman (Robbert); R.D.M. de Kuyper (Ruben Dennis Maurice); I.N. Fabbricotti (Isabelle)

    2016-01-01

    textabstractBackground: The impact of integrated working on professionals’ objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary

  8. Coping with complexity: designing homes and facilities for frail and dependent elderly in a changing society

    NARCIS (Netherlands)

    Verkerk, M.J.; van Hoof, J.; Demiris, G.; Wouters, E.J.M.

    2017-01-01

    Demographic changes, technological innovations, and plurality in values place architects and consulting engineers for large challenges. This chapter unravels the different types of complexity that play a role in designing homes for frail elderly and facilities for adults with dementia. Five types of

  9. Multicomponent Program to Reduce Functional Decline in Frail Elderly People : A Cluster Controlled Trial

    NARCIS (Netherlands)

    Ruikes, Franca G. H.; Zuidema, Sytse U.; Akkermans, Reinier P.; Assendelft, Willem J. J.; Schers, Henk J.; Koopmans, Raymond T. C. M.

    2016-01-01

    Background: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. Methods: We

  10. Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial

    NARCIS (Netherlands)

    Ruikes, F.G.; Zuidema, S.U.; Akkermans, R.P.; Assendelft, W.J.; Schers, H.J.; Koopmans, R.T.

    2016-01-01

    BACKGROUND: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. METHODS: We

  11. Bio-impedance analysis for appendicular skeletal muscle mass assessment in (pre-) frail elderly people

    NARCIS (Netherlands)

    Baar, van H.; Hulshof, P.J.M.; Tieland, C.A.B.; Groot, de C.P.G.M.

    2015-01-01

    Background & aims Screening populations for skeletal muscle mass (SMM) is important for early detection of sarcopenia. Our aim was to develop an age specific bio-impedance (BI) prediction equation for the assessment of appendicular skeletal muscle mass (ASMM) in (pre-) frail elderly people aged

  12. The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital

    DEFF Research Database (Denmark)

    Andreasen, Jane; Lund, Hans; Aadahl, Mette

    2015-01-01

    INTRODUCTION: Frail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen shortly after discharge. An investigation into the daily life experiences...... of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission. METHODS: The qualitative methodological approach was interpretive description. Data were...... gathered using individual interviews. The participants were frail elderly patients over 65 years of age, who were interviewed at their home 1 week after discharge from an acute admission to a medical ward. RESULTS: Four main categories were identified: "The system," "Keeping a social life," "Being...

  13. Pain in the Frail or Elderly Patient: Does Tapentadol Have a Role?

    Science.gov (United States)

    Veal, Felicity C; Peterson, Gregory M

    2015-06-01

    Persistent pain affects the elderly disproportionally, occurring in 50% of elderly community-dwelling patients and 80% of aged care residents. The management of pain in the elderly and frail patient is complicated because of the risks posed by changes in pharmacokinetics and pharmacodynamics, polypharmacy, and drug-disease interactions. Trials evaluating the efficacy of analgesics have often excluded elderly patients and universally excluded frail patients; therefore, the true efficacy and side-effect profiles in these population groups are largely unknown, especially for long-term use. A stepwise approach is recommended to managing pain, commencing with paracetamol and adding on opioids when needed to manage pain. However, because of the short duration of clinical trials, exclusion of frail patients, and minimal inclusion of elderly patients, the decision as to which opioid should be added on to paracetamol is a difficult one. This article reviews the evidence surrounding a newer opioid, tapentadol. Tapentadol acts on both the mu receptors and on neuronal reuptake of noradrenaline, and has no significant analgesically active metabolites, which theoretically presents some advantages, particularly in comparison with tramadol. However, the evidence to support tapentadol is weak and the trials were often methodologically poor and sponsored almost universally by the drug company. Currently, there is insufficient evidence to support the use of tapentadol over other opioids, which have been on the market longer, are less expensive, and have better established safety profiles. As a first-line agent after the failure of paracetamol alone, morphine, oxycodone, fentanyl, or buprenorphine are still the preferred evidence-based choices for add-on opioid therapy for elderly or frail patients.

  14. Expert knowledge elicitation using computer simulation: the organization of frail elderly case management as an illustration.

    Science.gov (United States)

    Chiêm, Jean-Christophe; Van Durme, Thérèse; Vandendorpe, Florence; Schmitz, Olivier; Speybroeck, Niko; Cès, Sophie; Macq, Jean

    2014-08-01

    Various elderly case management projects have been implemented in Belgium. This type of long-term health care intervention involves contextual factors and human interactions. These underlying complex mechanisms can be usefully informed with field experts' knowledge, which are hard to make explicit. However, computer simulation has been suggested as one possible method of overcoming the difficulty of articulating such elicited qualitative views. A simulation model of case management was designed using an agent-based methodology, based on the initial qualitative research material. Variables and rules of interaction were formulated into a simple conceptual framework. This model has been implemented and was used as a support for a structured discussion with experts in case management. The rigorous formulation provided by the agent-based methodology clarified the descriptions of the interventions and the problems encountered regarding: the diverse network topologies of health care actors in the project; the adaptation time required by the intervention; the communication between the health care actors; the institutional context; the organization of the care; and the role of the case manager and his or hers personal ability to interpret the informal demands of the frail older person. The simulation model should be seen primarily as a tool for thinking and learning. A number of insights were gained as part of a valuable cognitive process. Computer simulation supporting field experts' elicitation can lead to better-informed decisions in the organization of complex health care interventions. © 2013 John Wiley & Sons, Ltd.

  15. Comparison of 10 single and stepped methods to identify frail older persons in primary care: diagnostic and prognostic accuracy.

    Science.gov (United States)

    Sutorius, Fleur L; Hoogendijk, Emiel O; Prins, Bernard A H; van Hout, Hein P J

    2016-08-03

    Many instruments have been developed to identify frail older adults in primary care. A direct comparison of the accuracy and prevalence of identification methods is rare and most studies ignore the stepped selection typically employed in routine care practice. Also it is unclear whether the various methods select persons with different characteristics. We aimed to estimate the accuracy of 10 single and stepped methods to identify frailty in older adults and to predict adverse health outcomes. In addition, the methods were compared on their prevalence of the identified frail persons and on the characteristics of persons identified. The Groningen Frailty Indicator (GFI), the PRISMA-7, polypharmacy, the clinical judgment of the general practitioner (GP), the self-rated health of the older adult, the Edmonton Frail Scale (EFS), the Identification Seniors At Risk Primary Care (ISAR PC), the Frailty Index (FI), the InterRAI screener and gait speed were compared to three measures: two reference standards (the clinical judgment of a multidisciplinary expert panel and Fried's frailty criteria) and 6-years mortality or long term care admission. Data were used from the Dutch Identification of Frail Elderly Study, consisting of 102 people aged 65 and over from a primary care practice in Amsterdam. Frail older adults were oversampled. The accuracy of each instrument and several stepped strategies was estimated by calculating the area under the ROC-curve. Prevalence rates of frailty ranged from 14.8 to 52.9 %. The accuracy for recommended cut off values ranged from poor (AUC = 0.556 ISAR-PC) to good (AUC = 0.865 gait speed). PRISMA-7 performed best over two reference standards, GP predicted adversities best. Stepped strategies resulted in lower prevalence rates and accuracy. Persons selected by the different instruments varied greatly in age, IADL dependency, receiving homecare and mood. We found huge differences between methods to identify frail persons in prevalence

  16. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

    OpenAIRE

    Shimada, Hiroyuki; Suzukawa, Megumi; Ishizaki, Tatsuro; Kobayashi, Kumiko; Kim, Hunkyung; Suzuki, Takao

    2011-01-01

    Abstract Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotom...

  17. Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people.

    Science.gov (United States)

    Tieland, M; Brouwer-Brolsma, E M; Nienaber-Rousseau, C; van Loon, L J C; De Groot, L C P G M

    2013-10-01

    Serum 25-hydroxyvitamin D (25(OH)D) status has been associated with muscle mass, strength and physical performance in healthy elderly people. Yet, in pre-frail and frail elderly people this association has not been studied. The objective of this study was to explore the association between vitamin D intake and serum 25(OH)D status with muscle mass, strength and physical performance in a pre-frail and frail elderly population. This cross-sectional study included 127 pre-frail and frail elderly people in The Netherlands. Whole body and appendicular lean mass (ALM) (dual energy X-ray absorptiometry), leg strength (one repetition maximum), handgrip strength and physical performance (short physical performance battery) were measured, and blood samples were collected for the assessment of serum 25(OH)D status (liquid chromatography-tandem mass spectrometry). In addition, habitual dietary intake (3-day food records) and physical activity data (accelerometers) were collected. In total, 53% of the participants had a serum 25(OH)D level below 50  nmol/l. After adjustment for confounding factors, 25(OH)D status was associated with ALM (β=0.012, P=0.05) and with physical performance (β=0.020, PVitamin D intake was associated with physical performance (β=0.18, P0.05). In this frail elderly population, 25(OH)D status is low and suggests a modest association with reduced ALM and impaired physical performance. In addition, vitamin D intake tended to be associated with impaired physical performance. Our findings highlight the need for well-designed intervention trials to assess the impact of vitamin D supplementation on 25(OH)D status, muscle mass and physical performance in pre-frail and frail elderly people.

  18. Failure to Thrive: Paradigm for the Frail Elder.

    Science.gov (United States)

    Berkman, Barbara; And Others

    1989-01-01

    Conducted retrospective study of 82 elderly "failure to thrive" (FTT) inpatients. Findings suggest FTT diagnosis when patient's functional ability to live with multisystem diseases, cope with ensuing problems, and manage own care are remarkably diminished and no longer responsive to health care interventions. Attempt to clarify clinical picture of…

  19. Early rehospitalizations of frail elderly patients – the role of medications: a clinical, prospective, observational trial

    Directory of Open Access Journals (Sweden)

    Ekerstad N

    2017-08-01

    Full Text Available Niklas Ekerstad,1,2 Kristoffer Bylin,3 Björn W Karlson3,4 1Department of Cardiology, NU (NÄL-Uddevalla Hospital Group, Trollhättan, 2Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, Linköping, 3Department of Acute and Internal Medicine, NU (NÄL-Uddevalla Hospital Group, Trollhättan, 4Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Background and objective: Early readmissions of frail elderly patients after an episode of hospital care are common and constitute a crucial patient safety outcome. Our purpose was to study the impact of medications on such early rehospitalizations. Patients and methods: This is a clinical, prospective, observational study on rehospitalizations within 30 days after an acute hospital episode for frail patients over the age of 75 years. To identify adverse drug reactions (ADRs, underuse of evidence-based treatment and avoidability of rehospitalizations, the Naranjo score, the Hallas criteria and clinical judgment were used. Results: Of 390 evaluable patients, 96 (24.6% were rehospitalized. The most frequent symptoms and conditions were dyspnea (n = 25 and worsened general condition (n = 18. The most frequent diagnoses were heart failure (n = 17 and pneumonia/acute bronchitis (n = 13. By logistic regression analysis, independent risk predictors for rehospitalization were heart failure (odds ratio [OR] = 1.8; 95% CI = 1.1–3.1 and anemia (OR = 2.3; 95% CI = 1.3–4.0. The number of rehospitalizations due to probable ADRs was 13, of which two were assessed as avoidable. The number of rehospitalizations probably due to underuse of evidence-based drug treatment was 19, all of which were assessed as avoidable. The number of rehospitalizations not due to ADRs or underuse of evidence-based drug treatment was 64, of which none was assessed as avoidable. Conclusion: One out of four

  20. Architecture for the Elderly and Frail People, Well-Being Elements Realizations and Outcomes

    DEFF Research Database (Denmark)

    Knudstrup, Mary-Ann

    2011-01-01

    -being elements in the nursing home environments that contribute to enhancing the well-being of the elderly and how these elements is ensured attention during a decision making process related to the design and the establishing of nursing homes. With basis in four Danish representative case studies, various case...... data from the decision making process are collected, covering the planning, the design and the realization of four newly built nursing homes in Denmark. The case studies clearly shows that the architectural well-being elements appear weak in the decision making process, when they are conflicting......The relationship between architecture, housing and well-being of elderly and frail people is a topic of growing interest to consultants and political decision makers working on welfare solutions for elderly citizens. The objective of the research presented here is to highlight which well...

  1. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients.

    Directory of Open Access Journals (Sweden)

    Liesbeth Hempenius

    Full Text Available The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.Data of 260 patients (intervention n = 127, Control n = 133 were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88, an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87 and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49.A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.Nederlands Trial Register, Trial ID NTR 823.

  2. Kidney function and cognitive decline in frail elderly: two faces of the same coin?

    Science.gov (United States)

    Coppolino, Giuseppe; Bolignano, Davide; Gareri, Pietro; Ruberto, Carmen; Andreucci, Michele; Ruotolo, Giovanni; Rocca, Maurizio; Castagna, Alberto

    2018-06-04

    Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-population with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment. 2229 geriatric subjects were screened for frailty and CKD. Severity of CKD was assessed by eGFR (CKD-EPI formula). Frailty was established by the Fried Index. Functional, general health and cognitive status were assessed by validated score measures. Final analysis included 271 frail CKD subjects (162 women, 109 men). Mean eGFR was 64.25 ± 25.04 mL/min/1.73 m 2 . Prevalence of mild-to-moderate CKD (stage 3-4) was 44%. Twenty-six percent of patients had severe cognitive impairment, while mild and moderate impairment was found in 7 and 67% of individuals, respectively. All subjects had poor functional and general health status. Cognitive capacities significantly decreased across CKD stages (p for trend cognitive status remained an independent predictor of eGFR (β = 0.465; p cognitive impairment. Future studies are advocated to clarify whether the combination of kidney and mental dysfunction may portend a higher risk of worsen outcomes in this high-risk population.

  3. Assessing basic needs in frail older persons calls for aesthetic nursing skills – an ethnographic approach

    DEFF Research Database (Denmark)

    Kollerup, Mette Geil; Angel, Sanne

    2015-01-01

    Background: Despite research on caring for older persons' basic needs, a number of hospital admissions occur which had been preventable, given the proper attention to caring for the basic needs. Literature show that caring for the basic needs of frail older persons can be complicated if they are ......Background: Despite research on caring for older persons' basic needs, a number of hospital admissions occur which had been preventable, given the proper attention to caring for the basic needs. Literature show that caring for the basic needs of frail older persons can be complicated...

  4. Utility of minimal preparation ct colonography in detecting colorectal cancer in elderly and frail patients.

    Science.gov (United States)

    Meiklejohn, D J; Ridley, L J; Ngu, M C; Cowlishaw, J L; Duller, A; Ridley, W

    2018-06-11

    Colorectal cancers result in substantial morbidity and mortality to Australian society each year. The usual investigation for bowel malignancyis optical colonoscopy (OC), withcomputed tomographic colonography (CTC) used as an alternative investigation. The catharsis and colon insufflation associated with these investigations pose a higher risk in the elderly and frail. Risks include perforation, serum electrolyte disturbance, and anaesthesia/sedation risks.Minimal preparation computed tomographic colonography (MPCTC) eliminates these risks. This paper audits a 6-year period ofMPCTC in an Australian tertiary referral hospital. 145 patients underwent MPCTC during the study period. There were 7 true positives, 2 false positives and 2 false negatives. Analysis of this population indicates a sensitivity of 0.78 (95% CI 0.51 - 1.05), specificity of 0.99 (95% CI 0.97 - 1.01), positive predictive value (PPV) of 0.78 (95% CI 0.51 - 1.05) and negative predictive value (NPV) of 0.99 (95% CI 0.97 - 1.01). These findings are concordant with other published studies. The auditconfirmsthatminimal preparation CT colonography is a reasonable alternative to OC and CTC in detecting colorectal cancer in symptomatic elderly and frail patients, without the procedural risks inherent inmore invasive investigations. For most patients MPCTC ruled out significant colorectal carcinoma with a high negative predictive value. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Quasi-Experimental Study of the Effectiveness of an Integrated Service Delivery Network for the Frail Elderly

    Science.gov (United States)

    Tourigny, Andre; Durand, Pierre J.; Bonin, Lucie; Hebert, Rejean; Rochette, Louis

    2004-01-01

    The aim of this study was to examine the effectiveness of a new, integrated service delivery (ISD) network of health and social services for frail elderly living in a semi-urban community. A quasi-experimental study was conducted from 1997 to 2000, with measures taken before implementation (T0) and every 12 months after implementation for a 3-year…

  6. The effects of an integrated care intervention for the frail elderly on informal caregivers: A quasi-experimental study

    NARCIS (Netherlands)

    B. Janse (Benjamin); R. Huijsman (Robbert); R.D.M. de Kuyper (Ruben Dennis Maurice); I.N. Fabbricotti (Isabelle)

    2014-01-01

    markdownabstract__Abstract__ Background: This study explored the effects of an integrated care model aimed at the frail elderly on the perceived health, objective burden, subjective burden and quality of life of informal caregivers. Methods. A quasi-experimental design with before/after

  7. Evaluating an integrated neighbourhood approach to improve well-being of frail elderly in a Dutch community: A study protocol

    NARCIS (Netherlands)

    J.M. Cramm (Jane); H.M. van Dijk (Hanna); F.J.B. Lötters (Freek); N.J.A. van Exel (Job); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: An important condition for independent living is having a well-functioning social network to provide support. An Integrated Neighbourhood Approach (INA) creates a supportive environment for the frail elderly, offering them tailored care in their local context that allows them

  8. Protein supplementation improves physical performance in frail elderly people: a randomized double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Tieland, C.A.B.; Rest, van de O.; Dirks, M.L.; Zwaluw, van der N.L.; Mensink, M.R.; Loon, van L.J.C.; Groot, de C.P.G.M.

    2012-01-01

    Objectives: Protein supplementation has been proposed as an effective dietary strategy to increase skeletal muscle mass and improve physical performance in frail elderly people. Our objective was to assess the impact of 24 weeks of dietary protein supplementation on muscle mass, strength, and

  9. Vitamin D deficiency is associated with functional decline and falls in frail elderly women despite supplementation.

    Science.gov (United States)

    Kotlarczyk, M P; Perera, S; Ferchak, M A; Nace, D A; Resnick, N M; Greenspan, S L

    2017-04-01

    We examined the impact of daily supplementation on vitamin D deficiency, function, and falls in female long-term care residents. Initial vitamin D deficiency was associated with greater functional decline and increased fall risk despite guideline-recommended supplementation, highlighting the importance of preventing vitamin D deficiency in frail elderly. Institute of Medicine (IOM) guidelines recommend 800 IU vitamin D daily for older adults and maintaining serum 25-hydroxyvitamin D [25(OH) D] above 20 ng/ml for optimal skeletal health. The adequacy of IOM guidelines for sustaining function and reducing falls in frail elderly is unknown. Female long-term care residents aged ≥65 enrolled in an osteoporosis clinical trial were included in this analysis (n = 137). Participants were classified based on baseline 25(OH) D levels as deficient (30 ng/ml, n = 71). Deficient women were provided initial vitamin D repletion (50,000 IU D 3 weekly for 8 weeks). All were supplemented with 800 IU vitamin D 3 daily for 24 months. Annual functional assessments included Activities of Daily Living (ADLs), Instrumental ADL (IADL), physical performance test (PPT), gait speed, cognition (SPMSQ), and mental health (PHQ-9). We used linear mixed models for analysis of functional measures and logistic regression for falls. Daily supplementation maintained 25(OH) D levels above 20 ng/ml in 95% of participants. All groups demonstrated functional decline. Women initially deficient had a greater decline in physical function at 12 (IADL -2.0 ± 0.4, PPT -3.1 ± 0.7, both p elderly. Further study of optimal 25(OH) D levels for maintaining function and preventing falls is needed.

  10. The relationship between disease and function and perceived health in very frail elders.

    Science.gov (United States)

    Mulrow, C D; Gerety, M B; Cornell, J E; Lawrence, V A; Kanten, D N

    1994-04-01

    To study associations between disease and observed function and self-perceived health in very frail elders. Cross-sectional survey of nine nursing homes in San Antonio, TX. 194 elderly long-stay nursing home residents dependent in at least two ADLs and without severe cognitive impairment. Burden of disease (BOD) was chart abstracted using a standardized protocol that assessed types and severities of 59 categorizations of chronic and acute medical conditions. Observed function and self-perceived health status were assessed independently by the Katz Activities of Daily Living scale (ADL) and the Sickness Impact Profile (SIP), respectively. Summary BOD scores had a low, but statistically significant, univariate correlation with ADL scores (r = 0.21, P = 0.003) and no significant correlation with SIP scores (R = -0.008). Multiple linear regression analyses, including the 24 most frequent disease categories, showed that disease explained significant amounts of ADL (r2 = 0.25, P = 0.001) and borderline significant amounts of SIP (r2 = 0.16, P = 0.11). Models including both disease and sociodemographic, cognitive, and affective variables showed disease added significant incremental explantation beyond the other factors to ADL (incremental r2 = 0.14, P = 0.04), but not to SIP (incremental r2 = 0.08, P > 0.10). Disease, observed function, and self-perceived health status are separate, but interrelated entities, with disease having a stronger relationship to observed function than self-perceived health. Comprehensive assessment of frail elders may need to include all three areas, and studies that focus on one area should take into account the other two as potential important covariates.

  11. Frail Elders in an Urban District Setting in Malaysia: Multidimensional Frailty and Its Correlates.

    Science.gov (United States)

    Sathasivam, Jeyanthini; Kamaruzzaman, Shahrul Bahyah; Hairi, Farizah; Ng, Chiu Wan; Chinna, Karuthan

    2015-11-01

    In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state. © 2015 APJPH.

  12. Quality of life and fall risk in frail hospitalized elderly patients

    Science.gov (United States)

    Öztürk, Zeynel Abidin; Özdemir, Sedat; Türkbeyler, İbrahim Halil; Demir, Zeynep

    2017-11-13

    Background/aim: Frailty is a complex, multifactorial, and important geriatric syndrome characterized by decline in physiological reserves and functional deficiency in multiple systems. The aim of the current study is to investigate the prevalence of frailty and to determine the correlation between quality of life (QoL) and falling risk in geriatric hospitalized patients. Materials and methods: A total of 420 patients, aged 65 years and above, were enrolled in the study. All participants were hospitalized at a university hospital in the internal medicine clinics. The Cardiovascular Health Study (CHS) frailty scale, Health-Related Quality of Life Short Form (SF-36) scale, and Hendrich II Fall Risk Model were administered to the patients. Demographic data of patients, number of chronic diseases, and information on used medication were also collected.Results: The median age of patients was 71.9 ± 6.3 years and 49.5% of the patients were female. By applying the CHS frailty scale, the proportion of frail patients was determined to be 65.5%. There were statistically significant differences among quality of life mean scores of robust, prefrail, and frail patients (P patients had the lowest scores in all SF-36 subgroups. Eighty-three (19.8%) patients were in the low-risk group while 337 (80.2%) were high-risk according to the Hendrich II Fall Risk Model. The rate of patients with high falling risk and poor QoL reached a maximum in the frail group (96%).Conclusion: Frailty is an important geriatric syndrome in elderly hospitalized patients. Poor QoL and high falling risk are issues commonly experienced with frailty.

  13. Caring for frail elders with musculoskeletal conditions and family caregivers' subjective well-being: The role of multidimensional caregiver burden.

    Science.gov (United States)

    Lu, Nan; Liu, Jinyu; Lou, Vivian W Q

    2015-01-01

    The present study examined the unique set of correlates of each dimension of the burden experienced by family caregivers of frail elders with musculoskeletal (MSK) conditions in China, and the role of caregiver burden in between caregiver stressors and subjective well-being. The data was derived from a community sample of 494 elder-caregiver dyads from six urban districts of Shanghai (China). The elders were aged 75 or above, needed assistance in activities of daily living (ADL) and had MSK conditions. The family caregivers were these elders' primary caregivers and at the age of 18 or older. Path analysis was used to examine the proposed model. Care recipients' functional health, cognitive status and behavioral problems affected the multiple dimensions of caregiver burden differently. These three stressors also indirectly affected caregivers' subjective well-being through physical, social and developmental burden. The findings highlighted the mediator role of caregiver burden in between caregiver stressors and subjective well-being, which supported burden-as-mediator theory in understanding family caregiving for frail elders with musculoskeletal conditions in a Chinese context. The focus of intervention should be varied according to the levels of the primary stressors. Policy and intervention implications with regard to the ways of helping Chinese families care for their frail elders with MSK conditions were discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Construct validity of the Groningen Frailty Indicator established in a large sample of home-dwelling elderly persons : Evidence of stability across age and gender

    NARCIS (Netherlands)

    Peters, L. L.; Boter, H.; Burgerhof, J. G. M.; Slaets, J. P. J.; Buskens, E.

    Background: The primary objective of the present study was to evaluate the validity of the Groningen frailty Indicator (GFI) in a sample of Dutch elderly persons participating in LifeLines, a large population-based cohort study. Additional aims were to assess differences between frail and non-frail

  15. Factors associated with the utilization and costs of health and social services in frail elderly patients

    Directory of Open Access Journals (Sweden)

    Kehusmaa Sari

    2012-07-01

    Full Text Available Abstract Background Universal access is one of the major aims in public health and social care. Services should be provided on the basis of individual needs. However, municipal autonomy and the fragmentation of services may jeopardize universal access and lead to variation between municipalities in the delivery of services. This paper aims to identify patient-level characteristics and municipality-level service patterns that may have an influence on the use and costs of health and social services of frail elderly patients. Methods Hierarchical analysis was applied to estimate the effects of patient and municipality-level variables on services utilization. Results The variation in the use of health care services was entirely due to patient-related variables, whereas in the social services, 9% of the variation was explained by the municipality-level and 91% by the patient-level characteristics. Health-related quality of life explained a major part of variation in the costs of health care services. Those who had reported improvement in their health status during the preceding year were more frequent users of social care services. Low informal support, poor functional status and poor instrumental activities of daily living, living at a residential home, and living alone were associated with higher social services expenditure. Conclusions The results of this study showed municipality-level variation in the utilization of social services, whereas health care services provided for frail elderly people seem to be highly equitable across municipalities. Another important finding was that the utilization of social and health services were connected. Those who reported improvement in their health status during the preceding year were more frequently also using social services. This result suggests that if municipalities continue to limit the provision of support services only for those who are in the highest need, this saving in the social sector may, in

  16. Developing an assessment based on physical fitness age to evaluate motor function in frail and healthy elderly women.

    Science.gov (United States)

    Nakagaichi, Masaki; Anan, Yuya; Hikiji, Yuto; Uratani, Sou

    2018-01-01

    The purpose of this study was to identify a method for assessing physical fitness age that is easy to use with both frail and healthy elderly women and to examine its validity. Principal component analysis was used to develop a formula of physical fitness age from four motor function variables. The subjects comprised 688 (75.7±6.0 years) elderly women, in order to develop a physical fitness scale. The formula for calculating physical fitness age was expressed as physical fitness age =-0.419× grip strength -0.096× balancing on one leg with eyes open -0.737×30 s chair stand +0.503× figure-of-8 walking test +0.47× chronological age +52.68. Measures obtained from subjects in the frail elderly (n=11, 73.0±2.3 years) and exercise (n=10, 70.8±3.1 years) groups were used to examine the validity of the assessment. The mean physical fitness age of the frail elderly group (79.0±3.7 years) was significantly higher than its mean chronological age (73.0±2.3 years, p fitness age of the exercise group (65.6±3.1 years) was significantly lower than the chronological age (70.8±3.1 years, p fitness age scores are applicable to frail and healthy elderly women. Physical fitness age is a valid measure of motor function in elderly women.

  17. The Value of a Gardening Service for the Frail Elderly and People With a Disability Living in the Community.

    Science.gov (United States)

    Same, Anne; Lee, Elinda Ai Lim; McNamara, Beverley; Rosenwax, Lorna

    2016-11-01

    Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening ( n = 38) and post-gardening service delivery interviews ( n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health. Results indicate that gardening services should be fundamental to planning for these populations to remain or return to living in the community.

  18. Actual use of and satisfaction associated with rollators and "shopping carts" among frail elderly Japanese people using day-service facilities.

    Science.gov (United States)

    Kitajima, Eiji; Moriuchi, Takefumi; Iso, Naoki; Sagari, Akira; Kikuchi, Yasuyuki; Higashi, Toshio

    2017-07-01

    Purpose This study aimed at clarifying the actual use of and satisfaction with rollators and "shopping carts" (wheeled walkers with storage) among frail elderly people, who were certified by a long-term care insurance system as users of facilities that provide day-service nursing care and rehabilitation. Methods We identified 1247 frail elderly people who used day-service facilities, and evaluated their actual use of, and satisfaction with, rollators and shopping carts. Results Forty-four (3.5%) individuals used rollators, and 53 (4.3%) used shopping carts. The shopping cart group contained more individuals who were certified as care level 1 (26.4%), than the rollator group (20.5%), and 52.8% of the shopping cart group was certified as care levels 1-3. The scores for "repairs and services" and "follow-up" from the Quebec User Evaluation of Satisfaction with assistive Technology second version (QUEST 2.0) survey were significantly higher in the rollator group than in the shopping cart group. Conclusions The QUEST 2.0 scores revealed that shopping cart users exhibit insufficient "repairs and services" and "follow-up" scores. As frail elderly people with poor care status accounted for >50% of the shopping cart group, these individuals urgently need walking aids that are tailored to their care status. Implications for Rehabilitation We conclude that walking aid fitting must be tailored to each persons care status, and suggest that a system should be established to allow occupational or physical therapists to provide this fitting Moreover, our analysis of the QUEST2.0 service scores revealed that repairs, services, and follow-up are insufficient to meet the needs of shopping cart users.

  19. The effect of caregiver support interventions for informal caregivers of community-dwelling frail elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Maja Lopez Hartmann

    2012-08-01

    Full Text Available Introduction: Informal caregivers are important resources for community-dwelling frail elderly. But caring can be challenging. To be able to provide long-term care to the elderly, informal caregivers need to be supported as well. The aim of this study is to review the current best evidence on the effectiveness of different types of support services targeting informal caregivers of community-dwelling frail elderly. Methods: A systematic literature search was performed in Medline, PsychINFO, Ovid Nursing Database, Cinahl, Embase, Cochrane Central Register of Controlled Trials and British Nursing Index in september 2010. Results: Overall, the effect of caregiver support interventions is small and also inconsistent between studies. Respite care can be helpful in reducing depression, burden and anger. Interventions at the individual caregivers' level can be beneficial in reducing or stabilizing depression, burden, stress and role strain. Group support has a positive effect on caregivers' coping ability, knowledge, social support and reducing depression. Technology-based interventions can reduce caregiver burden, depression, anxiety and stress and improve the caregiver's coping ability. Conclusion: Integrated support packages where the content of the package is tailored to the individual caregivers' physical, psychological and social needs should be preferred when supporting informal caregivers of frail elderly. It requires an intense collaboration and coordination between all parties involved.

  20. Minimal preparation CT for the diagnosis of suspected colorectal cancer in the frail and elderly patient

    International Nuclear Information System (INIS)

    Koo, B.C.; Ng, C.S.; U-King-Im, J.; Prevost, A.T.; Freeman, A.H.

    2006-01-01

    Colorectal cancer is a common malignancy with an increased incidence in the elderly population. Traditional methods of evaluating this disease have included double contrast barium enema and colonoscopy. Unfortunately, in the frail and elderly patient, these investigations can be difficult to perform and are often not tolerated. Minimal preparation computed tomography (MPCT) of the colon has been suggested as an alternative in this patient population. In this technique, no bowel preparation is used apart from the administration of oral contrast medium. The patient is imaged only in the supine position, without per rectal insufflation of gas or barium. This article reviews the experience to date of MPCT in detecting colonic tumours, and compares its efficacy to the traditional methods. A meta-analysis of the studies allowed estimation of the pooled sensitivity of MPCT to be 83% (95% confidence interval: 76-89%), and pooled specificity to be 90% (95% CI: 85-94%). An added advantage of MPCT is the ability to identify extra-colonic pathology, and this aspect is also reviewed. In addition, the common radiological features and pitfalls in identifying colonic tumours by MPCT are discussed

  1. Minimal preparation CT for the diagnosis of suspected colorectal cancer in the frail and elderly patient

    Energy Technology Data Exchange (ETDEWEB)

    Koo, B.C. [Department of Radiology, Addenbrooke' s NHS Trust, Cambridge (United Kingdom)]. E-mail: bkoo@doctors.org.uk; Ng, C.S. [Division of Diagnostic Imaging, Department of Radiology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX (United States); U-King-Im, J. [Department of Radiology, Addenbrooke' s NHS Trust, Cambridge (United Kingdom); Prevost, A.T. [Department of Public Health and Primary Care, Centre of Applied Medical Statistics, Univeristy of Cambridge, Institute of Public Health, Cambridge (United Kingdom); Freeman, A.H. [Department of Radiology, Addenbrooke' s NHS Trust, Cambridge (United Kingdom)

    2006-02-15

    Colorectal cancer is a common malignancy with an increased incidence in the elderly population. Traditional methods of evaluating this disease have included double contrast barium enema and colonoscopy. Unfortunately, in the frail and elderly patient, these investigations can be difficult to perform and are often not tolerated. Minimal preparation computed tomography (MPCT) of the colon has been suggested as an alternative in this patient population. In this technique, no bowel preparation is used apart from the administration of oral contrast medium. The patient is imaged only in the supine position, without per rectal insufflation of gas or barium. This article reviews the experience to date of MPCT in detecting colonic tumours, and compares its efficacy to the traditional methods. A meta-analysis of the studies allowed estimation of the pooled sensitivity of MPCT to be 83% (95% confidence interval: 76-89%), and pooled specificity to be 90% (95% CI: 85-94%). An added advantage of MPCT is the ability to identify extra-colonic pathology, and this aspect is also reviewed. In addition, the common radiological features and pitfalls in identifying colonic tumours by MPCT are discussed.

  2. Retirement migration, the 'other' story: caring for frail elderly British citizens in Spain.

    Science.gov (United States)

    Hall, Kelly; Hardill, Irene

    2016-03-01

    Recent years have seen a growth in research on retirement/lifestyle migration to Spain, however this has tended to focus on the reasons for moving, as well as the lifestyles adopted as part of a healthy and active retirement. However, ageing in Spain can bring challenges as a person's resources for independent living diminish. This paper draws on narrative interviews with vulnerable older British people in Spain, focusing on those who have encountered a severe decline in health, are frail and in need of care. It looks at the formal and informal networks and agencies that support these individuals, in particular the resources and strategies they employ to access care. Drawing on a framework of care provision developed by Glucksmann and Lyons, four broad modes of provision for old age care used by older British people in Spain are identified: state/public, family/community, voluntary/not-for-profit and market/for-profit. The paper argues that there are language, cultural, spatial and financial barriers when accessing care in Spain as an older British citizen. It is concluded that there are some frail, vulnerable people that may fall through a support gap, whereby they are no longer the responsibility of UK welfare services, yet not fully recognised in their new country of residence, and asks if more should be done to support this population.

  3. Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: A qualitative study

    DEFF Research Database (Denmark)

    Tove, Lindhardt; Hallberg, Ingalill Rahm; Poulsen, Ingrid

    2008-01-01

    BACKGROUND: Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment....... OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated....... PARTICIPANTS: Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. METHOD: Open interviews using an interview guide. Manifest and latent content analysis was applied. RESULT: The main theme Encountering relatives-to be caught between ideals and practice...

  4. Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: a qualitative study

    DEFF Research Database (Denmark)

    Lindhardt, Tommi Bo; Hallberg, I.R.; Poulsen, Ingrid

    2008-01-01

    BACKGROUND: Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment....... OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated....... PARTICIPANTS: Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. METHOD: Open interviews using an interview guide. Manifest and latent content analysis was applied. RESULT: The main theme Encountering relatives-to be caught between ideals and practice...

  5. Predictive biomarkers for death and rehospitalization in comorbid frail elderly heart failure patients.

    Science.gov (United States)

    Pacho, Cristina; Domingo, Mar; Núñez, Raquel; Lupón, Josep; Núñez, Julio; Barallat, Jaume; Moliner, Pedro; de Antonio, Marta; Santesmases, Javier; Cediel, Germán; Roura, Santiago; Pastor, M Cruz; Tor, Jordi; Bayes-Genis, Antoni

    2018-05-09

    Heart failure (HF) is associated with a high rate of readmissions within 30 days post-discharge and in the following year, especially in frail elderly patients. Biomarker data are scarce in this high-risk population. This study assessed the value of early post-discharge circulating levels of ST2, NT-proBNP, CA125, and hs-TnI for predicting 30-day and 1-year outcomes in comorbid frail elderly patients with HF with mainly preserved ejection fraction (HFpEF). Blood samples were obtained at the first visit shortly after discharge (4.9 ± 2 days). The primary endpoint was the composite of all-cause mortality or HF-related rehospitalization at 30 days and at 1 year. All-cause mortality alone at one year was also a major endpoint. HF-related rehospitalizations alone were secondary end-points. From February 2014 to November 2016, 522 consecutive patients attending the STOP-HF Clinic were included (57.1% women, age 82 ± 8.7 years, mean Barthel index 70 ± 25, mean Charlson comorbidity index 5.6 ± 2.2). The composite endpoint occurred in 8.6% patients at 30 days and in 38.5% at 1 year. In multivariable analysis, ST2 [hazard ratio (HR) 1.53; 95% CI 1.19-1.97; p = 0.001] was the only predictive biomarker at 30 days; at 1 year, both ST2 (HR 1.34; 95% CI 1.15-1.56; p < 0.001) and NT-proBNP (HR 1.19; 95% CI 1.02-1.40; p = 0.03) remained significant. The addition of ST2 and NT-proBNP into a clinical predictive model increased the AUC from 0.70 to 0.75 at 30 days (p = 0.02) and from 0.71 to 0.74 at 1 year (p < 0.05). For all-cause death at 1 year, ST2 (HR 1.50; 95% CI 1.26-1.80; p < 0.001), and CA125 (HR 1.41; 95% CI 1.21-1.63; p < 0.001) remained independent predictors in multivariable analysis. The addition of ST2 and CA125 into a clinical predictive model increased the AUC from 0.74 to 0.78 (p = 0.03). For HF-related hospitalizations, ST2 was the only predictive biomarker in multivariable analyses, both at 30

  6. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

    Directory of Open Access Journals (Sweden)

    Shimada Hiroyuki

    2011-08-01

    Full Text Available Abstract Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. Results All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points compared with the no risk SRRST group (0 point were 6.15 (p Conclusion These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

  7. Effect of whole-body vibration exercise on mobility, balance ability and general health status in frail elderly patients: a pilot randomized controlled trial.

    Science.gov (United States)

    Zhang, Li; Weng, Changshui; Liu, Miao; Wang, Qiuhua; Liu, Liming; He, Yao

    2014-01-01

    To study the effects of whole-body vibration exercises on the mobility function, balance and general health status, and its feasibility as an intervention in frail elderly patients. Pilot randomized controlled trial. Forty-four frail older persons (85.27 ± 3.63 years) meeting the Fried Frailty Criteria. All eligible subjects were randomly assigned to the experimental group, who received a whole-body vibration exercise alone (vibration amplitude: 1-3 mm; frequency: 6-26 Hz; 4-5 bouts × 60 seconds; 3-5 times weekly), or a control group, who received usual care and exercises for eight weeks. The Timed Up and Go Test, 30-second chair stand test, lower extremities muscle strength, balance function, balance confidence and General Health Status were assessed at the beginning of the study, after four weeks and eight weeks of the intervention. Whole-body vibration exercise reduced the time of the Timed Up and Go Test (40.47 ± 15.94 s to 21.34 ± 4.42 s), improved the bilateral knees extensor strength (6.96 ± 1.70 kg to 11.26 ± 2.08 kg), the posture stability (surface area ellipse: 404.58 ± 177.05 to 255.95 ± 107.28) and General Health Status (Short-form Health Survey score: 24.51 ± 10.69 and 49.63 ± 9.85 to 45.03 ± 11.15 and 65.23 ± 9.39, respectively). The repeated-measures ANOVA showed that there were significant differences in the Timed Up and Go Test, 30-second chair stand test, bilateral knees extensor strength, activities-specific balance confidence score and general health status between the two groups (P balance and the general health status in the frail elderly.

  8. Delivering Integrated Care to the Frail Elderly: The Impact on Professionals’ Objective Burden and Job Satisfaction

    Directory of Open Access Journals (Sweden)

    Benjamin Janse

    2016-08-01

    Full Text Available Background: The impact of integrated working on professionals’ objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary care practice as a single entry point, and included proactive frailty screening, a comprehensive assessment of patient needs, case management, multidisciplinary teams, care plans and protocols, task delegation and task specialisation, a shared information system, a geriatric care network and integrated funding. Methods: A quasi-experimental design with a control group was used. Data regarding objective burden involved the professionals’ time investments over a 12-month period that were collected from patient medical records (n = 377 time registrations, transcripts of meetings and patient questionnaires. Data regarding job satisfaction were collected using questionnaires that were distributed to primary care and home-care professionals (n = 180 after the intervention’s implementation. Within- and between-groups comparisons and regression analyses were performed.  Results: Non-patient related time was significantly higher in the experimental group than in the control group, whereas patient-related time did not differ. Job satisfaction remained unaffected by the intervention. Conclusion and Discussion: Integrated working is likely to increase objective burden as it requires professionals to perform additional activities that are largely unrelated to actual patient care. Implications for research and practice are discussed. [Current Controlled Trials ISRCTN05748494].

  9. Characteristics of residential areas and transportational walking among frail and non-frail Dutch elderly: Does the size of the area matter?

    NARCIS (Netherlands)

    A. Schop-Etman (Astrid); C.B.M. Kamphuis (Carlijn); R. Prins (Remco); A. Burdorf (Alex); F.H. Pierik (Frank); F.J. van Lenthe (Frank)

    2014-01-01

    textabstractBackground: A residential area supportive for walking may facilitate elderly to live longer independently. However, current evidence on area characteristics potentially important for walking among older persons is mixed. This study hypothesized that the importance of area characteristics

  10. Characteristics of residential areas and transportational walking among frail and non-frail Dutch elderly : Does the size of the area matter?

    NARCIS (Netherlands)

    Etman, Astrid; Kamphuis, Carlijn B M; Prins, Richard G.; Burdorf, Alex; Pierik, Frank H.; van Lenthe, Frank J.

    2014-01-01

    Background: A residential area supportive for walking may facilitate elderly to live longer independently. However, current evidence on area characteristics potentially important for walking among older persons is mixed. This study hypothesized that the importance of area characteristics for

  11. Characteristics of residential areas and transportational walking among frail and non-frail Dutch elderly: does the size of the area matter?

    NARCIS (Netherlands)

    Etman, A.; Kamphuis, C.B.M.; Prins, R.G.; Burdorf, A.; Pierik, F.H.; Lenthe, F.J. van

    2014-01-01

    Background: A residential area supportive for walking may facilitate elderly to live longer independently. However, current evidence on area characteristics potentially important for walking among older persons is mixed. This study hypothesized that the importance of area characteristics for

  12. Challenges and strategies pertaining to recruitment and retention of frail elderly in research studies: a systematic review.

    Science.gov (United States)

    Provencher, Véronique; Mortenson, W Ben; Tanguay-Garneau, Laurence; Bélanger, Karine; Dagenais, Marion

    2014-01-01

    Recruitment and retention of frail elderly in research studies can be difficult. To identify challenges and strategies pertaining to recruitment and retention of frail elderly in research studies. A systematic review was conducted. Four databases (MEDLINE, CINAHL, AgeLine, Embase) were searched from January 1992 to December 2012. Empirical studies were included if they explored barriers to or strategies for recruitment or retention of adults aged 60-plus who were identified as frail, vulnerable or housebound. Two researchers independently determined the eligibility of each abstract reviewed and assessed the level of evidence presented. Data concerning challenges encountered (type and impact) and strategies used (type and impact) were abstracted. Of 916 articles identified in the searches, 15 met the inclusion criteria. The level of evidence of the studies retained varied from poor to good. Lack of perceived benefit, distrust of research staff, poor health and mobility problems were identified as common challenges. The most frequently reported strategies used were to establish a partnership with staff that participants knew and trusted, and be flexible about the time and place of the study. However, few studies performed analyses to compare the impact of specific challenges and strategies on refusal or drop-out rates. This review highlights the need to improve knowledge about the impact of barriers and strategies on recruitment and retention of frail older adults. This knowledge will help to develop innovative and cost-effective ways to increase and maintain participation, which may improve the generalizability of research findings to this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Antonio Giulio de Belvis

    2004-12-01

    Full Text Available

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

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

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

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

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

  14. Effects of comprehensive geriatric assessment on physical fitness in an acute medical setting for frail elderly patients.

    Science.gov (United States)

    Åhlund, Kristina; Bäck, Maria; Öberg, Birgitta; Ekerstad, Niklas

    2017-01-01

    Frail elderly people often use emergency care. During hospitalization, physical decline is common, implying an increased risk of adverse health outcomes. Comprehensive Geriatric Assessment (CGA) has been shown to be beneficial for these patients in hospital care. However, there is very limited evidence about the effects on physical fitness. The aim was to compare effects on physical fitness in the acute care of frail elderly patients at a CGA unit versus conventional care, 3 months after discharge. A clinical, prospective, controlled trial with two parallel groups was conducted. Patients aged ≥75 years, assessed as frail and in need of inpatient care, were assigned to a CGA unit or conventional care. Measurements of physical fitness, including handgrip strength (HS), timed up-and-go (TUG), and the 6-minute walk test (6-MWT) were made twice, at the hospital index care period and at the 3-month follow-up. Data were analyzed as the mean change from index to the 3-month follow-up, and dichotomized as decline versus stability/improvement in physical fitness. In all, 408 participants, aged 85.7±5.4 years, were included. The intervention group improved significantly in all components of physical fitness. The controls improved in TUG and declined in HS and 6-MWT. When the changes were dichotomized the intervention group declined to a lesser extent; HS p elderly patients at a CGA unit is superior to conventional care in terms of preserving physical fitness at 3 months follow-up. CGA management may positively influence outcomes of great importance for these patients, such as mobility, strength, and endurance.

  15. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people.

    Science.gov (United States)

    Shimada, Hiroyuki; Suzukawa, Megumi; Ishizaki, Tatsuro; Kobayashi, Kumiko; Kim, Hunkyung; Suzuki, Takao

    2011-08-12

    Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p fall, 15.04 (p falls, and 5.05 (p fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status. These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

  16. Validation of the Mini Nutritional Assessment-Short Form in a Population of Frail Elders without Disability. Analysis of the Toulouse Frailty Platform Population in 2013.

    Science.gov (United States)

    Lilamand, M; Kelaiditi, E; Cesari, M; Raynaud-Simon, A; Ghisolfi, A; Guyonnet, S; Vellas, B; van Kan, G Abellan

    2015-05-01

    To assess the validity of the Mini Nutritional Assessment-Short Form (MNA-SF) in elderly patients from the Toulouse Frailty Platform. Overall, 267 patients aged 65 and over, without severe cognitive impairment (i.e. Mini Mental Status Examination > 20 and CDRvalidity of the French version of the MNA-SF for good nutritional status (defined as a full MNA score≥24/30). Analyses were conducted in the overall sample and then in subgroups of frail and pre-frail subjects according to the frailty phenotype. Optimal cut-off points were determined to obtain the best sensitivity/specificity ratio and the highest number of correctly classified subjects. Among 267 patients, mean age=81.5±5.8; women=67.0%; 138 (51.7%) were frail, 98 (36.7%) were pre-frail and 31 (11.6%) were robust. Given their MNA-SF scores, 201 (75.3%) had a good nutritional status, 61 (22.8%) were at risk of malnutrition and 5 (1.9%) were malnourished. In the overall sample, but also in subgroups of pre-frail or frail elders, the areas under ROC curves were 0.954, 0.948 and 0.958 respectively. The 11 points cut-off provided the best correct classification ratio (91.4%); sensitivity=94.0%, specificity=83.3%. The MNA-SF appeared to be a validated and effective tool for malnutrition screening in frail elders. Implementing this tool in clinical routine should contribute to improving the screening of malnourished frail individuals.

  17. [Personality disorders in the elderly].

    Science.gov (United States)

    Saarela, Tuula; Stenberg, Jan-Henry

    2011-01-01

    The diagnostic assessment of old age personality disorders is challenging. Medical illnesses and cognitive impairment may influence the clinical symptoms. Common elements of effective approaches such as building a collaborative relationship and maintaining consistency as well as structured framework of treatment can be tailored to the problems of a patient. Pharmacological treatment guidelines of personality disorders need to be individually applied to elderly persons. Comorbid depression is often the primary symptom seen and needs to be treated. Psychiatry should take steps to promote effective treatments and provide support and clinical supervision to health staff treating these individuals.

  18. Developing and Testing the Effectiveness of a Novel Health Qigong for Frail Elders in Hong Kong: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Hector W. H. Tsang

    2013-01-01

    Full Text Available Eight-Section Brocades and Yijin Jing consist of some routine movements that are too difficult for frail elders. A novel health qigong protocol was developed and its effectiveness for frail elders was examined using a randomized clinical trial (RCT. An expert panel performed functional anatomy analysis and safety field test prior to the RCT. The experimental group (n=61, 83±6 yr was given a 12-week qigong exercise program, while the comparison group (n=55, 84±6 yr participated in a newspaper reading program with the same duration and frequency. Pre-, mid-, post-, and follow-up assessments were conducted. At 12 weeks, the qigong group had significant improvements in thinking operations (F=4.05, P=.02 and significant reduction of resting heart rate (F=3.14, P=.045 as compared to the newspaper reading group. A trend of improvements in grip strength and a decreasing trend of depression levels were observed among the qigong group. Significant perceived improvements in physical health (F=13.01, P=.001, activities of daily living (F=5.32, P=.03, and overall health status (F=15.26, P=.0001 were found. There are improvements in some aspects of psychosocial, cognitive, physical, and physiological domains. Clinical applications and possibilities for further research are discussed.

  19. [Effects of a fall prevention program on falls in frail elders living at home in rural communities].

    Science.gov (United States)

    Yoo, Jae-Soon; Jeon, Mi Yang; Kim, Chul-Gyu

    2013-10-01

    This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.

  20. Social Problems of Families Caring for a Frail Elderly Referrals to Public Hospitals Clinics in Karaj City

    Directory of Open Access Journals (Sweden)

    Mehrzad Babaei

    2007-04-01

    Full Text Available Objectives: One of the most important challenges for modem societies is the increasing of elder population. Caring these people is also another important matter for health systems. Families do most of caring responsibilities of the elders who face with many problems for meeting the elders' needs. The aim of this study was to determine the problems of families caring a frail elder who came to the clinics of public hospitals in karaj city in 2002. Methods & Materials: this study was a correlational descriptive research that 90 families were selected through purposive sampling. Data collection tool was a questionnaire. The method of data collection was interview and then filling the questionnaires by the researcher. Results: findings of the study showed that the age range of elders was 77±9, most of them came to the hospitals for heart diseases. The activity of daily living independency score was 46±5.7. The majority of help and support of elders was done by women. Most of families expressed the social family relationship problems from high to medium level, the leisure activity problems from medium to high level and the economical problems from medium to high level. All of woman expressed doing job problems from high to medium level and most of men expressed these problems from medium to low level. As a whole, women caregivers' problems were more than men caregivers' problems. Also the results showed that, an increase in the elder age, dependency in activity of daily living, mental and cognitive disorders of the elder and the time of physical support of the elder by other members would increase. Conclusion: this study show, in regards to increasing the elder population in our country special planning must be designed and done as programs for elders and their families. In case of continuity of caring the elders and not supporting these families by health systems, possibility of existing burnout and burden in them will as such so that elder abuse

  1. Meta-analysis of Dysphagia and Aspiration Pneumonia in Frail Elders

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Vanobbergen, J.N.; Bronkhorst, E.M.; Schols, J.M.; Baat, C. de

    2011-01-01

    As part of a systematic literature review, a comprehensive literature search was carried out to identify risk factors for aspiration pneumonia in frail older people. A prominent risk factor found was dysphagia with evidence level 2a, according to the Oxford Centre for Evidence-based Medicine Levels

  2. Overall Quality of Life (OQoL) questionnaire in frail elderly: a study of reproducibility and responsiveness of the Depression List (DL)

    NARCIS (Netherlands)

    Gregersen, M.; Jordansen, M.M.; Gerritsen, D.L.

    2015-01-01

    INTRODUCTION: The DL is a generic interview-based questionnaire and previously validated in measuring OQoL in nursing home residents. Our aim was to examine its reproducibility and responsiveness in the frail elderly. MATERIALS AND METHODS: The design was three repeated DL-measures 10, 30 and 365

  3. A Smart Insole to Promote Healthy Aging for Frail Elderly Individuals: Specifications, Design, and Preliminary Results.

    Science.gov (United States)

    Piau, Antoine; Charlon, Yoann; Campo, Eric; Vellas, Bruno; Nourhashemi, Fati

    2015-05-25

    Older individuals frequently experience reversible "frailty syndrome,", increasing incidence of disability. Although physical exercise interventions may delay functional decline, there are difficulties in implementing them and performing seamless follow-up at home. Very few technological solutions attempt to address this challenge and improve individual participation. Our objectives are to (1) develop a technological solution designed to support active aging of frail older persons, (2) conduct a first laboratory evaluation of the device, and (3) design a multidimensional clinical trial to validate our solution. We conducted a first phase of multidisciplinary meetings to identify real end users and health professional's unmet needs, and to produce specifications for the architecture of the solution. In a second phase, we performed laboratory tests of the first proposed prototype (a smart insole) with 3 healthy volunteers. We then designed an ongoing clinical trial to finalize the multidimensional evaluation and improvement of the solution. To respond to the needs expressed by the stakeholders (frailty monitoring and adherence improvement), we developed a prototype of smart shoe insole to monitor key parameters of frailty during daily life and promote walking. It is a noninvasive wireless insole, which automatically measures gait parameters and transmits information to a remote terminal via a secure Internet connection. To ensure the solution's autonomy and transparency, we developed an original energy harvesting system, which transforms mechanical energy produced by the user's walking movement into electrical energy. The first laboratory tests of this technological solution showed good reliability measures and also a good acceptability for the users. We have planned an original iterative medical research protocol to validate our solution in real life. Our smart insole could support preventive strategies against disability in primary care by empowering the older

  4. Effects of a continuum of care intervention on frail older persons' life satisfaction: a randomized controlled study.

    Science.gov (United States)

    Berglund, Helene; Hasson, Henna; Kjellgren, Karin; Wilhelmson, Katarina

    2015-04-01

    The aim of this study was to analyse effects of a comprehensive continuum of care (intervention group) on frail older persons' life satisfaction, as compared to those receiving usual care (control group). The intervention included geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care-planning meetings in older persons' own homes. Improvements in older persons' subjective well-being have been shown in studies including care planning and coordination by a case manager. However, effects of more complex continuum of care interventions on frail older persons' life satisfaction are not well explored. Randomised controlled study. The validated LiSat-11 scale was used in face-to-face interviews to assess older persons' life satisfaction at baseline and at three, six and 12 months after the baseline. The odds ratio for improving or maintaining satisfaction was compared for intervention and control groups from baseline to three-month, three- to six-month as well as six- to 12-month follow-ups. Older persons who received the intervention were more likely to improve or maintain satisfaction than those who received usual care, between 6 and 12 month follow-ups, for satisfaction regarding functional capacity, psychological health and financial situation. A comprehensive continuum of care intervention comprising several components had a positive effect on frail older persons' satisfaction with functional capacity, psychological health and financial situation. Frail older persons represent a great proportion of the persons in need of support from the health care system. Health care professionals need to consider continuum of care interventions' impact on life satisfaction. As life satisfaction is an essential part of older persons' well-being, we propose that policy makers and managers promote comprehensive continuum of care solutions. © 2014 John Wiley & Sons Ltd.

  5. Stroke Rehabilitation in Frail Elderly with the Robotic Training Device ACRE: A Randomized Controlled Trial and Cost-Effectiveness Study

    Directory of Open Access Journals (Sweden)

    M. Schoone

    2011-01-01

    Full Text Available The ACRE (ACtive REhabilitation robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, stroke impact, quality of life and emotional well-being were assessed. In total, 24 patients were included. In this small number no significant effects of the ACRE training were found. A large number of 136 patients were excluded. Main reasons for exclusion were lack of physiological or cognitive abilities. Further improvement of the ACRE can best be focused on making the system suitable for self-training and development of training software for activities of daily living.

  6. The use of minimal preparation computed tomography for the primary investigation of colon cancer in frail or elderly patients

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Philip; Burnett, Hugh; Nicholson, David A

    2002-05-01

    AIM: To assess the place of computed tomography (CT) of the colon in frail or elderly patients with symptoms suggestive of colon cancer. METHOD: A total of 195 patients (median age 76 years) underwent CT of the abdomen and pelvis following the administration of positive oral contrast medium but no bowel preparation. All had symptoms suggestive of colon cancer. CT findings were classified as normal/diverticular disease (DD), possible colon cancer, definite colon cancer or extracolonic pathology. Accuracy of CT was assessed against patient outcome. Association between symptoms and colon cancer was assessed by chi-squared test. RESULTS: There were 47 deaths and median follow up for those alive was 16 months. Overall sensitivity of CT was 100% and specificity 87% for detection of colon cancer. One hundred and ten normal/DD CT examinations had no significant bowel lesion on follow up. Of 12 cases defined as 'definite cancers' on CT, there were nine colon cancers, two extracolonic cancers, and one normal. Of 23 'possible cancers' on CT, there were two colon cancers, three DD masses and 18 normal/DD. Fifty examinations had extracolonic findings including 33 (17%) cases of significant abdominal disease. CT findings led to a halt in investigations in 115 cases (59%), colonoscopy in 18 (9%) cases and surgery in 16 (8%) cases. None of the symptoms present showed a significant association with colon cancer (all P > 0.05). CONCLUSION: Minimal preparation CT is a non-invasive and sensitive method for investigating colon cancer in frail or elderly patients. It has a 100% negative predictive value and also detects a large number of extracolonic lesions. Robinson, P. et al. (2002)

  7. The use of minimal preparation computed tomography for the primary investigation of colon cancer in frail or elderly patients

    International Nuclear Information System (INIS)

    Robinson, Philip; Burnett, Hugh; Nicholson, David A.

    2002-01-01

    AIM: To assess the place of computed tomography (CT) of the colon in frail or elderly patients with symptoms suggestive of colon cancer. METHOD: A total of 195 patients (median age 76 years) underwent CT of the abdomen and pelvis following the administration of positive oral contrast medium but no bowel preparation. All had symptoms suggestive of colon cancer. CT findings were classified as normal/diverticular disease (DD), possible colon cancer, definite colon cancer or extracolonic pathology. Accuracy of CT was assessed against patient outcome. Association between symptoms and colon cancer was assessed by chi-squared test. RESULTS: There were 47 deaths and median follow up for those alive was 16 months. Overall sensitivity of CT was 100% and specificity 87% for detection of colon cancer. One hundred and ten normal/DD CT examinations had no significant bowel lesion on follow up. Of 12 cases defined as 'definite cancers' on CT, there were nine colon cancers, two extracolonic cancers, and one normal. Of 23 'possible cancers' on CT, there were two colon cancers, three DD masses and 18 normal/DD. Fifty examinations had extracolonic findings including 33 (17%) cases of significant abdominal disease. CT findings led to a halt in investigations in 115 cases (59%), colonoscopy in 18 (9%) cases and surgery in 16 (8%) cases. None of the symptoms present showed a significant association with colon cancer (all P > 0.05). CONCLUSION: Minimal preparation CT is a non-invasive and sensitive method for investigating colon cancer in frail or elderly patients. It has a 100% negative predictive value and also detects a large number of extracolonic lesions. Robinson, P. et al. (2002)

  8. Thermo-expandable prostatic stents for bladder outlet obstruction in the frail and elderly population: An underutilized procedure?

    Directory of Open Access Journals (Sweden)

    Kapil Sethi

    2017-11-01

    Full Text Available Purpose: To report our outcomes with the use of a thermo-expandable metallic intraprostatic stent (Memokath for patients with bladder outlet obstruction (BOO secondary to prostatic obstruction, and to assess it is a feasible option for many frail and elderly men unsuitable for surgery. Materials and Methods: We reviewed patients who underwent insertion of a Memokath stent for BOO over 17 years (January 1999 to December 2015 at one regional center over a long follow-up period (median, 7 years. Patients were selected if they had obstructive urinary symptoms or urinary retention with an indwelling catheter in situ, and were ineligible for transurethral resection of the prostate (TURP under general or spinal anesthesia. Primary outcomes assessed were the improvement in urinary symptoms and voiding parameters, as well as the ability to void spontaneously if catheterized, along with complications. Results: One hundred forty-four patients who presented with BOO or urinary retention had a Memokath stent inserted. Ninety patients (62.5% had a successful stent insertion with a significant difference between the median preoperative (550 mL and postoperative residual volume (80 mL, p<0.0001. Nearly two-thirds of men (64% returned to unassisted voiding with no increased risk of complications over time. Fifty-four patients (37.5% experienced stent failure. Main complications requiring stent removal or repositioning were migration, occlusion, refractory urinary retention and irritative voiding symptoms. Conclusions: In elderly and frail men with BOO deemed unsuitable to undergo TURP, prostatic stent is a safe and practical alternative to long-term catheterization.

  9. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    Science.gov (United States)

    Ekerstad, Niklas; Karlson, Björn W; Dahlin Ivanoff, Synneve; Landahl, Sten; Andersson, David; Heintz, Emelie; Husberg, Magnus; Alwin, Jenny

    2017-01-01

    The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. This is a clinical, prospective, randomized, controlled, one-center intervention study. This study was conducted in a large county hospital in western Sweden. The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female. This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. After adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14-0.79), ambulation (OR =0.19, 95% CI =0.1-0.37), dexterity (OR =0.38, 95% CI =0.19-0.75), emotion (OR =0.43, 95% CI =0.22-0.84), cognition (OR = 0.076, 95% CI =0.033-0.18) and pain (OR =0.28, 95% CI =0.15-0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32-0.96), and the two groups did not differ significantly in terms of hospital care costs ( P >0.05). Patients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality, at no higher cost.

  10. Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person's Pathway.

    LENUS (Irish Health Repository)

    2018-01-25

    We addressed the research question "what factors enable the successful development and implementation of a frail older person\\'s pathway within the acute setting". A rapid realist review (RRR) was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources)-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE) study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person\\'s pathway.

  11. Construct validity of the Groningen Frailty Indicator established in a large sample of home-dwelling elderly persons: Evidence of stability across age and gender.

    Science.gov (United States)

    Peters, L L; Boter, H; Burgerhof, J G M; Slaets, J P J; Buskens, E

    2015-09-01

    The primary objective of the present study was to evaluate the validity of the Groningen Frailty Indicator (GFI) in a sample of Dutch elderly persons participating in LifeLines, a large population-based cohort study. Additional aims were to assess differences between frail and non-frail elderly and examine which individual characteristics were associated with frailty. By December 2012, 5712 elderly persons were enrolled in LifeLines and complied with the inclusion criteria of the present study. Mann-Whitney U or Kruskal-Wallis tests were used to assess the variability of GFI-scores among elderly subgroups that differed in demographic characteristics, morbidity, obesity, and healthcare utilization. Within subgroups Kruskal-Wallis tests were also used to examine differences in GFI-scores across age groups. Multivariate logistic regression analyses were performed to assess associations between individual characteristics and frailty. The GFI discriminated between subgroups: statistically significantly higher GFI-median scores (interquartile range) were found in e.g. males (1 [0-2]), the oldest old (2 [1-3]), in elderly who were single (1 [0-2]), with lower socio economic status (1 [0-3]), with increasing co-morbidity (2 [1-3]), who were obese (2 [1-3]), and used more healthcare (2 [1-4]). Overall age had an independent and statistically significant association with GFI scores. Compared with the non-frail, frail elderly persons experienced statistically significantly more chronic stress and more social/psychological related problems. In the multivariate logistic regression model, psychological morbidity had the strongest association with frailty. The present study supports the construct validity of the GFI and provides an insight in the characteristics of (non)frail community-dwelling elderly persons participating in LifeLines. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Strategies used by case managers supporting frail, community-dwelling older persons, to engage primary care physicians in interprofessional collaboration

    OpenAIRE

    Van Durme, Thérèse; Cès, Sophie; Karam, Marlène; Macq, Jean; RCN 2014 Annual International Nursing Research Conference

    2014-01-01

    Background and aim Although it is known that case management for frail older persons (FOP) is more likely to foster positive outcomes when the case manager works closely with the primary care physicians (PCP) [1], engaging PCPs to collaborate is often a difficult process, especially when the case management function is new [2]. The aim of this study was to provide insight on how newly implemented case management projects managed to engage FOPs’ PCP in the case management process, (to what ext...

  13. Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

    Science.gov (United States)

    Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

    2016-09-01

    At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The

  14. Health-Promoting Interventions for Persons Aged 80 and Older Are Successful in the Short TermuResults from the Randomized and Three-Armed Elderly Persons in the Risk Zone Study

    DEFF Research Database (Denmark)

    Gustafsson, S.; Wilhelmson, K.; Eklund, K.

    2012-01-01

    OBJECTIVES: To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (>= 80) is at risk of becoming frail and whether a multiprofessional group...

  15. A prehabilitation program for physically frail community-living older persons.

    Science.gov (United States)

    Gill, Thomas M; Baker, Dorothy I; Gottschalk, Margaret; Gahbauer, Evelyne A; Charpentier, Peter A; de Regt, Paul T; Wallace, Sarah J

    2003-03-01

    To describe the development and implementation of a preventive, home-based physical therapy program (PREHAB) and to provide evidence for the safety and interrater reliability of the PREHAB protocol. Demonstration study. General community. Ninety-four physically frail, community-living persons, aged 75 years or older, who were randomized to the PREHAB program in a clinical trial. The PREHAB program built on the physical therapy component of 2 previous home-based protocols. A total of 223 assessment items were linked to 28 possible interventions, including progressive balance and conditioning exercises, by using detailed algorithms and decisions rules that were automated on notebook computers. The percentages of participants who were eligible for and who completed each intervention, the extent of progress noted in the balance and conditioning exercises, adherence to the training program, and adverse events. Participants who completed the PREHAB program and those who ended it prematurely received an average of 9.7 and 7.2 interventions during an average of 14.9 and 9.5 home visits, respectively. With few exceptions, the completion rate and interrater reliability for the specific interventions were high. Despite high self-reported adherence to the training program, the majority of participants did not advance beyond the initial Thera-Band level for the upper- and lower-extremity conditioning exercises, and only about a third advanced to the highest 2 levels of the balance exercises. Adverse events were no more common in the PREHAB group than in the educational control group. Our results support the feasibility and safety of the PREHAB program, but also show the special challenges and pitfalls of such a strategy when it is implemented among persons of advanced age and physical frailty. Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

  16. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    Directory of Open Access Journals (Sweden)

    Ekerstad N

    2016-12-01

    Full Text Available Niklas Ekerstad,1,2 Björn W Karlson,3 Synneve Dahlin Ivanoff,4 Sten Landahl,5 David Andersson,6 Emelie Heintz,7 Magnus Husberg,2 Jenny Alwin2 1Department of Cardiology, NU (NÄL-Uddevalla Hospital Group, Trollhattan, 2Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, 3Department of Molecular and Clinical Medicine, Institute of Medicine, 4Centre for Ageing and Health, AGECAP, Department of Health and Rehabilitation, 5Department of Geriatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 6Division of Economics, Department of Management and Engineering, Linköping University, Linköping, 7Health Outcomes and Economic Evaluation Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden Objective: The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA unit is superior to the care in a conventional acute medical care unit. Design: This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting: This study was conducted in a large county hospital in western Sweden. Participants: The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206 or control group (n=202. Mean age of the patients was 85.7 years, and 56% were female. Intervention: This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements: The primary outcome was the change in health-related quality of life (HRQoL 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3. Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results: After adjustment by

  17. The effects of a muscle resistance program on the functional capacity, knee extensor muscle strength and plasma levels of IL-6 and TNF-alpha in pre-frail elderly women: a randomized crossover clinical trial--a study protocol.

    Science.gov (United States)

    Lustosa, Lygia P; Coelho, Fernanda M; Silva, Juscelio P; Pereira, Daniele S; Parentoni, Adriana N; Dias, João M D; Dias, Rosangela C; Pereira, Leani S M

    2010-07-28

    With the increase in the elderly population, a growing number of chronic degenerative diseases and a greater dependency on caregivers have been observed. Elderly persons in states of frailty remain more susceptible to significant health complications. There is evidence of an inverse relationship between plasma levels of inflammatory mediators and levels of functionality and muscle strength, suggesting that muscle-strengthening measures can aid in inflammatory conditions. The purpose of this study will be verified the effect of a muscle-strengthening program with load during a ten-week period in pre-frail elderly women with attention to the following outcomes: (1) plasma levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), (2) functional capacity and (3) knee extensor muscle strength. The study design is a randomized crossover clinical trial evaluating 26 elderly women (regardless of their race and/or social condition) who are community residents, older than 65, and classified as pre-frail according to the criteria previously described by Fried et al. (2004). All subjects will be assessed using the Timed up and go and 10-Meter Walk Test functional tests. The plasma levels of IL-6 and TNF-alpha will be assessed by ELISA (enzyme-linked immunosorbent assay) with high sensitivity kits (QuantikineHS, R&D Systems Minneapolis, MN, U.S.). Knee extensor muscle strength will be assessed using the Byodex System 3 Pro(R) isokinetic dynamometer at angular speeds of 60 and 180 degrees/s. The intervention will consist of strengthening exercises of the lower extremities at 50 to 70% of 1RM (maximal resistance) three times per week for ten weeks. The volunteers will be randomized into two groups: group E, the intervention group, and group C, the control group that did not initiate any new activities during the initial study period (ten weeks). After the initial period, group C will begin the intervention and group E will maintain everyday activities without

  18. The effects of a muscle resistance program on the functional capacity, knee extensor muscle strength and plasma levels of IL-6 and TNF-α in pre-frail elderly women: a randomized crossover clinical trial - a study protocol

    Directory of Open Access Journals (Sweden)

    Dias João MD

    2010-07-01

    Full Text Available Abstract Background With the increase in the elderly population, a growing number of chronic degenerative diseases and a greater dependency on caregivers have been observed. Elderly persons in states of frailty remain more susceptible to significant health complications. There is evidence of an inverse relationship between plasma levels of inflammatory mediators and levels of functionality and muscle strength, suggesting that muscle-strengthening measures can aid in inflammatory conditions. The purpose of this study will be verified the effect of a muscle-strengthening program with load during a ten-week period in pre-frail elderly women with attention to the following outcomes: (1 plasma levels of interleukin-6 (IL-6 and tumor necrosis factor alpha (TNF-α, (2 functional capacity and (3 knee extensor muscle strength. Methods/Design The study design is a randomized crossover clinical trial evaluating 26 elderly women (regardless of their race and/or social condition who are community residents, older than 65, and classified as pre-frail according to the criteria previously described by Fried et al. (2004. All subjects will be assessed using the Timed up and go and 10-Meter Walk Test functional tests. The plasma levels of IL-6 and TNF-α will be assessed by ELISA (enzyme-linked immunosorbent assay with high sensitivity kits (Quantikine®HS, R&D Systems Minneapolis, MN, U.S.. Knee extensor muscle strength will be assessed using the Byodex System 3 Pro® isokinetic dynamometer at angular speeds of 60 and 180°/s. The intervention will consist of strengthening exercises of the lower extremities at 50 to 70% of 1RM (maximal resistance three times per week for ten weeks. The volunteers will be randomized into two groups: group E, the intervention group, and group C, the control group that did not initiate any new activities during the initial study period (ten weeks. After the initial period, group C will begin the intervention and group E will

  19. 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.

  20. Ingestive Skill Difficulties are Frequent Among Acutely-Hospitalized Frail Elderly Patients, and Predict Hospital Outcomes

    DEFF Research Database (Denmark)

    Hansen, Tina; Lambert, Heather; Faber, Jens

    2012-01-01

    Purpose : To examine the relationship between ingestive skill performance while eating and drinking and frailty status in acutely-hospitalized elderly patients and to examine whether there is a relationship between the proportion of ingestive skill difficulties and Length of Hospital Stay (LOS) a...

  1. Geriatric Traumatology : The effectiviness of integrated orthogeriatric treatment on 1-year outcome in frail elderly with hip fracture

    NARCIS (Netherlands)

    Folbert, Ellis

    2017-01-01

    In an elderly person, a hip fracture can have severe consequences for the patient due to the risk of loss of mobility and early death. As the population ages, the number of patients with hip fractures will increase. The treatment is complex due to the occurrence of several disorders, malnutrition,

  2. The prevalence of frailty and related factors in community-dwelling Turkish elderly according to modified Fried Frailty Index and FRAIL scales.

    Science.gov (United States)

    Akın, Sibel; Mazıcıoglu, Mumtaz M; Mucuk, Salime; Gocer, Semsinnur; Deniz Şafak, Elif; Arguvanlı, Sibel; Ozturk, Ahmet

    2015-10-01

    The purpose of this study is to determine the prevalence of frailty with the Fried Frailty Index (FFI) and FRAIL scales (Fatigue, Resistance, Ambulation, Illness, Low weight) and also its associated factors in the community-dwelling Turkish elderly. This is a cross-sectional population-based study in an urban area with a population of over 1,200,000. We sampled 1/100 of the elderly population. Frailty prevalence was assessed with a modified version of the FFI and FRAIL scale. Nutritional status was assessed by Mini Nutritional Assessment. Cognitive function was assessed by Mini-Mental State Examination. Depressive mood was assessed by GDS. Functional capacity was assessed by the instrumental activities of daily living scale. Falls and fear of falling were noted. Uni- and multivariate analyses were done to determine associated factors for frailty. A total of 906 community-dwelling elderly were included, in whom the mean age and standard deviation (SD) of age were 71.5 (5.6) years (50.6 % female). We detected frailty (female 30.4 %, male 25.2 %), pre-frailty and non-frailty prevalence with FFI as 27.8, 34.8, and 37.4 %, respectively. The prevalence of frailty (female 14.5 %, male 5.4 %), pre-frailty and non-frailty with the FRAIL scale was detected as 10, 45.6, and 44.4 %. Coexisting associated factors related with frailty in both models were found as depressive mood, cognitive impairment, and malnutrition in multivariate analysis. According to both scales, frailty was strongly associated with cognitive impairment, depressive mood, and malnutrition in the community-dwelling Turkish elderly population.

  3. The relative and absolute reliability of the Functional Independence and Difficulty Scale in community-dwelling frail elderly Japanese people using long-term care insurance services.

    Science.gov (United States)

    Saito, Takashi; Izawa, Kazuhiro P; Watanabe, Shuichiro

    2017-06-01

    The newly developed Functional Independence and Difficulty Scale is a tool for assessing the performance of basic activities of daily living in terms of both independence and difficulty. The reliability of this new scale has not been assessed. The aim of this study was to examine the relative reliability and absolute reliability of the newly developed scale in community-dwelling frail elderly people in Japan. Participants were 47 community-dwelling elderly subjects (22 for assessing test-retest reliability and 25 for assessing inter-rater reliability). As relative reliability indices, intra-class correlation coefficients were used. From an absolute reliability perspective, we conducted Bland-Altman analysis and calculated the limit of agreement or minimal detectable change to determine the acceptable range of error. Intra-class correlation coefficients for test-retest and inter-rater reliability were 0.90 (P reliability was -5.2 to 1.8, representing an increase of over six points for improvement and a decrease of over two points for decline of basic activities of daily living ability. The minimal detectable change for inter-rater reliability was 3.7, indicating that a three-point difference might be existed between difference raters. The results of this study demonstrated that the FIDS appeared to be a reliable instrument for use in Japanese community-dwelling frail elderly people. While further research using a large and more diverse sample of participants is needed, our findings support the use of FIDS in clinical practice or clinical research targeting frail elderly Japanese people.

  4. Single-Agent Panitumumab in Frail Elderly Patients With Advanced RAS and BRAF Wild-Type Colorectal Cancer: Challenging Drug Label to Light Up New Hope

    Science.gov (United States)

    Cremolini, Chiara; Aprile, Giuseppe; Lonardi, Sara; Orlandi, Armando; Mennitto, Alessia; Berenato, Rosa; Antoniotti, Carlotta; Casagrande, Mariaelena; Marsico, Valentina; Marmorino, Federica; Cardellino, Giovanni Gerardo; Bergamo, Francesca; Tomasello, Gianluca; Formica, Vincenzo; Longarini, Raffaella; Giommoni, Elisa; Caporale, Marta; Di Bartolomeo, Maria; Loupakis, Fotios; de Braud, Filippo

    2015-01-01

    Background. No prospective trials have specifically addressed the efficacy and safety of panitumumab in elderly patients with metastatic colorectal cancer (CRC). We aimed at assessing the efficacy and safety of single agent panitumumab in “frail” elderly patients diagnosed with metastatic RAS and BRAF wild-type CRC. Materials and Methods. Forty elderly patients (aged ≥75 years) with metastatic RAS-BRAF wild-type CRC received off-label prescriptions of single-agent panitumumab at seven Italian institutions. Treatment was administered as first line in patients with absolute contraindication to any chemotherapy or as second-line treatment after failure of a fluoropyrimidine-based treatment, in the presence of contraindication to irinotecan. The outcome measures included objective response rate (ORR), as well as progression-free survival (PFS), disease control rate (DCR), overall survival (OS), and safety. Results. The median PFS and OS were 6.4 months (95% confidence interval [CI]: 4.9–8 months) and 14.3 months (95% CI: 10.9–17.7 months), respectively. ORR was 32.5%, and DCR was 72.5%. Dose reductions related to adverse events (AEs) were reported in 9 (23%) patients, but no permanent treatment discontinuation caused by was reported. The most frequent grade 3 AE was skin rash, with an incidence of 20%. Conclusion. Panitumumab is effective and well-tolerated in frail elderly patients with RAS-BRAF wild-type metastatic CRC and deemed unfit for chemotherapy. A randomized study is needed to confirm these data. Implications for Practice: Treatment of elderly patients with metastatic colorectal cancer represents a difficult challenge in clinical practice. A significant proportion of frail elderly patients do not receive treatment, reflecting ongoing uncertainty of clinical benefit and toxicity of chemotherapy. Unfit condition in this cohort of patients further limits antineoplastic prescription and consequently patient survival. RAS and BRAF wild-type status could

  5. The short-term effects of an integrated care model for the frail elderly on health, quality of life, health care use and satisfaction with care

    Directory of Open Access Journals (Sweden)

    Wilhelmina Mijntje Looman

    2014-12-01

    Full Text Available Purpose: This study explores the short-term value of integrated care for the frail elderly by evaluating the effects of the Walcheren Integrated Care Model on health, quality of life, health care use and satisfaction with care after three months. Intervention: Frailty was preventively detected in elderly living at home with the Groningen Frailty Indicator. Geriatric nurse practitioners and secondary care geriatric nursing specialists were assigned as case managers and co-ordinated the care agreed upon in a multidisciplinary meeting. The general practitioner practice functions as a single entry point and supervises the co-ordination of care. The intervention encompasses task reassignment between nurses and doctors and consultations between primary, secondary and tertiary care providers. The entire process was supported by multidisciplinary protocols and web-based patient files. Methods: The design of this study was quasi-experimental. In this study, 205 frail elderly patients of three general practitioner practices that implemented the integrated care model were compared with 212 frail elderly patients of five general practitioner practices that provided usual care. The outcomes were assessed using questionnaires. Baseline measures were compared with a three-month follow-up by chi-square tests, t-tests and regression analysis. Results and conclusion: In the short term, the integrated care model had a significant effect on the attachment aspect of quality of life. The frail elderly patients were better able to obtain the love and friendship they desire. The use of care did not differ despite the preventive element and the need for assessments followed up with case management in the integrated care model. In the short term, there were no significant changes in health. As frailty is a progressive state, it is assumed that three months are too short to influence changes in health with integrated care models. A more longitudinal approach is

  6. Feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit Plus™ for frail elderly: study protocol for a feasibility trial.

    Science.gov (United States)

    Gomes, Gisele Cristine Vieira; Bacha, Jéssica Maria Ribeiro; do Socorro Simões, Maria; Lin, Sumika Mori; Viveiro, Larissa Alamino Pereira; Varise, Eliana Maria; Filho, Wilson Jacob; Pompeu, José Eduardo

    2017-01-01

    Frailty can be defined as a medical syndrome with multiple causes and contributors, characterized by diminished strength and endurance and reduced physiological function that increases the vulnerability to develop functional dependency and/or death. Studies have shown that the most commonly studied exercise protocol for frail older adults is the multimodal training. Interactive video games (IVGs) involve tasks in virtual environments that combine physical and cognitive demands in an attractive and challenging way. The aim of this study will be to evaluate the feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit Plus TM (NWFP) for frail older adults. The study is a randomized controlled, parallel group, feasibility trial. Participants will be randomly assigned to the experimental group (EG) and control group (CG). The EG will participate in 14 training sessions, each lasting 50 min, twice a week. In each training session, the participants will play five games, with three attempts at each game. The first attempt will be performed with the assistance of a physical therapist to correct the movements and posture of the patients and subsequent attempts will be performed independently. Scores achieved in the games will be recorded. The participants will be evaluated by a blinded physical therapist at three moments: before and after intervention and 30 days after the end of the intervention (follow-up). We will assess the feasibility, acceptability, safety, and clinical outcomes (postural control, gait, cognition, quality of life, mood, and fear of falling). Due to the deficiencies in multiple systems, studies have shown that multimodal interventions including motor-cognitive stimulation can improve the mobility of frail elderly adults. IVGs, among them the NWFP, are considered as a multimodal motor-cognitive intervention that can potentially improve motor and cognitive functions in the frail elderly. However, there is still no evidence

  7. Evolution of an Early Illness Warning System to Monitor Frail Elders in Independent Living

    Directory of Open Access Journals (Sweden)

    Gregory L. Alexander

    2011-01-01

    Full Text Available This paper describes the evolution of an early illness warning system used by an interdisciplinary team composed of clinicians and engineers in an independent living facility. The early illness warning system consists of algorithms which analyze resident activity patterns obtained from sensors embedded in residents' apartments. The engineers designed an automated reasoning system to generate clinically relevant alerts which are sent to clinicians when significant changes occur in the sensor data, for example declining activity levels. During January 2010 through July 2010, clinicians and engineers conducted weekly iterative review cycles of the early illness warning system to discuss concerns about the functionality of the warning system, to recommend solutions for the concerns, and to evaluate the implementation of the solutions. A total of 45 concerns were reviewed during this period. Iterative reviews resulted in greater efficiencies and satisfaction for clinician users who were monitoring elder activity patterns.

  8. The effect of geriatric intervention in frail elderly patients receiving chemotherapy for colorectal cancer

    DEFF Research Database (Denmark)

    Lund, C M; Vistisen, K K; Dehlendorff, C

    2017-01-01

    patients are offered inclusion and are then randomized to two groups (the intervention group and the control group). Patients in the intervention group receive a full geriatric assessment of comorbidity, medication, psycho-cognitive function, physical, functional and nutrition status, and interventions......BACKGROUND: Better surgical techniques, chemotherapy and biological therapy have improved survival in patients with colorectal cancer (CRC), most markedly in younger patients. About half of patients over 70 years receive dose reductions or early treatment discontinuation of the planned adjuvant...... or first-line treatment due to side effects. The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary evaluation of an elderly individual's health status. This assessment in older patients with cancer can predict survival, chemotherapy toxicity and morbidity. METHODS: This randomized phase II...

  9. The effects of the combination of chlorhexidine/thymol- and fluoride-containing varnishes on the severity of root caries lesions in frail institutionalised elderly people.

    Science.gov (United States)

    Brailsford, S R; Fiske, J; Gilbert, S; Clark, D; Beighton, D

    2002-01-01

    To compare the clinical effects of a fluoride-containing varnish (Fluor-Protector) in combination with a chlorhexidine-containing varnish (Cervitec) on existing root caries lesions in a group of frail elderly subjects. A randomised double blind longitudinal study was utilised. Subjects (n = 102) were randomly allocated to a Test or Placebo group. All leathery and soft root caries lesions in all subjects were coated with Fluor-Protector while the lesions in the Test group were also coated with Cervitec and the lesions in the Placebo group were coated with a Placebo varnish. Treatments were repeated five times in a 12-month period. Clinical parameters associated with root caries, measurements of individual lesions and salivary levels of caries associated bacteria were made at intervals. The clinical severity of the lesions in the Test group did not change significantly during the 12-month study period. In the Placebo group the mean lesion width and lesion height and length of exposed root increased significantly and the lesions were significantly closer to the gingival margin. There were no significant changes in the salivary levels of caries-associated microorganisms after 12 months although, in both groups, there was initially a significant reduction in the salivary levels of mutans streptococci. The combination of Fluor-Protector and Cervitec is a useful, simple, quick and non-invasive method for the control and management of existing root caries lesions. The procedure could be performed by a dental hygienist and may be usefully applied in other high-risk groups including persons with Parkinson's disease, debilitating neuromuscular conditions and dry mouth from whatever cause. Copyright 2002 Elsevier Science Ltd.

  10. The short mean length of stay of post-emergency geriatric units is associated with the rate of early readmission in frail elderly.

    Science.gov (United States)

    Traissac, Thalie; Videau, Marie-Neige; Bourdil, Marie-José; Bourdel-Marchasson, Isabelle; Salles, Nathalie

    2011-06-01

    Specific postemergency short-stay geriatric units may decrease length of hospital stay, functional decline, and early readmission rates. The aim of this study was to evaluate risk factors of early rehospitalization in a shortstay geriatric unit. This study was a prospective observational study comprising over one year patients aged over 75 years, admitted to the post-emergency short-stay geriatric unit (Hôpital Saint André, Bordeaux, France) and discharged home. Socio-demographic data, length of hospital stay, and a standardized geriatric assessment were collected for all patients. One month after home discharge, patients were followed-up by phone, and the hospital readmission rate was calculated. descriptive, unvaried and multivariate analyses were carried out. A total of 476 patients were included in this study (mean age 86.5±6 yrs; 154 men, 322 women). Mean length of stay in the post-emergency short-stay geriatric unit was 6.3±2.7 days, and a total of 68 (14.3%) patients were readmitted within one month after home discharge. The readmission rate was associated with a diagnosis of delirium (Odds Ratio (OR) 1.9; 95% CI 1.1-3.3; p=0.02), mean length of stay exceeding 6 days (OR 1.9, 95% CI 1.1-3.5; p=0.02), and decision of home discharge (OR 2.4; 95% CI 1.4-4.1; p=0.002). Short mean lengths of stay were not considered as a risk factor for readmissions within one month, even in frail, dependent, hospitalized elderly persons.

  11. Interventions to delay institutionalization of frail older persons: design of a longitudinal study in the home care setting

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    De Almeida Mello Johanna

    2012-08-01

    Full Text Available Abstract Background Older people usually prefer staying at home rather than going into residential care. The Belgian National Institute for Health and Disability Insurance wishes to invest in home care by financing innovative projects that effectively help older people to stay at home longer. In this study protocol we describe the evaluation of 34 home care projects. These projects are clustered according to the type of their main intervention such as case management, night care, occupational therapy at home and psychological/psychosocial support. The main goal of this study is to identify which types of projects have the most effect in delaying institutionalization of frail older persons. Methods/design This is a longitudinal intervention study based on a quasi-experimental design. Researchers use three comparison strategies to evaluate intervention - comparison among different types of projects, comparisons between older persons in the projects and older persons not benefiting from a project but who are still at home and between older persons in the projects and older persons who are already institutionalized. Projects are asked to include clients who are frail and at risk of institutionalization. In the study we use internationally validated instruments such as the interRAI Home Care instrument, the WHO-QOL-8 and the Zarit Burden Interview-12. These instruments are filled out at baseline, at exit from the project and 6 months after baseline. Additionally, caregivers have to do a follow-up every 6 months until exit from the project. Criteria to exit the cohort will be institutionalization longer than 3 months and death. The main analysis in the study consists of the calculation of incidence rates, cumulative incidence rates and hazard rates of definitive institutionalization through survival analyses for each type of project. Discussion This research will provide knowledge on the functional status of frail older persons who are still living at

  12. Interventions to delay institutionalization of frail older persons: design of a longitudinal study in the home care setting.

    Science.gov (United States)

    De Almeida Mello, Johanna; Van Durme, Therese; Macq, Jean; Declercq, Anja

    2012-08-06

    Older people usually prefer staying at home rather than going into residential care. The Belgian National Institute for Health and Disability Insurance wishes to invest in home care by financing innovative projects that effectively help older people to stay at home longer. In this study protocol we describe the evaluation of 34 home care projects. These projects are clustered according to the type of their main intervention such as case management, night care, occupational therapy at home and psychological/psychosocial support. The main goal of this study is to identify which types of projects have the most effect in delaying institutionalization of frail older persons. This is a longitudinal intervention study based on a quasi-experimental design. Researchers use three comparison strategies to evaluate intervention--comparison among different types of projects, comparisons between older persons in the projects and older persons not benefiting from a project but who are still at home and between older persons in the projects and older persons who are already institutionalized. Projects are asked to include clients who are frail and at risk of institutionalization. In the study we use internationally validated instruments such as the interRAI Home Care instrument, the WHO-QOL-8 and the Zarit Burden Interview-12. These instruments are filled out at baseline, at exit from the project and 6 months after baseline. Additionally, caregivers have to do a follow-up every 6 months until exit from the project. Criteria to exit the cohort will be institutionalization longer than 3 months and death. The main analysis in the study consists of the calculation of incidence rates, cumulative incidence rates and hazard rates of definitive institutionalization through survival analyses for each type of project. This research will provide knowledge on the functional status of frail older persons who are still living at home. This is important information to identify determinants of

  13. Minimal preparation computed tomography instead of barium enema/colonoscopy for suspected colon cancer in frail elderly patients: an outcome analysis study

    Energy Technology Data Exchange (ETDEWEB)

    Kealey, S.M.; Dodd, J.D.; MacEneaney, P.M.; Gibney, R.G.; Malone, D.E. E-mail: d.malone@st-vincents.ie

    2004-01-01

    AIM: To evaluate the efficacy of minimal preparation computed tomography (MPCT) in diagnosing clinically significant colonic tumours in frail, elderly patients. MATERIALS AND METHODS: A prospective study was performed in a group of consecutively referred, frail, elderly patients with symptoms or signs of anaemia, pain, rectal bleeding or weight loss. The MPCT protocol consisted of 1.5 l Gastrografin 1% diluted with sterile water administered during the 48 h before the procedure with no bowel preparation or administration of intravenous contrast medium. Eight millimetre contiguous scans through the abdomen and pelvis were performed. The scans were double-reported by two gastrointestinal radiologists as showing definite (>90% certain), probable (50-90% certain), possible (<50% certain) neoplasm or normal. Where observers disagreed the more pessimistic of the two reports was accepted. The gold standard was clinical outcome at 1 year with positive end-points defined as (1) histological confirmation of CRC, (2) clinical presentation consistent with CRC without histological confirmation if the patient was too unwell for biopsy/surgery, and (3) death directly attributable to colorectal carcinoma (CRC) with/without post-mortem confirmation. Negative end-points were defined as patients with no clinical, radiological or post-mortem findings of CRC. Patients were followed for 1 year or until one of the above end-points were met. RESULTS: Seventy-two patients were included (mean age 81; range 62-93). One-year follow-up was completed in 94.4% (n=68). Mortality from all causes was 33% (n=24). Five histologically proven tumours were diagnosed with CT and there were two probable false-negatives. Results were analysed twice: assuming all CT lesions test positive and considering 'possible' lesions test negative [brackets] (95% confidence intervals): sensitivity 0.88 (0.47-1.0) [0.75 (0.35-0.97)], specificity 0.47 (0.34-0.6) [0.87 (0.75-0.94)], positive predictive value 0

  14. Public telesurveillance service for frail elderly living at home, outcomes and cost evolution: a quasi experimental design with two follow-ups

    Directory of Open Access Journals (Sweden)

    Deaudelin Isabelle

    2006-07-01

    Full Text Available Abstract Background Telesurveillance is a technologically based modality that allows the surveillance of patients in the natural setting, mainly home. It is based on communication technologies to relay information between a patient and a central call center where services are coordinated. Different types of telesurveillance systems have been implemented, some being staffed with non-health professionals and others with health professional, mainly nurses. Up to now, only telesurveillance services staffed with non-health professionals have been shown to be effective and efficient. The objective of this study was to document outcomes and cost evolution of a nurse-staffed telesurveillance system for frail elderly living at home. Methods A quasi experimental design over a nine-month period was done. Patients (n = 38 and caregivers (n = 38 were selected by health professionals from two local community health centers. To be eligible, elders had to be over 65, live at home with a permanent physical, slight cognitive or motor disability or both and have a close relative (the caregiver willing to participate to the study. These disabilities had to hinder the accomplishment of daily life activities deemed essential to continue living at home safely. Three data sources were used: patient files, telesurveillance center's quarterly reports and personal questionnaires (Modified Mini-Mental State, Functional Autonomy Measurement System, Life Event Checklist, SF-12, Life-H, Quebec User Evaluation of Satisfaction with Assistive Technology, Caregiver Burden. The telesurveillance technology permitted, among various functionalities, bi-directional communication (speaker-receiver between the patient and the response center. Results A total of 957 calls for 38 registered clients over a 6-month period was recorded. Only 48 (5.0% of the calls were health-related. No change was reported in the elders' quality of life and daily activity abilities. Satisfaction was very

  15. Neuroanatomical correlates of personality in the elderly.

    Science.gov (United States)

    Wright, Christopher I; Feczko, Eric; Dickerson, Bradford; Williams, Danielle

    2007-03-01

    Extraversion and neuroticism are two important and frequently studied dimensions of human personality. They describe individual differences in emotional responding that are quite stable across the adult lifespan. Neuroimaging research has begun to provide evidence that neuroticism and extraversion have specific neuroanatomical correlates within the cerebral cortex and amygdala of young adults. However, these brain areas undergo alterations in size with aging, which may influence the nature of these personality factor-brain structure associations in the elderly. One study in the elderly demonstrated associations between perisylvian cortex structure and measures of self transcendence [Kaasinen, V., Maguire, R.P., Kurki, T., Bruck, A., Rinne, J.O., 2005. Mapping brain structure and personality in late adulthood. NeuroImage 24, 315-322], but the neuroanatomical correlates of extraversion and neuroticism, or other measures of the Five Factor Model of personality have not been explored. The purpose of the present study was to investigate the structural correlates of neuroticism and extraversion in healthy elderly subjects (n=29) using neuroanatomic measures of the cerebral cortex and amygdala. We observed that the thickness of specific lateral prefrontal cortex (PFC) regions, but not amygdala volume, correlates with measures of extraversion and neuroticism. The results suggest differences in the regional neuroanatomic correlates of specific personality traits with aging. We speculate that this relates to the influences of age-related structural changes in the PFC.

  16. Frail Institutionalized Older Persons A Comprehensive Review on Physical Exercise, Physical Fitness, Activities of Daily Living, and Quality-of-Life

    NARCIS (Netherlands)

    Weening-Dijksterhuis, Elizabeth; de Greef, Mathieu H. G.; Scherder, Erik J. A.; Slaets, Joris P. J.; van der Schans, Cees P.

    Weening-Dijksterhuis E, de Greef MHG, Scherder EJA, Slaets JPJ, van der Schans CP: Frail institutionalized older persons: A comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Phys Med Rehabil 2011;90:156Y168. The objective of this study

  17. Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Benefit Cognition in Frail Elderly Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Abe, Sakiko; Ezaki, Osamu; Suzuki, Motohisa

    2017-01-01

    The combined supplementation of medium-chain triglycerides (MCTs), L-leucine-rich amino acids, and cholecalciferol (vitamin D 3 ) increase muscle strength and function in frail elderly individuals. However, their effects on cognition are unknown. We enrolled 38 elderly nursing home residents (mean age±SD, 86.6±4.8 y) in a 3-mo randomized, controlled, parallel group trial. The participants were randomly allocated to 3 groups: the first group received a L-leucine (1.2 g)- and cholecalciferol (20 μg)-enriched supplement with 6 g of MCT (LD+MCT); the second group received the same supplement with 6 g of long-chain triglycerides (LD+LCT); and the third group did not receive any supplements (control). Cognition was assessed at baseline and after the 3-mo intervention. The difference in changes among the groups was assessed with ANCOVA, adjusting for age and the baseline value as covariates. After 3 mo, the Mini-Mental State Examination (MMSE) score in the LD+MCT group increased by 10.6% (from 16.6 to 18.4 points, p<0.05). After 3 mo, the Nishimura geriatric rating scale for mental status (NM scale) score in the LD+MCT group increased by 30.6% (from 24.6 to 32.2 points, p<0.001), whereas that in the LD+LCT and control groups decreased by 11.2% (from 31.2 to 27.7 points, p<0.05) and 26.1% (from 27.2 to 20.1 points, p<0.001), respectively. The combined supplementation of MCTs (6 g), L-leucine-rich amino acids, and cholecalciferol may improve cognitive function in frail elderly individuals.

  18. Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Increase Muscle Strength and Function in Frail Elderly Adults in a Randomized Controlled Trial.

    Science.gov (United States)

    Abe, Sakiko; Ezaki, Osamu; Suzuki, Motohisa

    2016-05-01

    Sarcopenia, the loss of skeletal muscle mass, strength, and function, is common in elderly individuals but difficult to treat. A combination of nutrients was investigated to treat sarcopenia in very frail elderly adults. We enrolled 38 elderly nursing home residents (11 men and 27 women with a mean ± SD age of 86.6 ± 4.8 y) in a 3-mo randomized, controlled, single-blind, parallel group trial. The participants were randomly allocated to 3 groups. The first group received a daily l-leucine (1.2 g) and cholecalciferol (20 μg)-enriched supplement with 6 g medium-chain triglycerides (TGs) (MCTs) (LD + MCT); the second group received the same leucine and cholecalciferol-enriched supplement with 6 g long-chain TGs (LD + LCT); and the third group did not receive any supplements (control). The supplement and oils were taken at dinner, and changes in muscle mass, strength, and function were monitored. The increase in body weight in the LD + MCT (1.1 ± 1.0 kg) and LD + LCT (0.8 ± 1.1 kg) groups was greater than that in the control group (-0.5 ± 0.9 kg) (P elderly individuals. This trial was registered at the University Hospital Medical Information Network Clinical Trials Registry as UMIN000017567. © 2016 American Society for Nutrition.

  19. Protein Supplementation Augments Muscle Fiber Hypertrophy but Does Not Modulate Satellite Cell Content During Prolonged Resistance-Type Exercise Training in Frail Elderly.

    Science.gov (United States)

    Dirks, Marlou L; Tieland, Michael; Verdijk, Lex B; Losen, Mario; Nilwik, Rachel; Mensink, Marco; de Groot, Lisette C P G M; van Loon, Luc J C

    2017-07-01

    Protein supplementation increases gains in lean body mass following prolonged resistance-type exercise training in frail older adults. We assessed whether the greater increase in lean body mass can be attributed to muscle fiber type specific hypertrophy with concomitant changes in satellite cell (SC) content. A total of 34 frail elderly individuals (77 ± 1 years, n = 12 male adults) participated in this randomized, double-blind, placebo-controlled trial with 2 arms in parallel. Participants performed 24 weeks of progressive resistance-type exercise training (2 sessions per week) during which they were supplemented twice-daily with milk protein (2 × 15 g) or a placebo. Muscle biopsies were taken at baseline, and after 12 and 24 weeks of intervention, to determine type I and type II muscle fiber specific cross-sectional area (CSA), SC content, and myocellular characteristics. In the placebo group, a trend for a 20% ± 11% increase in muscle fiber CSA was observed in type II fibers only (P = .051), with no increase in type I muscle fiber CSA. In the protein group, type I and II muscle fiber CSA increased by 23% ± 7% and 34% ± 10% following 6 months of training, respectively (P  .05). No changes in myonuclear content and SC contents were observed over time in either group (both P > .05). Regression analysis showed that changes in myonuclear content and domain size are predictive of muscle fiber hypertrophy. Protein supplementation augments muscle fiber hypertrophy following prolonged resistance-type exercise training in frail older people, without changes in myonuclear and SC content. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  20. Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Grodzicki Tomasz

    2009-01-01

    Full Text Available Abstract Background Consistently swelling proportion of the frail elderly within a modern society challenges the overstrained public health sector to provide both adequate medical care and comprehensive assistance in their multiple functional deficits of daily living. Easy-to-apply and task-specific ways of addressing this issue are being sought out, with a view to proposing systemic solutions for nationwide application. Methods The present randomised, double-blind, placebo-controlled, 7-week clinical trial aimed to determine whether specifically structured, intensive exercise regimens, combined with nutritional supplementation, might improve and help sustain individual muscle strength and mobility, and possibly enhance individual functional capabilities in an on-going quest for active prevention of care-dependency. Ninety-one frail elderly (F 71 M 20; mean age 79 years were recruited from both nursing home residents and community dwellers and randomly split into four groups: Group I – progressive resistance exercises (PRE + functionally-oriented exercises (FOE + nutritional supplementation (NS, Group II – PRE + FOE + placebo, Group III – standard exercises (SE + FOE + NS, Group IV – SE + FOE + placebo. Each group pursued a 45 min. exercise session 5 times weekly. The subjects' strength with regard to four muscle groups, i.e. hip and knee extensors and flexons, was assessed at 80% (1 RM weekly, whereas their balance and mobility at baseline and at the end of the study. Results The study was completed by 80 subjects. Despite its relatively short duration significant differences in muscle strength were noted both in Group I and Group II (p = 0.01; p = 0.04; respectively, although this did not translate directly into perceptible improvement in individual mobility. Notable improvements in individual mobility were reported in Group III and Group IV (p = 0.002, although without positive impact on individual muscle strength. Conclusion

  1. Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial

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    Favela J

    2013-01-01

    the baseline questionnaire. The final 133 subjects were randomized into the NV+AB (n = 45, NV-only (n = 44, and control (n = 44 groups. There were no statistically significant differences in the baseline characteristics of the groups. The mean age overall was 76.3 years (standard deviation 4.7 and 45% were men. At the baseline, 61.65% were classified as frail. At end of follow-up the adjusted prevalence of frailty in NV+AB group was 23.3% versus 58.3% in the control group.Conclusion: An intervention based on NV+AB seems to have a positive effect on frailty scores.Keywords: gerontechnology, frailty, elderly

  2. [High-grade pressure sores in frail older high-risk persons. A retrospective postmortem case-control-study].

    Science.gov (United States)

    Von Renteln-Kruse, W; Krause, T; Anders, J; Kühl, M; Heinemann, A; Püschel, K

    2004-04-01

    Some old persons at risk do develop, but others, at comparable risk, do not develop high-grade pressure sores. To evaluate potentially different risk factors, we performed a post mortem case-control study in old persons who developed high-grade pressure sores within six months until 14 days before death. Consecutive cases with pressure sores grade >/=3 and potential controls at comparably high risk for pressure sores were examined before cremation. After written informed consent had been obtained by the next relatives, all available nursing and medical records of the deceased were thoroughly evaluated. Cases and controls were matched according to age, gender, immobility, and cachexia.A total of 100 cases with 71 pressure sores grade 3 and 29 pressure sores grade 4 were compared to 100 controls with 27 pressure sores grade pressure sores in frail older high-risk persons. Sedative drug effects and impaired patient compliance with preventive and therapeutic measures may also be associated with the development of high-grade pressure sores in old persons at high risk.

  3. Differences in lifestyle, physical performance and quality of life between frail and robust Brazilian community-dwelling elderly women.

    Science.gov (United States)

    Sewo Sampaio, Priscila Yukari; Sampaio, Ricardo Aurélio Carvalho; Coelho Júnior, Hélio José; Teixeira, Luis Felipe M; Tessutti, Vitor D; Uchida, Marco Carlos; Arai, Hidenori

    2016-07-01

    To investigate the lifestyles, physical performance and quality of life (QOL) of frail and robust Brazilian community-dwelling older women, and to identify risk factors for frailty. Frailty was assessed using the Kihon Checklist. Lifestyles were assessed using a questionnaire. Physical performance was assessed by measuring walking speeds, performance on the one-leg stand test and the five-times chair stand test and handgrip strength. QOL was assessed using the Short Form-8 questionnaire. Participants were divided into frail and robust groups based on their total Kihon Checklist scores. A total of 109 participants (age 70.8 ± 6.87 years) were included in this study (robust n = 85, frail n = 24). Differences in living structures (P financial satisfaction (P = 0.004) and the frequencies with which participants leave the house (P performance (walking speed P financial dissatisfaction, a sedentary lifestyle, falls, and malnutrition. Furthermore, they showed poorer physical performance and QOL. An early, well-focused approach is crucial, especially for older adults who walk slowly and have bodily pain to preserve health and QOL. Geriatr Gerontol Int 2016; 16: 829-835. © 2015 Japan Geriatrics Society.

  4. WA4 Volunteering in partnership: a public health approach to delivering compassionate care to those at end of life and the frail elderly.

    Science.gov (United States)

    Wilson, Gail

    2015-04-01

    Young people are often denied volunteering experiences with vulnerable dying people as this is considered to be 'too distressing'. This project challenged this paternalistic attitude and trained young people to volunteer in the hospice, and other organisations to enhance the delivery of compassionate care. To promote dignity in care, for older people, people with dementia, those at end of life and those with learning disabilities. To reduce social isolation and the stigma associated with dying and being old. To create new volunteering opportunities for young people to raise their awareness of the needs of the dying and the frail elderly. Develop a model of best practice - that could be replicated in other parts of the country. A health promotion approach was used combining education and a community development, partnership approach. Results 120 Volunteers delivered over 3,650 hrs of volunteering activities, supporting individuals to engage in social activities. The project broke myths about having 16-18 year olds volunteering. The relationship between the hospice and the local community has strengthened and the employability skills for the young people taking part have increased. 16% of those who responded to an exit survey had gained full time employment, 9% had gained university places. The personalisation of care for the frail elderly and those at end of life has increased by the use of volunteers. Young volunteers need mentoring. Staff needs support to feel confident to utilise the volunteers and let go of myths about risks. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Cross-cultural adaptation and validity of the "Edmonton Frail Scale - EFS" in a Brazilian elderly sample Adaptación cultural y validez de la Edmonton Frail Scale - EFS en una muestra de ancianos brasileños Adaptação cultural e validade da Edmonton Frail Scale - EFS em uma amostra de idosos brasileiros

    Directory of Open Access Journals (Sweden)

    Suzele Cristina Coelho Fabrício-Wehbe

    2009-12-01

    Full Text Available This study aimed to assess the cross-cultural adaptation of the Edmonton Frail Scale (EFS and its validity in a Brazilian elderly sample. Translation and back-translation were performed, as well as discussion with professionals and elderly for conceptual equivalence, semantic validation and pre-test of the scale. The scale was applied to 137 elderly aged 65 years or older who lived in the community. In the know-groups validation of the frailty diagnosis between gender, age and cognitive deficit, elder elderly, female and with a cognitive deficit scored higher on the frailty diagnosis. A negative convergent correlation was found between the EFS and the Functional Independence Measure (FIM (-0.53, pEl objetivo de este estudio fue evaluar la adaptación cultural de la Edmonton Frail Scale (EFS y su validez en una muestra de ancianos brasileños. Fueron realizadas las etapas de traducción y retrotraducción, discusión con profesionales y ancianos para equivalencia conceptual, validación semántica y prueba piloto de la escala. El instrumento fue aplicado en 137 ancianos, con 65 años o más de edad, que vivían en la comunidad. En la validación de grupos conocidos, del diagnóstico de fragilidad entre sexo, edad y déficit cognitivo, los ancianos con edad más avanzada, sexo femenino y con déficit cognitivo tuvieron mayor puntuación en el diagnóstico de fragilidad. Hubo una correlación convergente negativa de la EFS con la Medida de Independencia Funcional (MIF (-0,53, pO objetivo deste estudo foi avaliar a adaptação cultural da Edmonton Frail Scale (EFS e sua validade em uma amostra de idosos brasileiros. Foram realizadas as etapas de tradução e retrotradução, discussão com profissionais e idosos para equivalência conceitual, validação semântica e pré-teste da escala. O instrumento foi aplicado em 137 idosos, com 65 anos ou mais de idade, que viviam na comunidade. Na validação de grupos conhecidos, do diagnóstico de

  6. State tax incentives for persons giving informal care to the elderly

    Science.gov (United States)

    Hendrickson, Michael C.

    1988-01-01

    Programs for informal caregivers of frail elderly can be adopted by States to address some of the problems associated with an expanding and costly long-term care system. In this article, highlights are given from a 3-year study of Idaho and Arizona tax incentive programs. Characteristics of informal caregivers and elderly participants are described, and elderly participants are compared with elderly nonparticipants and with the general elderly population. Tax incentives were positively related to the level of service and financial support provided by informal caregivers. Data were inadequate to determine whether the induced informal help substituted for public expenditures. PMID:10312965

  7. State tax incentives for person giving informal care of the elderly.

    Science.gov (United States)

    Hendrickson, M C

    1988-12-01

    Programs for informal caregivers of frail elderly can be adopted by States to address some of the problems associated with an expanding and costly long-term care system. In this article, highlights are given from a 3-year study of Idaho and Arizona tax incentive programs. Characteristics of informal caregivers and elderly participants are described, and elderly participants are compared with elderly nonparticipants and with the general elderly population. Tax incentives were positively related to the level of service and financial support provided by informal caregivers. Data were inadequate to determine whether the induced informal help substituted for public expenditures.

  8. Conducting research with African elderly persons: Is their ...

    African Journals Online (AJOL)

    The increase in social research conducted as a result of HIV/AIDS raises further concerns about the ethics of conducting research on elderly African persons with regards to issues of autonomy and informed consent. This paper examines the ethics and the notion of vulnerability of African elderly persons within the context of ...

  9. Application of Pole Walking to Day Service Centers for Use by Community-dwelling Frail Elderly People

    Directory of Open Access Journals (Sweden)

    Susumu Ota

    2014-03-01

    Conclusion: The effects of 3 months of pole walking on community-dwelling elderly day service users showed improved Physical Component Summary scores of higher QoL. However, there was no significant effect of physical functions due to the intervention.

  10. [Health status of elderly persons in Korea].

    Science.gov (United States)

    Choi, Y H; Kim, M S; Byon, Y S; Won, J S

    1990-12-01

    This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychological and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practitioners working in Kungsang-Buk-Do, Kyngsang-Nam-Do, Jonla Buk-Do, and Kyung Ki-Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climatization functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows: 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliability indicated by a Cronbach = 0.97793. 2. Average score of the subjects physical health status was 4,054 in a 5 point likert scale, mental-emotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status; physical health status was the

  11. Consumer responses to the Wisconsin Partnership Program for Elderly Persons: a variation on the PACE Model.

    Science.gov (United States)

    Kane, Robert L; Homyak, Patricia; Bershadsky, Boris; Lum, Yat-Sang

    2002-04-01

    The Wisconsin Partnership Program (WPP) is a variation on the Program for All-inclusive Care of the Elderly (PACE) model that is designed to be more flexible by allowing frail elderly dual-eligible (for both Medicare and Medicaid) clients to use their regular primary care physicians instead of relying on the physician hired by PACE. Case management is provided by a team of nurse, social worker, and nurse practitioner. The latter is charged with communicating with the client's primary physician. We compared the functional status and satisfaction of WPP elderly enrollees with those of two sets of dually eligible controls drawn from the Medicaid waiver rosters. One set of controls came from persons in the same county who opted not to enroll in WPP. The second came from matched counties that did not have access to the WPP. Enrollees were interviewed in person. Family members were interviewed by telephone. The prevalence of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) dependency was lower for the WPP sample than that for the controls. The pattern of unmet needs was generally comparable. About half of each sample had a written advance directive. Overall, there were few areas of significant difference in beneficiaries' satisfaction. The WPP families were more satisfied than either control group that services were provided when needed and were better coordinated. There were no significant differences in the prevalence of any aspect of care burden. The impact of WPP seems limited. There is some evidence that families perceive better coordinated care. A more complete evaluation will await the analysis of the differences in utilization patterns between WPP and the controls.

  12. Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care.

    Science.gov (United States)

    Hasson, Henna; Blomberg, Staffan; Dunér, Anna

    2012-03-22

    Prior studies measuring fidelity of complex interventions have mainly evaluated adherence, and not taken factors affecting adherence into consideration. A need for studies that clarify the concept of fidelity and the function of factors moderating fidelity has been emphasized. The aim of the study was to systematically evaluate implementation fidelity and possible factors influencing fidelity of a complex care continuum intervention for frail elderly people. The intervention was a systematization of the collaboration between a nurse with geriatric expertise situated at the emergency department, the hospital ward staff, and a multi-professional team with a case manager in the municipal care services for older people. Implementation was evaluated between September 2008 and May 2010 with observations of work practices, stakeholder interviews, and document analysis according to a modified version of The Conceptual Framework for Implementation Fidelity. A total of 16 of the 18 intervention components were to a great extent delivered as planned, while some new components were added to the model. No changes in the frequency or duration of the 18 components were observed, but the dose of the added components varied over time. Changes in fidelity were caused in a complex, interrelated fashion by all the moderating factors in the framework, i.e., context, staff and participant responsiveness, facilitation, recruitment, and complexity. The Conceptual Framework for Implementation Fidelity was empirically useful and included comprehensive measures of factors affecting fidelity. Future studies should focus on developing the framework with regard to how to investigate relationships between the moderating factors and fidelity over time. ClinicalTrials.gov, NCT01260493.

  13. Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care

    Science.gov (United States)

    2012-01-01

    Background Prior studies measuring fidelity of complex interventions have mainly evaluated adherence, and not taken factors affecting adherence into consideration. A need for studies that clarify the concept of fidelity and the function of factors moderating fidelity has been emphasized. The aim of the study was to systematically evaluate implementation fidelity and possible factors influencing fidelity of a complex care continuum intervention for frail elderly people. Methods The intervention was a systematization of the collaboration between a nurse with geriatric expertise situated at the emergency department, the hospital ward staff, and a multi-professional team with a case manager in the municipal care services for older people. Implementation was evaluated between September 2008 and May 2010 with observations of work practices, stakeholder interviews, and document analysis according to a modified version of The Conceptual Framework for Implementation Fidelity. Results A total of 16 of the 18 intervention components were to a great extent delivered as planned, while some new components were added to the model. No changes in the frequency or duration of the 18 components were observed, but the dose of the added components varied over time. Changes in fidelity were caused in a complex, interrelated fashion by all the moderating factors in the framework, i.e., context, staff and participant responsiveness, facilitation, recruitment, and complexity. Discussion The Conceptual Framework for Implementation Fidelity was empirically useful and included comprehensive measures of factors affecting fidelity. Future studies should focus on developing the framework with regard to how to investigate relationships between the moderating factors and fidelity over time. Trial registration ClinicalTrials.gov, NCT01260493. PMID:22436121

  14. Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care

    Directory of Open Access Journals (Sweden)

    Hasson Henna

    2012-03-01

    Full Text Available Abstract Background Prior studies measuring fidelity of complex interventions have mainly evaluated adherence, and not taken factors affecting adherence into consideration. A need for studies that clarify the concept of fidelity and the function of factors moderating fidelity has been emphasized. The aim of the study was to systematically evaluate implementation fidelity and possible factors influencing fidelity of a complex care continuum intervention for frail elderly people. Methods The intervention was a systematization of the collaboration between a nurse with geriatric expertise situated at the emergency department, the hospital ward staff, and a multi-professional team with a case manager in the municipal care services for older people. Implementation was evaluated between September 2008 and May 2010 with observations of work practices, stakeholder interviews, and document analysis according to a modified version of The Conceptual Framework for Implementation Fidelity. Results A total of 16 of the 18 intervention components were to a great extent delivered as planned, while some new components were added to the model. No changes in the frequency or duration of the 18 components were observed, but the dose of the added components varied over time. Changes in fidelity were caused in a complex, interrelated fashion by all the moderating factors in the framework, i.e., context, staff and participant responsiveness, facilitation, recruitment, and complexity. Discussion The Conceptual Framework for Implementation Fidelity was empirically useful and included comprehensive measures of factors affecting fidelity. Future studies should focus on developing the framework with regard to how to investigate relationships between the moderating factors and fidelity over time. Trial registration ClinicalTrials.gov, NCT01260493.

  15. A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial.

    Science.gov (United States)

    Tarazona-Santabalbina, Francisco José; Gómez-Cabrera, Mari Carmen; Pérez-Ros, Pilar; Martínez-Arnau, Francisco Miguel; Cabo, Helena; Tsaparas, Konstantina; Salvador-Pascual, Andrea; Rodriguez-Mañas, Leocadio; Viña, José

    2016-05-01

    Frailty can be an important clinical target to reduce rates of disability. To ascertain if a supervised-facility multicomponent exercise program (MEP) when performed by frail older persons can reverse frailty and improve functionality; cognitive, emotional, and social networking; as well as biological biomarkers of frailty, when compared with a controlled population that received no training. This is an interventional, controlled, simple randomized study. Researchers responsible for data gathering were blinded for this study. Participants from 2 primary rural care centers (Sollana and Carcaixent) of the same health department in Spain were enrolled in the study between December 2013 and September 2014. We randomized a volunteer sample of 100 men and women who were sedentary, with a gait speed lower than 0.8 meters per second and frail (met at least 3 of the frailty phenotype criteria). Participants were randomized to a supervised-facility MEP (n = 51, age = 79.5, SD 3.9) that included proprioception, aerobic, strength, and stretching exercises for 65 minutes, 5 days per week, 24 weeks, or to a control group (n = 49, age = 80.3, SD 3.7). The intervention was performed by 8 experienced physiotherapists or nurses. Protein-calorie and vitamin D supplementation were controlled in both groups. Our MEP reverses frailty (number needed to treat to recover robustness in subjects with attendance to ≥50% of the training sessions was 3.2) and improves functional measurements: Barthel (trained group 91.6 SD 8.0 vs 82.0 SD 11.0 control group), Lawton and Brody (trained group 6.9 SD 0.9 vs 5.7 SD 2.0 control group), Tinetti (trained group 24.5 SD 4.4 vs 21.7 SD 4.5 control group), Short Physical Performance Battery (trained group 9.5 SD 1.8 vs 7.1 SD 2.8 control group), and physical performance test (trained group 23.5 SD 5.9 vs 16.5 SD 5.1 control group) as well as cognitive, emotional, and social networking determinations: Mini-Mental State Examination (trained

  16. Being next of kin to an elderly person with cancer

    DEFF Research Database (Denmark)

    Esbensen, Bente Appel

    2010-01-01

    Background: Being next of kin to an elderly person with cancer and its impact on everyday life has been sparsely researched. Such understanding is needed to support both the sufferers and their relatives in dealing with issues arising after a cancer diagnosis in old age. Aim: To illuminate...... the experience of life as next of kin to an elderly person with cancer. Method: A qualitative study was used to illuminate the experience of next of kin of elderly people with cancer. In total, 16 (mean age 61, range 42-80) persons were interviewed. Open-ended interviews were used to get closer...... to their experiences. Manifest and latent content analysis were used. Findings: Two main categories Transformations of roles and Changed frames of mind were identified, as well as four subcategories. The study showed that the cancer activated perceptions in the next of kin about aging and growing old. The onset...

  17. Quality of life of elderly persons with newly diagnosed cancer

    DEFF Research Database (Denmark)

    Esbensen, B A; Osterlind, K; Roer, O

    2004-01-01

    The aim was to investigate quality of life (QoL) in elderly persons newly diagnosed with cancer (65+ years) in relation to age, contact with the health-care system, ability to perform activities of daily living (ADL), hope, social network and support, and to identify which factors were associated...

  18. An approach to balance problems and falls in elderly persons

    OpenAIRE

    de Villiers, L; Kalula, S Z

    2015-01-01

    Gait instability and falls are common in elderly persons and have devastating consequences, with substantial morbidity and mortality. Furthermore, they are a precipitant for functional decline, increasing frailty and institutionalisation. The rate of falls and severity of complications increase with age and frailty. A consequence of falls with or without injury is that at least a third of persons develop a fear of falling, which leads to functional decline and a progressive decline in gait. T...

  19. Influence of diabetes on physical function among the elderly persons

    Directory of Open Access Journals (Sweden)

    Farzana Tabassum

    2009-07-01

    Full Text Available There is growing recognition that the complications associated with type-2 diabetes may translate into functional impairments in older people.This cross sectional study was conducted between January and June 2008 to determine the influence of diabetes on physical functions in an elderly (³55 years population. Fifty-five elderly diabetics attending the out-patient department of a diabetic centre were selected by convenient sampling and compared with fifty-five non-diabetic elderly persons of the near-by community. Their physical functions were assessed by Barthel Index, SF-36 Health Survey and Modified Physical Performance test. Diabetic elderly persons, on average, obtained lower scores in all these three tests. After removing the effect of socio-demographic variables, influence of diabetes on level of independence measured by Barthel Index did not persist. However, the difference in SF-36 health survey and Modified Physical Performance test scores between diabetics and non-diabetics remained significant after controlling for socio-demographic variables. The current study showed influence of diabetes on physical functions in the elderly. People should be motivated and guided properly to practice a healthy lifestyle in order to prevent and control diabetes and thus avoid complications of diabetes mellitus and disabilities in later life. Ibrahim Med. Coll. J. 2009; 3(2: 45-49

  20. Increased walking variability in elderly persons with congestive heart failure

    Science.gov (United States)

    Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

    1994-01-01

    OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P young: P < 0.001), and no overlap between elderly subjects with and without congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

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

    Science.gov (United States)

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

    2017-08-01

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

  2. [The effects of social networks on health check-up service use among pre-frail older adults (candidate so-called "specified elderly individuals") compared with older people in general].

    Science.gov (United States)

    Sugisawa, Hidehiro; Sugihara, Yoko

    2011-09-01

    Nursing care prevention programs cannot accomplish their goals without effective screening of pre-frail older people. Health check-up services provide a very opportunity for this purpose. In the present study we examined not only the direct and indirect effects of social networks on check-up service use among candidate pre-frail older people, but also whether these effects differ from those among older people in general. Subjects for this study were respondents of a survey for probability sampled aged 65 and over living in a city, Tokyo. Individuals who gave effective responses to items used in our analysis made up 55.8 percent of the sample. 734 candidate pre-frail older people were selected using the screening criteria provided by the ministry of Heath, Labor and Welfare. The general category of older people numbered 2,057, excluding the candidates and elderly certified for long-term care. Social networks were measured from five aspects: family size; contact with children or relatives living separately; contact with neighbors or friends; involvement in community activities; and seeing a doctor. Our model of indirect effects of social networks on check-up use included awareness of nursing care prevention programs as a mediating factor. Information about whether the subjects used the health check-up service was provided.by the regional government. Magnitude of the effects was evaluated from two aspects; using statistical tests and focusing on marginal effects. Although none of the social network indicators had direct significant impacts on check-up use, contact with children or relatives living separately, contact with neighbors or friends, or involvement with community activities demonstrated significant indirect influence. Contact with neighbors or friends, involvement with community activities, or seeing a doctor had direct significant effects on use among the general category of older people, but none of the social network indicators demonstrated significant

  3. Personality factors and cognitive functioning in elderly with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Neusa Maria de Oliveira Chardosim

    Full Text Available ABSTRACT Parkinson's disease (PD is a chronic and progressive neurological disease, resulting from cell degeneration in the substantia nigra, responsible for the production of dopamine. Objective: This study aimed to characterize the cognitive functioning, personality factors and prevalence of depressive and anxiety symptoms in individuals with Parkinson's disease (PD. Furthermore, this study sought to analyze whether personality factors were predictors of cognitive functioning. Methods: The sample consisted of 30 elderly with PD. Participants completed a sociodemographic data sheet, the NEO-FFI-R (Five Factor Inventory NEO Revised, the Montreal Cognitive Assessment, the Beta-III, the phonemic verbal fluency test and semantics (Animals, the digits span subtest of the Wechsler Intelligence Scale for Adults and the Boston Naming Test and the word list of the CERAD battery, the Geriatric Depression Scale and the Beck Anxiety Inventory. Results: The elderly with PD presented impairment in verbal episodic memory and executive functions. Most of the participants demonstrated low levels of neuroticism. The extraversion factor was positively correlated with executive functions and the openness to experience factor was positively correlated with verbal episodic memory. It was concluded that the elderly with PD presented memory and executive function impairments. The factor that most contributed to performance of the elderly with PD on memory and executive function tasks was the extraversion factor.

  4. Effect of Metformin on Handgrip Strength, Gait Speed, Myostatin Serum Level, and Health-related Quality of Life: A Double Blind Randomized Controlled Trial among Non-diabetic Pre-frail Elderly Patients.

    Science.gov (United States)

    Laksmi, Purwita Wijaya; Setiati, Siti; Tamin, Tirza Z; Soewondo, Pradana; Rochmah, Wasilah; Nafrialdi, Nafrialdi; Prihartono, Joedo

    2017-04-01

    sarcopenia contributes to the development of frailty syndrome. Frailty syndrome is potentially improved by modifying insulin resistance, inflammation, and myostatin level. This study is aimed to investigate the effect of metformin on handgrip strength, gait speed, myostatin serum level, and health-related quality of life (HR-QoL) among non-diabetic pre-frail elderly patients. a double blind randomized controlled trial study was conducted on non-diabetic elderly outpatients aged ≥ 60 years with pre-frail status based on phenotype and/ or index criteria (Cardiovascular Health Study and/ or Frailty Index 40 items) consecutively recruited from March 2015 to June 2016 at Cipto Mangunkusumo Hospital. One-hundred-twenty subjects who met the research criteria were randomized and equally assigned into 3 x 500 mg metformin or placebo group. The study outcomes were measured at baseline and after 16 weeks of intervention. out of 120 subjects, 43 subjects in metformin group and 48 subjects in placebo group who completed the intervention. There was a significant improvement on the mean gait speed of metformin group by 0.39 (0.77) second or 0.13 (0.24) meter/second that remained significant after adjusting for important prognostic factors (p = 0.024). There was no significant difference on handgrip strength, myostatin serum level, and HR-QoL between both groups. 3 x 500 mg metformin for 16 weeks was statistically significant and clinically important in improving usual gait speed as one of the HR-QoL dimensions, but did not significantly improve the EQ-5D index score, handgrip strength, nor myostatin serum level.

  5. Music therapy for institutionalised elderly persons with depression

    Directory of Open Access Journals (Sweden)

    Amal Dev

    2015-01-01

    Full Text Available The geriatric population of India accounts more than six per cent of the total population. The number of elderly in Kerala is expected to reach 7.2 million by 2021 and 11.9 millions in 2051. The present study was conducted to (a assess the level of depressive symptom in institutionalised elderly persons before and after the music therapy, and (b to evaluate the effect of music therapy on depressive symptoms in elderly. An experimental research design with a one group pre-test post-test design was adopted. The purposive sample consisted of 40 elderly with depressive symptom. The tools used were (a a proforma to collect socio-demographic data, (b Geriatric Depression Scale, (c Mini Mental Status Examination, and (d Beck’s Depression Inventory. Each of the selected samples was given music therapy through individual walkman for 30 minutes in the evening hours for a regular period of 21 days. Post test was conducted a week after the completion of this exercise. There was a significant reduction in the depressive symptoms before and after the experiment (t=3.65, p<0.001. The study has major implication in the mental health practice, education, administration, and research. It’s a cost-effective and safe nursing intervention proven effective in reducing depressive symptoms. Applying music therapy shall augment the effect of alternative therapies and to apply it, there is no need for the nursing professionals to undergo any additional training.

  6. Protocol for a single-centre, randomised controlled study of a preoperative rehabilitation bundle in the frail and elderly undergoing abdominal surgery.

    Science.gov (United States)

    Abdullah, Hairil Rizal; Lien, Victoria Peixin; Ong, Hwee Kuan; Er, Pei Ling; Hao, Ying; Khan, Shariq Ali; Liu, Christopher Weiyang

    2017-08-04

    Frail patients have decreased physiological reserves and consequently, they are unable to recover as quickly from surgery. Frailty, as an entity, is a risk factor of increased morbidity and mortality. It is also associated with a longer time to discharge. This trial is undertaken to determine if a novel prehabilitation protocol (10-day bundle of interventions-physiotherapy, nutritional supplementation and cognitive training) can reduce the postoperative length of stay of frail patients who are undergoing elective abdominal surgery, compared with standard care. This is a prospective, single-centre, randomised controlled trial with two parallel arms. 62 patients who are frail and undergoing elective abdominal surgery will be recruited and randomised to receive either a novel prehabilitation protocol or standard care. Participants will receive telephone reminders preoperatively to encourage protocol compliance. Data will be collected for up to 30 days postoperatively. The primary outcome of the trial will be the postoperative length of stay and the secondary outcomes are the postoperative complications and functional recovery during the hospital admission. This study has been approved by the Singapore General Hospital Institutional Review Board (CIRB Ref: 2016/2584). The study is also listed on ClinicalTrials.gov (Trial number: NCT02921932). All participants will sign an informed consent form before randomisation and translators will be made available to non-English speaking patients. The results of this study will be published in peer-reviewed journals as well as national and international conferences. The data collected will also be made available in a public data repository. NCT02921932 (ClinicalTrials.gov). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sandra Haider

    Full Text Available The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35 conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23 received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2 to 3.0 pg/l (min-max = 2.0-20.8, and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9 to 0.3 mg/dl (min-max = 0.1-3.0 after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45 were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  8. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Science.gov (United States)

    Haider, Sandra; Grabovac, Igor; Winzer, Eva; Kapan, Ali; Schindler, Karin Emmi; Lackinger, Christian; Titze, Sylvia; Dorner, Thomas Ernst

    2017-01-01

    The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  9. Quality of care for frail older persons in a homecare setting: what is it and how can it be measured?

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Sela, Adi Hannah; Iecovich, Esther; Golander, Hava

    2017-11-02

    As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers. We interviewed a convenience sample of older persons cared for by migrant live-in caregivers and their relatives. When relatives reported that older persons could not be interviewed due to advanced dementia, only relatives were interviewed. Overall, 72 older persons and 117 relatives were interviewed. We used the Quality of Care Questionnaire (QuCQ) developed for this study to examine the main components of quality of care in this population. Factor analysis using older persons' data revealed two factors. In the first factor, "caretaking," items concerning provision of prompt care exhibited the highest loadings. Items measuring interpersonal aspects of the care dynamic had the highest loadings in the second factor, thus labeled "relationship." The factor analysis based on relatives' data yielded similarities and differences with the one based on older persons' data. Yet, there were significant correlations between relative and older persons' responses when using the older persons' factor structure. According to older persons and relatives, quality of care depends on the extent to which older persons' care-related needs, as well as social ones, are addressed. Appropriate evaluation of quality of care in the live-in setting is important for its improvement.

  10. Decision-making deficits in normal elderly persons associated with executive personality disturbances.

    Science.gov (United States)

    Nguyen, Christopher M; Barrash, Joseph; Koenigs, Anna L; Bechara, Antoine; Tranel, Daniel; Denburg, Natalie L

    2013-11-01

    The problems that some community-dwelling elderly persons develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elderly persons. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness). Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities. Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making. Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making.

  11. Older persons' definitions and explanations of elder abuse in the Netherlands

    DEFF Research Database (Denmark)

    Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

    2016-01-01

    persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of......In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semi-structured interviews with 35 older persons who had no experience with abuse. Our findings show...... that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older...

  12. Aging in balance : physical exercise and nutrient dense foods for the vulnerable elderly

    NARCIS (Netherlands)

    Chin A Paw, M.

    1999-01-01

    The main goal of prevention and health care for elderly people is optimizing 'quality of life'. Frail older persons have limited reserves and are therefore at an increased risk of a decline in health, which may lead to dependency and disability. This thesis focuses on the health-related effects of

  13. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents

    NARCIS (Netherlands)

    Mathey, M.F.A.M.; Siebelink, E.; Graaf, de C.; Staveren, van W.A.

    2001-01-01

    Taste and smell losses occur with aging. These changes may decrease the enjoyment of food and may subsequently reduce food consumption and negatively influence the nutritional status of elderly persons, especially those who are frail. The objective of this study was to determine if the addition of

  14. Self-reported physical fitness in frail older persons : Reliability and validity of the self-assessment of physical fitness (Sapf)

    NARCIS (Netherlands)

    Weening - Dijksterhuis, Elizabeth; de Greef, Mathieu H. G.; Krijnen, Wim; van der Schans, Cees P.

    2012-01-01

    In very old and/ or frail older people living in long-term care facilities, physical inactivity negatively affects activities of daily living. The main reason to assess older adults' perceived fitness is to establish the relation with their beliefs about their ability to perform physical activity

  15. Self-reported physical fitness in frail older persons : reliability and validity of the Self-Assessment of Physical Fitness (SAPF)

    NARCIS (Netherlands)

    Weening-Dijksterhuis, Betsy; de Greef, Mathieu; Krijnen, Wim; van der Schans, Cees

    2012-01-01

    In very old and/or frail older people living in long-term care facilities, physical inactivity negatively affects activities of daily living. The main reason to assess older adults' perceived fitness is to establish the relation with their beliefs about their ability to perform physical activity

  16. Knowledge and attitude of elderly persons towards dental implants.

    Science.gov (United States)

    Müller, Frauke; Salem, Kamel; Barbezat, Cindy; Herrmann, François R; Schimmel, Martin

    2012-06-01

    Despite their unrivalled place in restorative treatment, dental implants are still scarcely used in elderly patients. The aim of this survey was therefore to identify potential barriers for accepting an implant treatment. Participants were recruited from a geriatric hospital, two long-term-care facilities and a private clinic. The final study sample comprised 92 persons, 61 women and 31 men with an average age of 81.2 ± 8.0 years. In a semi-structured interview, the participants' knowledge of implants and attitude towards a hypothetical treatment with dental implants were evaluated. Twenty-seven participants had never heard of dental implants, and another 13 participants could not describe them. The strongest apprehensions against implants were cost, lack of perceived necessity and old age. Univariate and multiple linear regression analysis identified being women, type and quality of denture, having little knowledge on implants and being hospitalised as the risk factors for refusing implants. However, old age as such was not associated with a negative attitude. The acceptance of dental implants in the elderly population might be increased by providing further information and promoting oral health in general. Regardless of the age, dental implants should be placed when patients are still in good health and live independently. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  17. Quality of life of elderly persons with newly diagnosed cancer

    DEFF Research Database (Denmark)

    Esbensen, B A; Osterlind, K; Roer, O

    2004-01-01

    The aim was to investigate quality of life (QoL) in elderly persons newly diagnosed with cancer (65+ years) in relation to age, contact with the health-care system, ability to perform activities of daily living (ADL), hope, social network and support, and to identify which factors were associated...... with low QoL. The sample consisted of 101 patients (75 women and 26 men) newly diagnosed with cancer. EORTC QLQ-C30, Nowotny's Hope Scale, Katz ADL and the Interview Schedule for Social Interaction (ISSI) were used. The analysis was carried out in four age groups and revealed no significant differences...... in QoL. Compared with the other age groups, those of a high age (80+ years) more often lived alone, used more home-help service and had a smaller social network. Factors associated with low QoL were 'no other incomes than retirement pension', 'low level of hope' and 'lung cancer'. In addition, 'being...

  18. Handgrip strength does not represent an appropriate measure to evaluate changes in muscle strength during an exercise intervention program in frail elderly people

    NARCIS (Netherlands)

    Tieland, C.A.B.; Verdijk, L.; Groot, de C.P.G.M.; Loon, van L.J.C.

    2015-01-01

    Although handgrip strength is considered a strong predictor of negative health outcomes, it is unclear whether handgrip strength represents a useful measure to evaluate changes in muscle strength following resistance-type exercise training in elderly people. We assessed whether measuring handgrip

  19. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Tieland, C.A.B.; Dirks, M.L.; Zwaluw, van der N.L.; Verdijk, L.; Rest, van de O.; Groot, de C.P.G.M.; Loon, van L.C.

    2012-01-01

    Objectives Protein supplementation has been proposed as an effective dietary strategy to augment the skeletal muscle adaptive response to prolonged resistance-type exercise training in elderly people. Our objective was to assess the impact of protein supplementation on muscle mass, strength, and

  20. Effects of a randomized controlled recurrent fall prevention program on risk factors for falls in frail elderly living at home in rural communities.

    Science.gov (United States)

    Jeon, Mi Yang; Jeong, HyeonCheol; Petrofsky, Jerrold; Lee, Haneul; Yim, JongEun

    2014-11-14

    Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program--31 subjects in the experimental group and 31 subjects in the control group. When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (pbalance. This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history.

  1. Fear of Falling among Community-dwelling Elderly Women Receiving Visiting Nursing Services in Japan

    OpenAIRE

    Takai, Kiyako; Honda, Sumihisa; Ye, Zhaojia; Abe, Yasuyo; Takamura, Noboru; Osaki, Makoto; Kusano, Yosuke; Takemoto, Tai-Ichiro; Aoyagi, Kiyoshi

    2007-01-01

    Although fear of falling is a common and serious problem among elderly people, little is known about the risk factors associated with fear of falling among frail elderly persons in Japan. To assess the fear of falling and investigate related factors, we conducted a study among 167 Japanese women aged 59 or older, who were receiving visiting nursing services. Fear of falling was measured by asking subjects about being afraid of falling (yes/no) and completing the Japanese version of Falls Effi...

  2. Renal physiology in elderly persons with severe immobility syndrome.

    Science.gov (United States)

    Musso, Carlos; Liakopoulos, Vassilios; Pangre, Norma; DiTrolio, Julio; Jauregui, Ricardo; De Miguel, Raul; Stefanidis, Ioanis; Imperiali, Nora; Algranati, Luis

    2009-01-01

    The immobility syndrome (IS) is a common condition in the elderly and consists of a reduction in the capacity to perform daily activities because of motor function deterioration. This syndrome leads to characteristic structural and physiological changes in the body, but renal physiology studies have not been conducted on this population. For this reason, we decided to study prospectively changes in renal function in these individuals. We enrolled into this study 17 volunteers over 64 years of age, all of whom lived in the same nursing home. The patients were divided into two groups: nine healthy mobile persons and eight others who suffered from severe IS. Exclusion criteria were the presence of any disease or use of any drug that could induce water and electrolytes alteration. Blood and urine samples were drawn to measure sodium, potassium, creatinine, urea, calcium, phosphorus, magnesium, and uric acid in order to obtain their fractional excretion. Plasma osmolality and vasopressin were also measured. Total body water and lean body mass were obtained by bioelectrical impedance analysis. Statistical analysis was performed applying Student's t-test (P = 0.01) and Pearson's correlation test. A significant difference in body water composition was found between the groups. Thus in the IS group plasma sodium level was slightly lower and total water content was significantly higher than in the mobile subjects: 140 +/- 5 vs. 143 +/- 1 mmol/l (P = 0.01); 61 +/- 8% vs. 50 +/- 10% (P immobility syndrome than in healthy mobile elderly. In contrast with the mobile group, for which there was a good positive correlation between plasma osmolality and plasma vasopressin, for individuals with IS there was no correlation between plasma osmolality and plasma vasopressin.

  3. Elderly health and implementation of the Brazilian National Health Policy for Elderly Persons on the performed actions in basic healthcare

    Directory of Open Access Journals (Sweden)

    SCHMINSKI VIEIRA, Roseli

    2016-06-01

    Full Text Available The Brazilian National Health Policy for Elderly Persons (PNSPI – in Portuguese was formulated by the Ministry of Health through Ordinance No. 2.528/2006 in line with the 1988 Brazilian Constitution. The study investigated whether municipalities from the South region of the State of Santa Catarina had knowledge and applied the PNSPI, on the performed actions in basic healthcare, especially on the Units of Family Healthcare Services based on what the Constitution and the Statute of the Elderly comprise. A deductive method with a qualitative approach and a descriptive research were used. As a result, some difficulties experienced by the research subjects related to two important points of policies and strategies of PNSPI were identified: the lack of a planned policy and of a continuous health education for the elderly; and the lack of a stimulating exercise of social control, whether in the health sector, or in the Municipal Council of Elderly People.

  4. Survival strategies – living with an elderly person suffering from dementia

    DEFF Research Database (Denmark)

    Lauritzen, Jette; Suzhen, Liu; Bro Aaen, Karen

    College, School of Nursing, Sichuan University, Chengdu, China. Background: In China and Denmark the numbers of elderly demented citizens are rising. Therefore the contact between the Primary Health Care nurses and relatives of elderly demented persons has increased, in order to enable the elderly to stay...... groups of relatives, living in China and Denmark, has been performed. Preliminary Results: A thematic analysis of the interview transcripts identified themes such as the use of strategies in form of harassment of the elderly demented and fighting loneliness as a caregiver by using the Primary Health Care...

  5. Evaluation and Comparison of Cognitive State and Depression in Elderly Admitted in Sanitarium with Elderly Sited in Personal Home

    OpenAIRE

    Mohamad-baghere Sohrabi; Pone Zolfaghari; Farzane Mahdizade; Seyd-Mohammad Aghayan; Mojtaba Ghasemian- Aghmashhadi; Zahra Shariati; Ahmad Khosravi

    2008-01-01

    Introduction: In this study cognitive state and geriatric depression in elderly living in sanatorium and personal home were evaluated. Methods: The present study was conducted on 46 aged subjects living in sanitarium and 90 aged subjects staying in personal homes. Mini mental status examination (MMSE) and geriatric depression scale (GDS) questionnaires were completed according to the standard examination. Results: As for the cognitive state of the aged living in sanitarium, 13 cases (28.3%) s...

  6. Older persons' definitions and explanations of elder abuse in the Netherlands.

    Science.gov (United States)

    Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

    2016-01-01

    In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semistructured interviews with 35 older persons who had no experience with abuse. Our findings show that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of, and explanation for, elder abuse may influence their detection and reporting behavior, as they may tend to acknowledge only severe cases of intentional physical violence that leave clear and therefore physically detectable evidence.

  7. Clothing for Elderly Persons: Management and Caring Strategies ...

    African Journals Online (AJOL)

    This paper examines the clothing requirements of the elderly across the globe and the management and caring strategies in supporting them. There is however, no specific requirement for the elderly in terms of what they wear or how they dress over and above the requirements of early adult life in many nations of the world.

  8. Perceptions of Elder Abuse From Community-Dwelling Older Persons and Professionals Working in Western Switzerland.

    Science.gov (United States)

    Roulet Schwab, Delphine; Wangmo, Tenzin

    2017-09-01

    Older persons' perspectives regarding elder abuse remain little studied. However, definitions of elder abuse and effective prevention strategies require adaptation to the needs and cultures of targeted populations. This study explored the views of older persons and professionals to evaluate their converging and diverging perspectives toward elder abuse and its prevention. The study employed a qualitative approach where six focus groups were held in Western Switzerland (the French-speaking part of the country). Four focus groups with 25 older persons from varying socioeconomic backgrounds, and the other two focus groups were carried out with 16 professionals working in the field of elder abuse prevention. For the focus groups, we used the technique of free associations to begin the discussions and vignette-like statements to explore participants' attitudes toward elder abuse. These were followed by open-ended questions. The transcripts from the focus groups were analyzed thematically and resulted in four main themes: (a) varied associations of the term "abuse," (b) judging elder abuse situations in terms of abuse and severity, (c) self-identification with elder abuse, and (d) prevention of elder abuse. Study findings demonstrated that older persons hold views that are partly different from the views of professionals. Furthermore, perceptions of older persons could be stratified based on the socioeconomic status of the participants. These diverging perspectives reflect the heterogeneity of the senior citizen population and highlight the need for research cognizant of these differences. The results of this study provide strategies for improved targeting of preventive measures, underline the importance of integrating the perspectives of older persons, and reveal the need to expand the commonly accepted definitions of elder abuse so that they better reflect the affected individuals.

  9. Changes in metabolic correlates of personality traits in healthy elderly women

    International Nuclear Information System (INIS)

    Park, Hyun Soo; Cho, Sang Soo; Yoon, Eun Jin; Bang, Seong Ae; Kim, Yu Kyeong; Kim, Sang Eun

    2007-01-01

    Personality traits are generally known to be stable, although the brain changes with aging. Especially women experience striking alterations in the neuroendocrinergic system at menopause, which may cause considerable changes in personality traits and alter their underlying neural substrates. To investigate changes in the neural substrates underlying personality traits, we investigated metabolic correlates of personality traits in women before and after menopause. We obtained FDG PET images from 13 young (24.0±3.1 y) and 11 elderly females (66.8±3.3 y). Three factors of personality traits (novelty seeking (NS), harm avoidance (HA), reward dependence (RD)) were assessed using Cloninger's 240-item Temperament and Characteristic Inventory. Three ANCOVA maps were created in SPM2 (P < 0.01 uncorrected, k = 100), each constructed to assess the metabolic correlates of each temperament factor. In young females NS scores were negatively correlated with glucose metabolism in the right insula and right cingulate; in elderly females, the right cuneus. In young females HA scores were positively correlated with glucose metabolism in the right lingual gyrus; in elderly females, the left anterior cingulate and bilateral hippocampus. Only in elderly females, HA scores were negatively correlated with glucose metabolism in the right orbital gyrus and bilateral frontal gyri. In young females, RD scores were positively correlated with glucose metabolism in the bilateral frontal gyri and bilateral cingulate; in elderly females, the right middle frontal gyrus. In young females, RD scores were negatively correlated with glucose metabolism in the right precuneus; in elderly females, the left insula. We found that neural substrates underlying personality traits in females were dissociable across young and elderly women. These results may provide better understanding of differential prevalence and susceptibility to psychiatric illnesses in young and elderly females

  10. Changes in metabolic correlates of personality traits in healthy elderly women

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Soo; Cho, Sang Soo; Yoon, Eun Jin; Bang, Seong Ae; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Personality traits are generally known to be stable, although the brain changes with aging. Especially women experience striking alterations in the neuroendocrinergic system at menopause, which may cause considerable changes in personality traits and alter their underlying neural substrates. To investigate changes in the neural substrates underlying personality traits, we investigated metabolic correlates of personality traits in women before and after menopause. We obtained FDG PET images from 13 young (24.0{+-}3.1 y) and 11 elderly females (66.8{+-}3.3 y). Three factors of personality traits (novelty seeking (NS), harm avoidance (HA), reward dependence (RD)) were assessed using Cloninger's 240-item Temperament and Characteristic Inventory. Three ANCOVA maps were created in SPM2 (P < 0.01 uncorrected, k = 100), each constructed to assess the metabolic correlates of each temperament factor. In young females NS scores were negatively correlated with glucose metabolism in the right insula and right cingulate; in elderly females, the right cuneus. In young females HA scores were positively correlated with glucose metabolism in the right lingual gyrus; in elderly females, the left anterior cingulate and bilateral hippocampus. Only in elderly females, HA scores were negatively correlated with glucose metabolism in the right orbital gyrus and bilateral frontal gyri. In young females, RD scores were positively correlated with glucose metabolism in the bilateral frontal gyri and bilateral cingulate; in elderly females, the right middle frontal gyrus. In young females, RD scores were negatively correlated with glucose metabolism in the right precuneus; in elderly females, the left insula. We found that neural substrates underlying personality traits in females were dissociable across young and elderly women. These results may provide better understanding of differential prevalence and susceptibility to psychiatric illnesses in young and elderly females.

  11. Prevalence and determinants of depression among elderly persons in a rural community from northern India.

    Science.gov (United States)

    Behera, Priyamadhaba; Sharan, Pratap; Mishra, Ashwani Kumar; Nongkynrih, Baridalyne; Kant, Shashi; Gupta, Sanjeev Kumar

    2016-01-01

    Globally, more than 350 million people of all ages suffer from depression. Elderly persons are more vulnerable to depression. We conducted this study to estimate the prevalence of depression, and to study the association of depression with sociodemographic and clinical variables among elderly persons in a rural community. We conducted a community-based cross-sectional study among 395 randomly selected elderly persons aged 60 years and above in a rural area of Ballabgarh, Haryana, India. The participants were screened by using the Geriatric Depression Scale, and diagnosis was confirmed by the Mini International Neuropsychiatric Interview. Multivariate analysis was done for independent predictors of depression. The prevalence of depression was 11.4% (95% CI 8.6%-14.9%). Living in a nuclear family (adjusted odds ratio [AOR] 8.98, 95% CI 3.40-23.71), lack of physical activity (AOR 4.95, 95% CI 2.00-12.27), whole-time involvement in household work (AOR 4.47, 95% CI 1.18-16.93), presence of two or more chronic diseases (AOR 4.45, 95% CI 1.60-12.35), having no role in family decision-making (AOR 2.77, 95% CI 1.19-6.42), sleep problems in past one year (AOR 2.97, 95% CI 1.32-6.69) and bilateral hearing impairment (AOR 4.00, 95% CI 1.80-8.88) were factors associated with depression in elderly persons. Depression is common among elderly persons in rural areas. Individuals providing healthcare to elderly persons need to be trained to identify depression and take appropriate action; elderly persons with chronic diseases and hearing impairment deserve special attention.

  12. Negative Stereotypes Underlying Other-Person Perceptions of the Elderly

    Science.gov (United States)

    Umphrey, Don; Robinson, Tom

    2007-01-01

    When assessing effects of advertisements on themselves and on people in their mid-40s and 70s, more than 30% of respondents drew upon negative stereotypes when making estimates about effects of advertising messages on the elderly. There was no difference between first-year university students and seniors majoring in advertising in the rate of…

  13. Aripiprazole for acute mania in an elderly person

    Directory of Open Access Journals (Sweden)

    Balaji Bharadwaj

    2011-01-01

    Full Text Available New-onset bipolar disorder is rare in the elderly. Symptom profile is similar to that in young adults but the elderly are more likely to have neurological co-morbidities. There are no case reports of elderly mania being treated with aripiprazole, an atypical antipsychotic. A 78-year-old gentleman presented to us with symptoms suggestive of mania of 1 month′s duration. He had similar history 3 years ago and a family history of postpartum psychosis in his mother. There were no neurological signs on examination and work-up for an organic etiology was negative except for age-related cerebral atrophy. He improved with aripiprazole and tolerated the medications well. The use of psychotropic medications in the elderly is associated with side-effects of sedation, increased cardiovascular risk, and greater risk of extra-pyramidal side-effects. The use of partial dopaminergic antagonists like aripiprazole may be useful in the balancing of effects and side-effects.

  14. Breast cancer in elderly person: which role for radiotherapy

    International Nuclear Information System (INIS)

    Horn, S.; Cutuli, B.

    2011-01-01

    The authors briefly discuss the issue and practices of treatment of elderly women suffering from breast cancer. Even if radiotherapy is sometimes forgotten in such cases, disease characteristics and the tolerance capacity of the patient must be considered before implementing treatment protocols. Short communication

  15. Cobalamin Deficiency in Elderly Patients: A Personal View

    Directory of Open Access Journals (Sweden)

    Emmanuel Andrès

    2008-01-01

    Full Text Available Cobalamin (vitamin B12 deficiency is particularly common in the elderly (>65 years of age but is often unrecognized because its clinical manifestations are subtle; however, they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. In the elderly, the main causes of cobalamin deficiency are pernicious anemia and food-cobalamin malabsorption. Food-cobalamin malabsorption syndrome is a disorder characterized by the inability to release cobalamin from food or its binding proteins. This syndrome is usually caused by atrophic gastritis, related or unrelated to Helicobacter pylori infection, and long-term ingestion of antacids and biguanides. Management of cobalamin deficiency with cobalamin injections is currently well documented but new routes of cobalamin administration (oral and nasal are being studied, especially oral cobalamin therapy for food-cobalamin malabsorption.

  16. [Diagnosis and management of chronic renal failure in the elderly].

    Science.gov (United States)

    Segalen, Isabelle; Le Meur, Yannick

    2016-01-01

    The incidence of chronic renal failure in the elderly is rising due to the ageing of the general population. Its management, and notably nephroprotective therapies, must be adapted to the elderly person who is often frail and with multiple pathologies. The decision to start extra-renal purification does not depend on the patient's chronological age but on their physiological age and requires dialogue between the patient and their family, the geriatrician and the nephrologist. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Beliefs in the paranormal: age and sex differences among elderly persons and undergraduate students.

    Science.gov (United States)

    Vitulli, W F; Tipton, S M; Rowe, J L

    1999-12-01

    Beliefs in the paranormal were rated stronger in younger as compared to elderly adults by Emmons and Sobal in 1981, and sex correlates of paranormal beliefs appeared to be stronger in women than in men by Irwin in 1994. This research studied possible linkages between age and sex with a comparative analysis between results of Vitulli and Luper's 1998 survey among undergraduate students and data from elderly men (M = 72 yr., SD = 9.2, n = 21) and women (M = 69.3 yr., SD = 7.7, n = 55). Crawford and Christensen's 1995 12-item Extrasensory Perception Survey was administered to elderly persons living in apartment complexes and private homes, participating in activities in a recreation center, or attending a continuing-education seminar. A 2 x 2 multivariate analysis of variance from responses on the 12-item survey showed that undergraduate men and elderly women had the highest ratings on paranormal beliefs. The self-selecting characteristics of a segment of the elderly sample led to a post hoc univariate analysis of variance by partitioning that sample into those who were attending a continuing-education seminar versus all other elderly persons. Summated ratings (total scores) for this survey showed main effects for these subsamples and for sex. Sex and age differences were discussed in the context of the hypothesis of social marginality.

  18. Low intensity vibration of ankle muscles improves balance in elderly persons at high risk of falling

    Science.gov (United States)

    Toosizadeh, Nima; Mohler, Jane

    2018-01-01

    In our study we examined postural performance of young healthy persons (HY), elderly healthy persons (HE), and elderly persons at high risk of falling (FR). Anterio-posterior (AP) and medio-lateral (ML) ankle and hip angular deviations, as well as linear displacements of the center of mass (COM) were assessed in persons standing with eyes either open or closed, while none, and 40 and 30 Hz vibrations were applied bilaterally to the ankle muscle gastrocnemius. During quiet standing with eyes open, balance parameters in FR group differed from those in healthy groups. ML ankle and hip angular deviations, as well as COM linear displacements were noticeably larger in FR group. During quiet standing with eyes closed, all balance parameters in participants of all groups had a clear trend to increase. During standing with eyes open, 40 Hz vibration increased all but one balance parameter within HY group, ankle angular deviations in HE group, but none in FR group. In response to 30 Hz vibration, only ankle angular deviations and COM linear displacements increased in HY group. There were no changes in both elderly groups. During standing with eyes closed, 40 and 30 Hz vibrations did not produce consistent changes in balance parameters in HY and HE groups. In FR persons, 40 Hz vibration did not change balance parameters. However, in FR groups, 30 Hz vibration decreased ankle and hip angular deviations, and COM linear displacements. The major result of the study is a finding that low intensity vibration of ankle muscles makes balance better in elderly persons at high risk of falling. This result is clinically relevant because it suggests that applying mild vibration to ankle muscles while standing and walking might benefit elderly persons, improving their postural performance and reducing a risk of unexpected falls. PMID:29579098

  19. Case management for frail older adults through tablet computers and Skype.

    Science.gov (United States)

    Berner, Jessica; Anderberg, Peter; Rennemark, Mikael; Berglund, Johan

    2016-12-01

    Frail older adults are high consumers of medical care due to their age and multiple chronic conditions. Regular contact with a case manager has been proven to increase well-being of frail older adults and reduce their number of health-care visits. Skype calls through tablet PCs can offer easier communication. This paper examines frail older adults' use of tablet computers and Skype, with their case managers. Interviews were conducted on 15 frail older adults. A content analysis was used to structure and analyze the data. The results indicate that tablet computers were experienced in a positive way for most frail older adults. Conflicting feelings did emerge, however, as to whether the frail elderly would adopt this in the long run. Skype needs to be tested further as to whether this is a good solution for communication with their case managers. Strong technical support and well-functioning technology are important elements to facilitate use. Using Skype and tablet PCs do have potential for frail older adults, but need to be tested further.

  20. Ethical Issues Relative to Autonomy and Personal Control in Independent and Cognitively Impaired Elders.

    Science.gov (United States)

    Rice, Virginia Hill; And Others

    1997-01-01

    Discusses ethical issues surrounding health care for independent elders, those in long-term care, and those with cognitive impairments, as well as death, dying, euthanasia, and assisted suicide. Suggests that nurses should focus on older adults' choice, autonomy, and personal control. (SK)

  1. 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

  2. Multidisciplinary team, working with elderly persons living in the community: a systematic literature review.

    Science.gov (United States)

    Johansson, Gudrun; Eklund, Kajsa; Gosman-Hedström, Gunilla

    2010-01-01

    As the number of elderly persons with complex health needs is increasing, teams for their care have been recommended as a means of meeting these needs, particularly in the case of elderly persons with multi-diseases. Occupational therapists, in their role as team members, exert significant influence in guiding team recommendations. However, it has been emphasized that there is a lack of sound research to show the impact of teamwork from the perspective of elderly persons. The aim of this paper was to explore literature concerning multidisciplinary teams that work with elderly persons living in the community. The research method was a systematic literature review and a total of 37 articles was analysed. The result describes team organisation, team intervention and outcome, and factors that influence teamwork. Working in a team is multifaceted and complex. It is important to enhance awareness about factors that influence teamwork. The team process itself is also of great importance. Clinical implications for developing effective and efficient teamwork are also presented and discussed.

  3. 78 FR 31451 - Pet Ownership for the Elderly or Persons With Disabilities in Multifamily Rental Housing...

    Science.gov (United States)

    2013-05-24

    ... Pet Ownership for the Elderly or Persons With Disabilities in Multifamily Rental Housing; Accumulation of Deposits for Costs Attributable to Pets AGENCY: Office of the Secretary, HUD. ACTION: Proposed... disabilities allow for the residents of such housing to own common household pets, subject to the residents...

  4. The Longitudinal Elderly Person Shadowing Program: Outcomes from an Interprofessional Senior Partner Mentoring Program

    Science.gov (United States)

    Basran, Jenny F. S.; Dal Bello-Haas, Vanina; Walker, Doreen; MacLeod, Peggy; Allen, Bev; D'Eon, Marcel; McKague, Meredith; Chopin, Nicola S.; Trinder, Krista

    2012-01-01

    The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults.…

  5. Gender and preferences for personal contact: key variables in the Internet Banking use by elderly people.

    OpenAIRE

    Ramón Jerónimo, Mª Ángeles; Peral Peral, Begoña; Villarejo Ramos, Ángel Francisco

    2013-01-01

    The analysis of the services offered by the Internet Banking and the response of clients to these services constitute a powerful tool for the success in this market. In the case of elders, the population is heterogeneous and the understanding of differences in responses and behaviours is the basis for any good strategic development driven to the personalization of the service. The present study aims to analyse the gender gap in the use of Internet Baking and preferences for personal contact i...

  6. Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons

    OpenAIRE

    Reginold, William; Luedke, Angela C.; Tam, Angela; Itorralba, Justine; Fernandez-Ruiz, Juan; Reginold, Jennifer; Islam, Omar; Garcia, Angeles

    2015-01-01

    Background/Aims: This study used 3-Tesla magnetic resonance imaging (MRI) tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH) and cognitive function in elderly persons. Methods: Brain T2-weighted fluid-attenuated inversion recovery (FLAIR) and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tes...

  7. Which Fall Ascertainment Method Captures Most Falls in Pre-Frail and Frail Seniors?

    Science.gov (United States)

    Teister, Corina J; Chocano-Bedoya, Patricia O; Orav, Endel J; Dawson-Hughes, Bess; Meyer, Ursina; Meyer, Otto W; Freystaetter, Gregor; Gagesch, Michael; Rizzoli, Rene; Egli, Andreas; Theiler, Robert; Kanis, John A; Bischoff-Ferrari, Heike A

    2018-06-15

    There is no consensus on most reliable falls ascertainment method. Therefore, we investigated which method captures most falls among pre-frail and frail seniors from two randomized controlled trials conducted in Zurich, Switzerland, a 18-month trial (2009-2010) including 200 community-dwelling pre-frail seniors with a prior fall and a 12-month trial (2005-2008) including 173 frail seniors with acute hip fracture. Both included the same fall ascertainment methods: monthly active-asking, daily self-report diary, and a call-in hotline. We compared number of falls reported and estimated overall and positive percent agreement between methods. Pre-frail seniors reported 499 falls (rate = 2.5/year) and frail seniors reported 205 falls (rate = 1.4/year). Most falls were reported by active-asking: 81% of falls in pre-frail, and 78% in frail seniors. Among pre-frail seniors, diaries captured additional 19% falls, while hotline added none. Among frail seniors, hotline added 16% falls, while diaries added 6%. The positive percent agreement between active-asking and diary was 100% among pre-frail and 88% among frail seniors. While monthly active-asking captures most falls in both groups, this method alone missed 19% of falls in pre-frail and 22% in frail seniors. Thus, a combination of active-asking and diaries for pre-frail, and active-asking and the hotline for frail seniors is warranted.

  8. Capacity to Vote in Persons with Dementia and the Elderly

    Directory of Open Access Journals (Sweden)

    Luis Javier Irastorza

    2011-01-01

    Full Text Available The capacity to vote in patients with mental illness is increasingly questioned. The objective of this study is to evaluate this capacity in a group of subjects with dementia (Alzheimer's disease and other elderly subjects without dementia. With a sample of 68 subjects with dementia and 25 controls living in a senior residence, a transversal study was carried out over 4 months. Subjects were evaluated with the Mini-Mental State Examination (MMSE and the Competence Assessment Tool for voting (CAT-V. The results were more positive for the Doe criteria (as part of the CAT-V, and a correlation was found with the MMSE in subjects with dementia and, to a lesser degree, in the controls. We conclude that the capacity to vote is related to cognitive deterioration and, within that, is more related to understanding and appreciation.

  9. Balancing struggles with desired results in everyday activities: strategies for elderly persons with physical disabilities.

    Science.gov (United States)

    Bontje, Peter; Asaba, Eric; Josephsson, Staffan

    2016-03-01

    The number of elderly persons with disabilities needing support with everyday activities increasing in Japan and around the world. Yet, engagement in everyday activities can support the quality of their daily life. Despite research focusing on reported meanings of people's actions, there is still limited knowledge on how engagement in everyday activity is enacted along with the meanings of persons' actions. The aim of the present study was to identify meanings of persons' actions within everyday activities of elderly Japanese with physical disabilities. Five elderly persons with physical disabilities living in the community participated in this study. Data were gathered by 10 participant observations of everyday activities supplemented with 13 unstructured interviews. Narrative analysis was used to identify meanings of persons' actions. The analysis identified an overall plot termed 'balancing struggles with desired results'. This plot illustrated that participants' and other involved individuals balanced problematic situations with finding situations that accommodated their needs. Meanings of these actions were further identified as three complementary strategies. Two of three strategies aimed to mitigate given problems, one by 'acting on a plan to achieve one's goals', the other by 'taking a step in a preferred direction by capitalising on emerging opportunities'. The third strategy focused on avoiding undesirable experiences by 'modifying problematic situations'. In conclusion, these findings call for care and rehabilitation providers' sensitivity to shifting foci of what matters in daily life's situations as well as aligning with persons' skills, resources and perspectives. Accordingly, the judicious and flexible use of these complementary strategies can enhance elderly persons' quality of daily living through everyday activities. © 2015 Nordic College of Caring Science.

  10. [SOCIAL SERVICES ORGANIZATION FOR ELDERLY CITIZENS AND DISABLED PERSONS IN SOUTH FEDERAL DISTRICT OF RUSSIA].

    Science.gov (United States)

    Bashkireva, A S; Bogdanov, E A; Shestakov, V P; Svintsov, A A; Chernova, G I; Cherniakina, T S

    2015-01-01

    The article presents a comparative analysis of the effectiveness of the individual rehabilitation programs among elderly citizens and disabled persons of the Astrakhan region, the part of the South Federal District of Russia. We analyzed the data of the statistical survey of the social services provided rehabilitation facilities for the elderly and disabled people in the Astrakhan region. Analytical results thus obtained shown that the network of agencies and centers of social rehabilitation in the Astrakhan region did not correspond to the needs of elderly people and disabled persons. The negative dynamics in the number of social care centers as well as in the number of people who were provided with their services revealed the need for optimization of the institutional structure and its management. These specific characteristics of the social rehabilitation services in the Astrakhan region thus identified should be taken into consideration in order to improve the rehabilitation programs among elderly citizens and disabled persons in the South Region of the Russian Federation.

  11. The Relation of Personality Traits Wth Depression Severity in Active and Non-Active Elderly Women in Tehran City

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Aslankhani

    2010-07-01

    Full Text Available Objectives: The purpose of this study was to investigate the relation of personality traits with depression in active and non – active elderly women in Tehran city. Methods & Materials: The present research is descriptive–correlation. For this purpose, 188 elderly women (94 active and 94 non - active elders in the age range of 63-82 in Tehran city availably selected as statistical sample. Measurement instrument were demographic questionnaire, Beck depression questionnaire and NEO personality traits questionnaire. Data were analyzed using descriptive statistic (mean and standard deviation and inferential statistic (independent t test, Pearson correlation and Enter multi variant Regression. Results: Results showed that there was significant difference in personality traits and depression between active women with non-active women elders (P<0.05. Also, the result showed that significant correlation between depression score on neuroticism, extroversion, openness and conscientiousness in active women elders and conscientiousness and openness in non-active women elders (P<0.05. The results of multi variant regression also indicated that openness and extroversion variants in active elders and conscientiousness variant in non-active elders have linear relationship with criteria variant (depression and can predict its changes. Conclusion: Based on results of present research, sport and physical activity can be afforded the increase of positive personality traits (for example extroversion and openness and decrease of depression in women elders.

  12. Quality of life of elderly persons with cancer: a 6-month follow-up

    DEFF Research Database (Denmark)

    Esbensen, Bente Appel; Osterlind, Kell; Hallberg, Ingalill Rahm

    2007-01-01

    The aim of this study was to investigate possible changes in quality of life (QoL) in elderly persons diagnosed with cancer (65 years and above), in relation to age, contact with the health-care system, activities of daily living, hope, social network and support. The investigation points were...... aged (age 65+) recently diagnosed with cancer (74 women, 27 men), but was reduced to 75 (57 women, 18 men) by the 6-month investigation point. EORTC QLQ C30, Katz ADL, Nowotny's Hope Scale and Interview Schedule for Social Interaction were used in structured personal interviews and questionnaires...... of elderly persons with cancer: those with advanced disease and decreased hope, and those with increased need of both informal and formal assistance....

  13. Exercise testing and hemodynamic performance in healthy elderly persons

    International Nuclear Information System (INIS)

    Hitzhusen, J.C.; Hickler, R.B.; Alpert, J.S.; Doherty, P.W.

    1984-01-01

    To determine the effect of age on cardiovascular performance, 39 healthy elderly men and women, 70 to 83 years old, underwent treadmill thallium-201 exercise perfusion imaging and radionuclide equilibrium angiography at rest and during supine bicycle exercise. Five volunteers who had a positive exercise thallium test response were excluded from the study. Radionuclide left ventricular ejection fraction, regional wall abnormalities, relative cardiac output, stroke volume, end-diastolic volume and end-systolic volume were measured. Seventy-four percent of the subjects maintained or increased their ejection fraction with exercise. With peak exercise, mean end-diastolic volume did not change, end-systolic volume decreased and cardiac output and stroke volume increased. Moreover, in 35% of the subjects, minor regional wall motion abnormalities developed during exercise. There was no significant difference in the response of men and women with regard to these variables. However, more women than men had difficulty performing bicycle ergometry because they had never bicycled before. Subjects who walked daily performed the exercise tests with less anxiety and with a smaller increase in heart rate and systolic blood pressure

  14. [The benefits of doing excercise in the elderly].

    Science.gov (United States)

    Avila-Funes, José Alberto; García-Mayo, Emilio José

    2004-01-01

    Advanced age is associated with changes in body composition such as muscular mass loss, which is defined as sarcopenia. The former term plays a key role in the frailty model, although its source is unknown. Myriad strategies have been used to improve and increase muscular mass and function in older persons. The muscle is a versatile system that owes its great capacity to adaption to regular exercise programs. Aerobic exercise and resistance training improve muscular function and can minimize and even reverse sarcopenia in the elderly (healthy, very elderly or frail). The main difference in prescribing exercise for healthy adults and elderly individuals is that intensity of training program is lower for the latter. This review is aimed toward the physiopathologic aspects and clinical implications regarding muscular mass loss and to programs directed toward increasing strength and/or endurance in the elderly.

  15. The Relation of Personality Traits Wth Depression Severity in Active and Non-Active Elderly Women in Tehran City

    OpenAIRE

    Mohammad Ali Aslankhani; Ahmad Farokhi; Parvane Shamsipour Dehkordi; Amir Shams; Mohammad Reza Ghasemian Moghaddam

    2010-01-01

    Objectives: The purpose of this study was to investigate the relation of personality traits with depression in active and non – active elderly women in Tehran city. Methods & Materials: The present research is descriptive–correlation. For this purpose, 188 elderly women (94 active and 94 non - active elders) in the age range of 63-82 in Tehran city availably selected as statistical sample. Measurement instrument were demographic questionnaire, Beck depression questionnaire and...

  16. Improving activities of daily living for nursing home elder persons in Taiwan.

    Science.gov (United States)

    Chang, Su-Hsien; Wung, Shu-Fen; Crogan, Neva L

    2008-01-01

    Excess disability among nursing home elder persons can be prevented or remediated. Because of self-selected disuse and caregiver support of dependency, nursing home residents are likely to develop excess disability. No study was found to test a theory-based program aimed at improving elder persons' self-care abilities for Taiwanese nursing home elder persons who are at risk for developing excess disability. The purpose of this study was to test the effectiveness of a theory-based intervention program on self-care, specifically on activities of daily living (ADLs) performance among nursing home elder persons in Taiwan. A secondary aim was to determine the correlation between ADLs performance and three bliss concepts: life satisfaction, self-esteem, and motivation in health behavior. This study used a quasi-experimental, two-group, pretest-posttest design. Forty-two qualified participants were recruited from two nursing homes located in southern Taiwan and assigned to either the experimental group (n = 21) or the comparison group (n = 21). Participants in the experimental group received the Self-Care Self-Efficacy Enhancement Program (SCSEEP), and those in the comparison group received biweekly social visits for 6 weeks. Levels of ADLs performance were measured by Tappen's Refined ADL Assessment Scale. Life satisfaction was measured by Adams' Life Satisfaction Index A. Self-esteem was measured by Rosenberg's Self-Esteem Scale. Motivation in health behavior was measured by Cox's Health Self-Determinism Index. Elder persons receiving the SCSEEP had significant improvement in feeding, dressing, grooming, and washing activities. Self-esteem (p = .011) and life satisfaction (p = .033) but not motivation in health behavior (p = .282) were positively correlated with levels of ADLs performance. The SCSEEP provides a theory-based intervention model for Taiwanese nursing home elder persons aimed at improving ADLs performance. Further research with a larger sample size is

  17. Elderly persons' perception and acceptance of using wireless sensor networks to assist healthcare.

    Science.gov (United States)

    Steele, Robert; Lo, Amanda; Secombe, Chris; Wong, Yuk Kuen

    2009-12-01

    This is an exploratory study carrying out qualitative research into the perceptions, attitudes and concerns of elderly persons towards wireless sensor network (WSN) technologies in terms of their application to healthcare. This work aims to provide guidance on the dimensions and items that may be included in the development of a more in-depth questionnaire to further validate the importance of the identified factors as well as the relationships between them. This study aims to contribute to opening up a communication channel between users and researchers, informing the research community in relation to applications and functionalities that users deem as either desirable, inadequate or in need of further development. Focus groups were conducted with elderly individuals who were still living independently. To explore elderly persons' perceptions and thoughts on current wireless sensor network (WSN) technologies and designs, discussion points were designed from concepts identified from various user acceptance theories and models. Participants were given an introduction to explain the functionality and capabilities of WSN and motes and were shown a sample mote, the Crossbow Mica2Dot. Participants were then asked to discuss their perceptions and concerns towards the likelihood of using a WSN-based healthcare system in their home. We have identified sixteen concepts in relation to the elderly participants' perception, concerns and attitudes towards WSN systems. Those concepts were further classified into six themes describing the determinants that may affect an elderly person's acceptance of WSNs for assisting healthcare. Some of our exploratory findings in this study indicate for example that independence is highly valued by elderly people and hence any system or technology that can prolong that independence tends to be highly regarded, that privacy of WSN health data might not be as important as typically considered, and there are also indications that cost may be the

  18. Dynamic Parameters of Balance Which Correlate to Elderly Persons with a History of Falls

    Science.gov (United States)

    Muir, Jesse W.; Kiel, Douglas P.; Hannan, Marian; Magaziner, Jay; Rubin, Clinton T.

    2013-01-01

    Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; polder persons with no recent fall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement). Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score (“B-score”) algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly “non-fallers” had a B-score of 0.334, compared to 0.645 for those with a fall history (ppostural sway elements may identify individuals at greatest risk of falling, allowing interventions to target those with greatest need of attention. PMID:23940592

  19. Personality traits influencing somatization symptoms and social inhibition in the elderly

    Directory of Open Access Journals (Sweden)

    Wongpakaran T

    2014-01-01

    Full Text Available Tinakon Wongpakaran, Nahathai WongpakaranFaculty of Medicine, Chiang Mai University, Chiang Mai, ThailandPurpose: Somatization is a common symptom among the elderly, and even though personality disorders have been found to be associated with somatization, personality traits have not yet been explored with regard to this symptom. The aim of this study is to investigate the relationship between personality traits and somatization, and social inhibition.Patients and methods: As part of a cross-sectional study of a community sample, 126 elderly Thais aged 60 years or over completed self-reporting questionnaires related to somatization and personality traits. Somatization was elicited from the somatization subscale when using the Symptom Checklist SCL-90 instrument. Personality traits were drawn from the 16 Personality Factor Questionnaire and social inhibition was identified when using the inventory of interpersonal problems. In addition, path analysis was used to establish the influence of personality traits on somatization and social inhibition.Results: Of the 126 participants, 51% were male, 55% were married, and 25% were retired. The average number of years in education was 7.6 (standard deviation =5.2. “Emotional stability” and “dominance” were found to have a direct effect on somatization, as were age and number of years in education, but not sex. Also, 35% of the total variance could be explained by the model, with excellent fit statistics. Dominance was found to have an indirect effect, via vigilance, on social inhibition, which was also influenced by number of years in education and emotional stability. Social inhibition was not found to have any effect on somatization, although hypothetically it should.Conclusion: “Emotional stability”, “dominance”, and “vigilance”, as well as age and the number of years in education, were found to have an effect on somatization. Attention should be paid to these factors in the elderly

  20. Acute changes in pulse pressure in relation to constituents of particulate air pollution in elderly persons

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, Lotte [Occupational and Environmental Medicine, Unit of Lung Toxicology, K.U.Leuven, Leuven (Belgium); Buczynska, Anna [Departement of Chemistry, UA, Wilrijk (Belgium); Walgraeve, Christophe [Research group EnVOC, Department of Sustainable Organic Chemistry and Technology, UGent, Gent (Belgium); Delcloo, Andy [Royal Meteorological Institute, Brussels (Belgium); Potgieter-Vermaak, Sanja [Departement of Chemistry, UA, Wilrijk (Belgium); Molecular Science Institute, School of Chemistry, University of Witwatersrand, Johannesburg (South Africa); Division of Chemistry and Environmental Science, Manchester Metropolitan University, Manchester (United Kingdom); Van Grieken, Rene [Departement of Chemistry, UA, Wilrijk (Belgium); Demeestere, Kristof; Dewulf, Jo; Van Langenhove, Herman [Research group EnVOC, Department of Sustainable Organic Chemistry and Technology, UGent, Gent (Belgium); De Backer, Hugo [Royal Meteorological Institute, Brussels (Belgium); Nemery, Benoit, E-mail: ben.nemery@med.kuleuven.be [Occupational and Environmental Medicine, Unit of Lung Toxicology, K.U.Leuven, Leuven (Belgium); Nawrot, Tim S. [Occupational and Environmental Medicine, Unit of Lung Toxicology, K.U.Leuven, Leuven (Belgium); Centre for Environmental Sciences, Hasselt University, Diepenbeek (Belgium)

    2012-08-15

    An increased pulse pressure (difference between systolic and diastolic blood pressure) suggests aortic stiffening. The objective of this study was to examine the acute effects of both particulate matter (PM) mass and composition on blood pressure, among elderly persons. We carried out a panel study in persons living in elderly homes in Antwerp, Belgium. We recruited 88 non-smoking persons, 70% women with a mean age of 83 years (standard deviation: 5.2). Blood pressure was measured and a blood sample was collected on two time points, which were chosen so that there was an exposure contrast in ambient PM exposure. The elemental content of the collected indoor and outdoor PM{sub 2.5} (particulate matter with an aerodynamic diameter <2.5 {mu}m) mass concentration was measured. Oxygenated polycyclic aromatic hydrocarbons (oxy-PAHs) on outdoor PM{sub 10} (particulate matter with an aerodynamic diameter <10 {mu}m) were measured. Each interquartile range increase of 20.8 {mu}g/m Superscript-Three in 24-h mean outdoor PM{sub 2.5} was associated with an increase in pulse pressure of 4.0 mmHg (95% confidence interval: 1.8-6.2), in persons taking antihypertensive medication (n=57), but not in persons not using antihypertensive medication (n=31) (p for interaction: 0.02). Vanadium, iron and nickel contents of PM{sub 2.5} were significantly associated with systolic blood pressure and pulse pressure, among persons on antihypertensive medication. Similar results were found for indoor concentrations. Of the oxy-PAHs, chrysene-5,6-dione and benzo[a]pyrene-3,6-dione were significantly associated with increases in systolic blood pressure and pulse pressure. In elderly, pulse pressure was positively associated with acute increases in outdoor and indoor air pollution, among persons taking antihypertensive medication. These results might form a mechanistic pathway linking air pollution as a trigger of cardiovascular events.

  1. Ageing and Non-Formal Care for Elderly Persons in Croatia

    Directory of Open Access Journals (Sweden)

    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

  2. Prostate cancer radiotherapy in elderly person; Radiotherapie du cancer de la prostate chez la personne agee

    Energy Technology Data Exchange (ETDEWEB)

    Serre, A. [Centre Alexis-Vautrin, Nancy (France)

    2011-10-15

    The author discusses the issue of prostate cancer radiotherapy in the case of elderly persons. The choice of the therapeutic strategy (local, hormonotherapy, simple monitoring) is complex. Different aspects must be considered: the carcinologic situation assessment, the patient health condition, the patient life expectancy, and the possible side effects of treatment. Radiotherapy appears to be a major therapeutic asset, but dose levels, toxicity effects must then be considered. Short communication

  3. Etiology, diagnosis, and demographic analysis of maxillofacial trauma in elderly persons: A 10-year investigation

    DEFF Research Database (Denmark)

    Possebon, Anna Paula da Rosa; Granke, Gabriela; Faot, Fernanda

    2017-01-01

    Purpose The aim of this study was to investigate etiologies and diagnoses of maxillofacial trauma in emergency services in Brazil over a period of 10 years. Additionally, associations among sex, age, accident location, and dependent variables were analyzed. Understanding the epidemiology of trauma...... understanding of the physiological changes associated with aging, and preventive action to reduce falls, traffic accidents, and aggression in this population could be beneficial with regard to quality of life for elderly persons....

  4. Quality of life of elderly persons with cancer: a 6-month follow-up

    DEFF Research Database (Denmark)

    Esbensen, Bente Appel; Osterlind, Kell; Hallberg, Ingalill Rahm

    2007-01-01

    aged (age 65+) recently diagnosed with cancer (74 women, 27 men), but was reduced to 75 (57 women, 18 men) by the 6-month investigation point. EORTC QLQ C30, Katz ADL, Nowotny's Hope Scale and Interview Schedule for Social Interaction were used in structured personal interviews and questionnaires......L, by the significant >/=10 units, from baseline to 6-month follow-up, while about 70% remained stable in QoL from baseline. The majority of the elderly persons with cancer showed an ability to adjust to the new condition. However, in clinical practice, specific attention should be paid to the most vulnerable groups...

  5. Perceived family and friend support and the psychological well-being of American and Chinese elderly persons.

    Science.gov (United States)

    Poulin, John; Deng, Rong; Ingersoll, Travis Sky; Witt, Heather; Swain, Melanie

    2012-12-01

    This study examines two sources of informal support-perceived family and friend support-and the psychological well-being-self-esteem, depression and loneliness-of 150 Chinese and 145 American elders. There were no significant differences between the elderly American and Chinese persons' mean scores on family and friend support. The multiple linear regression analyses with interaction terms (country x family support and country x friend support), however, indicated that the relationship between family support and depression and family support and loneliness was stronger for the Chinese elderly than the US elderly. Conversely, the relationship between friend support and depression and friend support and loneliness is stronger for US elderly than Chinese elderly. The implications of these findings for social work practice in both countries is discussed.

  6. Dynamic parameters of balance which correlate to elderly persons with a history of falls.

    Science.gov (United States)

    Muir, Jesse W; Kiel, Douglas P; Hannan, Marian; Magaziner, Jay; Rubin, Clinton T

    2013-01-01

    Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; pfall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement). Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score ("B-score") algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly "non-fallers" had a B-score of 0.334, compared to 0.645 for those with a fall history (pfalling, allowing interventions to target those with greatest need of attention.

  7. Tc-99m-DMSA renal uptake rate and renal volume of elderly persons

    International Nuclear Information System (INIS)

    Ohishi, Yukihiko; Machida, Toyohei; Kido, Akira

    1987-01-01

    Renal function of erderly persons was evaluated by the radionuclide renal function test based on the renal uptake rate and the renal volume determined by Tc-99m-DMSA transectional tomographic images using single photon emission computed tomography (SPECT). Forty-three erderly cases (13 healthy persons and 30 patients with various types of renal disorders) aged between 60 and 87 on an average of 70 were studied and compared with results obtained from 20 healthy adults (18 - 45 years old). Renal volume was calculated from the summation of voxels in the region districted by equi-count threshold level (percentage to maximum count) on each section of the SPECT image. Attenuation correction was made by GE-STAR protocol utilizing Sorrenson's precorrection method. The renal uptake rate was expressed as a percentage of the total radioactivity detected within the renal volume, against an amount of dose injected. In the 26 kidneys of 13 healthy elderly persons, Tc-99m-DMSA renal uptake was 23 ± 5 %, which was significantly lower (p < 0.01) than that of healthy adults being 27 ± 2 %. A correlation coefficient between renal volume and uptake of 79 kidneys of 43 elderly persons was 0.5081 (p < 0.01). Creatinine clearance (Ccr) was better correlated with the total renal uptake (r = 0.6471, p < 0.01) than with the total renal volume (r = 0.3592, p < 0.01). This method is considered to be useful for clinical purpose as a test of renal function for elderly persons since it requires neither blood nor urine samples. (author)

  8. Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people

    Directory of Open Access Journals (Sweden)

    de Vries Oscar J

    2011-01-01

    Full Text Available Abstract Background Falls in frail elderly are a common problem with a rising incidence. Gait and postural instability are major risk factors for falling, particularly in geriatric patients. As walking requires attention, cognitive impairments are likely to contribute to an increased fall risk. An objective quantification of gait and balance ability is required to identify persons with a high tendency to fall. Recent studies have shown that stride variability is increased in elderly and under dual task condition and might be more sensitive to detect fall risk than walking speed. In the present study we complemented stride related measures with measures that quantify trunk movement patterns as indicators of dynamic balance ability during walking. The aim of the study was to quantify the effect of impaired cognition and dual tasking on gait variability and stability in geriatric patients. Methods Thirteen elderly with dementia (mean age: 82.6 ± 4.3 years and thirteen without dementia (79.4 ± 5.55 recruited from a geriatric day clinic, walked at self-selected speed with and without performing a verbal dual task. The Mini Mental State Examination and the Seven Minute Screen were administered. Trunk accelerations were measured with an accelerometer. In addition to walking speed, mean, and variability of stride times, gait stability was quantified using stochastic dynamical measures, namely regularity (sample entropy, long range correlations and local stability exponents of trunk accelerations. Results Dual tasking significantly (p Conclusions The observed trunk adaptations were a consistent instability factor. These results support the concept that changes in cognitive functions contribute to changes in the variability and stability of the gait pattern. Walking under dual task conditions and quantifying gait using dynamical parameters can improve detecting walking disorders and might help to identify those elderly who are able to adapt walking

  9. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    Directory of Open Access Journals (Sweden)

    Grace Haeson Park

    2014-03-01

    Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

  10. A SIMPLE FRAILTY QUESTIONNAIRE (FRAIL) PREDICTS OUTCOMES IN MIDDLE AGED AFRICAN AMERICANS

    Science.gov (United States)

    MORLEY, J.E.; MALMSTROM, T.K.; MILLER, D.K.

    2015-01-01

    Objective To validate the FRAIL scale. Design Longitudinal study. Setting Community. Participants Representative sample of African Americans age 49 to 65 years at onset of study. Measurements The 5-item FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight), at baseline and activities of daily living (ADLs), instrumental activities of daily living (IADLs), mortality, short physical performance battery (SPPB), gait speed, one-leg stand, grip strength and injurious falls at baseline and 9 years. Blood tests for CRP, SIL6R, STNFR1, STNFR2 and 25 (OH) vitamin D at baseline. Results Cross-sectionally the FRAIL scale correlated significantly with IADL difficulties, SPPB, grip strength and one-leg stand among participants with no baseline ADL difficulties (N=703) and those outcomes plus gait speed in those with no baseline ADL dependencies (N=883). TNFR1 was increased in pre-frail and frail subjects and CRP in some subgroups. Longitudinally (N=423 with no baseline ADL difficulties or N=528 with no baseline ADL dependencies), and adjusted for the baseline value for each outcome, being pre-frail at baseline significantly predicted future ADL difficulties, worse one-leg stand scores, and mortality in both groups, plus IADL difficulties in the dependence-excluded group. Being frail at baseline significantly predicted future ADL difficulties, IADL difficulties, and mortality in both groups, plus worse SPPB in the dependence-excluded group. Conclusion This study has validated the FRAIL scale in a late middle-aged African American population. This simple 5-question scale is an excellent screening test for clinicians to identify frail persons at risk of developing disability as well as decline in health functioning and mortality. PMID:22836700

  11. [Predictors of institutionalization of elderly persons in dependency situation in Andalusia].

    Science.gov (United States)

    Pinzón-Pulido, Sandra; Garrido Peña, Francisco; Reyes Alcázar, Víctor; Lima-Rodríguez, Joaquín Salvador; Raposo Triano, María Fernanda; Martínez Domene, Manuel; Alonso Trujillo, Federico

    2016-01-01

    Identifying preferences regarding type of care and risk factors for institutionalization of elderly persons in dependency situations in Andalusia. The data on 200,039 persons registered in the System for Autonomy and Dependency Care over the period 2007-2012 were analysed. The study population was described in terms of: age, dependency situation, preferences, support network and clinical factors at the time of inclusion in the study. Separate analysis was made for men and women. A logistic regression model was designed to determine the risk factors for institutionalization for each sex. 87,4% of women and 85,9% of men expressed their wish to receive care in their own home. The risk of institutionalization is three times higher among men than among women. Among women, the risks of institutionalization are: level of dependency, wishing to move into a residential care home, medium consistency and fragility of support network and being diagnosed with dementia. Among men, the risks are: wishing to move into a residential care home and low or medium consistency of support network. Care in the home is the preferred alternative for elderly persons in dependency situations. The risk of institutionalization is conditioned more by the preferences of the person and their family and the characteristics of the support network than by individual's clinical condition. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  12. Exploratory study toward development of the French version of the questionnaire on personality traits (QPT/VKP-4) in an elderly population in comparison to young adults.

    Science.gov (United States)

    Courtois, R; Enfoux, A; Plaisant, O; Coutard, N; Duijsens, I J; Réveillère, C; Camus, V; El-Hage, W

    2014-08-01

    This research is an exploratory study toward development of the French version of the Questionnaire on Personality Traits (QPT/VKP-4). The goal was to assess its association with the Big Five Inventory (BIG-5) and to explore the personality characteristics of the elderly compared to young adults. The 241 participants included 83 elderly people and 158 young adults. Borderline and anxious personality disorders were less frequent in elderly women than in young women, and depressive personality disorder was less frequent in elderly men. Dimension scores were higher for Conscientiousness in the elderly, Agreeableness in elderly women, and Extraversion in elderly men. Statistically significant correlations were found between personality dimension scores using the VKP-4 and the BIG-5.

  13. A summary risk score for the prediction of Alzheimer disease in elderly persons.

    Science.gov (United States)

    Reitz, Christiane; Tang, Ming-Xin; Schupf, Nicole; Manly, Jennifer J; Mayeux, Richard; Luchsinger, José A

    2010-07-01

    To develop a simple summary risk score for the prediction of Alzheimer disease in elderly persons based on their vascular risk profiles. A longitudinal, community-based study. New York, New York. Patients One thousand fifty-one Medicare recipients aged 65 years or older and residing in New York who were free of dementia or cognitive impairment at baseline. We separately explored the associations of several vascular risk factors with late-onset Alzheimer disease (LOAD) using Cox proportional hazards models to identify factors that would contribute to the risk score. Then we estimated the score values of each factor based on their beta coefficients and created the LOAD vascular risk score by summing these individual scores. Risk factors contributing to the risk score were age, sex, education, ethnicity, APOE epsilon4 genotype, history of diabetes, hypertension or smoking, high-density lipoprotein levels, and waist to hip ratio. The resulting risk score predicted dementia well. According to the vascular risk score quintiles, the risk to develop probable LOAD was 1.0 for persons with a score of 0 to 14 and increased 3.7-fold for persons with a score of 15 to 18, 3.6-fold for persons with a score of 19 to 22, 12.6-fold for persons with a score of 23 to 28, and 20.5-fold for persons with a score higher than 28. While additional studies in other populations are needed to validate and further develop the score, our study suggests that this vascular risk score could be a valuable tool to identify elderly individuals who might be at risk of LOAD. This risk score could be used to identify persons at risk of LOAD, but can also be used to adjust for confounders in epidemiologic studies.

  14. Prevalence, Awareness, Treatment and Control of Diabetes Among Elderly Persons in an Urban Slum of Delhi

    Directory of Open Access Journals (Sweden)

    Arvind Kumar Singh

    2012-01-01

    Full Text Available Background : The increasing proportion of elderly persons is contributing to an increase in the prevalence of diabetes. The residents of urban slums are more vulnerable due to poverty and lack of access to health care. Objective: To estimate the prevalence of diabetes in elderly persons in an urban slum and to assess their awareness, treatment and control of this condition. Materials and Methods : All persons aged 60 years and above, residing in an urban slum of Delhi, were included in this cross-sectional community- based study. Data were collected on sociodemographic variables. The participants′ awareness and treatment of diabetes was recorded. Their fasting blood sugar was estimated using an automated glucometer. Diabetes was diagnosed if fasting blood glucose was ≥126 mg/dL, or if the participant was taking treatment for diabetes. Impaired fasting blood glucose was diagnosed if fasting blood glucose was 110-125 mg/dL. Results: Among the 474 participants studied, the prevalence of diabetes was estimated to be 18.8% (95% CI 15.3-21.5. It decreased with increasing age, and was higher among women. The prevalence of impaired fasting blood glucose was 19.8% (95% CI 16.3-23.7. It was higher among women. One-third of the diabetic participants were aware of their condition; two-thirds of these were on treatment and three-fourths of those on treatment had controlled fasting blood sugar level. The awareness, treatment and control were better among women. Conclusions : Diabetes is common among elderly persons in urban slums. Its magnitude and low awareness warrant effective public health interventions for their treatment and control.

  15. [Development of a staging classification for leisure activities and social communication in dependent elderly persons].

    Science.gov (United States)

    Okochi, Jiro; Takamuku, Kiyoshi; Higashi, Kentaro; Orimo, Kenichiro; Honma, Tatsuya; Nishiwaki, Keiko; Ando, Shigeru

    2014-01-01

    The aim of this study was to develop a simple staging classification to measure leisure activity and social communication among the elderly at geriatric health care facilities. In order to construct a staging scale for measuring the participation of the elderly subjects, we developed a list of 28 items for three domains: leisure activities, social participation and communication. Data were obtained from users of institutional and day care services at geriatric health service facilities. The Rasch model was applied to test the degree of item fit and difficulty. Simple staging scales were constructed based on 12 leisure activity and nine social communication items. The validity and reliability were tested using these newly developed scales according to the Rasch model and assessments of the test-retest reliability. The participants were 3,458 elderly persons, of whom 1,560 were currently using institutional services and 1,898 were using day care services. Among the 28 items, "traveling" was identified as the most difficult and "watching television" was identified as the easiest. Because items related to "social participation," such as volunteer activities, exhibited a low frequency, they were not used in the further analyses. Simple staging scales were constructed by analyzing the remaining items of leisure activities and social communication according to the Rasch model. The thresholds within the scales were determined in order of item difficulty. Cohen's kappa, as assessed by two different evaluators, was 0.75 for leisure activities and 0.77 for social communication. In this study, we developed staging scales for leisure activity and social communication. The construct validity and test-retest reliability were adequate for both scales. Service providers can improve service quality by using these scales for individual case management of elderly persons in conjunction with existing scales of activities of daily living.

  16. Dynamic parameters of balance which correlate to elderly persons with a history of falls.

    Directory of Open Access Journals (Sweden)

    Jesse W Muir

    Full Text Available Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4, 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1. Center of pressure (COP was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; p<0.05, while three measures of balance were significantly worse in fallers as compared to older persons with no recent fall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement. Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score ("B-score" algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly "non-fallers" had a B-score of 0.334, compared to 0.645 for those with a fall history (p<0.001. A weighted amalgam of postural sway elements may identify individuals at greatest risk of falling, allowing interventions to target those with greatest need of attention.

  17. Personality, Emotional Qualities of Leisure, and Subjective Well-Being in the Elderly.

    Science.gov (United States)

    Kahlbaugh, Patricia; Huffman, Loreen

    2017-07-01

    In this study, we examined personality traits of older adults and their emotional experiences associated with engaging in specific leisure activities. Older individuals (17 males, 32 females), ages ranging from 65 to 97 years (mean age 74), completed measures of Big Five personality traits, positive and negative affect, subjective well-being (SWB), independent functioning, and an emotion-activity inventory. As expected, Extraversion, Agreeableness, Conscientiousness, and Openness to experience were related to positive affect, while Neuroticism was related to negative affect. Openness and Agreeableness were related to positive emotions experienced in social and cognitive domains, and Agreeableness was related to greater SWB, greater positive affect, and more positively experienced activities. Neuroticism was related to lower SWB and fewer positively experienced activities. These findings suggest that assessing the fit between personality and emotions experienced during activities should be considered when creating programs tailored to elderly individuals, with the goal of encouraging more active and rewarding lives.

  18. Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons

    Directory of Open Access Journals (Sweden)

    William Reginold

    2015-10-01

    Full Text Available Background/Aims: This study used 3-Tesla magnetic resonance imaging (MRI tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH and cognitive function in elderly persons. Methods: Brain T2-weighted fluid-attenuated inversion recovery (FLAIR and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tests and were classified as normal controls (n = 15 or with Alzheimer's dementia (n = 11. Tractography was generated by the Fiber Assignment by Continuous Tracking method. All tracts that crossed WMH were segmented. The average fractional anisotropy and average mean diffusivity of these tracts were quantified. We studied the association between cognitive test scores with the average mean diffusivity and average fractional anisotropy of tracts while controlling for age, total WMH volume and diagnosis. Results: An increased mean diffusivity of tracts crossing WMH was associated with worse performance on the Wechsler Memory Scale-III Longest Span Forward (p = 0.02. There was no association between the fractional anisotropy of tracts and performance on cognitive testing. Conclusion: The mean diffusivity of tracts crossing WMH measured by tractography is a novel correlate of performance on the Wechsler Memory Scale-III Longest Span Forward in elderly persons.

  19. Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons.

    Science.gov (United States)

    Reginold, William; Luedke, Angela C; Tam, Angela; Itorralba, Justine; Fernandez-Ruiz, Juan; Reginold, Jennifer; Islam, Omar; Garcia, Angeles

    2015-01-01

    This study used 3-Tesla magnetic resonance imaging (MRI) tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH) and cognitive function in elderly persons. Brain T2-weighted fluid-attenuated inversion recovery (FLAIR) and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tests and were classified as normal controls (n = 15) or with Alzheimer's dementia (n = 11). Tractography was generated by the Fiber Assignment by Continuous Tracking method. All tracts that crossed WMH were segmented. The average fractional anisotropy and average mean diffusivity of these tracts were quantified. We studied the association between cognitive test scores with the average mean diffusivity and average fractional anisotropy of tracts while controlling for age, total WMH volume and diagnosis. An increased mean diffusivity of tracts crossing WMH was associated with worse performance on the Wechsler Memory Scale-III Longest Span Forward (p = 0.02). There was no association between the fractional anisotropy of tracts and performance on cognitive testing. The mean diffusivity of tracts crossing WMH measured by tractography is a novel correlate of performance on the Wechsler Memory Scale-III Longest Span Forward in elderly persons.

  20. [Refusal of care faced by case manager from elderly persons in complex situation: cross perspectives].

    Science.gov (United States)

    Corvol, A; Balard, F; Moutel, G; Somme, D

    2014-01-01

    Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals' attitudes and ethical challenges. Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers. Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits. To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  1. Association Between Extraversion and Exercise Performance Among Elderly Persons Receiving a Videogame Intervention.

    Science.gov (United States)

    Zaitsu, Kosuke; Nishimura, Yuki; Matsuguma, Hiroyuki; Higuchi, Shigekazu

    2015-10-01

    We examined the effects of an exergame intervention on exercise performance, as well as the influence of players' personality traits on the effects of the intervention. In total, 16 elderly persons (>65 years old) participated in the study for 12 weeks. Participants were required to complete the Big Five Scale. We measured the number of times that the sit-to-stand exercise was performed during the interventions with and without exergames. We compared the average number of times that the sit-to-stand exercise was performed per day in each of the two conditions. The average number of times that exercise was undertaken with exergame use was greater than that without exergame use; however, no significant difference was found. The difference between the average number of times that exercise occurred with and without exergame use was positively correlated with neuroticism, negatively correlated with extraversion, and not associated with conscientiousness. The intervention comprising the use of exergames has a positive motivational influence among less extraverted elderly persons.

  2. Dynamic Parameters of Balance Which Correlate to Elderly Persons with a History of Falls

    OpenAIRE

    Muir, Jesse W.; Kiel, Douglas P.; Hannan, Marian; Magaziner, Jay; Rubin, Clinton T.

    2013-01-01

    Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the ...

  3. Diabetes mellitus in elderly

    Directory of Open Access Journals (Sweden)

    Farida Chentli

    2015-01-01

    Full Text Available Diabetes mellitus (DM frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60–65 years old, DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is "go slowly and individualize" to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin.

  4. Screening of the frail patient in the emergency department

    DEFF Research Database (Denmark)

    Jørgensen, Rasmus; Brabrand, Mikkel

    2017-01-01

    to detect frailty in patients. ≥. 65. years by their ability to identify the risk of adverse outcomes. Methods: An extensive medical literature search of Embase and PubMed was conducted, to identify studies using frailty screening scales in the emergency department. Data was subsequently extracted...... and evaluated from the results of the included studies. Results: Four studies met the exact inclusion criteria. Four different frailty screening scales: Clinical Frailty Scale, Deficit Accumulation Index, Identification of Seniors At Risk and The Study of Osteoporotic Fracture frailty index used...... emergency department visit. Frailty does however not predict increased risk of 30. day emergency department revisit. Further research highlighting the value of screening for frailty level in elderly emergency department patients is needed. Learning points: Although frail elders in need of further geriatric...

  5. [Depression and burden on primary caregivers of elderly persons with physical dependence of the UMF 171].

    Science.gov (United States)

    Navarro-Sandoval, Cristina; Uriostegui-Espíritu, Lizbeth Carlota; Delgado-Quiñones, Edna Gabriela; Sahagún-Cuevas, Minerva Natalia

    2017-01-01

    According to the National Health and Nutrition Survey of 2012, more than a quarter of older adults (26.9%) have some degree of disability, requiring a primary caregiver to perform basic activities of daily living. The aim is to determine the prevalence of depression and burden on primary caregivers of elderly persons with physical dependence. A descriptive cross-sectional study with non-probability sampling that included the primary caregivers of elderly patients with physical dependence. Barthel scale was applied as a tool to measure the level of physical dependence in elderly patients; while the primary caregivers were applied to the Beck Depression and Zarit scale for assessing the level of caregiver burden. A sample of 76 primary caregivers was calculated and descriptive statistical analysis was performed. Of the 76 primary caregivers, 55.3% were without depression, 32.9% had mild depression, and 11.8% with moderate depression. According to the Zarit scale, 40.8% had no burden, 44.7% had burden light, and 14.5% intense burden. The role of primary caregiver is a stressful task which can interfere with their family health; so our role is to provide care not only to the geriatric dependent patients, but also to their caregiver.

  6. Satisfaction in everyday life for frail 85-years old adults:

    DEFF Research Database (Denmark)

    Johannesen, A; Petersen, Janne; Avlund, K

    2004-01-01

    The purpose of this study was to investigate whether social relations, continuity, self-determination, and use of own resources are associated with everyday life satisfaction among 85-year-old adults with physical disabilities. The population includes 187 frail men and women from the longitudinal......) feel able to manage their own lives; (4) do not live alone; and (5) have not lately lost close friends. Lack of everyday life satisfaction is associated with (1) using home-care services and (2) living in an institution. The findings stress the importance of helping old persons stay active...... study of the 1914 population in Glostrup, Copenhagen. Participants were all interviewed in their homes by an occupational therapist. Findings provide evidence that frail older adults more frequently express satisfaction with their daily lives when they (1) are occupied as usual; (2) have friends; (3...

  7. Satisfaction in everyday life for frail 85-years old adults:

    DEFF Research Database (Denmark)

    Johannesen, A; Petersen, Janne; Avlund, K

    2004-01-01

    ) feel able to manage their own lives; (4) do not live alone; and (5) have not lately lost close friends. Lack of everyday life satisfaction is associated with (1) using home-care services and (2) living in an institution. The findings stress the importance of helping old persons stay active......The purpose of this study was to investigate whether social relations, continuity, self-determination, and use of own resources are associated with everyday life satisfaction among 85-year-old adults with physical disabilities. The population includes 187 frail men and women from the longitudinal...... study of the 1914 population in Glostrup, Copenhagen. Participants were all interviewed in their homes by an occupational therapist. Findings provide evidence that frail older adults more frequently express satisfaction with their daily lives when they (1) are occupied as usual; (2) have friends; (3...

  8. Work–Life Integration and Workplace Rights for Domestic Workers in Support to Elderly Persons

    Directory of Open Access Journals (Sweden)

    Diane-Gabrielle Tremblay

    2015-05-01

    Full Text Available Our article shows that there is a real challenge in balancing work and family for employees working in support services in domestic work for elderly persons; their workplace rights on this issue are quite limited, and they depend largely on managers’ understanding and support. Given their difficult working conditions, these workers actually find quite a challenge in trying to reconcile work and family. Our article is based on a qualitative research mobilizing 33 semi-structured interviews with employees of the home care sector in the field of the social economy mainly but also in the private sector. We first present the concept of work–family and personal life, then the area of home care and domestic work for the elderly. Then, we present the particular challenges observed in reconciling work and family life, where possible by comparing men and women. The results highlight two major sources of differentiation: age and single parenthood. Those who are older highlight the fact that children have grown up, and they have (finally some time for themselves, even if their working conditions are difficult (broken schedules, etc.. In contrast, single women live a much more difficult situation concerning work–family, partly because of the lack of workplace rights on this issue and because of the poor working conditions for many (broken hours of work, low wages, difficult working conditions. We conclude with some recommendations, including the Right to request, which appears to be the best option, although it would need some further analysis.

  9. [Elder].

    Science.gov (United States)

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-09-01

    The aim of this review is to present scientific evidence on the biological, dietary, cultural and economic advantages of cow´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described. The updated scientific references on the importance of milk and dairy products on the dietary management of the most prevalent diseases of the eldery -among these energy-protein malnutrition, sarcopenia, obesity, sarcopenic obesity, osteoporosis, diabetes and cardiovascular diseases- are presented.

  10. Older persons' views and experience of elder abuse in South Western Nigeria: a community-based qualitative survey.

    Science.gov (United States)

    Cadmus, Eniola Olubukola; Owoaje, Eme Theodora; Akinyemi, Oluwaseun Oladapo

    2015-06-01

    Conventionally, existing information on elder abuse has been institution based, professionally driven, and in high-income countries. This study addresses the prevailing gap in knowledge through direct consultation of older persons in the community about their perceptions of elder abuse. Eight focus group discussions were carried out among males and females aged 60 years and above in a rural and an urban community in south western Nigeria. Data were transcribed and analyzed based on emergent themes. Findings from the study show that the perception of abuse by the respondents included the standard typologies except sexual abuse as well as societal issues such as disrespect and lack of recognition. Our study revealed a high level of awareness and experience of elder abuse among the participants in both communities. Effective social welfare and health services aided by targeted government policies are needed to improve the quality of life of the elderly. © The Author(s) 2014.

  11. Differences in Waiting List Prioritization Preferences of Occupational Therapists, Elderly People, and Persons With Disabilities: A Discrete Choice Experiment.

    Science.gov (United States)

    Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie Ehrmann

    2018-01-01

    To compare the preferences of occupational therapists, elderly people, and adults with disabilities regarding prioritization criteria for occupational therapy waiting lists in home care. Discrete choice experiment survey. Survey mailed to occupational therapists working in home care and community-dwelling elderly or disabled persons. A sample (N=714) of home-based occupational therapists (n=241), elderly persons from a bank of research participants (n=226), and adults with physical disabilities recruited through community organizations (n=247). Not applicable. The dependent variable was whether the referral scenario was prioritized or not in each question. The results were analyzed through logistic regression using conditional logit models. Prioritization preferences differed between groups (Ppeople who had a few falls (odds ratio vs no falls, 48.7), whereas elderly people and adults with disabilities most strongly prioritized people who were unable to enter and exit the home (odds ratio vs no difficulty entering and exiting the home, 30.8 for elderly people and 16.8 for persons with disabilities.) CONCLUSIONS: Our results highlight the gap between the priorities of home-based occupational therapists and their target clientele. Although further inquiry is needed to inform priority setting, the findings emphasize the importance of public or patient involvement in decisions on waiting list prioritization. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

    Directory of Open Access Journals (Sweden)

    Martin Estelle

    2010-12-01

    Full Text Available Abstract Background Although spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients. Methods A three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT: 1 Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2 Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT investigating needs related to each of the defined dimensions; 3 Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains. Results Four dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups. Conclusions The SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care.

  13. Factors Associated with Teenagers' Willingness to Volunteer with Elderly Persons: Application of the Theory of Planned Behavior (TPB)

    Science.gov (United States)

    Reuveni, Yehudit; Werner, Perla

    2015-01-01

    The purpose of this study was to investigate the factors associated with teenagers' willingness to volunteer with elderly persons using an expanded model of the Theory of Planned Behavior (TPB). Participants consisted of 258 ninth-grade students at a large high school in the northern part of Israel. Participants completed a structured…

  14. Protocols for the Assessment of Elder Abuse.

    Science.gov (United States)

    Fulmer, Terry; Wetle, Terrie

    The fact that many states have passed elder abuse reporting laws has left care providers with a dilemma. If suspected abuse is reported, the relationship between caregiver and patient may change and the family's difficulties may increase. Indicators of abuse are not easy to differentiate from health problems, especially in the frail elderly. An…

  15. Exploring the changing multidimensional experiences of frail older people towards the end of life: a narrative study

    OpenAIRE

    Lloyd, Anna Elizabeth

    2015-01-01

    Background Palliative care services have widened beyond cancer in recent years, yet frail older adults rarely receive such services. There is a need to understand the dynamic multidimensional end-of-life experiences of this group in order to assess how or if a palliative approach could be beneficial. Physical end-of-life trajectories for frail older people have been described but there remains little person centred research that describes changing experiences across physical...

  16. An evaluation of an integrated primary care approach to improve well-being among frail community-dwelling older people

    OpenAIRE

    Vestjens, Lotte; Murray Cramm, Jane; Nieboer, Anna Petra

    2016-01-01

    Introduction: A major challenge in primary health care is the substantial increase of the proportion of frail older persons with long-term conditions and multiple complex needs. The traditional primary care system in the Netherlands is fragmented and reactive. Consequently, current primary health care is not able to cope effectively with the increasing demands for health and social care, and to improve well-being among frail community-living older people. This calls for a fundamental transfor...

  17. Variations of insulin resistance and associated hormone levels in elderly and middle-aged male persons and their clinical significance

    International Nuclear Information System (INIS)

    Zhuo Liankun; Yan Daochun; Chen Xiumei; Liu Peng; Zhang Aihua

    2005-01-01

    To study the relationship between age and insulin resistance and the variation of associated hormones in elderly and middle-aged males, blood levels of LH, FSH, T, SHBG, TSH, INS were determined by RIA, FBG by GPO, IR by HOMA in 268 healthy male persons aged 41 to 60 years and in 80 normal control male persions of 35 to 40 years old. The results showed that levels of IR, LH, FSH, SHBG were increasing and T, TSH were decreasing along with the increase of age except for TSH. Therefore, analyzing these changes could evaluate the conditions of elderly and middle-aged males. (authors)

  18. The occurrence of antimicrobial resistance and class 1 integrons among commensal Escherichia coli isolates from infants and elderly persons

    Directory of Open Access Journals (Sweden)

    Kõljalg Siiri

    2009-12-01

    Full Text Available Abstract Background The aim of our study was to compare the presence of the intI1 gene and its associations with the antibiotic resistance of commensal Escherichia coli strains in children with/without previous antibiotic treatments and elderly hospitalized/healthy individuals. Methods One-hundred-and-fifteen intestinal E. coli strains were analyzed: 30 strains from 10 antibiotic-naive infants; 27 from 9 antibiotic-treated outpatient infants; 30 from 9 healthy elderly volunteers; and 28 from 9 hospitalized elderly patients. The MIC values of ampicillin, cefuroxime, cefotaxime, gentamicin, ciprofloxacin, and sulfamethoxazole were measured by E-test and IntI1 was detected by PCR. Results Out of the 115 strains, 56 (49% carried class 1 integron genes. Comparing persons without medical interventions, we found in antibiotic-naive children a significantly higher frequency of integron-bearing strains and MIC values than in healthy elderly persons (53% versus 17%; p Conclusion The prevalence of integrons in commensal E. coli strains in persons without previous medical intervention depended on age. The resistance of integron-carrying and non-carrying strains is more dependent on influencing factors (hospitalization and antibiotic administration in particular groups than merely the presence or absence of integrons.

  19. The Influence of Personality, Curriculum, and Memory Correlates on Formal Reasoning in Young Adults and Elderly Persons.

    Science.gov (United States)

    Blackburn, James A.

    The effects of age, sex, and curriculum upon the cognitive performance of 20 college students and 20 college-educated elderly individuals were examined. Young adult participants (M=20.55) and elderly participants (M=67.85) were given a battery of formal operational tasks, a measure of field independence/field dependence, a short-term memory…

  20. Consequences of Parental Divorce for Adult Children's Support of Their Frail Parents

    Science.gov (United States)

    Lin, I-Fen

    2008-01-01

    Using three waves of data from the Health and Retirement Study, I examined the association of parental divorce and remarriage with the odds that biological, adult children give personal care and financial assistance to their frail parents. The analysis included 5,099 adult children in the mother sample and 4,029 children in the father sample.…

  1. The impact of group music therapy on depression and cognition in elderly persons with dementia: a randomized controlled study.

    Science.gov (United States)

    Chu, Hsin; Yang, Chyn-Yng; Lin, Yu; Ou, Keng-Liang; Lee, Tso-Ying; O'Brien, Anthony Paul; Chou, Kuei-Ru

    2014-04-01

    The aims of this study were to determine the effectiveness of group music therapy for improving depression and delaying the deterioration of cognitive functions in elderly persons with dementia. The study had a prospective, parallel-group design with permuted-block randomization. Older persons with dementia (N = 104) were randomly assigned to the experimental or control group. The experimental group received 12 sessions of group music therapy (two 30-min sessions per week for 6 weeks), and the control group received usual care. Data were collected 4 times: (1) 1 week before the intervention, (2) the 6th session of the intervention, (3) the 12th session of the intervention, and (4) 1 month after the final session. Group music therapy reduced depression in persons with dementia. Improvements in depression occurred immediately after music therapy and were apparent throughout the course of therapy. The cortisol level did not significantly decrease after the group music therapy. Cognitive function significantly improved slightly at the 6th session, the 12th session, and 1 month after the sessions ended; in particular, short-term recall function improved. The group music therapy intervention had the greatest impact in subjects with mild and moderate dementia. The group music intervention is a noninvasive and inexpensive therapy that appeared to reduce elders' depression. It also delayed the deterioration of cognitive functions, particularly short-term recall function. Group music therapy may be an appropriate intervention among elderly persons with mild and moderate dementia.

  2. Indoor, outdoor, and personal exposure monitoring of particulate air pollution: the Baltimore elderly epidemiology-exposure pilot study

    Science.gov (United States)

    Williams, Ron; Creason, John; Zweidinger, Roy; Watts, Randall; Sheldon, Linda; Shy, Carl

    A 17-day pilot study investigating potential PM exposures of an elderly population was conducted near Baltimore, Maryland. Collection of residential indoor, residential outdoor, and ambient monitoring data associated with the subjects living at a common retirement facility was integrated with results from a paired epidemiological pilot study. This integration was used to investigate the potential pathophysiological health effects resulting from daily changes in estimated PM exposures with results reported elsewhere. Objectives of the exposure study were to determine the feasibility of performing PM exposure assessment upon an elderly population and establishing relationships between the various exposure measures including personal monitoring. PM 2.5 was determined to be the dominant outdoor size fraction (0.83 PM 2.5/PM 10 mass ratio by dichot monitoring). Individual 24-h PM 1.5 personal exposures ranged from 12 to 58 μg m -3. Comparison of data from matched sampling dates resulted in mean daily PM 1.5 personal, PM 2.5 outdoor, and PM 1.5 indoor concentrations of 34, 17, and 17 μg m -3, respectively. Activity patterns of the study population indicated a generally sedentary population spending a mean of 96% of each day indoors. Future studies would benefit from the use of a consistent sampling methodology across a larger number of PM measurement sites relevant to the elderly subjects, as well as a larger personal PM exposure study population to more successfully collect data needed in matched epidemiological-exposure studies.

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

    Science.gov (United States)

    Błachnio, Aleksandra; Buliński, Leszek

    2013-08-16

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

  4. Quality Registries in Sweden, Healthcare Improvements and Elderly Persons with Cognitive Impairments.

    Science.gov (United States)

    Mattsson, Titti

    2016-12-01

    Policy-makers, the medical industry and researchers are demonstrating a keen interest in the potential of large registries of patient data, both nationally and internationally. The registries offer promising ways to measure and develop operational quality within health and medical care services. As a result of certain favourable patient data regulations and government funding, the development of quality registries is advanced in Sweden. The combination of increasing demand for more cost-efficient healthcare that can accommodate the demographic development of a rapidly ageing population, and the emergence of eHealth with an increasing digitalisation of patient data, calls attention to quality registries as a possible way for healthcare improvements. However, even if the use of registries has many advantages, there are some drawbacks from a patient privacy point of view. This article aims to analyse this growing interdependence of quality registries for the healthcare sector. It discusses some lessons from the Swedish case, with particular focus on the collection of data from elderly persons with cognitive impairments.

  5. Relations between postural stability, gait and falls in elderly persons--preliminary report.

    Science.gov (United States)

    Baczkowicz, Dawid; Szczegielniak, Jan; Proszkowiec, Małgorzata

    2008-01-01

    Balance control in elderly patients is the area of interest of many researchers. The results of their studies suggest that the measurement of shifts in the centre of foot pressure on the support base (COP) can be used as a tool for identification of fall-prone persons. It is interesting whether there are any relations between functional status, gait, posture stability and the risk of falling. The aim of this study was to find the answer to this question. The study involved 20 patients (mean age 78.1+/-11.6). The functional status of the patients was evaluated according to the Barthel Index. Postural stability was assessed with the use of a Neurocom Balance Master platform. Three measurements were taken with visual feedback (eyes open-EO) and three without visual feedback (eyes closed-EC). Balance control was also evaluated with the Berg test and on the basis of the history of episodes of falling in the preceding six months. Gait was evaluated with the six-minute walking test. The parameters recorded by the force platform showed a significant relation to the values obtained in the Berg test (r=-0.60; pfalls showed a significant relation only to the EO test (r=0.4; pfalls was connected with increased body sway. 3. The functional status of the patient and the balance control evaluation according to the Berg test failed to determine the risk of falling. 4. A relation was observed between postural stability, functional status and gait.

  6. A pilot study on the views of elderly regional Australians of personally controlled electronic health records.

    Science.gov (United States)

    Kerai, Paresh; Wood, Pene; Martin, Mary

    2014-03-01

    Australia introduced its version of personal health records in July 2012. Success of the personally controlled electronic health record (PCEHR) relies on acceptance during the early stages. The main aim of this study was to investigate the views of a sample of elderly people in a non-metropolitan region in Australia on the PCEHR, and to assess their acceptance levels of this concept. A self-administered questionnaire was distributed to a non-probability convenience sample of respondents recruited from meetings of Probus, a community club for active business and professional retirees. Approximately three-quarters of the respondents had computer and Internet access at home. If not accessed at home a computer at a general practitioner's practice was seen as beneficial in accessing the PCEHR. Respondents felt that access to their health record would help them make decisions about their own health and improve their communication with healthcare providers. The majority of respondents were in favour of the PCEHR although some expressed concerns about the security of their PCEHR. There was mixed opinion surrounding the access by health professionals to an individual's PCEHR. This study has revealed important information about views of the PCEHR. While the respondents were generally in favour of the concept, there were still some concerns about the security of the PCEHR suggesting further reassurance may be required. The study also highlighted some measures, in particular provision of General Practitioner computer access points and print-out facilities that may need to be considered during these initial implementation stages in order to improve adoption rates once the technology is fully available. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Pressure ulcer prevention in frail older people.

    Science.gov (United States)

    Barry, Maree; Nugent, Linda

    2015-12-16

    Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork.

  8. Prospective cohort study of fever incidence and risk in elderly persons living at home

    Science.gov (United States)

    Yokobayashi, Kenichi; Matsushima, Masato; Watanabe, Takamasa; Fujinuma, Yasuki; Tazuma, Susumu

    2014-01-01

    Objective To determine the incidence of fever among elderly persons under home medical management, diagnosis at fever onset and outcomes from a practical standpoint. Design Prospective cohort study. Setting 5 clinics in residential areas of Tokyo that process an average of 50–200 outpatients/day. Participants Patients (n=419) aged ≥65 years who received home medical management from the five clinics between 1 October 2009 and 30 September 2010. Main outcome measures Fever (≥37.5°C or ≥1.5°C above usual body temperature), diagnosis at onset and outcomes (cure at home, hospitalisation and death). Results The incidence of fever was 2.5/1000 patient-days (95% CI 2.2 to 2.8). Fever occurred at least once (229 fever events) among one-third of the participants during the study period. Fever was more likely to arise in the wheelchair users or bedridden than in ambulatory individuals (HR 1.9 (95% CI 1.3 to 2.8; p<0.01); in patients with moderate-to-severe rather than those with none-to-mild cognitive impairment (HR, 1.7 (95% CI 1.1 to 2.6, p=0.01); and in those whose care-need levels were ≥3 rather than ≤2 (HR, 4.5 (95% CI 2.9 to 7.0; p<0.01). The causes of fever were pneumonia/bronchitis (n=103), skin and soft tissue infection (n=26), urinary tract infection (n=22) and the common cold (n=13). Fever was cured in 67% and 23% of patients at home and in hospital, respectively, and 5% of patients each died at home and in hospital. Antimicrobial agents treated 153 (67%) events in the home medical care setting. Conclusions Fever was more likely to occur in those requiring higher care levels and the main cause of fever was pneumonia/bronchitis. Healthcare providers should consider the conditions of elderly residents with lower objective functional status. PMID:25009132

  9. Safety and Security of Older Persons in Tehran, Iran: A Sociological Appraisal of Elder Abuse

    Science.gov (United States)

    Sheykhi, Mohammad Taghi

    2010-01-01

    The article explores and evaluates the quality of life, safety, and security of elderly people in Tehran City in Iran. In that, different dimensions of material and social well-being, and abuse of people of the age 65 and above, are assessed. Besides the human rights, the dignity, and the gradual decline of the elderly's social security are…

  10. Capitalized design of smart medicine box for elderly person based on quality function deployment (QFD)

    Science.gov (United States)

    Lestari, Brina Cindy; Dewi, Dyah Santhi; Widodo, Rusminto Tjatur

    2017-11-01

    The elderly who has a particular disease need to take some medicines in everyday with correct dosages and appropriate by time schedules. However, the elderly frequently forget to take medicines because of their memory weakened. Consequently, the product innovation of elderly healthcare is required for helping elderly takes some medicine more easily. This research aims to develop a smart medicine box by applying quality function deployment method. The first step is identifying elderly requirements through an ethnographic approach by interviewing thirty-two of elderly people as respondents. Then, the second step is translated elderly requirements to technical parameter for designing a smart medicine box. The smart box design is focused on two main requirements which have highest importance rating including alarm reminder for taking medicine and automatic medicine box. Finally, the prototype design has been created and tested by using usability method. The result shown that 90% from ten respondents have positive respond on the feature of smart medicine box. The voice of alarm reminder smart medicine box is easy to understand by elderly people for taking medicines.

  11. Efficacy of spinal magnetic stimulation in elderly persons with chronic constipation

    Directory of Open Access Journals (Sweden)

    Chih-Pin Wang

    2012-03-01

    Conclusion: Our findings reveal that SMS intervention may benefit elderly patients with severe constipation. The amelioration of geriatric bowel dysfunction across the subtypes of slow transit constipation and PFD indicated that SMS, featuring broad-spectrum applications, can be an effective form of adjuvant treatment in the care of elderly adults.

  12. Recall Responses to Tetanus and Diphtheria Vaccination Are Frequently Insufficient in Elderly Persons

    Science.gov (United States)

    Weinberger, Birgit; Schirmer, Michael; Matteucci Gothe, Raffaella; Siebert, Uwe; Fuchs, Dietmar; Grubeck-Loebenstein, Beatrix

    2013-01-01

    Demographic changes and a more active life-style in older age have contributed to an increasing public awareness of the need for lifelong vaccination. Currently many older persons have been vaccinated against selected pathogens during childhood but lack regular booster immunizations. The impact of regular vaccinations when started late in life was analyzed in an open, explorative trial by evaluating the immune response against tetanus and diphtheria in healthy older individuals. 252 persons aged above 60 years received a booster vaccination against tetanus, diphtheria, pertussis and polio and a subcohort (n=87) was recruited to receive a second booster vaccination against tetanus, diphtheria and pertussis 5 years later. The percentage of unprotected individuals at the time of enrollment differed substantially for tetanus (12%) and diphtheria (65%). Despite protective antibody concentrations 4 weeks after the first vaccination in almost all vaccinees, antibodies had again dropped below protective levels in 10% (tetanus) and 45% (diphtheria) of the cohort after 5 years. Protection was restored in almost all vaccinees after the second vaccination. No correlation between tetanus- and diphtheria-specific responses was observed, and antibody concentrations were not associated with age-related changes in the T cell repertoire, inflammatory parameters, or CMV-seropositivity suggesting that there was no general biological “non-responder type.” Post-vaccination antibody concentrations depended on pre-existing plasma cells and B cell memory as indicated by a strong positive relationship between post-vaccination antibodies and pre-vaccination antibodies as well as antibody-secreting cells. In contrast, antigen-specific T cell responses were not or only weakly associated with antibody concentrations. In conclusion, our findings demonstrate that single shot vaccinations against tetanus and/or diphtheria do not lead to long-lasting immunity in many elderly persons despite

  13. Attitudinal Change in Elderly Citizens Toward Social Robots: The Role of Personality Traits and Beliefs About Robot Functionality.

    Science.gov (United States)

    Damholdt, Malene F; Nørskov, Marco; Yamazaki, Ryuji; Hakli, Raul; Hansen, Catharina Vesterager; Vestergaard, Christina; Seibt, Johanna

    2015-01-01

    Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter the participants interacted with a tele-operated robot (Telenoid) during their lunch (c. 30 min.) for up to 3 days. Half of the participants were informed that the robot was tele-operated (IC) whilst the other half were naïve to its functioning (UC). Post-encounter assessments of attitudes toward robots and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference between the IC and UC groups in attitude change toward robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r = 0.619) and to psychological relatedness (r = 0.581) whilst Neuroticism correlated negatively (r = -0.582) with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes toward robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance reductions

  14. Attitudinal change in elderly citizens towards social robots: the role of personality traits and beliefs about robot functionality.

    Directory of Open Access Journals (Sweden)

    Malene Flensborg Damholdt

    2015-11-01

    Full Text Available Attitudes towards robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes towards robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i the information provided about robot functionality, (ii the number of encounters, (iii personality type. Fourteen elderly residents at a rehabilitation centre participated. Pre-encounter attitudes towards robots, anthropomorphic thinking, and personality were assessed. Thereafter the participants interacted with a tele-operated robot (Telenoid during their lunch (c. 30 min. for up to three days. Half of the participants were informed that the robot was tele-operated (IC whilst the other half were naïve to its functioning (UC. Post-encounter assessments of attitudes towards robots and anthropomorphic thinking were undertaken to assess change. Attitudes towards robots were assessed with a new generic 35-item questionnaire (Attitudes towards social robots scale: ASOR-5, offering a differentiated conceptualization of the conditions for social interaction.There was no significant difference between the IC and UC groups in attitude change towards robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r=.619 and to psychological relatedness (r=.581 whilst Neuroticism correlated negatively (r=-.582 with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes towards robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance

  15. A self-reported screening tool for detecting community-dwelling older persons with frailty syndrome in the absence of mobility disability: the FiND questionnaire.

    Science.gov (United States)

    Cesari, Matteo; Demougeot, Laurent; Boccalon, Henri; Guyonnet, Sophie; Abellan Van Kan, Gabor; Vellas, Bruno; Andrieu, Sandrine

    2014-01-01

    The "frailty syndrome" (a geriatric multidimensional condition characterized by decreased reserve and diminished resistance to stressors) represents a promising target of preventive interventions against disability in elders. Available screening tools for the identification of frailty in the absence of disability present major limitations. In particular, they have to be administered by a trained assessor, require special equipment, and/or do not discriminate between frail and disabled individuals. Aim of this study is to verify the agreement of a novel self-reported questionnaire (the "Frail Non-Disabled" [FiND] instrument) designed for detecting non-mobility disabled frail older persons with results from reference tools. Data are from 45 community-dwelling individuals aged ≥60 years. Participants were asked to complete the FiND questionnaire separately exploring the frailty and disability domains. Then, a blinded assessor objectively measured the frailty status (using the phenotype proposed by Fried and colleagues) and mobility disability (using the 400-meter walk test). Cohen's kappa coefficients were calculated to determine the agreement between the FiND questionnaire with the reference instruments. Mean age of participants (women 62.2%) was 72.5 (standard deviation 8.2) years. Seven (15.6%) participants presented mobility disability as being unable to complete the 400-meter walk test. According to the frailty phenotype criteria, 25 (55.6%) participants were pre-frail or frail, and 13 (28.9%) were robust. Overall, a substantial agreement of the instrument with the reference tools (kappa = 0.748, quadratic weighted kappa = 0.836, both p valuesFiND disability domain and the 400-meter walk test was excellent (kappa = 0.920, pFiND questionnaire presents a very good capacity to correctly identify frail older persons without mobility disability living in the community. This screening tool may represent an opportunity for diffusing awareness about frailty

  16. Effect of influenza and pneumococcal vaccines in elderly persons in years of low influenza activity.

    Science.gov (United States)

    Christenson, Brith; Pauksen, Karlis; Sylvan, Staffan P E

    2008-04-28

    The present prospective study was conducted from 2003-2005, among all individuals 65 years and older in Uppsala County, a region with 300 000 inhabitants situated close to the Stockholm urban area.The objective of this study was to assess the preventive effect of influenza and pneumococcal vaccination in reducing hospitalisation and length of hospital stay (LOHS) even during periods of low influenza activity. The specificity of the apparent vaccine associations were evaluated in relation to the influenza seasons. In 2003, the total study population was 41,059, of which 12,907 (31%) received influenza vaccine of these, 4,447 (11%) were administered the pneumococcal vaccine. In 2004, 14,799 (34%) individuals received the influenza vaccine and 8,843 (21%) the pneumococcal vaccine and in 2005 16,926 (39%) individuals were given the influenza vaccine and 12,340 (28%) the pneumococcal vaccine.Our findings indicated that 35% of the vaccinated cohort belonged to a medical risk category (mainly those persons that received the pneumococcal vaccine). Data on hospitalisation and mortality during the 3-year period were obtained from the administrative database of the Uppsala county council. During the influenza seasons, reduction of hospital admissions and significantly shorter in-hospital stay for influenza was observed in the vaccinated cohort (below 80 years of age). For individuals who also had received the pneumococcal vaccine, a significant reduction of hospital admissions and of in-hospital stay was observed for invasive pneumococcal disease and for pneumococcal pneumonia. Effectiveness was observed for cardiac failure even in persons that also had received the pneumococcal vaccine, despite that the pneumococcal vaccinated mainly belonged to a medical risk category. Reduction of death from all causes was observed during the influenza season of 2004, in the 75-84-year old age group and in all age-groups during the influenza season 2005. The present study confirmed the

  17. Effect of influenza and pneumococcal vaccines in elderly persons in years of low influenza activity

    Directory of Open Access Journals (Sweden)

    Sylvan Staffan PE

    2008-04-01

    Full Text Available Abstract Background The present prospective study was conducted from 2003–2005, among all individuals 65 years and older in Uppsala County, a region with 300 000 inhabitants situated close to the Stockholm urban area. The objective of this study was to assess the preventive effect of influenza and pneumococcal vaccination in reducing hospitalisation and length of hospital stay (LOHS even during periods of low influenza activity. The specificity of the apparent vaccine associations were evaluated in relation to the influenza seasons. Results In 2003, the total study population was 41,059, of which 12,907 (31% received influenza vaccine of these, 4,447 (11% were administered the pneumococcal vaccine. In 2004, 14,799 (34% individuals received the influenza vaccine and 8,843 (21% the pneumococcal vaccine and in 2005 16,926 (39% individuals were given the influenza vaccine and 12,340 (28% the pneumococcal vaccine. Our findings indicated that 35% of the vaccinated cohort belonged to a medical risk category (mainly those persons that received the pneumococcal vaccine. Data on hospitalisation and mortality during the 3-year period were obtained from the administrative database of the Uppsala county council. During the influenza seasons, reduction of hospital admissions and significantly shorter in-hospital stay for influenza was observed in the vaccinated cohort (below 80 years of age. For individuals who also had received the pneumococcal vaccine, a significant reduction of hospital admissions and of in-hospital stay was observed for invasive pneumococcal disease and for pneumococcal pneumonia. Effectiveness was observed for cardiac failure even in persons that also had received the pneumococcal vaccine, despite that the pneumococcal vaccinated mainly belonged to a medical risk category. Reduction of death from all causes was observed during the influenza season of 2004, in the 75–84-year old age group and in all age-groups during the influenza

  18. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

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

    2004-01-01

    Background. The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. Methods. The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  19. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

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

    2004-01-01

    BACKGROUND: The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. METHODS: The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  20. Handgrip performance in relation to self-perceived fatigue, physical functioning and circulating IL-6 in elderly persons without inflammation

    Directory of Open Access Journals (Sweden)

    Gorus Ellen

    2007-03-01

    Full Text Available Abstract Background Low grip strength is recognized as one of the characteristics of frailty, as are systemic inflammation and the sensation of fatigue. Contrary to maximal grip strength, the physical resistance of the muscles to fatigue is not often included in the clinical evaluation of elderly patients. The aim of this study was to investigate if the grip strength and the resistance of the handgrip muscles to fatigue are related to self-perceived fatigue, physical functioning and circulating IL-6 in independently living elderly persons. Methods Forty elderly subjects (15 female and 25 male, mean age 75 ± 5 years were assessed for maximal grip strength, as well as for fatigue resistance and grip work (respectively time and work delivered until grip strength drops to 50% of its maximum during sustained contraction, self perceived fatigue (VAS-Fatigue, Mob-Tiredness scale and the energy & fatigue items of the WHOQOL-100, self rated physical functioning (domain of physical functioning on the MOS short-form and circulating IL-6. Relationships between handgrip performance and the other outcome measures were assessed. Results In the male participants, fatigue resistance was negatively related to actual sensation of fatigue (VAS-F, p Conclusion Well functioning elderly subjects presenting less handmuscle fatigue resistance and weaker grip strength are more fatigued, experience more tiredness during daily activities and are more bothered by fatigue sensations. Body weight seems to play an important role in the relation of muscle performance to fatigue perception. Elderly patients complaining from fatigue should be physically assessed, both evaluating maximal grip strength and fatigue resistance, allowing the calculation of grip work, which integrates both parameters. Grip work might best reflect the functional capacity resulting from the development of a certain strength level in relation to the time it can be maintained.

  1. Care of the elderly persons in the system of social protection in the Republic of Srpska

    OpenAIRE

    Lepir Ljubo

    2010-01-01

    The number of the elderly in the overall population is increasing, which poses a need to seek an adequate model of organizing social care of the elderly. Most of them get social safety through the social welfare system. A functional and sustainable social welfare system requires application of efficient management and technique models based on the theoretical premises of contemporary management. The role and the importance of old people's protection in a social welfare system is becoming a to...

  2. Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: observational prospective study.

    Science.gov (United States)

    Cabré, Mateu; Serra-Prat, Mateu; Force, Ll; Almirall, Jordi; Palomera, Elisabet; Clavé, Pere

    2014-03-01

    To determine whether oropharyngeal dysphagia is a risk factor for readmission for pneumonia in elderly persons discharged from an acute geriatric unit. Observational prospective cohort study with data collection based on clinical databases and electronic clinical notes. All elderly individuals discharged from an acute geriatric unit from June 2002 to December 2009 were recruited and followed until death or December 31, 2010. All individuals were initially classified according to the presence of oropharyngeal dysphagia assessed by bedside clinical examination. Main outcome measure was readmission for pneumonia. Clinical notes were reviewed by an expert clinician to verify diagnosis and classify pneumonia as aspiration or nonaspiration pneumonia. A total of 2,359 patients (61.9% women, mean age 84.9 y) were recruited and followed for a mean of 24 months. Dysphagia was diagnosed in 47.5% of cases. Overall, 7.9% of individuals were readmitted for pneumonia during follow-up, 24.2% of these had aspiration pneumonia. The incidence rate of hospital readmission for pneumonia was 3.67 readmissions per 100 person-years (95% CI 3.0-4.4) in individuals without dysphagia and 6.7 (5.5-7.8) in those with dysphagia, with an attributable risk of 3.02 readmissions per 100 person-years (1.66-4.38) and a rate ratio of 1.82 (1.41-2.36). Multivariate Cox regression showed an independent effect of oropharyngeal dysphagia, with a hazard ratio of 1.6 (1.15-2.2) for hospitalization for pneumonia, 4.48 (2.01-10.0) for aspiration pneumonia, and 1.44 (1.02-2.03) for nonaspiration pneumonia. Oropharyngeal dysphagia is a very prevalent and relevant risk factor associated with hospital readmission for both aspiration and nonaspiration pneumonia in the very elderly persons.

  3. [Governance in a project addressing care of disabled elderly persons within the regional healthcare system of Tuscany, Italy].

    Science.gov (United States)

    Pedace, Claudio; Rosa, Antonella; Francesconi, Paolo; Acampora, Anna; Ricciardi, Walter; Damiani, Gianfranco

    2017-01-01

    Population aging and the concurrent increase of age-related chronic degenerative diseases and disability are associated with an increased proportion of elderly persons who are dependent in activities of daily living (ADL). ADL-dependent persons need continuous and long-term health and social care according to the "taking charge" rationale, in order to warrant access and continuity of care. A healthcare system needs to respond to the long-term and complex needs, such as those of disabled elderly people, by providing appropriate health and social care services in Primary Care. A Primary Health Care system is organized according to two governance levels have distinct aims but are closely inter-dependent in their operational mechanisms. The system governance is accountable for the community and individual health protection while the delivery governance is accountable for the provision of services in accordance with appropriateness, safety and economic criteria. Delivery governance can be considered "integrated governance" as a synergy exists between two decision-making systems guiding provider choices, which are corporate governance and clinical governance. The aim of this study was to analyse the abovementioned governance levels within the healthcare system in Tuscany (Italy) referring to long-term residential care for disabled elderly people. The case of excessive accesses to emergency departments from different types of Nursing Homes (NH) is used as an example to analyse different levels of responsibility involved in the management of a critical phenomenon. Suggestions for improvement in the different levels of governance for disabled elderly people are provided, in order to support institutional programming activities.

  4. Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

    Science.gov (United States)

    Watanabe, Kumi; Tanaka, Emiko; Wu, Bailiang; Kobayashi, Zyunko; Mochizuki, Yukiko; Kim, Yeon; Watanabe, Taeko; Okumura, Rika; Ito, Sumio; Anme, Tokie

    2017-01-01

    Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social

  5. Being in a Bubble: the experience of loneliness among frail older people.

    Science.gov (United States)

    Taube, Elin; Jakobsson, Ulf; Midlöv, Patrik; Kristensson, Jimmie

    2016-03-01

    The aim of this study was to explore the experience of loneliness among frail older people living at home. Loneliness is a threat to the physical and psychological well-being with serious consequences if left unattended. There are associations between frailty and poor psychological well-being, implying that frail older people who experience loneliness are vulnerable. Qualitative content analysis, focusing on both latent and manifest content. Frail older people (65+ years), living at home and who have experienced various levels in intensity of loneliness, were purposively selected from a larger interventional study (N = 12). For this study, 'frail' means being dependent in activities of daily life and having repeated contacts with healthcare services. Data were collected between December 2009-August 2011. Semi-structured interviews were performed, audio recorded and transcribed verbatim. The analysis resulted in the overall theme 'Being in a Bubble', which illustrates an experience of living in an ongoing world, but excluded because of the participants' social surroundings and the impossibility to regain losses. The theme 'Barriers' was interpreted as facing physical, psychological and social barriers for overcoming loneliness. The theme 'Hopelessness' reveals the experience when not succeeding in overcoming these barriers, including seeing loneliness as a constant state. A positive co-existing dimension of loneliness, offering independence, was reflected in the theme 'Freedom'. The findings suggest that future strategies for intervening should target the frail older persons' individual barriers and promoting the positive co-existing dimension of loneliness. When caring, a person centred approach, encompassing knowledge regarding physical and psychological aspects, including loneliness, is recommended. © 2015 John Wiley & Sons Ltd.

  6. Sensible aging : nutrient dense foods and physical exercise for the vulnerable elderly

    NARCIS (Netherlands)

    Jong, de N.

    1999-01-01

    As a consequence of present western health policy, an increasing number of elderly people live in the community. A particularly vulnerable group among the total elderly population are the so-called 'frail elderly' who have a reduced physiologic reserve and are classified at risk. Increasing

  7. Mildly Elevated Serum Bilirubin Levels Are Negatively Associated with Carotid Atherosclerosis among Elderly Persons

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Hasegawa, Yoichi; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2014-01-01

    Serum bilirubin may have a beneficial role in preventing oxidative changes in atherosclerosis. Limited information is available on whether serum total bilirubin is an independent confounding factor for carotid atherosclerosis {for example, intima-media thickness (IMT), plaque} measured noninvasively by B-mode ultrasonography only among elderly persons. The study subjects were 325 men aged 79±8 (mean ± standard deviation) years and 509 women aged 81±8 years that were enrolled consecutively from patients aged ≥60 years in the medical department. Carotid IMT and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that in men age (β = 0.199, p = 0.002), smoking status (β = 0.154, p = 0.006), GGT (β = -0.139, p = 0.039), and GGT (β = -0.133, p = 0.022) were significantly and independently associated with carotid IMT, and in women age (β = 0.186, pbilirubin (β = -0.119, p = 0.006), and prevalence of cardiovascular disease (CVD) (β = 0.103, p = 0.017) were also independently associated with carotid IMT. The odds ratios (ORs) {95% confidence interval (CI)} of increasing serum bilirubin category were negatively associated with carotid IMT ≥1.0 mm and plaque in both genders. Compared to subjects with a serum bilirubin of Quartile-1, the multivariate-OR (95% CI) of carotid plaque was 0.25 (0.11–0.57) in the Quartile-4 male group, and 0.41 (0.21–0.78) in the Quartile-2 female group, 0.51 (0.26–0.98) in the Quartile-3 female group, and 0.46 (0.24–0.89) in the Quartile-4 female group. Our data demonstrated an independently negative association between serum bilirubin and carotid atherosclerosis in both genders. PMID:25479598

  8. Cost-effectiveness of hip protectors in frail institutionalized elderly

    NARCIS (Netherlands)

    van Schoor, N.M.; de Bruyne, M.C.; van der Roer, N.; Lommerse, E.; van Tulder, M.; Bouter, L.M.; Lips, P.T.A.M.

    2004-01-01

    A randomized controlled trial was performed to examine the cost-effectiveness of external hip protectors in the prevention of hip fractures. Since the hip protectors were not effective in preventing hip fractures in our study, the main objective became to examine whether the use of hip protectors

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Legal protection of elderly persons and risk of their victimization by criminal acts with elements of domestic violence

    Directory of Open Access Journals (Sweden)

    Mirić Filip

    2012-01-01

    Full Text Available The aging process is inevitable. It follows the individual from birth until death. Due to the inability of people to influence it, there is a greater obligation of society to provide the people in the „third age“ a dignified life, without any form of victimization. The author defines which people are considered old according to positive legal acts of the Republic of Serbia. The subject of this paper are the factors that increase the risk of victimization of the elderly within the family, taking into account the physical, psychological, sexual and economic violence against the elderly, as well as mechanisms for their legal protection from domestic violence, as one of the most effective tools of the state and society in general for protection of this particularly vulnerable social group. Relevant provisions of the Criminal Code and the Code of Criminal Procedure of the Republic of Serbia with a critical analysis of the incrimination of offenses with elements of domestic violence where the victim is usually an old person will be analyzed. From the subject defined in this manner, stems the paper‘ s mainly descriptive goal of describing the phenomenon through the analysis of the major forms of violence to which the elderly within the family are exposed (physical, psychological, economic and sexual violence. The purpose of the paper is also to analyze the factors that increase the risk of victimization of the elderly and the mechanisms for their legal protection from domestic violence, point out the harm of this type of violence and thus contribute to combating this negative social phenomenon.

  11. Watching elderly and disabled person's physical condition by remotely controlled monorail robot

    Science.gov (United States)

    Nagasaka, Yasunori; Matsumoto, Yoshinori; Fukaya, Yasutoshi; Takahashi, Tomoichi; Takeshita, Toru

    2001-10-01

    We are developing a nursing system using robots and cameras. The cameras are mounted on a remote controlled monorail robot which moves inside a room and watches the elderly. It is necessary to pay attention to the elderly at home or nursing homes all time. This requires staffs to pay attention to them at every time. The purpose of our system is to help those staffs. This study intends to improve such situation. A host computer controls a monorail robot to go in front of the elderly using the images taken by cameras on the ceiling. A CCD camera is mounted on the monorail robot to take pictures of their facial expression or movements. The robot sends the images to a host computer that checks them whether something unusual happens or not. We propose a simple calibration method for positioning the monorail robots to track the moves of the elderly for keeping their faces at center of camera view. We built a small experiment system, and evaluated our camera calibration method and image processing algorithm.

  12. [Rehabilitation service to the elder person victim of accidents and violence on different regions of Brazil].

    Science.gov (United States)

    Ribeiro, Adalgisa Peixoto; Barter, Elaine Aparecida Chaves de Paiva

    2010-09-01

    The purpose of this work is to describe the structure and characterize the services offered for rehabilitation of elder people, victims of accidents and violence, based on the main public policies of health for this population in Brazil. Following the principles of the triangulation method, a 27 question questionnaire was applied to 19 rehabilitation services (five in Manaus, seven in Recife, two in Brasília, two in Rio de Janeiro and three in Curitiba) about structure and organization of the service besides data registration. Managers and health professionals were interviewed about the flow, characterization and specificities of the service to elder people, protection chains, services evaluation and suggestions. Services in Manaus and Brasília are better prepared to attend elder victims of accidents and violence. The services in Brasília surpass the specific issues of elderly care. The rehabilitation units in Recife are more unprepared, especially regarding laboratorial support, qualification of professionals to identify and attend the cases of violence, registration and analysis of data. It is concluded that the rehabilitation service presents great fragility on the implantation of public policies and in insertion of the violence theme.

  13. Mildly elevated serum total bilirubin levels are negatively associated with carotid atherosclerosis among elderly persons with type 2 diabetes.

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Hasegawa, Yoichi; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    Diabetes is strongly associated with several mechanisms of tissue damage such as oxidative stress. Serum bilirubin may have a beneficial role in preventing oxidative changes in cardiovascular disease (CVD). Limited information is available on whether serum bilirubin is an independent confounding factor for carotid atherosclerosis among elderly persons with type 2 diabetes. The study subjects were 169 men aged 79 ± 8 (mean ± SD) years and 205 women aged 81 ± 8 years that were enrolled consecutively from patients in the medical department. Carotid intima-media thickness (IMT) and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that serum total bilirubin (β = -0.160) was significantly associated with carotid IMT. Compared to subjects with a serum total bilirubin of tertile-1 (0.13-0.58 mg/dL), the multivariate-adjusted odds ratio (95% confidence interval) of carotid IMT ≥1.0 mm including plaque and carotid plaque was 0.46 (0.23-0.93) and 0.32 (0.17-0.60) in the Tertile-3 group (0.87-1.93 mg/dL), respectively. Next, data were further stratified by gender, age, smoking status, medication and prevalence of CVD. There were no significant differences in serum total bilirubin levels between selected subgroups. Our data demonstrated a negative association between serum total bilirubin and carotid atherosclerosis among elderly persons with type 2 diabetes.

  14. Moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a day care center.

    Science.gov (United States)

    Bocchi, Silvia Cristina Mangini; Cano, Karen Cristina Urtado; Baltieri, Lilian; Godoy, Daniele Cristina; Spiri, Wilza Carla; Juliani, Carmen Maria Casquel Monti

    2010-09-01

    This study aimed at understanding the interactional experience between family caregivers and disabled elderly persons supported in a Day Care Center according to the caregiver's perspective. It also aimed at developing a representative theoretical model for the events experienced by such caregiver. The Grounded Theory was used as methodological framework whereas Interactional Symbolism served as the theoretical framework. Observation and interviews were used for data collection. The following phenomenon arose from the results: feeling of support by the Day Care Center, by the strength of the bond with the elderly and by spirituality in order to continue playing the challenging role of a family caregiver for a disabled elderly person. The study made possible to understand that, among these three supporting cornerstones for coping with the burden generated by the family caregiver role, the care model promoted by the Day Care Center was the intervenient variable in the process of improving the quality of life of the family caregiver-disabled elderly person binomial. This allowed the identification of the main category--moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a Day Care Center.

  15. Do informal caregivers for elderly in the community use support measures? A qualitative study in five European countries.

    Science.gov (United States)

    Willemse, Evi; Anthierens, Sibyl; Farfan-Portet, Maria Isabel; Schmitz, Olivier; Macq, Jean; Bastiaens, Hilde; Dilles, Tinne; Remmen, Roy

    2016-07-16

    Informal caregivers are essential figures for maintaining frail elderly at home. Providing informal care can affect the informal caregivers' physical and psychological health and labour market participation capabilities. They need support to prevent caregiver burden. A variety of existing support measures can help the caregiver care for the elderly at home, but with some limitations. The objective of this review was to explore the experiences of informal caregivers caring for elderly in the community with the use of supportive policy measures in Belgium and compare these to the experiences in other European countries. An empirical qualitative case study research was conducted in five European countries (Belgium, The Netherlands, Luxembourg, France and Germany). Semi-structured interviews were conducted with informal caregivers and their dependent elderly. Interview data from the different cases were analysed. In particular data from Belgium was compared to data from the cases abroad. Formal services (e.g. home care) were reported to have the largest impact on allowing the caregiver to care for the dependent elderly at home. One of the key issues in Belgium is the lack of timely access to reliable information about formal and informal services in order to proactively support the informal caregiver. Compared to the other countries, informal caregivers in Belgium expressed more difficulties in accessing support measures and navigating through the health system. In the other countries information seemed to be given more timely when home care was provided via care packages. To support the informal caregiver, who is the key person to support the frail elderly, fragmentation of information regarding supportive policy measures is an important issue of concern.

  16. Absence of nocturnal fall in blood pressure in elderly persons with Alzheimer-type dementia.

    Science.gov (United States)

    Otsuka, A; Mikami, H; Katahira, K; Nakamoto, Y; Minamitani, K; Imaoka, M; Nishide, M; Ogihara, T

    1990-09-01

    Circadian changes of the blood pressure and heart rate in elderly normotensive bedridden patients with severe dementia of the Alzheimer type (group D) were compared with those in elderly normotensive bedridden patients without dementia (group R), normotensive subjects with normal daily activity (group N), and hypertensive patients with normal daily activity (group H). In groups R, N, and H, the blood pressure increased in the afternoon and decreased at midnight; in group D, however, although it increased in the afternoon, it did not decrease at night. The circadian changes of the heart rate were similar in all four groups, showing maxima in the afternoon and minima at midnight. Thus, a specific alteration was found in the circadian rhythm of the blood pressure in patients with Alzheimer-type dementia.

  17. Promoting access to innovation for frail old persons. IAGG (International Association of Gerontology and Geriatrics), WHO (World Health Organization) and SFGG (Société Française de Gériatrie et de Gérontologie) Workshop--Athens January 20-21, 2012.

    Science.gov (United States)

    Berrut, G; Andrieu, S; Araujo de Carvalho, I; Baeyens, J P; Bergman, H; Cassim, B; Cerreta, F; Cesari, M; Cha, H B; Chen, L K; Cherubini, A; Chou, M Y; Cruz-Jentoft, A J; De Decker, L; Du, P; Forette, B; Forette, F; Franco, A; Guimaraes, R; Guttierrez-Robledo, L M; Jauregui, J; Khavinson, V; Lee, W J; Peng, L N; Perret-Guillaume, C; Petrovic, M; Retornaz, F; Rockwood, K; Rodriguez-Manas, L; Sieber, C; Spatharakis, G; Theou, O; Topinkova, E; Vellas, B; Benetos, A

    2013-01-01

    Frailty tends to be considered as a major risk for adverse outcomes in older persons, but some important aspects remain matter of debate. The purpose of this paper is to present expert's positions on the main aspects of the frailty syndrome in the older persons. Workshop organized by International Association of Gerontology and Geriatrics (IAGG), World Health Organization (WHO) and Société Française de Gériatrie et de Gérontologie (SFGG). Frailty is widely recognized as an important risk factor for adverse health outcomes in older persons. This can be of particular value in evaluating non-disabled older persons with chronic diseases but today no operational definition has been established. Nutritional status, mobility, activity, strength, endurance, cognition, and mood have been proposed as markers of frailty. Another approach calculates a multidimensional score ranging from "very fit" to "severely frail", but it is difficult to apply into the medical practice. Frailty appears to be secondary to multiple conditions using multiple pathways leading to a vulnerability to a stressor. Biological (inflammation, loss of hormones), clinical (sarcopenia, osteoporosis etc.), as well as social factors (isolation, financial situation) are involved in the vulnerability process. In clinical practice, detection of frailty is of major interest in oncology because of the high prevalence of cancer in older persons and the bad tolerance of the drug therapies. Presence of frailty should also be taken into account in the definition of the cardiovascular risks in the older population. The experts of the workshop have listed the points reached an agreement and those must to be a priority for improving understanding and use of frailty syndrome in practice. Frailty in older adults is a syndrome corresponding to a vulnerability to a stressor. Diagnostic tools have been developed but none can integrate at the same time the large spectrum of factors and the simplicity asked by the

  18. Empowerment of family caregivers of adults and elderly persons: A concept analysis.

    Science.gov (United States)

    Sakanashi, Sayori; Fujita, Kimie

    2017-10-01

    This concept analysis defined and described the components of empowerment of family caregivers who care for adults and the elderly. Rodgers evolutionary method of concept analysis was used. Data sources included Pub Med, CINAHL, Scopus, and Igaku Chuo Zasshi. Thirty articles published between 1995 and 2015 focusing on the empowerment of family caregivers providing care to adults and the elderly were selected. The analysis reveals 6 attributes, 5 antecedents, and 5 consequences. In addition, the results reveal structured aspects of family caregivers, care receivers, and other people surrounding them, and their relationships. Empowerment of adults' and elders' family caregivers may be defined as "positive control of one's mind and body, cultivating a positive attitude, proactively attempting to understand one's role as a caregiver to improve caregiving capabilities, focusing on others as well as oneself, supporting the independence of the care receiver, and creating constructive relationships with other people surrounding them." The components of empowerment clarified in this research can be used for the measurement of and interventions aimed at improving empowerment among family caregivers. Furthermore, clarifying the definition of empowerment among family caregivers enables researchers to better distinguish empowerment from similar concepts in the future. © 2017 John Wiley & Sons Australia, Ltd.

  19. Humour, beauty, and culture as personal health resources: experiences of elderly Swedish women.

    Science.gov (United States)

    Forssén, Annika S K

    2007-01-01

    This paper explores how a group of elderly women used humour, beauty, and cultural activities to maintain physical and mental well-being. The paper reports on one aspect of a qualitative study on women's work and health in a lifetime perspective. Interviews with 20 strategically selected Swedish women, aged 63 to 83 years, were audiotaped and analysed according to a phenomenological approach. During the interview process, the researchers became increasingly aware that the women had clear ideas about what enabled them to feel well and healthy - even when actually quite diseased. Creating and enjoying humour, beauty, and culture formed part of such strategies. Joking with workmates made hard, low-status jobs easier, helped them endure pain, and helped balance marital difficulties. Creating a nice and comfortable home gave pleasure and a little luxury in a life filled with necessities. Making articles for everyday use more beautiful was regarded as worthwhile, because it gave delight to them and their families. Gains from cultural activities were social, aesthetic, and existential - the latter through a feeling of self-recognition and being heard. Humour, beauty, and culture formed a greater part of these women's survival strategies than expected. Making everyday life more aesthetic is an undervalued aspect of women's health-creating work in the family. Through their lifelong experience as carers and homemakers, elderly women possess special knowledge regarding what may promote health, a knowledge that should be tapped. When supplying elderly women with social care, their needs for humour, beauty, and culture should be respected.

  20. [The contribution of living arrangements in the provision of care for elderly persons with functional impairments in São Paulo, Brazil].

    Science.gov (United States)

    Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia; Lima, Fernão Dias de

    2005-01-01

    To describe the functional performance, need for assistance, and living arrangements of elderly persons in the city of São Paulo, Brazil, as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). In 2000, 2 143 individuals 60 years of age or older were interviewed, using the standardized SABE questionnaire. The sample was obtained in two stages, using census sectors with replacement and probability proportional to population. To have the desired number of respondents 75 or older, additional homes close to the selected census sectors were found, with weighting of the final results. The functional performance of the elderly persons was measured in terms of their ability to perform basic activities of daily living (walking across a room, eating, lying down on a bed and getting up from it, using the bathroom, dressing and undressing, and bathing) and to carry out instrumental activities of daily living (buying and preparing food, performing light and heavy household chores, using the telephone, taking medications, and handling money). Functional impairment was defined as the need for assistance in performing at least one of the basic or instrumental activities. There were 66 types of living arrangements (household composition) identified and grouped into seven categories, according to with whom an elderly person lived and whether the other residents of the household were relatives or not. Of the individuals interviewed, 19.2% presented a functional impairment in basic activities and 26.5% in instrumental activities. The impairments were more common among women and among persons 75 or older. The proportion of elderly persons with an impairment who received help with basic activities ranged from 25.6% (lying down on the bed and getting up) to 70.5% (eating). With instrumental activities, the proportion receiving assistance ranged from 79.7% (light domestic chores) to 97.8% (buying food). With respect to living

  1. Health and well-being among elderly persons in Israel: the role of social class and immigration status.

    Science.gov (United States)

    Carmel, S; Lazar, A

    1998-01-01

    The purpose of the study was to compare three groups of Israeli elderly that differ in social class and immigration status on measures of health and psycho-social well-being, and assess the factors which explain their self-rated health (SRH). Based on a random sample of Israeli Jewish elderly (70 +), data were collected from 1138 persons during 1994 by structured home interviews. Social class differences among Israeli veterans were mainly found with regard to psycho-social characteristics. They were less conspicuous in health measures. New immigrants, who had a higher level of education than the veterans, but ranked lower on economic status, reported lower levels of health and psycho-social well-being than the veterans. Self-rated health among the immigrants was mainly explained by objective measures of health, and economic status, while in the higher social class of veterans it was also explained by education and psycho-social variables such as self-esteem and social support. These findings indicate that in contradiction to the convergence hypothesis, social class and immigration status affect health and well-being also in old age. It is suggested that the immigration crisis and factors related to the standard of living and health services in the countries of origin, as well as the lower social and economic status of the immigrants in Israel, outweigh their relative advantage in age and education in influencing their health and well-being. The differences found among the three groups in the factors that explain self-rated health have implications for the use of economic status as a relevant indicator of social class when considering health status among the elderly, and for the interpretation of SRH, as a global measure of health, in different socio-cultural groups.

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

    Science.gov (United States)

    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…

  3. ADIPOQ + 45T≥G Polymorphism, Food Ingestion, and Metabolic Syndrome in Elderly Persons.

    Science.gov (United States)

    Retamoso, Vanessa R; Maurer, Patrícia; Feijóo, Lyana B; Tavares, Graziela M S; Manfredini, Vanusa; Piccoli, Jacqueline C E

    2018-01-01

    The current nutritional transition process contributes further to accelerate the onset of metabolic disorders, as do a number of environmental factors that lead to the diagnosis of chronic diseases, as a diet of low nutritional value, is possibly related to the incidence of metabolic syndrome. In addition to these factors, metabolic syndrome may also be related to genetic factors, the ADIPOQ + 45T> G polymorphism has been associated with serum adiponectin levels, insulin sensitivity, and obesity, which affects adiponectin levels act as protective factor for cardiovascular disease. In this way, the present study aimed to analyze the possible association between the ADIPOQ + 45T> G gene polymorphism, usual diet and metabolic syndrome in the elderly. We evaluated inflammatory and biochemical markers compared with older age groups (age 60 years) with and without metabolic syndrome. In addition to the anthropometric measurements of weight, height and waist circumference, the ADIPOQ + 45T> G gene polymorphism was determined by PCR- RFLP, and food consumption was investigated using a food frequency questionnaire. The study included 111 elderly individuals. Our main results show that there was a significant relationship between the habitual consumption of milk for the group that had metabolic syndrome (p metabolic syndrome. There was an association between habitual dietary intake of white meat with haplotypes TG and GG. We conclude that the relationship between the habitual consumption of certain food groups and ADIPOQ indicates the need for further studies to develop a better understanding of this relationship; however, there was no association between the ADIPOQ + 45T> G gene polymorphism and metabolic syndrome in the group of elderly studied.

  4. Motivation to take part in integrated care – an assessment of follow-up home visits to elderly persons

    DEFF Research Database (Denmark)

    Hjelmar, U; Hendriksen, Carsten; Hansen, K

    2011-01-01

    to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly...... persons. Theory and methods: The analysis is based on inter-organizational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners...... understanding of values and learning potentials. Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities, such as a follow-up home visit...

  5. A posture recognition based fall detection system for monitoring an elderly person in a smart home environment.

    Science.gov (United States)

    Yu, Miao; Rhuma, Adel; Naqvi, Syed Mohsen; Wang, Liang; Chambers, Jonathon

    2012-11-01

    We propose a novel computer vision based fall detection system for monitoring an elderly person in a home care application. Background subtraction is applied to extract the foreground human body and the result is improved by using certain post-processing. Information from ellipse fitting and a projection histogram along the axes of the ellipse are used as the features for distinguishing different postures of the human. These features are then fed into a directed acyclic graph support vector machine (DAGSVM) for posture classification, the result of which is then combined with derived floor information to detect a fall. From a dataset of 15 people, we show that our fall detection system can achieve a high fall detection rate (97.08%) and a very low false detection rate (0.8%) in a simulated home environment.

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

    Science.gov (United States)

    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.

  7. An elderly person in the attitudes of medical students and medical residents: an ethical aspect

    Directory of Open Access Journals (Sweden)

    Fakhrudinova E.R.

    2017-06-01

    Full Text Available The objective of the study: to identify the attitudes towards elderly among the students and residents of SSMU n.a. V. I. Razumovsky. Material and Methods. Students of 3d and 6th courses and interns of 1st and 2d years (N=85 enrolled in the SSMU n.a. V. I. Razumovsky were involved in the research. The average age of respondents was 21 ±1.8 years. We used the technique of unfinished sentences, which allowed us to measure emotional load of the semantic field of the phenomenon of old age. Results. Among the respondents, most commonly old age is associated with responsibilities in the upbringing of grandchildren, wisdom and pension. The main reasons that hamper the interaction with the elderly respondents emphasized the conflict of older people and a decrease in cognitive functions. Conclusions. In the researched population there is mainly a positive image of old age. Medical students should be prepared to work with older people and a tolerant attitude to old age should be formed

  8. Longevity Candidate Genes and Their Association With Personality Traits in the Elderly

    NARCIS (Netherlands)

    Luciano, M.; Lopez, L.M.; de Moor, M.H.M.; Harris, S.E.; Davies, G.; Nutile, T.; Krueger, R.F.; Esko, T.; Schlessinger, D.; Toshiko, T.; Derringer, J.; Realo, A.; Hansell, N.K.; Pergadia, M.L.; Pesonen, A.-K.; Sanna, S.; Terracciano, A.; Madden, P.A.F.; Penninx, B.W.J.H.; Spinhoven, Ph.D.; Hartman, C.A.; Oostra, B.A.; Janssens, A.C.J.W.; Eriksson, J.G.; Starr, J.M.; Cannas, A.; Ferrucci, L.; Metspalu, A.; Wright, M.J.; Heath, A.C.; van Duijn, C.M.; Bierut, L.J.; Raikkonen, K.; Martin, N.G.; Ciullo, M.; Rujescu, D.; Boomsma, D.I.; Deary, I.J.

    2012-01-01

    Human longevity and personality traits are both heritable and are consistently linked at the phenotypic level. We test the hypothesis that candidate genes influencing longevity in lower organisms are associated with variance in the five major dimensions of human personality (measured by the NEO-FFI

  9. Longevity candidate genes and their association with personality traits in the elderly

    NARCIS (Netherlands)

    Luciano, Michelle; Lopez, Lorna M.; de Moor, Marleen H. M.; Harris, Sarah E.; Davies, Gail; Nutile, Teresa; Krueger, Robert F.; Esko, Tonu; Schlessinger, David; Toshiko, Tanaka; Derringer, Jaime L.; Realo, Anu; Hansell, Narelle K.; Pergadia, Michele L.; Pesonen, Anu-Katriina; Sanna, Serena; Terracciano, Antonio; Madden, Pamela A. F.; Penninx, Brenda; Spinhoven, Philip; Hartman, Catherina A.; Oostra, Ben A.; Janssens, A. Cecile J. W.; Eriksson, Johan G.; Starr, John M.; Cannas, Alessandra; Ferrucci, Luigi; Metspalu, Andres; Wright, Margeret J.; Heath, Andrew C.; van Duijn, Cornelia M.; Bierut, Laura J.; Raikkonen, Katri; Martin, Nicholas G.; Ciullo, Marina; Rujescu, Dan; Boomsma, Dorret I.; Deary, Ian J.

    Human longevity and personality traits are both heritable and are consistently linked at the phenotypic level. We test the hypothesis that candidate genes influencing longevity in lower organisms are associated with variance in the five major dimensions of human personality (measured by the NEO-FFI

  10. Singing in individual music therapy with elderly persons suffering from dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2001-01-01

    The focus of this research in progress is my clinical work with persons suffering from dementia, where we sing long familiar songs in the music therapy. In an exploratory case study approach I have made systematic observations of 6 individual residents living in a gerontopsychological unit. My...... hypotheses are …  … that singing has an influence on persons with dementia, and that this influence can be defined upon communicative characteristics.  … that persons with dementia in an advanced stage communicate musically, and that this musical communication can be recognised by a system of communicative...

  11. Primary cutaneous mucormycosis caused by Mucor irregularis in an elderly person.

    Science.gov (United States)

    Yamaguchi, Sayaka; Okubo, Yuko; Katano, Azusa; Sano, Ayako; Uezato, Hiroshi; Takahashi, Kenzo

    2015-02-01

    Primary cutaneous mucormycosis is a rare but often lethal severe fungal infection, which usually occurs in immunocompromised patients. We report a case of primary cutaneous mucormycosis caused by Mucor irregularis in an elderly patient. Seven months after the surgical dissection of the involved skin, cutaneous mucormycosis recurred at the peripheral edge of the skin graft. Shortly subsequent to the administration of liposomal amphotericin B, the remaining skin lesion was excised again. M. irregularis is rarely but increasingly reported as a cause of mucormycosis in immunocompetent individuals, especially in Asian farmers. M. irregularis may be largely disseminated in the soils of Asia and thus the trivial trauma at the time of farm work may be a trigger for the onset. These cases tend to leave severe cosmetic damage even in healthy individuals, although the vital prognosis is not affected. © 2014 Japanese Dermatological Association.

  12. A STUDY ON MORBIDITY PROFILE AMONG ELDERLY PERSONS IN A RURAL AREA OF KOZHIKODE DISTRICT

    Directory of Open Access Journals (Sweden)

    Hassan Koya Kalathingal

    2016-11-01

    Full Text Available BACKGROUND World population is aging, which is a concern of 21 st century because of advances in medical sciences and improved social conditions. In developing countries like India where aging occurs rapidly due to the phase of demographic transition characterised by rapid fertility decline and increase in life expectancy. In India for the year 2010, the estimates are 8% of total population are above the age of 60 years and is likely to rise to 19% by 2050. Aging is a time of multiple illness and general disability. Old age diseases are not always curable, but only treatable, implying a strain on financial as well as physical health infrastructure resources, both at the macro and micro levels. MATERIALS AND METHODS A cross-sectional study was done in 2016 in Atholi Panchayath of Kozhikode, which is situated in North Kerala. Elderly people with 60 years and above were included in the study. A sample size of 324 was calculated and cluster sampling method was done for selection of study subjects. Data was collected using a semi-structured questionnaire after getting ethical clearance and was analysed using SPSS software. RESULTS Among the 324 subjects participated in the study, 163 (50.3% were males and 161 (49.67% were females. Mean age of the study subjects were 68.11 yrs. (range 60-94. Majority of the respondents were in the age group of 60-64 years (39.2%. Most common morbidities among the respondents were musculoskeletal disorders (57.4% followed by vision problems (41.7%, gastric problems (39.2%, diabetes (31.5% and hypertension (30.7%. CONCLUSION In our country, proportion of elderly is consistently increasing and there is need to focus on their health needs. A multilevel approach including age friendly health infrastructure development, social security measures, residential care homes, free treatment, etc. are required to manage geriatric morbidity among rural population.

  13. The pharmacokinetics of piroxicam in elderly persons with and without renal impairment.

    Science.gov (United States)

    Rudy, A C; Figueroa, N L; Hall, S D; Brater, D C

    1994-01-01

    1. Piroxicam pharmacokinetics were assessed in three groups of subjects: (1) young healthy volunteers, (2) healthy elderly subjects (mean +/- s.d. creatinine clearance 88 +/- 13 ml min-1), and (3) elderly patients with renal insufficiency (creatinine clearance 60 +/- 10 ml min-1) following the administration of piroxicam 20 mg as a single dose and after chronic dosing of 20 mg once daily for 4 weeks. 2. Piroxicam and 5'-hydroxypiroxicam concentrations were measured by h.p.l.c. in serum and urine samples collected for 96 h after the single dose and for 144 h after chronic dosing. Unbound concentrations of piroxicam were determined by ultrafiltration. 3. Elimination half-lives, steady state concentrations of piroxicam and 5'-hydroxypiroxicam, clearances of total and unbound piroxicam, volumes of distribution normalized for body weight, and urinary recovery of 5'-hydroxypiroxicam were not influenced by age or renal function. Volumes of distribution after the single dose were significantly lower in women compared with men (mean +/- s.d. 10.0 +/- 2.9 l vs 12.9 +/- 5.0 l; 95% confidence interval of the difference 0.1 to 5.6). 4. Percent unbound piroxicam values were 1.46 +/- 0.3% after the single dose and 1.45 +/- 0.2% at steady state. There were significant reductions in clearance and clearance of unbound piroxicam between single and chronic doses. The half-lives of 5'-hydroxypiroxicam (80.9 +/- 44 h) were significantly longer than those of piroxicam (54.9 +/- 26 h) after chronic dosing. PMID:8148211

  14. Personal Emergency Response Systems--Communication Technology Aids Elderly and Their Families.

    Science.gov (United States)

    Dibner, Andrew S.

    Personal response systems (PRS) bring immediate help to aged and disabled persons at home at the touch of a button. The PRS user wears a tiny radio transmitter as a pendant or a bracelet and can send a telephone signal from any part of the home to a 24-hour emergency center when help is needed. This study examined research on the Lifeline system,…

  15. Clinicopathologic Characteristics of Influenza А(H1n1pdm during 2015–2016 Epidemic Period in Elderly Persons

    Directory of Open Access Journals (Sweden)

    O.N. Domashenko

    2016-09-01

    Full Text Available The objective of the study is to investigate clinical progression of influenza A(H1N1, influenzal pneumonia, pathomorphological pulmonary changes in the lungs in elderly persons in 2015–2016. Materials and methods. During 2015–2016 epidemic period 36 patients suffering from influenza А(H1N1 aged of 60–84 years old (24 male and 12 female patients were attended to the Donetsk Central Municipal Clinical Hospital № 1. Influenza with pneumonia was diagnosed in 24 patients (66.7 %. In 33.3 % the diagnosis of influenza А(H1N1 was confirmed by viral serology testing (hemagglutination-inhibition test, in 63.9 % — by the polymerase chain reaction method, including 87.5 % of deceased patients. Research findings. During 5 years prior to the disease there was no history of influenza vaccination in all patients. On the 5–9th sick day 66.7 % of the patients were hospitalized, 1 female patient (2.8 % was admitted to the department in 2 weeks after the disease onset. Apparent intoxication syndrome was observed from the first day of the disease in 41.7 % of patients with uncomplicated influenza. The duration of fever was 8.7 ± 2.6 days. All elderly patients with uncomplicated influenza recovered. Influenza complicated by pneumonia was diagnosed in 24 patients (66.7 %. In 36.1 % of patients pneumonia was total or subtotal, complicated by respiratory failure of II–III degree of severity. Patients suffering from influenza and influenzal pneumonia did not receive antiviral treatment with oseltamyvirum (Tamiflu due to the lack of this medicinal product in the pharmacy network under the conditions of the local armed conflict. Antibacterial therapy included intravenous meropenum, protected 3rd generation cephalosporins, respiratory fluoroquinolones, macrolides in usual dosages. Oxygen therapy was an indispensable condition for the complex treatment of patients with influenzal pneumonia via a facemask, airtight reservoir bag mask, airtight

  16. Krafttraining bei älteren "frail" Personen

    Directory of Open Access Journals (Sweden)

    Kapan A

    2013-01-01

    Full Text Available Aufgrund der demographischen Entwicklung in den westlichen Industrieländern kann bei einem Ausbleiben adäquater Präventionsmaßnahmen davon ausgegangen werden, dass in Österreich im Jahr 2050 356.000 gebrechliche („frail“ und 1,5 Millionen Personen mit Vorstufen erwartet werden können. Im Alter von 50–70 Jahren kann auch bei gesunder Ernährung und körperlicher Aktivität die Muskelkraft um bis zu 30 % nachlassen. Für den Erhalt der Mobilität und um dem Muskelabbau entgegenzuwirken nimmt das körperliche Training, vor allem das Krafttraining, einen wichtigen Stellenwert ein.

  17. "Research protocol: a synthesis of qualitative studies on the process of adaptation to dependency in elderly persons and their families"

    Science.gov (United States)

    2010-01-01

    Background Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. Methods/Design Objectives: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment. A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. Discussion This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts. PMID:20738846

  18. Interprofessional education in primary care for the elderly : a pilot study

    NARCIS (Netherlands)

    Oeseburg, Barth; Hilberts, Rudi; Luten, Truus A.; van Etten, Antoinette V. M.; Slaets, Joris P. J.; Roodbol, Petrie F.

    2013-01-01

    Background: The Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of nurses and physicians required to meet this demand. At present, the main focus of health care in the Netherlands lies on illness and treatment. However, (frail) elderly

  19. Factors associated with happiness in the elderly persons living in the community.

    Science.gov (United States)

    Luchesi, Bruna Moretti; de Oliveira, Nathalia Alves; de Morais, Daiene; de Paula Pessoa, Rebeca Mendes; Pavarini, Sofia Cristina I; Chagas, Marcos Hortes N

    2018-01-01

    The aim of the present study was to evaluate factors associated with happiness in a sample of Brazilian older adults. A study was conducted with 263 elderly people in the area of coverage of a family health unit located in the state of São Paulo, Brazil. The Subjective Happiness Scale was used to measure happiness, the final score of which determined one of three outcomes: not happy, intermediate, and happy. Disability, sociodemographic characteristics, and psychological, cognitive, and physical factors were considered for the multinomial logistic regression analysis. Statistically significant differences were found among the three groups regarding satisfaction with life, disability, social phobia, anxiety, depression, and frailty (p≤0.05). In the multinomial regression analysis, being "not happy" was significantly associated with satisfaction with life (RRR: 0.53), depression (RRR: 1.46), social phobia (RRR: 1.24), and age (RRR: 1.06). The present findings indicate that psychological factors and age influence the levels of happiness in older adults living in the community. Furthermore, better screening, diagnosis, and treatment of mental health disorders could increase the feeling of happiness among older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Unmasking the 'elderly mystique': Why it is time to make the personal political in ageing research.

    Science.gov (United States)

    Carney, Gemma M; Gray, Mia

    2015-12-01

    This article uses feminist scholarship to investigate 'the elderly mystique'-which contends that the potential of old age is masked by a set of false beliefs about ageing (i.e. ageism) which permeate social, economic, and political life (Cohen, 1988). The article presents a theoretical model which explores the extent to which institutionalised ageism shapes the trajectory of life after 60.(1) The hypothesis underpinning the model is simple: The challenge for ageing societies is not the average age of a given population, but rather, how age is used to structure economic, social and political life. An inter-disciplinary framework is used to examine how biological facts about ageing are used to segregate older from younger people, giving older people the status of 'other'; economically through retirement, politically through assumptions about 'the grey vote,' and socially through ageist stereotyping in the media and through denial and ridicule of the sexuality of older people. Each domain is informed by the achievements of feminist theory and research on sexism and how its successes and failures can inform critical investigations of ageism. The paper recognises the role of ageism in de-politicising the lived experience of ageing. The paper concludes that feminist scholarship, particularly work by feminists in their seventies, eighties, and nineties, has much to offer in terms of re-framing gerontology as an emancipatory project for current and future cohorts of older people. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Living in a continuous traumatic reality: Impact on elderly persons residing in urban and rural communities.

    Science.gov (United States)

    Regev, Irit; Nuttman-Shwartz, Orit

    2016-01-01

    This study is an exploration of the contribution of exposure to the continuous threat of Qassam rocket attacks to PTSD among elderly residents of urban and rural communities. Specifically, we examined the contribution of sociodemographic variables, psychological resources, and perceived social support to PTSD, and whether this relationship is mediated by cognitive appraisals. The sample consisted of 298 residents of 2 different communities: urban (n = 190), and rural (n = 108). We examined the main research question by calculating the correlations of the sociodemographic variables, the psychological resource (self-esteem), social support, and cognitive appraisals with the dependent variable (PTSD). Our model explained the variance in PTSD (53% for urban residents, and 56% for rural residents). Higher levels of PTSD were found among the urban residents. Most of the predictors contributed to PTSD, but differences were found between each type of community with regard to the combination of components. Results indicated that the type of community is related degree of protection against stress-related triggers such as Qassam rockets. The psychological resource (self-esteem) and cognitive appraisal variables were found to be important for older people facing a continuous threat, and can serve as a basis for professional intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Vitamin D supplementation and fracture incidence in elderly persons : A randomized, placebo-controlled clinical trial

    NARCIS (Netherlands)

    Lips, Paul; Graafmans, Wilco C.; Ooms, Marcel E.; Bezemer, P. Dick; Bouter, Lex M.

    1996-01-01

    Objective: To determine whether vitamin D supplementation decreases the incidence of hip fractures and other peripheral bone fractures. Design: Prospective, double-blind trial. Setting: Community setting (Amsterdam and surrounding area). Patients: 2578 persons (1916 women, 662 men) 70 years of age

  3. Transtorno de personalidade na terceira idade Personality disorders in an elderly patient

    Directory of Open Access Journals (Sweden)

    Fernanda Speggiorin Pereira

    2007-01-01

    Full Text Available CONTEXTO: Dificuldades interpessoais, instabilidade afetiva, distorções da relação médico-paciente e respostas imprevisíveis às intervenções são características centrais aos transtornos de personalidade que são encontradas tanto em pacientes jovens, como em adultos idosos. RELATO DE CASO: Encontra-se aqui descrito um caso de transtorno de personalidade em paciente de 68 anos de idade, com transtorno de personalidade do tipo histriônica e outras comorbidades psiquiátricas. CONCLUSÃO: Transtorno de personalidade é um diagnóstico raramente aventado no tratamento psiquiátrico no paciente idoso de difícil manejo. Deve-se nestes casos fazer uma investigação mais aprofundada do funcionamento da personalidade, pois a presença e a severidade do transtorno de personalidade têm implicações no plano da assistência de ambos os tratamentos psicológico e farmacológico.CONTEXT: Interpersonal difficulties, affective instability, distortions of the clinician-patient relationship, and unpredictable responses to clinical interventions, are characteristics found in older adults as well as in younger patients with personality disorders. CASE REPORT: We report the case of a 68 years old patient with histrionic personality disorder and other psychiatric comorbidities. CONCLUSION: Personality disorders are frequently overlooked in the diagnostic workout of complex psychogeriatric syndromes, and require a comprehensive assessment of personality traits. The correct identification of personality disorders and their subtypes is critical for planning the therapeutic approach, including pharmacotherapy and psychological management.

  4. Singing in Individual Music Therapy with Elderly Persons suffering from Dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2002-01-01

    To forget your keys, the name of your neighbour, where you put your glasses, or even forgetting your password, is annoying, - but well, it happens to all of us. But when you forget where you live, fail to recognise a close friend, forget what things around you are called, even your own name, then......, then you have a serious problem! The article describes a Ph.D.-research with focus on music therapy with persons suffering from dementia....

  5. Elders and patient participation revisited - a discourse analytic approach to older persons' reflections on patient participation.

    Science.gov (United States)

    Foss, Christina

    2011-07-01

    This study focuses on how older persons' accounts of participation might be framed and constructed based on their social and historical situatedness. The picture emerging from contemporary research tends to portray older people as a group who prefer to leave decisions to the professionals during a hospital stay. Through an approach that sought to contextualise the respondents' accounts of participation, different features of patient participation became visible. The study is based on a postmodern framework using a discursive approach, informed by the works of Foucault and on works that have been developed in line with his main ideas. Eighteen individual in-depth interviews with older people (age 80+) were conducted between one to two weeks after discharge from hospital. Findings indicate that older people actively position themselves in relation to various discourses at play in the hospital, and display a wide variety of strategies aimed at gaining influence. To the older persons in this study, participation was practised in a subtle and discreet way, as a matter of choosing a good strategy to interact with the personnel. Participation was also seen as a matter of balancing their own needs against the needs of others and as a behaviour that required self-confidence. The accounts of patient participation given by the older persons differed from the dominant and taken-for-granted discourse of patient participation as a right. As the older persons' understanding and practice of patient participation do not 'fit' the contemporary idea of participation, it is in danger of being ignored or overlooked by care-givers as well as by researchers. To identify older patients' wish to participate, one must actively search for it. © 2011 Blackwell Publishing Ltd.

  6. [Significances of the life experience for the long-lived elderly person in the process of death/dying and mourning].

    Science.gov (United States)

    Menezes, Tânia Maria de Oliva; Lopes, Regina Lúcia Mendonça

    2014-08-01

    This is a study using the Heideggerian theoretical-phenomenological approach, which sought to understand the significances of the life experience for the long-lived elderly person in the process of death/dying and mourning. It was conducted in 2009 with 16 long-lived senior citizens of both genders who were aged between 80 and 90, members of a community center for the elderly located in a suburban neighborhood of the city of Salvador in the state of Bahia, Brazil. The results showed that the long-lived elderly person experiences the mourning status process when relatives and friends become ill and die. Furthermore, they gave ambiguous reports with respect to the fear of death. With the attributed significances, it was possible to arrive at the unit of significance, namely the authenticity and lack of authenticity of the individual regarding imminent death. The conclusion reached is that long-lived elderly individuals faced with the process of death/dying and mourning is apparent or concealed in accordance with the moment they are experiencing and the opportunities that present themselves, in other words, it is greatly influenced by their past.

  7. Effects of Nordic walking on physical functions and depression in frail people aged 70 years and above.

    Science.gov (United States)

    Lee, Han Suk; Park, Jeung Hun

    2015-08-01

    [Purpose] This study investigated the effects of Nordic walking on physical functions and depression in frail people aged 70 years and above. [Subjects] Twenty frail elderly individuals ≥70 years old were assigned to either a Nordic walking group (n=8) or general exercise group (n=10). [Methods] The duration of intervention was equal in both groups (3 sessions/week for 12 weeks, 60 min/session). Physical function (balance, upper extremity strength, lower extremity strength, weakness) and depression were examined before and after the interventions. [Results] With the exception of upper extremity muscle strength, lower extremity strength, weakness, balance, and depression after Nordic walking demonstrated statistically significant improvement. However, in the general exercise group, only balance demonstrated a statistically significant improvement after the intervention. There were significant differences in the changes in lower extremity muscle strength, weakness and depression between the groups. [Conclusion] In conclusion, Nordic walking was more effective than general exercise. Therefore, we suggest that Nordic walking may be an attractive option for significant functional improvement in frail people over 70 years old.

  8. Personalized Medication Management: Towards a Design of Individualized Support for Elderly Citizens at Home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Olsen, Jesper Wolff

    2012-01-01

    Several technologies have been developed to support people's medication management, including pillboxes, specialized software applications, reminders and paper-based medication lists. Several of these technologies were discovered in older adults' homes during user studies carried out with the main...... purpose to help them to manage their medications and recall challenges. We confirm that a considerable number of older adults integrate their medication treatments into their daily life routines, and that the lack of knowledge, caregiver's support, medicine outside the home, forgetting medication intake...... towards the design of a personalized medication management system. We further describe our initial stage in a participatory design process as part of the ongoing Lev Vel Consortium....

  9. Processing older persons as clients in elderly care: A study of the micro-processes of care management practice.

    Science.gov (United States)

    Olaison, Anna

    2017-02-01

    Elder care has undergone a marketization in recent years in which various models for care management have been introduced with the aim of making assessments efficient. This article investigates the effects the care management model has on resource allocation for home care when handling the requests of older persons in the needs assessment process. Sixteen tape-recorded assessment conversations with associated case-file texts were analyzed through discourse analysis. The results show that a managerialist thinking has had a partial impact on the assessment process where the documentation requirements have entailed bureaucratization in terms of the transfer that occurs from talk to text. The findings from the study nevertheless indicate that the assessment conversations have clear elements of an individual-centred perspective in which there is room for a care rational dialogue. This constitutes a welfare policy dilemma today. Providing for older people's requests should be on the basis of quality and an individual-centred perspective and care management has had a contrary effect in which focus is directed instead towards needs assessment and bureaucratic processes.

  10. The role of sex and autonomy-connectedness in internalizing and externalizing personality pathology, coping and axis-I pathology: among psychiatric and healthy elderly.

    Science.gov (United States)

    Bachrach, Nathan; Croon, Marcel; Bekker, Marrie

    2017-06-01

    In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age. A path model was tested which was based on neo-analytical object relation, attachment- and primary-personality theory, among 100 clinical and 106 non-clinical elderly. In line with our model, autonomy-connectedness (self-awareness and capacity of managing new situations) was strongly associated to internalizing PDS in both groups. In both groups, neither sex nor autonomy-connectedness predicted externalizing PDS. Sex, internalizing as well as externalizing PDS and reactive defensive coping were associated to axis-I psychopathology. We conclude that sex and autonomy-connectedness were, similarly as in adult populations, associated to internalizing PDS and axis-I pathology. Treatment of elderly with internalizing PDS and axis-I psychopathology should therefore focus on enhancing autonomy-connectedness.

  11. Dietary strategies to augment muscle mass in the elderly

    NARCIS (Netherlands)

    Tieland, C.A.B.

    2013-01-01

    Background: The world population is aging rapidly. This growth of the aging population is accompanied by an increased number of frail elderly people who are at risk of adverse health outcomes such as disability, co-morbidity and

  12. Associations between ambient air pollution and daily mortality among elderly persons in Montreal, Quebec.

    Science.gov (United States)

    Goldberg, Mark S; Burnett, Richard T; Stieb, David M; Brophy, James M; Daskalopoulou, Stella S; Valois, Marie-France; Brook, Jeffrey R

    2013-10-01

    Persons with underlying health conditions may be at higher risk for the short-term effects of air pollution. We have extended our original mortality time series study in Montreal, Quebec, among persons 65 years of age and older, for an additional 10 years (1990-2003) to assess whether these associations persisted and to investigate new health conditions. We created subgroups of subjects diagnosed with major health conditions one year before death using billing and prescription data from the Quebec Health Insurance Plan. We used parametric log-linear Poisson models within the distributed lag non-linear models framework, that were adjusted for long-term temporal trends and daily maximum temperature, for which we assessed associations with NO2, O3, CO, SO2, and particles with aerodynamic diameters 2.5 μm in diameter or less (PM2.5). We found positive associations between daily non-accidental mortality and all air pollutants but O3 (e.g., for a cumulative effect over a 3-day lag, with a mean percent change (MPC) in daily mortality of 1.90% [95% confidence interval: 0.73, 3.08%] for an increase of the interquartile range (17.56 μg m(-3)) of NO2). Positive associations were found amongst persons having cardiovascular disease (cumulative MPC for an increase equal to the interquartile range of NO2=2.67%), congestive heart failure (MPC=3.46%), atrial fibrillation (MPC=4.21%), diabetes (MPC=3.45%), and diabetes and cardiovascular disease (MPC=3.50%). Associations in the warm season were also found for acute and chronic coronary artery disease, hypertension, and cancer. There was no persuasive evidence to conclude that there were seasonal associations for cerebrovascular disease, acute lower respiratory disease (defined within 2 months of death), airways disease, and diabetes and airways disease. These data indicate that individuals with certain health conditions, especially those with diabetes and cardiovascular disease, hypertension, atrial fibrillation, and cancer, may

  13. Incidence of second cervical vertebral fractures far surpassed the rate predicted by the changing age distribution and growth among elderly persons in the United States (2005-2008).

    Science.gov (United States)

    Zusman, Natalie L; Ching, Alexander C; Hart, Robert A; Yoo, Jung U

    2013-04-20

    Nationwide epidemiological cohort study. To characterize the incidence of second cervical vertebral (C2) fractures by age and geographical region among the elderly Medicare population and to elucidate if the rate changed in the years 2005 to 2008. Recent publications hypothesized that the rate of cervical vertebral fractures may be increasing. To date, there are no published nationwide reports describing the incidence and demographics of these injuries in the elderly US population. Incidence of C2 fracture in the years 2005 to 2008 was determined by querying PearlDiver Technologies, Inc. (Warsaw, IN), a commercially available database, using International Classification of Diseases code 805.02. Rates were calculated using the PearlDiver reported person-counts as the numerator and the Center for Medicare and Medicare Services midyear population file as the denominator, and reported per 10,000 person-years (10,000 p-y). The age and geographical distributions of fractures were examined. Variability in rates was analyzed using the mean, standard deviation, 95% confidence intervals, χ tests, and Pearson correlation coefficients. Although the elderly population increased by 6% between 2005 and 2008, the annual incidence of C2 fracture rose by 21%, from 1.58 to 1.91 per 10,000 p-y, trending upward in a straight-line function (r = 0.999, P = 0.0006). The incidence of fracture varied between age groups; however, an increase was observed in all age groups. Persons aged 65 to 74 years (the youngest age group) experienced the lowest incidence (0.63 in 2005 to 0.71 in 2008), and the rate of increase was the smallest among the age groups examined (13%). Persons aged 85 and older demonstrated the highest incidence (4.36-5.67) and the greatest increase (30%). From 2005 to 2008, the overall incidence of C2 fracture rose at a rate that was 3.5 times faster than the elderly population growth.

  14. Quality of life of elderly persons with cancer: a 3-month follow-up

    DEFF Research Database (Denmark)

    Esbensen, Bente Appel; Østerlind, Kell; Hallberg, Ingalill Rahm

    2006-01-01

    We investigated the quality of life (QoL) of newly diagnosed persons with cancer aged 65 years at baseline and 3 months after, in relation to age, contact with the healthcare system, activities of daily living, hope, social network and support using the European Organization for Research...... and Treatment of Cancer QLQ-C30, Katz ADL, Nowotny's Hope Scale, and the Interview Schedule for Social Interaction. Participation at baseline was 101 (74 women, 27 men), and after 3 months was 85(66 women, 19 men). Fatigue was the most reported symptom both at baseline and 3 months after. No significant changes...... were found in QoL from baseline to 3 months after, whereas perceived social network and 2 subscales ("confidence" and "comes from within") in Nowotny's Hope Scale deteriorated significantly. Dependency, reduced economic ability, and low level of hope were significantly associated with low QoL at the 3...

  15. Neuropsychiatric Inventory data in a Belgian sample of elderly persons with and without dementia

    Directory of Open Access Journals (Sweden)

    Squelard GP

    2012-10-01

    Full Text Available Gilles P Squelard,1 Pierre A Missotten,1 Louis Paquay,2 Jan A De Lepeleire,2 Frank JVM Buntinx,2 Ovide Fontaine,1 Stephane R Adam,1 Michel JD Ylieff11Clinical Psychology of Ageing, Qualidem Research Project, University of Liège (ULg, Liège, Belgium; 2KU Leuven, Department of Public Health and Primary Care, Leuven, BelgiumBackground/aims: This study assesses and compares prevalence of psychological and behavioral symptoms in a Belgian sample of people with and without dementia.Methods: A total of 228 persons older than 65 years with dementia and a group of 64 non-demented persons were assessed using the Neuropsychiatric Inventory (NPI in 2004.Results: Within the group without dementia, the most frequent symptoms were depression, agitation, and irritability. Within the group with dementia, the most common symptoms were depression, irritability, apathy, and agitation. Prevalence of delusions (P < 0.05, hallucinations (P < 0.05, anxiety (P < 0.05, agitation (P < 0.05, apathy (P < 0.01, aberrant motor behavior (P < 0.01, and eating disorders (P < 0.05 were significantly higher in the group with dementia.Conclusion: Depression, elation, irritability, disinhibition, and sleeping disorders are not specific to dementia. Agitation, apathy, anxiety, and delusions are more frequent in dementia but were not specific to the dementia group because their prevalence rates were close to 10% in the group without dementia. Hallucinations, aberrant motor behavior, and eating disorders are specific to dementia. The distinction between specific and nonspecific symptoms may be useful for etiological research on biological, psychological, and environmental factors.Keywords: behavior, behavior disorders, epidemiology, dementia, psychiatric symptoms, neuropsychiatry

  16. Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly : a cross-sectional study

    NARCIS (Netherlands)

    Hoeksema, A. R.; Spoorenberg, S. L. W.; Peters, L. L.; Meijer, H. J. A.; Raghoebar, G. M.; Vissink, A.; Wynia, K.; Visser, A.

    ObjectiveTo assess oral status and self-reported oral health in community-living elderly and to determine differences between relevant subgroups of oral status (remaining teeth, edentulous, implant-retained overdentures) and case complexity (robust, frail, complex care needs). Subjects and methodsIn

  17. Training with a balance exercise assist robot is more effective than conventional training for frail older adults.

    Science.gov (United States)

    Ozaki, Kenichi; Kondo, Izumi; Hirano, Satoshi; Kagaya, Hitoshi; Saitoh, Eiichi; Osawa, Aiko; Fujinori, Yoichi

    2017-11-01

    To examine the efficacy of postural strategy training using a balance exercise assist robot (BEAR) as compared with conventional balance training for frail older adults. The present study was designed as a cross-over trial without a washout term. A total of 27 community-dwelling frail or prefrail elderly residents (7 men, 20 women; age range 65-85 years) were selected from a volunteer sample. Two exercises were prepared for interventions: robotic exercise moving the center of gravity by the balance exercise assist robot system; and conventional balance training combining muscle-strengthening exercise, postural strategy training and applied motion exercise. Each exercise was carried out twice a week for 6 weeks. Participants were allocated randomly to either the robotic exercise first group or the conventional balance exercise first group. preferred and maximal gait speeds, tandem gait speeds, timed up-and-go test, functional reach test, functional base of support, center of pressure, and muscle strength of the lower extremities were assessed before and after completion of each exercise program. Robotic exercise achieved significant improvements for tandem gait speed (P = 0.012), functional reach test (P = 0.002), timed up-and-go test (P = 0.023) and muscle strength of the lower extremities (P = 0.001-0.030) compared with conventional exercise. In frail or prefrail older adults, robotic exercise was more effective for improving dynamic balance and lower extremity muscle strength than conventional exercise. These findings suggest that postural strategy training with the balance exercise assist robot is effective to improve the gait instability and muscle weakness often seen in frail older adults. Geriatr Gerontol Int 2017; 17: 1982-1990. © 2017 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  18. Non-tricyclic and Non-selective Serotonin Reuptake Inhibitor Antidepressants and Recurrent Falls in Frail Older Women.

    Science.gov (United States)

    Naples, Jennifer G; Kotlarczyk, Mary P; Perera, Subashan; Greenspan, Susan L; Hanlon, Joseph T

    2016-12-01

    To determine the risk of recurrent falls associated with antidepressants other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) among frail older women. This is a secondary analysis of the Zoledronic acid in frail Elders to STrengthen bone, or ZEST, trial data treated as a longitudinal cohort in 181 frail, osteoporotic women aged ≥65 years in long-term care. The primary exposure was individual non-TCA/non-SSRI antidepressants (i.e., serotonin norepinephrine reuptake inhibitors, mirtazapine, trazodone, and bupropion) at baseline and 6 months. The main outcome was recurrent (at least two) falls within 6 months after antidepressant exposure. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were derived using a generalized estimating equations model. At least 15% of women experienced recurrent falls between 0-6 and 6-12 months. At baseline and 6 months, 18.2% and 6.9% had a non-TCA/non-SSRI antidepressant, respectively. Adjusting for demographics, health status, and other drugs that increase risk of falls, non-TCA/non-SSRI antidepressant exposure significantly increased the risk of recurrent falls (AOR: 2.14; 95% CI: 1.01-4.54). Fall risk further increased after removing bupropion from the non-TCA/non-SSRI antidepressant group in sensitivity analyses (AOR: 2.73; 95% CI: 1.24-6.01). Other antidepressant classes may not be safer than TCAs/SSRIs with respect to recurrent falls in frail older women. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Lifestyle, socioeconomic characteristics, and medical history of elderly persons who receive seasonal influenza vaccination in a tax-supported healthcare system

    DEFF Research Database (Denmark)

    Hellfritzsch, Maja; Thomsen, Reimar Wernich; Baggesen, Lisbeth Munksgård

    2017-01-01

    inactivity (aPR: 1.08, 95% CI 1.03–1.13). Levels of education and income were similar in the two groups. Vaccinated persons had a higher prevalence of major physical limitations (aPR: 1.40, 95% CI 1.17–1.66) and need for assistance with activities of daily living (aPR: 1.29, 95% CI 1.13–1.47). Conclusion......Background Observational studies on effectiveness of influenza vaccination in the elderly are thought to be biased by healthier lifestyles and higher socioeconomic status among vaccinated vs. unvaccinated persons. We examined this hypothesis in a uniform tax-supported health care system with free......-of-charge influenza vaccination to the elderly. Methods We conducted a cross-sectional study among Danes aged 65–79 years participating in a survey. We compared elderly persons with and without a recent (within six months) influenza vaccination in terms of (i) lifestyle and socioeconomic characteristics obtained from...

  20. The effects of an active-assisted stretching program on functional performance in elderly persons: A pilot study

    Directory of Open Access Journals (Sweden)

    Damian C Stanziano

    2009-03-01

    Full Text Available Damian C Stanziano1,2, Bernard A Roos1,2,3,4, Arlette C Perry1, Shenghan Lai5, Joseph F Signorile1,31Department of Exercise and Sport Sciences, University of Miami, Coral Gables, FL, USA; 2Stein Gerontological Institute, Miami Jewish Home and Hospital, Miami, FL, USA; 3Geriatric Research, Education, and Clinical Center, Miami VA Healthcare System, Miami, FL, USA; 4Departments of Medicine and Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; 5Departments of Pathology and Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA Abstract: This study examined the impact of an eight-week active-assisted (AA stretching program on functionality, mobility, power, and range of motion (ROM in elderly residents of a residential retirement community. Seventeen volunteers (4 male, 13 female; 88.8 ± 5.36 years were randomly assigned to an AA or control group. The AA group performed 10 different AA stretches targeting the major joints of the body twice weekly for eight weeks. Controls attended classes requiring limited physical activity. All participants were assessed using four fl exibility and six functional tests, one week before and after the eight-week training period. A fully randomized repeated-measures ANCOVA with pretest scores as a covariate was used to detect differences between groups across time. The AA group demonstrated significant increases in ROM for most of the joints evaluated (p < 0.05 and significant increases in all performance measures (p < 0.05. Controls showed no improvements in functional or ROM measures (α = 0.05. Additionally, the AA group showed significantly better performance outcomes across the training period than controls. We conclude that our eight-week flexibility program effectively reduces age-related losses in ROM and improves functional performance in elderly persons with insufficient physical reserves to perform higher-intensity exercises.Keywords: proprioceptive neuromuscular

  1. Association of personality traits with oral health-related quality of life independently of objective oral health status: a study of community-dwelling elderly Japanese.

    Science.gov (United States)

    Takeshita, Hajime; Ikebe, Kazunori; Kagawa, Ryosuke; Okada, Tadashi; Gondo, Yasuyuki; Nakagawa, Takeshi; Ishioka, Yoshiko; Inomata, Chisato; Tada, Sayaka; Matsuda, Ken-ichi; Kurushima, Yuko; Enoki, Kaori; Kamide, Kei; Masui, Yukie; Takahashi, Ryutaro; Arai, Yasumichi; Maeda, Yoshinobu

    2015-03-01

    Oral health-related quality of life (OHRQoL) is being increasingly used in epidemiologic studies of dentistry. However, patient-reported OHRQoL does not always coincide with clinical measures. Previous studies have shown a relationship between OHRQoL and personality, but did not concomitantly investigate oral function. We aimed to examine the association among personality traits, oral function, and OHRQoL using a large sample of community-dwelling Japanese elderly. The participants (n = 938; age, 69-71 years) were drawn from a complete enumeration of an urban area and a rural area of both the Tokyo metropolitan area and Hyogo Prefecture. The self-perceived impact of OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). The oral status and socioeconomic characteristics were recorded in each participant, and personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) were assessed with the NEO-five-factor inventory. Multiple linear regression analysis was performed to examine the relationships between OHRQoL and other factors, with p Personality traits are associated with OHRQoL independently of objective measures of oral health status in community-dwelling elderly Japanese. This study showed personality traits are associated with OHRQoL independently of dental status and oral function in old Japanese people. As elderly patients undergo increasingly complex dental treatments, there is a need to evaluate patient personality traits prior to dental treatment and predict patient expectations and responses to planned treatment. This is advantageous in determining the most appropriate therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition

    Directory of Open Access Journals (Sweden)

    Muntinga Maaike E

    2012-04-01

    status, care needs and QALYs. We will investigate the level of implementation, barriers and facilitators to successful implementation and the extent to which the intervention manages to achieve the transition necessary to overcome challenges in elderly care. Discussion This is one of the first studies assessing the effectiveness, cost-effectiveness and implementation process of the chronic care model for frail community-dwelling older adults. Trial registration The Netherlands National Trial Register NTR2160.

  3. [Long term persistence of yellow fever neutralising antibodies in elderly persons].

    Science.gov (United States)

    Coulange Bodilis, H; Benabdelmoumen, G; Gergely, A; Goujon, C; Pelicot, M; Poujol, P; Consigny, P H

    2011-10-01

    The activity of the yellow fever virus is reemerging in areas without recent transmission history, such as northern Argentina and Paraguay, and persists in an epidemic mode in other countries in Africa and Latin America. Thus more and more travelers are at risk of being exposed to this disease. The population is becoming older, sometimes suffering from multiple pathologies. Moreover, the risk of serious adverse events associated with live-attenuated YF17D vaccine, such as multiple organ failure (YEL-AVD), reaches 1/50,000 vaccines in people over 65 versus 1/200,000 in the general population. We analyzed, in a retrospective study, the results of neutralizing antibody titers against yellow fever in people aged 60 and older, who had been previously vaccinated against yellow fever and had visited the International Vaccination Centre of the Institut Pasteur between January 2005 and February 2009. In this population of 84 persons (median age 69 years), the date of the last vaccination was always more than 10 years: it was precisely known in 68 subjects and alleged in 16 subjects. The median time since the previous vaccination was 14 years, with a maximum of 60 years. The indications of serology were: immunosuppressive therapy (19% of cases), cancer (32%), hemopathy (10.7%), HIV infection (3.6%), chronic hepatitis/chronic renal failure/dialysis (2.4%), autoimmune diseases (2.4%), and in 29.8% of cases, age alone was the indication of serology. The antibody titer was at a protective level in 95.2% of cases. The four individuals with negative serology had no formal documented proof of a previous vaccination against yellow fever. This serological study was able to show a persistent protective antibody titer, after a previous vaccination, even going back 60 years, allowing patients to travel in a yellow-fever endemic area despite a contraindication, and without requiring any vaccine booster.

  4. Age-friendly environments and life satisfaction among South Korean elders: person-environment fit perspective.

    Science.gov (United States)

    Park, Sojung; Lee, Sangchul

    2017-07-01

    Drawing on the person-environment (P-E) fit perspective, this study examined the role of environment on the well-being of vulnerable older adults in a non-western context. Using the indicators from the World Health Organization's (WHO) framework for age friendly cities (ACF), we examined life satisfaction among South Korean older adults, exploring the extent to which multidimensional environmental characteristics are associated with low socioeconomic status (SES). Using the regionally representative data from the Seoul City-wide needs assessment of middle- and old-aged adults, an analytic sample (N = 1657) focused on community-living individuals aged 65 and older. Multilevel regression models examined interaction between SES subgroups and varying aspects of the environment (i.e. physical, social, and service environment) as related to life satisfaction. Consistent with the environmental docility hypothesis, members of the most vulnerable subgroup in the Korean context - older adults who are living alone and poor - are more likely to have higher life satisfaction when they have higher levels of support in physical and social environments. Interestingly, a higher level of support in the service environment was related to lower life satisfaction for this subgroup. This study provides an empirical foundation for efforts to identify age-friendly environmental characteristics as modifiable environmental resources that can improve older adults' psychological well-being. As the first attempt to use WHO ACF indicators within the P-E fit perspective in a non-Western context, our study provides a foundation for designing support services or programs that effectively meet the needs of vulnerable older adults.

  5. My elder brother Fr Prof.Benignus Józef Wanat OCD. Personal family reminiscences

    Directory of Open Access Journals (Sweden)

    Edward Wanat

    2016-12-01

    . Father Benignus was instrumental in the achievement of many noteworthy events including the coronation with the papal crowns of the miraculous image of Our Lady of Czerna and the project management of the construction of the chapel of St. Raphael Kalinowski. Fr. Benignus was always quiet person, unassuming and generous in helping others. Although diagnosed with cancer, he continued his duties which included a provincial visitation to the Carmelite Mission in Africa. Later, despite his worsening health, (numerous tumours through his exceptional and strong devotion to our BVM, Queen of Carmel, he received, through Her intercession, the grace of a special healing and recovery.

  6. Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons - A Population Based Study

    Science.gov (United States)

    Parsaik, Ajay K; Singh, Balwinder; Roberts, Rosebud O; Pankratz, Shane; Edwards, Kelly K.; Geda, Yonas E; Gharib, H; Boeve, Bradley F; Knopman, David S; Petersen, Ronald C

    2014-01-01

    IMPORTANCE Association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) is not established. OBJECTIVE To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population based cohort. DESIGN A cross-sectional, population-based study. SETTING Olmsted County, Minnesota. PARTICIPANTS Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia. A total of 2,050 participants were evaluated and underwent in-person interview, neurological evaluation and neuropsychological testing to assess performance in memory, attention/executive function, visuospatial, and language domains. Subjects were diagnosed by consensus as cognitively normal, MCI or dementia according to published criteria. Clinical and subclinical hypothyroidism was ascertained from a medical records-linkage system. MAIN OUTCOME MEASURES Association of clinical and subclinical hypothyroidism with MCI. Results Among 1904 eligible participants, the frequency of MCI was 16% in 1450 subjects with normal thyroid function, 17% in 313 subjects with clinical hypothyroidism, and 18% in 141 subjects with subclinical hypothyroidism. After adjusting for covariates (age, gender, education, education years, sex, ApoE ε 4, depression, diabetes, hypertension, stroke, BMI and coronary artery disease) we found no significant association between clinical or subclinial hypothyroidism and MCI [OR 0.99 (95% CI 0.66–1.48) and OR 0.88 (95% CI 0.38–2.03) respectively]. No effect of gender interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidisn among males was 1.02 (95%CI, 0.57–1.82) and 1.29 (95%CI 0.68–2.44), among females was 1.04 (95% 0.66–1.66) and 0.86 (95% CI 0.37–2.02) respectively. Conclusion In this population based cohort of eldery, neither clinical nor subclinical hypothyrpodism was associated with MCI. Our findings

  7. Motivation to take part in integrated care - an assessment of follow-up home visits to elderly persons

    Directory of Open Access Journals (Sweden)

    Ulf Hjelmar

    2011-08-01

    Full Text Available Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons. Theory and methods: The analysis is based on inter-organisational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials. Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programs in order to fully exploit the potential health benefits.

  8. Motivation to take part in integrated care - an assessment of follow-up home visits to elderly persons

    Directory of Open Access Journals (Sweden)

    Ulf Hjelmar

    2011-08-01

    Full Text Available Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons.Theory and methods: The analysis is based on inter-organisational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses.Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials.Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programs in order to fully exploit the potential health benefits.

  9. Age-related changes in auditory and cognitive abilities in elderly persons with hearing aids fitted at the initial stages of hearing loss

    Directory of Open Access Journals (Sweden)

    C. Obuchi

    2011-03-01

    Full Text Available In this study, we investigated the relation between the use of hearing aids at the initial stages of hearing loss and age-related changes in the auditory and cognitive abilities of elderly persons. 12 healthy elderly persons participated in an annual auditory and cognitive longitudinal examination for three years. According to their hearing level, they were divided into 3 subgroups - the normal hearing group, the hearing loss without hearing aids group, and the hearing loss with hearing aids group. All the subjects underwent 4 tests: pure-tone audiometry, syllable intelligibility test, dichotic listening test (DLT, and Wechsler Adult Intelligence Scale-Revised (WAIS-R Short Forms. Comparison between the 3 groups revealed that the hearing loss without hearing aids group showed the lowest scores for the performance tasks, in contrast to the hearing level and intelligibility results. The other groups showed no significant difference in the WAIS-R subtests. This result indicates that prescription of a hearing aid during the early stages of hearing loss is related to the retention of cognitive abilities in such elderly people. However, there were no statistical significant correlations between the auditory and cognitive tasks.

  10. Usefulness of a single item in a mail survey to identify persons with possible dementia: a new strategy for finding high-risk elders.

    Science.gov (United States)

    Brody, Kathleen K; Maslow, Katie; Perrin, Nancy A; Crooks, Valerie; DellaPenna, Richard; Kuang, Daniel

    2005-04-01

    The objective of this study was to examine the characteristics of elderly persons who responded positively to a question about "severe memory problems" on a mailed health questionnaire yet were missed by the existing health risk algorithm to identify vulnerable elderly persons. A total of 324,471 respondents aged 65 and older completed a primary care health status questionnaire that gathered clinical information to quickly identify members with functional impairment, multiple chronic diseases, and higher medical care needs. The respondents were part of a large, integrated, not-for-profit managed care organization that implemented a model of care for elders using a uniform risk identification method across eight regions. Respondents with severe memory problems were compared to general respondents by morbidity, geriatric syndromes, functional impairments, service utilization, sensory impairments, sociodemographic characteristics, and activities of daily living. Of the respondents, 13,902 persons (4.3%) reported severe memory problems; the existing health risk algorithm missed 47.1% of these. When severe memory problems were included in the risk algorithm, identification increased from 11% to 13%, and risk prevalence by age groups ranged from 4.4% to 40.5%; one third had severe memory problems, a finding that was fairly consistent within age groups (28.4% to 36.5%). A question about severe memory problems should be incorporated into population risk-identification techniques. While false-negative rates are unknown, the false-positive rate of a self-report mail survey appears to be minimal. Persons reporting severe memory problems clearly have multiple comorbidities, higher prevalence of geriatric syndromes, and greater functional and sensory impairments.

  11. Elderly persons with ICU-acquired weakness: the potential role for β-hydroxy-β-methylbutyrate (HMB) supplementation?

    Science.gov (United States)

    Rahman, Adam; Wilund, Kenneth; Fitschen, Peter J; Jeejeebhoy, Khursheed; Agarwala, Ravi; Drover, John W; Mourtzakis, Marina

    2014-07-01

    Intensive care unit (ICU)-acquired weakness is common and characterized by muscle loss, weakness, and paralysis. It is associated with poor short-term outcomes, including increased mortality, but the consequences of reduced long-term outcomes, including decreased physical function and quality of life, can be just as devastating. ICU-acquired weakness is particularly relevant to elderly patients who are increasingly consuming ICU resources and are at increased risk for ICU-acquired weakness and complications, including mortality. Elderly patients often enter critical illness with reduced muscle mass and function and are also at increased risk for accelerated disuse atrophy with acute illness. Increasingly, intensivists and researchers are focusing on strategies and therapies aimed at improving long-term neuromuscular function. β-Hydroxy-β-methylbutyrate (HMB), an ergogenic supplement, has shown efficacy in elderly patients and certain clinical populations in counteracting muscle loss. The present review discusses ICU-acquired weakness, as well as the unique physiology of muscle loss and skeletal muscle function in elderly patients, and then summarizes the evidence for HMB in elderly patients and in clinical populations. We subsequently postulate on the potential role and strategies in studying HMB in elderly ICU patients to improve muscle mass and function. © 2013 American Society for Parenteral and Enteral Nutrition.

  12. Health status transitions in community-living elderly with complex care needs: a latent class approach.

    Science.gov (United States)

    Lafortune, Louise; Béland, François; Bergman, Howard; Ankri, Joël

    2009-02-03

    For older persons with complex care needs, accounting for the variability and interdependency in how health dimensions manifest themselves is necessary to understand the dynamic of health status. Our objective is to test the hypothesis that a latent classification can capture this heterogeneity in a population of frail elderly persons living in the community. Based on a person-centered approach, the classification corresponds to substantively meaningful groups of individuals who present with a comparable constellation of health problems. Using data collected for the SIPA project, a system of integrated care for frail older people (n = 1164), we performed latent class analyses to identify homogenous categories of health status (i.e. health profiles) based on 17 indicators of prevalent health problems (chronic conditions; depression; cognition; functional and sensory limitations; instrumental, mobility and personal care disability) Then, we conducted latent transition analyses to study change in profile membership over 2 consecutive periods of 12 and 10 months, respectively. We modeled competing risks for mortality and lost to follow-up as absorbing states to avoid attrition biases. We identified four health profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension. The profiles are stable over time and robust to mortality and lost to follow-up attrition. The differentiated and gender-specific patterns of transition probabilities demonstrate the profiles' sensitivity to change in health status and unmasked the differential relationship of physical and cognitive domains with progression in disability. Our approach may prove useful at organization and policy levels where many issues call for classification of individuals into pragmatically meaningful groups. In dealing with attrition biases, our analytical strategy could provide critical information for the planning of longitudinal studies of aging

  13. Health status transitions in community-living elderly with complex care needs: a latent class approach

    Directory of Open Access Journals (Sweden)

    Béland François

    2009-02-01

    Full Text Available Abstract Background For older persons with complex care needs, accounting for the variability and interdependency in how health dimensions manifest themselves is necessary to understand the dynamic of health status. Our objective is to test the hypothesis that a latent classification can capture this heterogeneity in a population of frail elderly persons living in the community. Based on a person-centered approach, the classification corresponds to substantively meaningful groups of individuals who present with a comparable constellation of health problems. Methods Using data collected for the SIPA project, a system of integrated care for frail older people (n = 1164, we performed latent class analyses to identify homogenous categories of health status (i.e. health profiles based on 17 indicators of prevalent health problems (chronic conditions; depression; cognition; functional and sensory limitations; instrumental, mobility and personal care disability Then, we conducted latent transition analyses to study change in profile membership over 2 consecutive periods of 12 and 10 months, respectively. We modeled competing risks for mortality and lost to follow-up as absorbing states to avoid attrition biases. Results We identified four health profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension. The profiles are stable over time and robust to mortality and lost to follow-up attrition. The differentiated and gender-specific patterns of transition probabilities demonstrate the profiles' sensitivity to change in health status and unmasked the differential relationship of physical and cognitive domains with progression in disability. Conclusion Our approach may prove useful at organization and policy levels where many issues call for classification of individuals into pragmatically meaningful groups. In dealing with attrition biases, our analytical strategy could provide critical

  14. Comportamiento del riesgo de caídas en el hogar en adultos mayores Behavior of falls risk at home of the elderly persons

    Directory of Open Access Journals (Sweden)

    Arlene Salas Mainegra

    2011-03-01

    Full Text Available Introducción: se realizó un estudio descriptivo, en la población de adultos mayores atendidos por el Consultorio del Médico de Familia # 4, perteneciente al policlínico "Ramón González Coro", del municipio Marianao, durante 2008. Objetivo: se realizó el análisis del comportamiento del riesgo de caídas de los adultos mayores en el hogar. Métodos: estudio de investigación descriptiva, en cuyo desarrollo se utilizó un modelo cualicuantitativo, y en su ejecución se emplearon métodos teóricos, empíricos y procedimientos estadísticos. Resultados: hubo un predomino del sexo femenino, el mayor por ciento de los adultos mayores presentó algún grado de dependencia, y tuvieron un mediano riesgo de sufrir una caída en su hogar.Introduction: a descriptive study was conducted in the elderly person population seen in the # 4 Family Physician Consulting Room of the "Ramón González Coro" polyclinic from the Marianao municipality during 2008. Objective: an analysis of the falls risk behavior of elderly persons at home was made. Methods: a descriptive research study was conducted using the qualitative and quantitative model and in its implementation theoretical, empirical methods as well as statistic procedures were used. Results: there was predominance of female sex, the higher percentage of elderly persons had some degree of dependence and also had a middle risk of suffering a fall at home.

  15. The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan

    Directory of Open Access Journals (Sweden)

    Li-Fan Liu

    2014-01-01

    Full Text Available A good understanding of the health heterogeneity of elderly people, their characteristics, patterns of health care utilization and subsequent expenditures is necessary to adequately evaluate the policy options and interventions aimed at improving quality and efficiency of care for older people. This article reviews studies that used Latent Class Analysis to identify four health profiles among elderly people in Taiwan: High Comorbidity (HC, Functional Impairment (FI, Frail (FR, and Relatively Healthy (RH. Variables associated with increased likelihood of being in the FR group were older age, female gender, and living with one’s family, and these also correlated with ethnicity and level of education. The HC group tended to use more ambulatory care services compared with those in the RH group. The HC group tended to be younger, better educated, and was more likely to live in urban areas than were people in the FI group. The FI group, apart from age and gender, was less likely be of Hakka ethnicity and more likely to live with others than were individuals in the RH group. The FI group had relatively high probabilities of needing assistance, and the FR group had higher healthcare expenditures. A person-centered approach would better satisfy current healthcare needs of elderly people and help forecast future expenditures.

  16. [Edmonton Frail Scale in Colombian older people. Comparison with the Fried criteria].

    Science.gov (United States)

    Ramírez Ramírez, Jairo Uriel; Cadena Sanabria, Miguel Oswaldo; Ochoa, Miguel Enrique

    The Edmonton Frailty Scale was developed in Alberta (Canada). It has been applied in different scenarios, such as acute units, day hospitals, and outpatient care. There are no studies published describing the usefulness of this scale in Colombia. A cross-sectional study and secondary diagnostic test analysis was designed with the objective of studying the criterion validity of the Edmonton Frail Scale using Fried's frailty criteria as standard. Patients 60 years old and over from the community were included. Patients with severe dementia, limited mobility, and unable to perform the tests were excluded. The study included 101 patients from the community in Floridablanca, Colombia. The mean age was 68.9 years, and 74% were women. The median walking speed was 1.1m/sec. According to the Fried's criteria, 46% were vigorous elderly, and the prevalence of frailty was 7.9%. Using the EFS, 78% were vigorous elderly, with a prevalence of frailty of 8.9%. Taking 6 or more points as a cut-off, the sensitivity of this scale was 75% and had a specificity of 88%. A similar frequency of frailty was found on applying the two measurement scales. It is important to highlight the multidimensional view of the Edmonton scale, complementing the data of the most physical and sarcopenia-centred phenotype of Fried's criteria. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Delayed postural control during self-generated perturbations in the frail older adults

    Directory of Open Access Journals (Sweden)

    Kubicki A

    2012-02-01

    Full Text Available Alexandre Kubicki1–3, François Bonnetblanc1,2, Geoffroy Petrement3, Yves Ballay1,2, France Mourey2,4¹UFR STAPS, Université de Bourgogne, Dijon, France; ²Motricité et Plasticité, Institut National de la Santé et de la Recherche Médicale (INSERM, Dijon, France; ³SARL Fovea Interactive, Campus Industriel – Espace Entreprises, Chalon sur Saône, France; 4UFR Médecine, Université de Bourgogne, Dijon, FrancePurpose: The aim of this study was to investigate the coordination between posture and movement in pathological aging (frailty in comparison with normal aging, with the hypothesis that in pathological aging, postural control evolves towards a more reactive mode for which the perturbation induced by the movement is not anticipated and leads to delayed and late postural adjustments.Methods: Elderly subjects performed rapid focal arm-raising movements towards a target, from an upright standing position in two stimuli conditions: simple reaction time and choice reaction time (CRT. Hand and center of pressure (CoP kinematics were compared between a control group and a frail group of the same age.Results: In frail individuals, the entire movement was impaired and slowed down. In addition, postural adjustments that classically precede and accompany the focal arm movement were delayed and reduced, especially in the CRT condition in which the motor prediction is more limited. Finally, a correlation between the time to CoP maximal velocity and the timed up-and-go score was observed.Conclusion: In these patients, it was concluded that the control of the CoP displacement evolved from a proactive mode in which the perturbation associated with the arm movement is anticipated toward a more reactive mode in which the perturbation is compensated by late and delayed adjustments.Keywords: frailty, anticipatory postural adjustments, backward disequilibrium

  18. Economic evaluation of a multifactorial, interdisciplinary intervention versus usual care to reduce frailty in frail older people.

    Science.gov (United States)

    Fairhall, Nicola; Sherrington, Catherine; Kurrle, Susan E; Lord, Stephen R; Lockwood, Keri; Howard, Kirsten; Hayes, Alison; Monaghan, Noeline; Langron, Colleen; Aggar, Christina; Cameron, Ian D

    2015-01-01

    To compare the costs and cost-effectiveness of a multifactorial interdisciplinary intervention versus usual care for older people who are frail. Cost-effectiveness study embedded within a randomized controlled trial. Community-based intervention in Sydney, Australia. A total of 241 community-dwelling people 70 years or older who met the Cardiovascular Health Study criteria for frailty. A 12-month multifactorial, interdisciplinary intervention targeting identified frailty characteristics versus usual care. Health and social service use, frailty, and health-related quality of life (EQ-5D) were measured over the 12-month intervention period. The difference between the mean cost per person for 12 months in the intervention and control groups (incremental cost) and the ratio between incremental cost and effectiveness were calculated. A total of 216 participants (90%) completed the study. The prevalence of frailty was 14.7% lower in the intervention group compared with the control group at 12 months (95% CI 2.4%-27.0%; P = .02). There was no significant between-group difference in EQ-5D utility scores. The cost for 1 extra person to transition out of frailty was $A15,955 (at 2011 prices). In the "very frail" subgroup (participants met >3 Cardiovascular Health Study frailty criteria), the intervention was both more effective and less costly than the control. A cost-effectiveness acceptability curve shows that the intervention would be cost-effective with 80% certainty if decision makers were willing to pay $A50,000 per extra person transitioning from frailty. In the very frail subpopulation, this reduced to $25,000. For frail older people residing in the community, a 12-month multifactorial intervention provided better value for money than usual care, particularly for the very frail, in whom it has a high probability of being cost saving, as well as effective. Trial registration: ACTRN12608000250336. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care

  19. Case studies of elderly patients with non-Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Stefano Luminari

    2011-10-01

    Full Text Available The treatment of patients with non- Hodgkin’s lymphoma (NHL is often the treatment of elderly patients, as most patients are older than 65 years at diagnosis. These elderly patients present particular therapeutic challenges, because they may be more frail and at greater risk of treatment-related toxicity, especially anthracycline-related cardiotoxicity, than younger patients. The following two case studies illustrate the challenges and therapeutic decision-making in managing elderly patients with an aggressive and an indolent form of lymphoma.

  20. Supporting frail older people and their family carers at home using information and communication technology: cost analysis.

    Science.gov (United States)

    Magnusson, Lennart; Hanson, Elizabeth

    2005-09-01

    This paper describes a cost analysis of a home-based support service for frail older people and their family carers in two municipalities in West Sweden and using information and communication technology. A key challenge facing nurse managers across Europe is an increasingly aged population, combined with reduced numbers of young adults of working age. New solutions are needed to provide quality, cost-effective community care services to frail older people and their family carers. A case study methodology involving five families was used, and included a detailed cost description of the technology-based service compared with usual services. Cost data were collected in June 2002. This work formed part of a larger project exploring the impact of a technology-based service known as, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). In addition to cost data, information was gathered on the quality of life of frail older people and their family carers, and the job satisfaction and work methods of nurses and other practitioners based in the community. The cost analysis comprised a description of the family and their caring situation, the perceived benefits of the telematic based support service and an assessment of its impact on the use of other care services. These analyses were carried out with the help of needs assessors who were known to the families, and nurses working in the ACTION call centre. All results were validated by the five participating families. Cost savings were achieved in all cases, and the benefits to older people and their carers were also considerable. As a result of the cost analysis and overall evaluation data, ACTION has been implemented as a mainstream service in the municipalities involved. Researchers, nurses, other practitioners and community care managers can work together with frail older people and their family carers to develop quality, cost-effective support services that reduce demands on staff

  1. Technology Evaluation in the Elderly Abstracts from the meeting held in Toronto, September 21?23, 2014

    OpenAIRE

    Muscedere, John; Kolomitro, Klodiana; Stockley, Denise; Barrie, Carol; Elliott, J.; Guenette, M.; Sneyers, B.; Little, A.; Perreault, M.M.; Rose, L.; Burry, L.; Hunt, Cindy; Ennis, Naomi; Ouchterlony, Donna; McNeil, Heather

    2015-01-01

    Technology Evaluation in the Elderly Network (TVN) was funded in July 2012 under the Canadian Networks of Centres of Excellence (NCE) program, to develop, rigorously evaluate, and ethically disseminate information about the use of technologies for the care of seriously ill elderly patients and their families. TVN?s vision is to position Canada as a global leader in providing the highest quality of care for its aging population. The focus is on the frail elderly with multiple chronic condition...

  2. Breast cancer in elderly person: which role for radiotherapy; Cancer du sein chez la personne agee: place de la radiotherapie?

    Energy Technology Data Exchange (ETDEWEB)

    Horn, S. [Centre Oscar-Lambret, Lille (France); Cutuli, B. [ICC Reims, Reims (France)

    2011-10-15

    The authors briefly discuss the issue and practices of treatment of elderly women suffering from breast cancer. Even if radiotherapy is sometimes forgotten in such cases, disease characteristics and the tolerance capacity of the patient must be considered before implementing treatment protocols. Short communication

  3. Aquatic physical therapy as a treatment modality in healthcare for non-institutionalized elderly persons: a systematic review

    Directory of Open Access Journals (Sweden)

    Gisele da Silveira Sarmento

    2011-03-01

    Full Text Available Objective: To review scientific literature pertaining to aquatic physical therapy in the elderly and institutionalized population. Methods: A qualitative systematic review of electronic databases MEDLINE and LILACS, with the topic index terms: “hydrotherapy”, “homes for the aged or residential facilities”, and “aged. In light of the lack of studies carried out on the institutionalized population, we opted for reviewing literature on the effectiveness of this modality of physical therapy treatment on the non-institutionalized elderly population in order to produce knowledge that can be critically analyzed according to its potential applicability for the institutionalized population. The methodological quality of the studies was assessed using the Delphi listing. Results: Of the 27 studies analyzed by their abstracts, 10 studies were excluded since they did not correspond to the eligibility criteria. We analyzed the subject characteristics of each study, as well as the quality of the methods (good methodological quality in 47% of the studies, the result measurements considered, the intervention strategies, the sites where they took place, and the professionals involved (76% by physical therapists. Conclusion: Although a large part of the studies demonstrated good results with aquatic physical therapy practice, none of them had been applied on long-stay institution for the elderly. Therefore, more studies are needed in this area for a model of assistance to long-stay institution for the elderly to be proposed.

  4. Pain in cognitively impaired older persons.

    Science.gov (United States)

    Parmelee, P A

    1996-08-01

    To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.

  5. The Comparison of Different Levels of Religious Attitude on Sense of Meaning, Loneliness and Happiness in Life of Elderly Persons Under Cover of Social Wlfare Organisation of Urmia City

    Directory of Open Access Journals (Sweden)

    Mahnaz Aliakbari Dehkordi

    2015-01-01

    Full Text Available Objectives: The aim of this study was the comparison of different levels of religious attitude on the sense of meaning, loneliness and happiness in the life of elderly persons under cover of social wlfare organisation of urmia city. Methods & Materials: The study was a descriptive analytical research and sample size of 221 persons (81 women and 140 men aged over 60 years using a random cluster sampling were selected. The Khodayari`s religious attitude questionnaire, Russell`s loneliness questionnaire, Salehi`s questionnaire for sense of meaning and oxford’s happiness questionnaire were used as instruments in this study. Results: The results of multivariate analysis of variance and scheffe method of follow-up showed that stronger levels of religious attitudes is associated with happiness and meaning of life in elderly persons (P<0.05. Also, the elderly who have strong religious attitude in comparison of the others feel less alone. Conclusion: Religious attitude is a preventive factor to reduce the problems of the elderly and on this basis the relevant authorities could strengthen religious beliefs of elderly persons by proper planning and providing their participation in religious activities.

  6. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial

    NARCIS (Netherlands)

    Faber, M.J.; Bosscher, R.J.; Chin, A.P.M.J.; van Wieringen, P.C.W.

    2006-01-01

    Faber MJ, Bosscher RJ, Chin A Paw MJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Objectives: To determine the effects of moderate intensity group-exercise programs on falls, functional

  7. Influence of type of prosthesis on oral environment and the number of missing teeth in elderly persons.

    Science.gov (United States)

    Tanaka, Junko; Tanaka, Masahiro

    2010-01-01

    The purpose of this study was to investigate the relationship between the number of missing teeth (MT) and the statuses of oral environmental factors (the stimulated salivary flow rate, buffering capacity, and the counts of mutans streptococci, lactobacilli, and Candida) in the elderly. The subjects were 64 elderly subjects with fixed prostheses and 49 who wore removable partial dentures aged over 65 years. We used one-way ANOVA to test for overall differences of the number of MT among 5 oral environmental factors. The significant differences were observed in the lactobacilli counts for different number of MT. The number of MT increased with an increase in the lactobacilli counts with removable denture. In conclusion, for the patients wearing removable dentures, increasing number of MT was associated with an increase in the lactobacilli counts in saliva. For the patients with crowns and fixed partial dentures, the number of MT was not significantly affected by salivary mutans streptococci, lactobacilli, and Candida counts.

  8. The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

    Science.gov (United States)

    Wang, Jye; Lin, Wender; Chang, Ling-Hui

    2018-01-01

    The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Bright-light effects on cognitive performance in elderly persons working simulated night shifts: psychological well-being as a mediator?

    Science.gov (United States)

    Kretschmer, Veronika; Schmidt, Klaus-Helmut; Griefahn, Barbara

    2013-11-01

    The present study examined whether the relationship between light exposure and cognitive functioning is mediated by psychological well-being in elderly persons working night shifts. The role of psychological well-being has been neglected so far in the relationship between bright light and cognitive performance. Sleepiness and mood were applied as indicators of psychological well-being. Cognitive functioning was examined in terms of concentration, working memory, and divided attention. A total of thirty-two test persons worked in three consecutive simulated night shifts, 16 under bright light (3,000 lux) and 16 under room light (300 lux). Concentration, working memory, and divided attention were measured by computerised tasks. The hypothesised mediators were recorded by questionnaires. Mediation analyses were conducted for estimating direct, total, and indirect effects in simple mediation models. Results indicate that sleepiness and mood did not function as mediators in the prediction of concentration, working memory, and/or divided attention by light exposure. Sleepiness led to an underestimation of the positive bright-light effect on concentration performance. Mood showed only a random effect due to the positive bright-light effect on working memory. Sleepiness and mood could completely be excluded as mediators in the relationship between light exposure and cognitive functioning. This study underlines that psychological well-being of elderly persons is not a critical component in the treatment of bright light on cognitive performance in the night shift workplace. In summary, it becomes evident that bright light has a strong direct and independent effect on cognitive performance, particularly on working memory and concentration.

  10. Person-centredness in elder care: A secondary analysis of data from a study among home-dwelling men and women in the Faroe Islands.

    Science.gov (United States)

    Róin, Ása

    2018-06-01

    As individuals in Western societies age, there is increasing demand for home-based care to help older people stay in their homes for as long as possible and provide services that ensure a person's quality of life in old age. Numerous attempts are made to develop a framework to secure quality of care. However, research has shown insufficient quality in care for older people. In this study, the purpose is to study how older people's experiences with home care reflect a person-centred approach to care. Data derived from an earlier study on ageing among home-dwelling men and women who are aged 67-91 and living in the Faroe Islands. Person-centredness as a concept is an often quoted, but ill-defined concept. Most studies concerning person-centred care are conducted within hospital wards or long-term care institutions. Empirical studies concerning home-dwelling older people receiving home care are scarce. The study is a secondary analysis of data from an earlier qualitative study. Latent thematic analysis was used which meant coding issues of potential interest and collecting these codes into themes. Three themes appeared to combine the initial codes: sense of involvement, sense of meaningfulness and contextual conditions. Overall, the analysis showed that the users were seldom involved in planning or scheduling the care they received. What they were offered did not always make sense to them or correspond to their needs or preferences. The number of interviews included was limited. However, findings from this study point at some possible barriers to successful implementation of person-centredness within elder care. Especially, contextual conditions seem to limit the facilitation of person-centred practices. Healthcare providers must take the user's preferences, resources and networks into consideration when coordinating and planning home care and, importantly, be open for negotiating needs. It is important to draw attention to the contrast between political intentions

  11. The Muscle Metabolome Differs between Healthy and Frail Older Adults.

    Science.gov (United States)

    Fazelzadeh, Parastoo; Hangelbroek, Roland W J; Tieland, Michael; de Groot, Lisette C P G M; Verdijk, Lex B; van Loon, Luc J C; Smilde, Age K; Alves, Rodrigo D A M; Vervoort, Jacques; Müller, Michael; van Duynhoven, John P M; Boekschoten, Mark V

    2016-02-05

    Populations around the world are aging rapidly. Age-related loss of physiological functions negatively affects quality of life. A major contributor to the frailty syndrome of aging is loss of skeletal muscle. In this study we assessed the skeletal muscle biopsy metabolome of healthy young, healthy older and frail older subjects to determine the effect of age and frailty on the metabolic signature of skeletal muscle tissue. In addition, the effects of prolonged whole-body resistance-type exercise training on the muscle metabolome of older subjects were examined. The baseline metabolome was measured in muscle biopsies collected from 30 young, 66 healthy older subjects, and 43 frail older subjects. Follow-up samples from frail older (24 samples) and healthy older subjects (38 samples) were collected after 6 months of prolonged resistance-type exercise training. Young subjects were included as a reference group. Primary differences in skeletal muscle metabolite levels between young and healthy older subjects were related to mitochondrial function, muscle fiber type, and tissue turnover. Similar differences were observed when comparing frail older subjects with healthy older subjects at baseline. Prolonged resistance-type exercise training resulted in an adaptive response of amino acid metabolism, especially reflected in branched chain amino acids and genes related to tissue remodeling. The effect of exercise training on branched-chain amino acid-derived acylcarnitines in older subjects points to a downward shift in branched-chain amino acid catabolism upon training. We observed only modest correlations between muscle and plasma metabolite levels, which pleads against the use of plasma metabolites as a direct read-out of muscle metabolism and stresses the need for direct assessment of metabolites in muscle tissue biopsies.

  12. Influence of Type of Prosthesis on Oral Environment and the Number of Missing Teeth in Elderly Persons

    Directory of Open Access Journals (Sweden)

    Junko Tanaka

    2010-01-01

    Full Text Available The purpose of this study was to investigate the relationship between the number of missing teeth (MT and the statuses of oral environmental factors (the stimulated salivary flow rate, buffering capacity, and the counts of mutans streptococci, lactobacilli, and Candida in the elderly. The subjects were 64 elderly subjects with fixed prostheses and 49 who wore removable partial dentures aged over 65 years. We used one-way ANOVA to test for overall differences of the number of MT among 5 oral environmental factors. The significant differences were observed in the lactobacilli counts for different number of MT. The number of MT increased with an increase in the lactobacilli counts with removable denture. In conclusion, for the patients wearing removable dentures, increasing number of MT was associated with an increase in the lactobacilli counts in saliva. For the patients with crowns and fixed partial dentures, the number of MT was not significantly affected by salivary mutans streptococci, lactobacilli, and Candida counts.

  13. Self-care as a health resource of elders

    DEFF Research Database (Denmark)

    Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.

    2007-01-01

    into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical...... practice, policy-making and research into health care of frail or robust elders.......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...

  14. Pilot Test of a New Personal Health System Integrating Environmental and Wearable Sensors for Telemonitoring and Care of Elderly People at Home (SMARTA Project).

    Science.gov (United States)

    Pigini, Lucia; Bovi, Gabriele; Panzarino, Claudia; Gower, Valerio; Ferratini, Maurizio; Andreoni, Giuseppe; Sassi, Roberto; Rivolta, Massimo W; Ferrarin, Maurizio

    2017-01-01

    The increase in life expectancy is accompanied by a growing number of elderly subjects affected by chronic comorbidities, a health issue which also implies important socioeconomic consequences. Shifting from hospital or community dwelling care towards a home personalized healthcare paradigm would promote active aging with a better quality of life, along with a reduction in healthcare-related costs. The aim of the SMARTA project was to develop and test an innovative personal health system integrating standard sensors as well as innovative wearable and environmental sensors to allow home telemonitoring of vital parameters and detection of anomalies in daily activities, thus supporting active aging through remote healthcare. A first phase of the project consisted in the definition of the health and environmental parameters to be monitored (electrocardiography and actigraphy, blood pressure and oxygen saturation, weight, ear temperature, glycemia, home interaction monitoring - water tap, refrigerator, and dishwasher), the feedbacks for the clinicians, and the reminders for the patients. It was followed by a technical feasibility analysis leading to an iterative process of prototype development, sensor integration, and testing. Once the prototype had reached an advanced stage of development, a group of 32 volunteers - including 15 healthy adult subjects, 13 elderly people with cardiac diseases, and 4 clinical operators - was recruited to test the system in a real home setting, in order to evaluate both technical reliability and user perception of the system in terms of effectiveness, usability, acceptance, and attractiveness. The testing in a real home setting showed a good perception of the SMARTA system and its functionalities both by the patients and by the clinicians, who appreciated the user interface and the clinical governance system. The moderate system reliability of 65-70% evidenced some technical issues, mainly related to sensor integration, while the patient

  15. Is Technology Present in Frailty? Technology a Back-up Tool for Dealing with Frailty in the Elderly: A Systematic Review.

    Science.gov (United States)

    Mugueta-Aguinaga, Iranzu; Garcia-Zapirain, Begonya

    2017-04-01

    This study analyzes the technologies used in dealing with frailty within the following areas: prevention, care, diagnosis and treatment. The aim of this paper is, on the one hand, to analyze the extent to which technology is present in terms of its relationship with frailty and what technological resources are used to treat it. Its other purpose is to define new challenges and contributions made by physiotherapy using technology. Eighty documents related to research, validation and/or the ascertaining of different types of hardware, software or both were reviewed in prominent areas. The authors used the following scales: in the area of diagnosis, Fried's phenotype model of frailty and a model based on trials for the design of devices. The technologies developed that are based on these models accounted for 55% and 45% of cases respectively. In the area of prevention, the results proved similar regarding the use of wireless sensors with cameras (35.71%), and Kinect™ sensors (28.57%) to analyze movements and postures that indicate a risk of falling. In the area of care, results were found referring to the use of different motion, physiological and environmental wireless sensors (46,15%), i.e. so-called smart homes. In the area of treatment, the results show with a percentage of 37.5% that the Nintendo ® Wii™ console is the most used tool for treating frailty in elderly persons. Further work needs to be carried out to reduce the gap existing between technology, frail elderly persons, healthcare professionals and carers to bring together the different views about technology. This need raises the challenge of developing and implementing technology in physiotherapy via serious games that may via play and connectivity help to improve the functional capacity, general health and quality of life of frail individuals.

  16. Sexuality through the eyes of the elderly.

    OpenAIRE

    Uchôa,Yasmim da Silva; Costa,Dayara Carla Amaral da; Silva Junior,Ivan Arnaldo Pamplona da; Silva,Saulo de Tarso Saldanha Eremita de; Freitas,Wiviane Maria Torres de Matos; Soares,Soanne Chyara da Silva

    2016-01-01

    Abstract Objective: to identify the perception of elderly persons about sexuality. Methods: a quantitative, observational and analytical cross-sectional study was performed in an institution specializing in elderly care in Belém, in the state of Pará. A questionnaire, produced by the authors, was applied to 200 elderly persons, aiming to identify issues related to sexuality both in their youth and today, as well as stimulant strategies and sexuality inhibiting factors among the elderly, amo...

  17. [Effects of autogenic training in elderly patients].

    Science.gov (United States)

    Kircher, T; Teutsch, E; Wormstall, H; Buchkremer, G; Thimm, E

    2002-04-01

    Autogenic training (AT) is a widely available relaxation method with beneficial outcome on physiological and psychological functioning. In our study, we wanted to test the effects of an AT course in cognitively impaired, frail elderly. After a 3 month waiting period (control), AT courses (intervention) of 3 months duration were offered in 2 nursing homes. Thirty-two frail elderly took part in the study, 24 of them had a psychiatric diagnosis (mean age 82.1 +/- 7.2 years, CAMCOG 75.5 +/- 15.7, MMSE 23.3 +/- 4.3, HAMD 10.0 +/- 3.6, NOSGER 57.2 +/- 18.4, AT-SYM 32.9 +/- 17.6 points). Eight participants dropped out during the waiting period, 8 during the course. From the 16 participants, 15 (94%) were able to learn the AT according to subjective, 9 (54%) according to objective criteria. The ability to practice the AT successfully correlated with the CAMCOG (p = 0.001) and the NOSGER (p = 0.01) score. Participants with a dementia syndrome had major difficulties, whereas age, depressiveness, and number of complaints (AT-SYM) had no influence on the ability to learn the AT. There was no intervention effect, measured with the HAMD, NOSGER, AT-SYM and MMSE. In the pre-post comparison of training sessions, a significant improvement in general well being was found (p < 0.001). Mentally impaired, frail elderly participants are able to learn the AT. Cognitive impairment is disadvantageous for a successful participation.

  18. Handling a challenging context: experiences of facilitating evidence-based elderly care.

    Science.gov (United States)

    Nygårdh, Annette; Ahlström, Gerd; Wann-Hansson, Christine

    2016-03-01

    To explore improvement facilitators' experiences of handling their commission to implement evidence-based practice in elderly care for frail older persons. Improvement facilitators were put in place across Sweden in a time-limited project by the government, with one part of the project being to evaluate the model before establishing this facilitation of evidence-based practice in elderly care. Two focus groups were interviewed twice. Each group comprised three respondents. The interviews were analysed using qualitative content analysis. A main theme, 'Moving forward by adjusting to the circumstances', described how the improvement facilitators handle their commitment. Five subthemes emerged: identifying barriers, keeping focus, maintaining motivation, building bridges and finding balance. The improvement facilitators' commitment is ambiguous because of unclear leadership of, and responsibility for the national investment. They have to handle leaders' different approaches and justify the need for evidence-based practice. The improvement facilitators did not reflect on the impact of programme adaptations on evidence-based practice. The findings emphasise the need for collaboration between the improvement facilitator and the nurse manager. To fully implement evidence-based practice, negotiations with current practitioners for adaptation to local conditions are necessary. Furthermore, the value of improving organisational performance needs to be rigorously communicated throughout the organisation. © 2015 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

  19. Myeloma in Elderly Patients: When Less Is More and More Is More.

    Science.gov (United States)

    Rosko, Ashley; Giralt, Sergio; Mateos, Maria-Victoria; Dispenzieri, Angela

    2017-01-01

    Multiple myeloma is a plasma cell malignancy that occurs among older adults and accounts for 15% of all hematologic malignancies in the United States. Thirty-five percent of patients are diagnosed at age 75 or older. Novel therapeutics and routine use of autologous stem cell transplantation (ASCT) have led to substantial improvements in patient survival, although improvements have been more impressive among patients younger than age 65. Finding the balance between under- and overtreating elderly patients is one of the biggest challenges specific to them as a subgroup of patients with MM. Decision making about which therapies and their dose intensity and duration should be influenced by a patient's functional status, personal preferences, disease characteristics, and ability to tolerate therapy. ASCT should be considered for all patients younger than age 80, assuming that they are not frail. The attainment of a stringent complete response and minimal residual disease negativity is associated with improved progression-free and overall survival. Again, consideration of quality of life for these patients is paramount. Although there is a growing list of tools to sort through these issues, a fully integrated approach has not yet been finely tuned, leaving additional work to be done for the treatment of elderly patients with MM.

  20. Home- and Community-Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review.

    Science.gov (United States)

    De Coninck, Leen; Bekkering, Geertruida E; Bouckaert, Leen; Declercq, Anja; Graff, Maud J L; Aertgeerts, Bert

    2017-08-01

    The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

    Directory of Open Access Journals (Sweden)

    Ricci NA

    2014-10-01

    Full Text Available Natalia Aquaroni Ricci,1 Germane Silva Pessoa,1 Eduardo Ferriolli,2 Rosangela Correa Dias,3 Monica Rodrigues Perracini1 1Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID, São Paulo, 2Faculty of Medicine, Universidade de São Paulo (USP, Ribeirão Preto, 3Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG, Belo Horizonte, Brazil Background: Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD and the frailty syndrome in older people.Purpose: To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly.Methods: This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference ­measurement, and smoking.Results: Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4% and the lowest one was smoking (10.4%. It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher’s exact test: P=0.005; P=0.021. Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher’s exact test: P≤0.001; P≤0.001. There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement.Conclusion: Hypertension was

  2. Self-perceived met and unmet care needs of frail older adults in primary care

    NARCIS (Netherlands)

    Hoogendijk, Emiel O; Muntinga, Maaike E; van Leeuwen, Karen M; van der Horst, Henriëtte E; Deeg, Dorly J H; Frijters, Dinnus H M; Hermsen, Lotte A H; Jansen, Aaltje P D; Nijpels, Giel; van Hout, Hein P J

    2013-01-01

    In order to provide adequate care for frail older adults in primary care it is essential to have insight into their care needs. Our aim was to describe the met and unmet care needs as perceived by frail older adults using a multi-dimensional needs assessment, and to explore their associations with

  3. Temporal characteristics of imagined and actual walking in frail older adults.

    Science.gov (United States)

    Nakano, Hideki; Murata, Shin; Shiraiwa, Kayoko; Iwase, Hiroaki; Kodama, Takayuki

    2018-05-09

    Mental chronometry, commonly used to evaluate motor imagery ability, measures the imagined time required for movements. Previous studies investigating mental chronometry of walking have investigated healthy older adults. However, mental chronometry in frail older adults has not yet been clarified. To investigate temporal characteristics of imagined and actual walking in frail older adults. We investigated the time required for imagined and actual walking along three walkways of different widths [width(s): 50, 25, 15 cm × length: 5 m] in 29 frail older adults and 20 young adults. Imagined walking was measured with mental chronometry. We observed significantly longer imagined and actual walking times along walkways of 50, 25, and 15 cm width in frail older adults compared with young adults. Moreover, temporal differences (absolute error) between imagined and actual walking were significantly greater in frail older adults than in young adults along walkways with a width of 25 and 15 cm. Furthermore, we observed significant differences in temporal differences (constant error) between frail older adults and young adults for walkways with a width of 25 and 15 cm. Frail older adults tended to underestimate actual walking time in imagined walking trials. Our results suggest that walkways of different widths may be a useful tool to evaluate age-related changes in imagined and actual walking in frail older adults.

  4. Hierarchy of higher-level physical functions: a longitudinal investigation on a nationally representative population of community-dwelling middle-aged and elderly persons.

    Science.gov (United States)

    Yeh, Chih-Jung; Wang, Ching-Yi; Tang, Pei-Fang; Lee, Meng-Chih; Lin, Hui-Sheng; Chen, Hui-Ya

    2012-01-01

    Understanding the hierarchy of higher-level physical functions to infer disability level (mild, moderate or severe) is essential for the precise targeting of preventive interventions and has been examined previously in a cross-sectional study. Based on longitudinal data, this study evaluated the hierarchy of higher-level physical functions. Data from a cohort of 2729 community-dwelling persons aged over 50 with no initial disability were drawn from the "Survey of Health and Living Status of the Elderly in Taiwan" from 1996 through 2007. The three-level hierarchy of eight chosen activities was examined by the median ages to disability onset with survival analyses and by Cox regressions, which examined the effects of sex and age on the development of this hierarchy. The progression of incident disability was as follows: mild level-running, carrying weight, and squatting; moderate level-climbing stairs, walking, and standing; and severe level-grasping and raising arms up. Women and older persons were at greater risk of developing more severe levels of disability. Another Cox regression with one index activity from each hierarchical level revealed similar results. The three-level hierarchy of higher-level physical functions has been validated longitudinally, suggesting rich research and clinical implications.

  5. Person-Centered Care for Older Adults With Serious Mental Illness and Substance Misuse Within a Program of All-Inclusive Care for the Elderly.

    Science.gov (United States)

    Cacchione, Pamela Z; Eible, Lisa; Gill, Le'Roi L; Huege, Steven F

    2016-05-01

    Providing person-centered care (PCC) to older adults with dual diagnosis, co-occurring serious mental illness (SMI), and substance misuse is complex and requires an interprofessional team. Older adults, who qualify for both Medicaid and Medicare (i.e., dual-eligibles) are overrepresented in the population of older adults with SMI and substance misuse. Programs of All-Inclusive Care for the Elderly (PACE) exist to support community living needs of nursing home-eligible older adults and are increasingly in a position to serve older adults with SMI and substance misuse issues. PACE programs provide integrated person-centered mental health care to address the serious medical, social, and emotional complications posed by having SMI and substance misuse disorders. The case study presented illustrates PCC provided to a dual-diagnosis PACE participant, illustrating the impact of recent and past trauma on current psychopathology and substance misuse. Finally, recommendations for addressing PCC of dual diagnosis within the PACE model are provided. [Journal of Gerontological Nursing, 42(5), 11-17.]. Copyright 2016, SLACK Incorporated.

  6. HEALTH SELF-EVALUATION OF ELDERLY PERSONS WITH VISUAL IMPAIRMENTS IN RELATION TO GENDER AND STATE OF HEALTH

    Directory of Open Access Journals (Sweden)

    Amela Teskeredžić

    2017-09-01

    Full Text Available Health self-evaluation, as a subjective measure, is related to person’s well-being because it encapsulates physical and emotional health evaluation. It has been concluded that subjective health is, for most of people, number one trait of quality of living that is connected to health. Individual is to decide which aspects of objective situation are important for their satisfaction in life. In other words, way in which a person will perceive and react to an objective situation depends on their personal traits. Aim of this research was to examine the differences in relation to gender and health state of visually impaired older persons of that live in institutional accommodation, by self-evaluation. Respondents sample was comprised of 40 visually impaired older persons, both genders (13 male and 27 female that live in nursing home “Dom penzionera” in Tuzla. Research has been conducted by interview, using questionnaire “Quality of life of adult persons with motoric disabilities in territory of Vojvodina” (Susnjevic, 2015. Because of the structure of questions in questionnaire, it was possible to apply it on visually impaired persons as well. Data acquired had been processed with descriptive statistics, hi-squre and t – test, in order to determine if there were differences in relation to gender and selfevaluation of physical and social functioning. Results of the research have shown that although means have proven that there are differences in acquired results between respondents of male and female gender, results of t-test have shown that those differences are not statistically significant. Presence of any kind of damage, and visual impairment as well can influence person’s psychological and physical integrity.

  7. An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls

    Directory of Open Access Journals (Sweden)

    Schuster Tibor

    2011-02-01

    Full Text Available Abstract Background Prevention of falls in the elderly is a public health target in many countries around the world. While a large number of trials have investigated the effectiveness of fall prevention programs, few focussed on interventions embedded in the general practice setting and its related network. In the Prevent Falls (PreFalls trial we aim to investigate the effectiveness of a pre-tested multi-modal intervention compared to usual care in this setting. Methods/Design PreFalls is a controlled multicenter prospective study with cluster-randomized allocation of about 40 general practices to an experimental or a control group. We aim to include 382 community dwelling persons aged 65 and older with an increased risk of falling. All participating general practitioners are trained to systematically assess the risk of falls using a set of validated tests. Patients from intervention practices are invited to participate in a 16-weeks exercise program with focus on fall prevention delivered by specifically trained local physiotherapists. Patients from practices allocated to the control group receive usual care. Main outcome measure is the number of falls per individual in the first 12 months (analysis by negative binomial regression. Secondary outcomes include falls in the second year, the proportion of participants falling in the first and the second year, falls associated with injury, risk of falls, fear of falling, physical activity and quality of life. Discussion Reducing falls in the elderly remains a major challenge. We believe that with its strong focus on a both systematic and realistic fall prevention strategy adapted to primary care setting PreFalls will be a valuable addition to the scientific literature in the field. Trial registration NCT01032252

  8. Screening for hazardous drinking using the Michigan Alcohol Screening Test-Geriatric Version (MAST-G) in elderly persons with acute cerebrovascular accidents.

    Science.gov (United States)

    Johnson-Greene, Doug; McCaul, Mary E; Roger, Patricia

    2009-09-01

    Effective and valid screening methods are needed to identify hazardous drinking in elderly persons with new onset acute medical illness. The goal of the current study was to examine the effectiveness of the Michigan Alcohol Screening Test-Geriatric Version (MAST-G) in identifying hazardous drinking among elderly patients with acute cerebrovascular accidents (CVA) and to compare the effectiveness of 2 shorter versions of the MAST-G with the full instrument. The study sample included 100 men and women who averaged 12 days posthemorrhagic or ischemic CVA admitted to a rehabilitation unit and who were at least 50 years of age and free of substance use other than alcohol. This cross-sectional validation study compared the 24-item full MAST-G, the 10-item Short MAST-G (SMAST-G), and a 2-item regression analysis derived Mini MAST-G (MMAST-G) to the reference standard of hazardous drinking during the past 3 months. Alcohol use was collected using the Timeline Followback (TLFB). Recent and lifetime alcohol-related consequences were collected using the Short Inventory of Problems (SIP). Nearly one-third (28%) of the study sample met the World Health Organization (WHO) criteria for hazardous drinking. Moderately strong associations were found for the MAST-G, SMAST-G, and MMAST-G with alcohol quantity and frequency and recent and lifetime alcohol consequences. All 3 MAST-G versions could differentiate hazardous from nonhazardous drinkers and had nearly identical area under the curve characteristics. Comparable sensitivity was found across the 3 MAST-G measures. The optimal screening threshold for hazardous drinking was 5 for the MAST-G, 2 for the SMAST-G, and 1 for the MMAST-G. The 10-item SMAST-G and 2-item MMAST-G are brief screening tests that show comparable effectiveness in detecting hazardous drinking in elderly patients with acute CVA compared with the full 24-item MAST-G. Implications for research and clinical practice are discussed.

  9. Perceptions, Expectations, and Informal Supports Influence Exercise Activity in Frail Older Adults

    Directory of Open Access Journals (Sweden)

    Louise Broderick

    2015-04-01

    Full Text Available This study aims to explore frail older adults’ perceptions of what influences their exercise behaviors. A qualitative descriptive design was used. Semi-structured, open-ended interviews were conducted with 29 frail older adults. Thematic content analysis established the findings. Frail older adults perceive exercise as a by-product of other purposeful activities such as manual work or social activities. Progression into frailty appears to be associated with a decline in non-family support, changing traditional roles within family support networks, and lower baseline activity levels. Frail older adults perceive exercise as incidental to more purposeful activities rather than an endpoint in itself. Therefore, exercise programs concentrating on functional outcomes may be more relevant for this population. Strategies that educate and promote social support networks may also benefit frail older adults.

  10. Effect of strength training on muscle function in elderly hospitalized patients

    DEFF Research Database (Denmark)

    Suetta, C; Magnusson, S P; Beyer, N

    2007-01-01

    Immobilization due to hospitalization and major surgery leads to an increased risk of morbidity, disability and a decline in muscle function especially in frail elderly individuals. In fact, many elderly patients fail to regain their level of function and self-care before admission to hospital....... Given that reduced lower limb muscle strength and loss of skeletal muscle mass (i.e. sarcopenia) have been associated with functional impairments and disability with aging, attempts to counteract this process seem highly relevant. In recent years, strength training has emerged as an effective method...... to induce muscle hypertrophy and increase muscle strength and functional performance in frail elderly individuals. Furthermore, there is increasing evidence that strength training is an effective method to restore muscle function in post-operative patients and in patients with chronic diseases. Despite this...

  11. Assessment of the knowledge level on profession of physiotherapist among students of technical science and elderly persons

    Directory of Open Access Journals (Sweden)

    Janusz Kocjan

    2017-03-01

    Full Text Available Introduction: Physiotherapy process enables the recovery of lost functions and return to maximum mobility. The range of physiotherapy includes procedures in situations where mobility and functioning are threatened by aging, injuries, diseases, a variety of disorders and conditions or environmental factors. Aim: The aim of the study was to determine the state of knowledge about the profession of physiotherapist among science students and people over 60 years of age. Material and methods: The study included 200 adult men and women in range of age: 21-75 years. The study was conducted on the basis of the author's questionnaire containing 10 questions refers to: others possible physiotherapist work places, physiotherapist duties, action for which physiotherapist is entitled, relationship of physiotherapist profession with medicine and physical education, as well as, use of physiotherapy treatment in various fields of medicine. Results: Among the elderly, only 27% of respondents correctly distinguishes between the terms "physiotherapist" and "physical therapist." The vast majority of respondents see the need for rehabilitation on the orthopedic and neurological wards. The low level of knowledge refers to less popular specializations (gynecology, pulmunologia. The vast majority of respondents considered physiotherapy as a profession closer related to medical sciences than physical education. Conslusions: The results of the study indicate to the inadequate level of knowledge about profession of physiotherapist, especially among people over 60 years old.

  12. Elderly who take care of elderly: a study on the Frailty Syndrome

    Directory of Open Access Journals (Sweden)

    Ariene Angelini dos Santos-Orlandi

    Full Text Available ABSTRACT Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services.

  13. Disagreement between subjective and actigraphic measures of sleep duration in a population-based study of elderly persons

    NARCIS (Netherlands)

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

    2008-01-01

    Sleep duration is an important concept in epidemiological studies. It characterizes a night's sleep or a person's sleep pattern, and is associated with numerous health outcomes. In most large studies, sleep duration is assessed with questionnaires or sleep diaries. As an alternative, actigraphy may

  14. Plasma adiponectin levels correlate positively with an increasing number of components of frailty in male elders.

    Directory of Open Access Journals (Sweden)

    Jaw-Shiun Tsai

    Full Text Available OBJECTIVE: Frailty is an important geriatric syndrome. Adiponectin is an important adipokine that regulates energy homeostasis. The aim of this study is to investigate the relationship between plasma adiponectin levels and frailty in elders. METHODS: The demographic data, body weight, metabolic and inflammatory parameters, including plasma glucose, total cholesterol, triglyceride, tumor necrosis factor alpha (TNF-α, c-reactive protein (CRP and adiponectin levels, were assessed. The frailty score was assessed using the Fried Frailty Index (FFI. RESULTS: The mean (SD age of the 168 participants [83 (49.4% men and 85 (50.6% women] was 76.86 (6.10 years. Judged by the FFI score, 42 (25% elders were robust, 92 (54.7% were pre-frail, and 34 (20.3% were frail. The mean body mass index was 25.19 (3.42 kg/m(2. The log-transformed mean (SD plasma adiponectin (µg/mL level was 1.00 (0.26. The log-transformed mean plasma adiponectin (µg/mL levels were 0.93 (0.23 in the robust elders, 1.00 (0.27 in the pre-frail elders, and 1.10 (0.22 in the frail elders, and the differences between these values were statistically significant (p  = 0.012. Further analysis showed that plasma adiponectin levels rose progressively with an increasing number of components of frailty in all participants as a whole (p for trend  = 0.024 and males (p for trend  = 0.037, but not in females (p for trend  = 0.223. CONCLUSION: Plasma adiponectin levels correlate positively with an increasing number of components of frailty in male elders. The difference between the sexes suggests that certain sex-specific mechanisms may exist to affect the association between adiponectin levels and frailty.

  15. Towards the development of a soft manipulator as an assistive robot for personal care of elderly people

    Directory of Open Access Journals (Sweden)

    Yasmin Ansari

    2017-03-01

    Full Text Available Manipulators based on soft robotic technologies exhibit compliance and dexterity which ensures safe human–robot interaction. This article is a novel attempt at exploiting these desirable properties to develop a manipulator for an assistive application, in particular, a shower arm to assist the elderly in the bathing task. The overall vision for the soft manipulator is to concatenate three modules in a serial manner such that (i the proximal segment is made up of cable-based actuation to compensate for gravitational effects and (ii the central and distal segments are made up of hybrid actuation to autonomously reach delicate body parts to perform the main tasks related to bathing. The role of the latter modules is crucial to the application of the system in the bathing task; however, it is a nontrivial challenge to develop a robust and controllable hybrid actuated system with advanced manipulation capabilities and hence, the focus of this article. We first introduce our design and experimentally characterize its functionalities, which include elongation, shortening, omnidirectional bending. Next, we propose a control concept capable of solving the inverse kinetics problem using multiagent reinforcement learning to exploit these functionalities despite high dimensionality and redundancy. We demonstrate the effectiveness of the design and control of this module by demonstrating an open-loop task space control where it successfully moves through an asymmetric 3-D trajectory sampled at 12 points with an average reaching accuracy of 0.79 cm ± 0.18 cm. Our quantitative experimental results present a promising step toward the development of the soft manipulator eventually contributing to the advancement of soft robotics.

  16. The Elder Problem

    Directory of Open Access Journals (Sweden)

    John W. Elder

    2017-03-01

    Full Text Available This paper presents an autobiographical and biographical historical account of the genesis, evolution and resolution of the Elder Problem. It begins with John W. Elder and his autobiographical story leading to his groundbreaking work on natural convection at Cambridge in the 1960’s. His seminal work published in the Journal of Fluid Mechanics in 1967 became the basis for the modern benchmark of variable density flow simulators that we know today as “The Elder Problem”. There have been well known and major challenges with the Elder Problem model benchmark—notably the multiple solutions that were ultimately uncovered using different numerical models. Most recently, it has been shown that the multiple solutions are indeed physically realistic bifurcation solutions to the Elder Problem and not numerically spurious artefacts. The quandary of the Elder Problem has now been solved—a major scientific breakthrough for fluid mechanics and for numerical modelling. This paper—records, reflections, reminiscences, stories and anecdotes—is an historical autobiographical and biographical memoir. It is the personal story of the Elder Problem told by some of the key scientists who established and solved the Elder Problem. 2017 marks the 50 year anniversary of the classical work by John W. Elder published in Journal of Fluid Mechanics in 1967. This set the stage for this scientific story over some five decades. This paper is a celebration and commemoration of the life and times of John W. Elder, the problem named in his honour, and some of the key scientists who worked on, and ultimately solved, it.

  17. Body composition as a frailty marker for the elderly community

    Directory of Open Access Journals (Sweden)

    Falsarella GR

    2015-10-01

    Full Text Available Gláucia Regina Falsarella,1 Lívia Pimenta Renó Gasparotto,1 Caroline Coutinho Barcelos,2 Ibsen Bellini Coimbra,1,2 Maria Clara Moretto,1 Mauro Alexandre Pascoa,3 Talita C B Rezende Ferreira,1 Arlete Maria Valente Coimbra1,41Gerontology Program, Faculty of Medical Sciences, 2Department of Medical Clinics, Faculty of Medical Sciences, 3Department Biodynamics of Movement, Faculty of Physical Education, 4Family Health Program, Gerontology Program, Faculty of Medical Sciences, State University of Campinas (Unicamp, Campinas, São Paulo, BrazilBackground: Body composition (BC in the elderly has been associated with diseases and mortality; however, there is a shortage of data on frailty in the elderly.Objective: To investigate the association between BC and frailty, and identify BC profiles in nonfrail, prefrail, and frail elderly people.Methods: A cross-sectional study comprising 235 elderly (142 females and 93 males aged ≥65 years, from the city of Amparo, State of São Paulo, Brazil, was undertaken. Sociodemographic and cognitive features, comorbidities, medication, frailty, body mass index (BMI, muscle mass, fat mass, bone mass, and fat percent (% data were evaluated. Aiming to examine the relationship between BC and frailty, the Mann–Whitney and Kruskal–Wallis nonparametric tests were applied. The statistical significance level was P<0.05.Results: The nonfrail elderly showed greater muscle mass and greater bone mass compared with the prefrail and frail ones. The frail elderly had greater fat % than the nonfrail elderly. There was a positive association between grip strength and muscle mass with bone mass (P<0.001, and a negative association between grip strength and fat % (P<0.001. Gait speed was positively associated with fat mass (P=0.038 and fat % (P=0.002. The physical activity level was negatively associated with fat % (P=0.022. The weight loss criterion was positively related to muscle mass (P<0.001, bone mass (P=0.009, fat mass

  18. Integrating housing and long-term care services for the elderly: a social marketing approach.

    Science.gov (United States)

    Moore, S T

    1991-01-01

    Subsidized senior high-rise apartments have tended to neglect the needs of an increasingly aged and frail resident population. Research demonstrates that this population has greater unmet needs than elderly who reside in traditional community housing. This paper makes the case for a vertically integrated marketing approach to serving the elderly. Such an approach would combine housing and community based long-term care services into a single system of care. Enriched senior high-rise apartments are a viable alternative for elders who need assistance in order to maintain an independent lifestyle.

  19. Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

    Science.gov (United States)

    Obrist, Seraina; Rogan, Slavko; Hilfiker, Roger

    2016-01-01

    Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81). The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed. PMID:27247571

  20. Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Seraina Obrist

    2016-01-01

    Full Text Available Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81. The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed.

  1. [Discharge planning in which a discharge planning nurse was involved in the choice of nutrition management for an elderly person with dementia].

    Science.gov (United States)

    Tanaka, Yuko; Ohori, Yoko; Seshimo, Akiyoshi

    2013-12-01

    A discharge planning nurse at an acute care hospital conducted discharge planning for an elderly person with dementia who is in his/her 90s and his/her family. The nurse was involved in the choice of nutrition management method and was able to support the family's decision-making. The family had high expectations for oral ingestion, and there was disparity between those expectations and the actual state of the disease, in which aspiration occurred frequently. The nurse respected the family's wishes, but also helped the family to correctly understand the state of the disease and to make satisfactory choices about future daily life. In order to guarantee safety, the discharge planning nurse held a conference with people related to homecare, such as the home-visiting physician, the home-visiting nurse, and the care manager. As a result of the conference, that family was able to feel satisfied with and choose gastrostomy as the nutrition method. The current situation was better understood because information was shared with the community, and the confidence in the community was strengthened by giving consideration to the family's burden. It was reconfirmed that the cooperation of local staff members is useful in discharge planning.

  2. The "BIOmarkers associated with Sarcopenia and PHysical frailty in EldeRly pErsons" (BIOSPHERE) study: Rationale, design and methods.

    Science.gov (United States)

    Calvani, Riccardo; Picca, Anna; Marini, Federico; Biancolillo, Alessandra; Cesari, Matteo; Pesce, Vito; Lezza, Angela Maria Serena; Bossola, Maurizio; Leeuwenburgh, Christiaan; Bernabei, Roberto; Landi, Francesco; Marzetti, Emanuele

    2018-05-10

    Sarcopenia, the progressive and generalised loss of muscle mass and strength/function, is a major health issue in older adults given its high prevalence and burdensome clinical implications. Over the years, this condition has been endorsed as a marker for discriminating biological from chronological age. However, the absence of a unified operational definition has hampered its full appreciation by healthcare providers, researchers and policy-makers. In addition to this unsolved debate, the complexity of musculoskeletal ageing represents a major challenge to the identification of clinically meaningful biomarkers. Here, we illustrate the advantages of biomarker discovery procedures in muscle ageing based on multivariate methodologies as an alternative approach to traditional single-marker strategies. The rationale, design and methods of the "BIOmarkers associated with Sarcopenia and PHysical frailty in EldeRly pErsons" (BIOSPHERE) study are described as an application of a multi-marker strategy for the development of biomarkers for the newly operationalised Physical Frailty & Sarcopenia condition. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  3. Evaluating an intervention to reduce fear of falling and associated activity restriction in elderly persons: design of a randomised controlled trial [ISRCTN43792817

    Directory of Open Access Journals (Sweden)

    van Eijk JThM

    2005-03-01

    Full Text Available Abstract Background Fear of falling and associated activity restriction is common in older persons living in the community. Adverse consequences of fear of falling and associated activity restriction, like functional decline and falls, may have a major impact on physical, mental and social functioning of these persons. This paper presents the design of a trial evaluating a cognitive behavioural group intervention to reduce fear of falling and associated activity restriction in older persons living in the community. Methods/design A two-group randomised controlled trial was developed to evaluate the intervention. Persons 70 years of age or over and still living in the community were eligible for study if they experienced at least some fear of falling and associated activity restriction. A random community sample of elderly people was screened for eligibility; those eligible for study were measured at baseline and were subsequently allocated to the intervention or control group. Follow-up measurements were carried out directly after the intervention period, and then at six months and 12 months after the intervention. People allocated to the intervention group were invited to participate in eight weekly sessions of two hours each and a booster session. This booster session was conducted before the follow-up measurement at six months after the intervention. People allocated to the control group received no intervention as a result of this trial. Both an effect evaluation and a process evaluation were performed. The primary outcome measures of the effect evaluation are fear of falling, avoidance of activity due to fear of falling, and daily activity. The secondary outcome measures are perceived general health, self-rated life satisfaction, activities of daily life, feelings of anxiety, symptoms of depression, social support interactions, feelings of loneliness, falls, perceived consequences of falling, and perceived risk of falling. The outcomes of

  4. [TOPICS-MDS: a versatile resource for generating scientific and social knowledge for elderly care].

    Science.gov (United States)

    van den Brink, Danielle; Lutomski, Jennifer E; Qin, Li; den Elzen, Wendy P J; Kempen, Gertrudis I J M; Krabbe, Paul F M; Steyerberg, Ewout W; Muntinga, Maaike; Moll van Charante, Eric P; Bleijenberg, Nienke; Olde Rikkert, Marcel G M; Melis, René J F

    2015-04-01

    Developed as part of the National Care for the Elderly Programme (NPO), TOPICS-MDS is a uniform, national database on the health and wellbeing of the older persons and caregivers who participated in NPO-funded projects. TOPICS-MDS Consortium has gained extensive experience in constructing a standardized questionnaire to collect relevant health care data on quality of life, health services utilization, and informal care use. A proactive approach has been undertaken not only to ensure the standardization and validation of instruments but also the infrastructure for external data requests. Efforts have been made to promote scientifically and socially responsible use of TOPICS-MDS; data has been available for secondary use since early 2014. Through this data sharing initiative, researchers can explore health issues in a broader framework which may have not been possible within individual NPO projects; this broader framework is highly relevant for influencing health policy. In this article, we provide an overview of the development and on-going progress of TOPICS-MDS. We further describe how information derived from TOPICS-MDS can be applied to facilitate future scientific innovations and public health initiatives to improve care for frail older persons and their caregivers.

  5. Elderly Suicide

    Science.gov (United States)

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

  6. Management of type 2 diabetes mellitus in the elderly: role of the pharmacist in a multidisciplinary health care team

    Directory of Open Access Journals (Sweden)

    Grossman S

    2011-05-01

    Full Text Available Samuel GrossmanDepartment of Veterans Affairs, New York Harbor Healthcare System, New York, NY, USA; Diabetes Care On-The-Go Inc, Brooklyn, NY, USA; Hunter-Bellevue School of Nursing, Hunter College, City University of New York, New York, NY, USA; Arnold and Marie Schwartz College of Pharmacy of Long Island University, Brooklyn, NY, USA; Garden State Association of Diabetes Educators, Edison, NJ, USAAbstract: Intensive glycemic control using insulin therapy may be appropriate for many healthy older adults to reduce premature mortality and morbidity, improve quality of life, and reduce health care costs. However, frail elderly people are more prone to develop complications from hypoglycemia, such as confusion and dementia. Overall, older persons with type 2 diabetes mellitus are at greater risk of death from cardiovascular disease (CVD than from intermittent hyperglycemia; therefore, diabetes management should always include CVD prevention and treatment in this patient population. Pharmacists can provide a comprehensive medication review with subsequent recommendations to individualize therapy based on medical and cognitive status. As part of the patient’s health care team, pharmacists can provide continuity of care and communication with other members of the patient’s health care team. In addition, pharmacists can act as educators and patient advocates and establish patient-specific goals to increase medication effectiveness, adherence to a medication regimen, and minimize the likelihood of adverse events.Keywords: glycemic control, hyperglycemia, continuity of care, hypertension and cardiovascular disease, elderly, type 2 diabetes, pharmacist

  7. Autonomy among physically frail older people in nursing home settings

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...... participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub......-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual...

  8. Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2.

    Science.gov (United States)

    Kimura, T; Ogura, F; Yamamoto, K; Uda, A; Nishioka, T; Kume, M; Makimoto, H; Yano, I; Hirai, M

    2017-04-01

    The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated. Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31). Over 40% elderly patients were prescribed PIMs

  9. Wii-hab for pre-frail older adults.

    Science.gov (United States)

    Daniel, Kathryn

    2012-01-01

    To examine the effectiveness of a novel intervention aimed at decreasing indices related to frailty through systematic, Progressive Functional Rehabilitation (PFR). Pre-frail volunteers were recruited to participate in a 15 week exercise intervention or control group. Those who met study criteria and consented were randomized into one of three groups: control, seated exercise, or Wii(®) -fit. Test measures were completed before and after the 15 week intervention period on all participants. Measures included: Senior Fitness Test, Body Weight, Balance Efficacy Scale, CHAMPS, Late-Life Function and Disability Index, MOS SF-36. Attendance was also recorded. There were improvements on several of the measures included in the Senior Fitness Test including chair stands, arm curls, step 2, six minute walk, sit and reach, and the timed up and go. A few participants did lose weight. All of the differences reflected improved physical functional status in the seated exercise or Wii-fit groups compared with the control group. Increased physical activity was beneficial for all who participated. There were improvements in physical performance scores on several of the measures on the senior fitness test in both the seated exercise and Wii-fit groups. Participants in the Wii-fit group also showed improvement in their reported caloric expenditure and balance confidence. This pilot study suggests a rehabilitation effect that was similar to the effect of community based senior fitness classes. A home video game console system with weight vest could be an effective alternative for pre-frail senior adults to group exercise classes. © 2012 Association of Rehabilitation Nurses.

  10. Perceptions and attitudes towards exercise among Chinese elders - the implications of culturally based self-management strategies for effective health-related help seeking and person-centred care.

    Science.gov (United States)

    Liu, Zhenmi; Speed, Shaun; Beaver, Kinta

    2015-04-01

    Encouraging the uptake of physical activity among a culturally diverse elderly population presents a challenge for health-care providers across the world. Little is known about the health-care needs of these populations, for example the increasingly ageing group of Chinese elders in many parts of the world who are now facing later life and increasing challenges to their health. This study aimed to explore behaviours and attitudes towards exercise among older Chinese immigrants in the UK to provide insights into the health of Chinese populations in the UK and elsewhere. A Grounded Theory approach using purposive and theoretical sampling with in-depth semi-structured interviews. Chinese elders were recruited from Chinese communities in the North West of England. Thirty-three participants were interviewed face-to-face and audio-recorded. Participants self-managed exercise based on cultural perceptions of health and ingrained Chinese values. Professional support and information was lacking and relied on folk norms rather than person-centred recommendations for healthy living. Inappropriate exercise regimes could act as a substitute for seeking health-related advice when exercise was often used as a self-monitored barometer to assess their perceived health status. Chinese elders may undertake inappropriate exercise, leading to high-risk situations, if appropriate professional information is not provided. Health-care practitioners should devote attention to understanding Chinese elders' attitudes towards exercise, as this may ultimately lead to successful health promotion activities. A person-centred approach that acknowledges and works with self-management practices is advocated. © 2012 John Wiley & Sons Ltd.

  11. Elderly outpatient profile and predictors of falls.

    Science.gov (United States)

    Gomes, Grace Angélica de Oliveira; Cintra, Fernanda Aparecida; Batista, Fernanda Sotelo; Neri, Anita Liberalesso; Guariento, Maria Elena; Sousa, Maria da Luz Rosario de; D'Elboux, Maria José

    2013-01-01

    CONTEXT AND OBJECTIVES Falls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects. DESIGN AND SETTING Cross-sectional descriptive study forming part of the project "Quality of Life of Frail Elderly People", carried out in Campinas, Brazil. METHODS The subjects were 145 elderly individuals (76.3 ± 7.8 years old), of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out. RESULTS Cluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found. CONCLUSIONS The results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  12. Elderly outpatient profile and predictors of falls

    Directory of Open Access Journals (Sweden)

    Grace Angélica de Oliveira Gomes

    Full Text Available CONTEXT AND OBJECTIVESFalls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects.DESIGN AND SETTINGCross-sectional descriptive study forming part of the project “Quality of Life of Frail Elderly People”, carried out in Campinas, Brazil.METHODSThe subjects were 145 elderly individuals (76.3 ± 7.8 years old, of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out.RESULTSCluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found.CONCLUSIONSThe results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  13. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship.

    Science.gov (United States)

    Bollwein, J; Volkert, D; Diekmann, R; Kaiser, M J; Uter, W; Vidal, K; Sieber, C C; Bauer, J M

    2013-04-01

    This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested. Cross-sectional study. Community-dwelling older adults were recruited in the region of Nürnberg, Germany. 206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination >24 points), 66.0% female. Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (malnutrition (17-23.5 points) were determined by MNA®. 15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (pmalnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p<0.01), and non-frail participants (p<0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p<0.05). These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.

  14. Quality of life/spirituality, religion and personal beliefs of adult and elderly chronic kidney patients under hemodialysis

    Directory of Open Access Journals (Sweden)

    Suzana Gabriela Rusa

    2014-12-01

    Full Text Available OBJECTIVE: to assess the quality of life of chronic kidney patients undergoing hemodialysis, using the WHOQOL-bref and WHOQOL-SRPB.METHOD: a descriptive and cross-sectional study was undertaken at a kidney replacement therapy service in the interior of the state of SP. The 110subjects who complied with the inclusion criteria answered the Subject Characterization Instrument, the WHOQOL-bref and WHOQOL-SRPB.RESULTS: most of the respondents were male (67.27%, with a mean age of 55.65 years, Catholic (55.45%, with unfinished primary education (33.64% and without formal occupation (79.08%. The WHOQOL-bref domains with the highest and lowest mean score were, respectively, "psychological" (µ=74.20 and "physical" (µ=61.14. The WHOQOL-SRPB domains with the highest and lowest mean score were, respectively, "completeness and integration" (µ=4.00 and "faith" (µ=4.40.CONCLUSIONS: the respondents showed high quality of life scores, specifically in the dimensions related to spirituality, religion and personal beliefs. Losses were evidenced in the physical domain of quality of life, possibly due to the changes resulting from the chronic kidney disease and hemodialysis treatment.

  15. STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2012-02-03

    Introduction: STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) is a new, systems-defined medicine review tool. We compared the performance of STOPP to that of established Beers\\' criteria in detecting potentially inappropriate medicines (PIMs) and related adverse drug events (ADEs) in older patients presenting for hospital admission. METHODS: we prospectively studied 715 consecutive acute admissions to a university teaching hospital. Diagnoses, reason for admission and concurrent medications were recorded. STOPP and Beers\\' criteria were applied. PIMs with clear causal connection or contribution to the principal reason for admission were determined. RESULTS: median patient age (interquartile range) was 77 (72-82) years. Median number of prescription medicines was 6 (range 0-21). STOPP identified 336 PIMs affecting 247 patients (35%), of whom one-third (n = 82) presented with an associated ADE. Beers\\' criteria identified 226 PIMs affecting 177 patients (25%), of whom 43 presented with an associated ADE. STOPP-related PIMs contributed to 11.5% of all admissions. Beers\\' criteria-related PIMs contributed to significantly fewer admissions (6%). CONCLUSION: STOPP criteria identified a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events than Beers\\' criteria. This finding has significant implications for hospital geriatric practice.

  16. Opinions of dentists on the barriers in providing oral health care to community-dwelling frail older people: a questionnaire survey.

    Science.gov (United States)

    Bots-VantSpijker, Pieternella C; Bruers, Josef J M; Bots, Casper P; Vanobbergen, Jacques N O; De Visschere, Luc M J; de Baat, Cees; Schols, Jos M G A

    2016-06-01

    The aim of this study was to investigate to what extent dentists in the Netherlands experience barriers in providing oral health care to community-dwelling older people. As most publications on the barriers in providing oral health care to older people consist of surveys on oral health care in care homes, it was decided to investigate the barriers dentists experience in their own dental practices while providing oral health care to community-dwelling frail older people. A representative sample of 1592 of the approximately 8000 dentists in the Netherlands aged 64 or younger were invited to respond to a questionnaire online. The dentists were asked to respond to 15 opinions concerning oral healthcare provision to community-dwelling frail older people aged 75 years or more who experience problems in physical, psychological and social areas, as well as possible financial problems. The total response rate was 37% (n = 595; male=76%; average age 49). The majority of those who responded agreed that the reimbursement of oral health care to older people is poor. Two thirds of those who responded (66%) agreed that there are limited opportunities to refer the frail and elderly with complex oral healthcare problems to a colleague with specific knowledge and skills. Dentists experienced barriers in two domains; a lack of knowledge and practical circumstances. It was concluded that the dentist's gender, age, year of graduation and the number of patients aged 75 years or more treated weekly were in some respect, related to the barriers encountered. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  17. Hipnosis como complemento en la cirugía oral del adulto mayor Hypnosis as a complement to oral surgery in elderly persons

    Directory of Open Access Journals (Sweden)

    Elina Muñiz Manzano

    2013-03-01

    Fajardo University Hospital in the year 2011. The variables analyzed were age, sex, number of hypnotic sessions, disease history, most frequent diagnoses and fear. Results: most patients fell into the 60-69 age group (70 %. The remaining 30 % were in the 70-79 age group. Female sex predominated with 70 %. The highest number of sessions was 58 in the 60-69 age group, with an average of 4 per patient. The most frequent pathological antecedents were hypertension in 14 (70 %, followed by type II diabetes in 2 (10 %. The most common diagnoses were fourth degree caries in 10 (50 %, followed by parodontic teeth in 4 (20 %. Fear was measured with a dedicated scale on which patient scores of 10, 8 and 7 were reduced to 4 and 5. Conclusions: hypnotic therapy was shown to be effective to relieve fear of oral surgery in elderly persons.

  18. A Survey of Abuse of the Elderly in Texas.

    Science.gov (United States)

    Anderson, Jeff; And Others

    Many elderly persons suffer abuse and neglect from which they cannot escape. Questions concerning the extent of elder abuse, the kinds of abuse, and underlying factors associated with elder abuse in Texas were explored in a survey of professionals most likely to encounter elder abuse in their work. Questionnaires (1,508) were mailed to agencies…

  19. Impact of resistance exercise program on functional capacity and muscular strength of knee extensor in pre-frail community-dwelling older women: a randomized crossover trial.

    Science.gov (United States)

    Lustosa, Lygia P; Silva, Juscélio P; Coelho, Fernanda M; Pereira, Daniele S; Parentoni, Adriana N; Pereira, Leani S M

    2011-01-01

    Frailty syndrome in elderly people is characterized by a reduction of energy reserves and also by a decreased of resistance to stressors, resulting in an increase of vulnerability. The aim of this study was to verify the effect of a muscle-strengthening program with load in pre-frail elder women with regards to the functional capacity, knee extensor muscle strength and their correlation. Thrity-two pre-frail community-dwelling women participated in this study. Potential participants with cognitive impairment (MEEM), lower extremities orthopedic surgery, fractures, inability to walk unaided, neurological diseases, acute inflammatory disease, tumor growth, regular physical activity and current use of immunomodulators were excluded. All partcipants were evaluated by a blinded assessor using: Timed up and go (TUG), 10-Meter Walk Test (10MWT) and knee extensor muscle strength (Byodex System 3 Pro® isokinetic dynamometer at angular speeds of 60 and 180(0)/s). The intervention consisted of strengthening exercises of the lower extremities at 70% of 1RM, three times/ week for ten weeks. The statistical analysis was performed using the ANOVA and Spearman tests After the intervention, it was observed statistical significance on the work at 180(0)/s (F=12.71, p=0.02), on the power at 180(0)/s (F=15.40, p=0.02) and on the functional capacity (TUG, F=9.54, p=0.01; TC10, F=3.80, p=0.01). There was a good negative and statistically significant correlation between the TUG and work at 60(0)/s, such as the TUG and work at 180(0)/s (r=-0.65, p=0.01; r=-0.72, p=0.01). The intervention improved the muscular power and the functional capacity. The increase of the power correlated with function, which is an important variable of the quality of life in the pre-frail elders. Article registered in the ISRCT register under number ISRCTN62824599.

  20. When and why frail elderly people give up independent living : The Netherlands as an example

    NARCIS (Netherlands)

    Steverink, Nardi

    As yet the determinants of the need for nursing homes and old age homes are not clearly understood. This may be due to the fact that care facilities providing different levels of care may yield different predictors of use. Moreover! the absence of theory and ignorance of the problems with 'use' as

  1. An ontology-based recommender system to promote physical activity for pre-frail elderly

    NARCIS (Netherlands)

    Nassabi, Hossein; op den Akker, Harm; Vollenbroek-Hutten, Miriam Marie Rosé

    2014-01-01

    The increasing ageing population and the prevalence of chronic diseases have introduced new challenges to healthcare systems motivating researchers to use telemonitoring solutions for providing care. In some solutions, a special focus has been given to promoting physical activity as it can decrease

  2. Precarity in late life: rethinking dementia as a 'frailed' old age.

    Science.gov (United States)

    Grenier, Amanda; Lloyd, Liz; Phillipson, Chris

    2017-02-01

    Approaches to ageing that are organised around productivity, success, and active late life have contributed to views of dementia as an unsuccessful, failed or 'frailed' old age. Operating through dominant frameworks, socio-cultural constructs and organisational practices, the 'frailties' of the body and mind are often used to mark the boundaries of health and illness in late life, and shape responses accordingly. Our concern is that both the taken for granted and the 'imagined' can further marginalise persons who occupy the locations of dementia and disablement. This article analyses the extent to which frailty and dementia are better understood in the context of new forms of insecurity affecting the life course. Drawing on the concept of 'precarity', this article shifts debates on the 'fourth age' away from age or stage-based thinking, into a recognition of the shared vulnerability and responsibilities for care. The argument of this article is that 'precarity' represents a 'new form of ageing', notably as regards its impact on the upper extremes of the life course. The article concludes with a call for a response that is grounded in an acknowledgement of the fragility and limitations which affect human lives, this requiring grounding in inclusive forms of citizenship. © 2017 Foundation for the Sociology of Health & Illness.

  3. Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools.

    Science.gov (United States)

    Perna, Simone; Francis, Matthew D'Arcy; Bologna, Chiara; Moncaglieri, Francesca; Riva, Antonella; Morazzoni, Paolo; Allegrini, Pietro; Isu, Antonio; Vigo, Beatrice; Guerriero, Fabio; Rondanelli, Mariangela

    2017-01-04

    The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender. We enrolled 366 hospitalised patients (women\\men: 251\\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength). According with the EFS, the 19.7% of subjects were classified as non frail, 66.4% as apparently vulnerable and 13.9% with severe frailty. The EFS scores were associated with cognition (MMSE: β = 0.980; p nutrition (MNA: β = -0.413; p performance (Handgrip: β = -0.114, p performance tool for stratifying the state of fragility in a group of institutionalized elderly. As matter of facts the EFS has been shown to be associated with several geriatric conditions such independence, drugs assumption, mood, mental, functional and nutritional status.

  4. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review.

    Science.gov (United States)

    Cadore, Eduardo Lusa; Rodríguez-Mañas, Leocadio; Sinclair, Alan; Izquierdo, Mikel

    2013-04-01

    The aim of this review was to recommend training strategies that improve the functional capacity in physically frail older adults based on scientific literature, focusing specially in supervised exercise programs that improved muscle strength, fall risk, balance, and gait ability. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus, and ScienceDirect databases were searched from 1990 to 2012. Studies must have mentioned the effects of exercise training on at least one of the following four parameters: Incidence of falls, gait, balance, and lower-body strength. Twenty studies that investigated the effects of multi-component exercise training (10), resistance training (6), endurance training (1), and balance training (3) were included in the present revision. Ten trials investigated the effects of exercise on the incidence of falls in elderly with physical frailty. Seven of them have found a fewer falls incidence after physical training when compared with the control group. Eleven trials investigated the effects of exercise intervention on the gait ability. Six of them showed enhancements in the gait ability. Ten trials investigated the effects of exercise intervention on the balance performance and seven of them demonstrated enhanced balance. Thirteen trials investigated the effects of exercise intervention on the muscle strength and nine of them showed increases in the muscle strength. The multi-component exercise intervention composed by strength, endurance and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults.

  5. Approaching neurological diseases to reduce mobility limitations in older persons.

    Science.gov (United States)

    Lauretani, Fulvio; Ceda, Gian Paolo; Pelliccioni, Pio; Ruffini, Livia; Nardelli, Anna; Cherubini, Antonio; Maggio, Marcello

    2014-01-01

    The rapidly increasing elderly population poses a major challenge for future health-care systems. Neurological diseases in older persons are particularly common and coexist with other clinical conditions. This is not surprising given that, for example, even patients with Alzheimer Disease (AD) could have relevant extrapyramidal signs at the moment of the diagnosis with motor signs having more negative prognostic value. Longitudinal studies conducted on Parkinson Disease (PD) showed that, after 20 years, dementia is not only present in almost all survivors but is also the main factor influencing nursing home admission. Recently, it has been reported the importance of Comprehensive Geriatric Assessment (CGA: comprehensive evaluation of cognition, depressive symptoms, mobility and functional assessment) as a tool reducing morbidity in frail older patients admitted to any acute hospital unit. The CGA should be considered as a technological device, for physicians who take care of older persons affected by overlapping neurological diseases. CGA is an extraordinary and cost effective instrument even in patients with advanced neurological diseases where allows to collect valuable information for an effective plan of management.

  6. Evaluating the Implementation and Feasibility of a Web-Based Tool to Support Timely Identification and Care for the Frail Population in Primary Healthcare Settings

    Directory of Open Access Journals (Sweden)

    Beverley Lawson

    2017-07-01

    Full Text Available Background Understanding and addressing the needs of frail persons is an emerging health priority for Nova Scotia and internationally. Primary healthcare (PHC providers regularly encounter frail persons in their daily clinical work. However, routine identification and measurement of frailty is not standard practice and, in general, there is a lack of awareness about how to identify and respond to frailty. A web-based tool called the Frailty Portal was developed to aid in identifying, screening, and providing care for frail patients in PHC settings. In this study, we will assess the implementation feasibility and impact of the Frailty Portal to: (1 support increased awareness of frailty among providers and patients, (2 identify the degree of frailty within individual patients, and (3 develop and deliver actions to respond to frailtyl in community PHC practice. Methods This study will be approached using a convergent mixed method design where quantitative and qualitative data are collected concurrently, in this case, over a 9-month period, analyzed separately, and then merged to summarize, interpret and produce a more comprehensive understanding of the initiative’s feasibility and scalability. Methods will be informed by the ‘Implementing the Frailty Portal in Community Primary Care Practice’ logic model and questions will be guided by domains and constructs from an implementation science framework, the Consolidated Framework for Implementation Research (CFIR. Discussion The ‘Frailty Portal’ aims to improve access to, and coordination of, primary care services for persons experiencing frailty. It also aims to increase primary care providers’ ability to care for patients in the context of their frailty. Our goal is to help optimize care in the community by helping community providers gain the knowledge they may lack about frailty both in general and in their practice, support improved identification of frailty with the use of screening

  7. Invasive strategy and frailty in very elderly patients with acute coronary syndromes.

    Science.gov (United States)

    Llaó, Isaac; Ariza-Solé, Albert; Sanchis, Juan; Alegre, Oriol; López-Palop, Ramon; Formiga, Francesc; Marín, Francisco; Vidán, María T; Martínez-Sellés, Manuel; Sionis, Alessandro; Vives-Borrás, Miguel; Gómez-Hospital, Joan Antoni; Gómez-Lara, Josep; Roura, Gerard; Díez-Villanueva, Pablo; Núñez-Gil, Iván; Maristany, Jaume; Asmarats, Lluis; Bueno, Héctor; Abu-Assi, Emad; Cequier, Àngel

    2018-04-03

    Current guidelines recommend an early invasive strategy in patients with non-ST segment elevation acute coronary syndromes (NSTEACS). The role of an invasive strategy in frail elderly patients remains controversial. The LONGEVO-SCA registry included unselected NSTEACS patients aged ≥80 years. A geriatric assessment was performed during hospitalization, including frailty. We evaluated the impact of an invasive strategy during the admission on the incidence of cardiac death, reinfarction or new revascularisation at 6-months. From 531 patients included, 145 (27.3%) were frail. Mean age was 84.3 years. Most patients underwent an invasive strategy (407/531, 76.6%). Patients undergoing an invasive strategy were younger and had lower proportion of frailty (23.3% vs 40.3%, pstrategy-frailty was significant (p=0.032) Conclusions: An invasive strategy was independently associated with better outcomes in very elderly patients with NSTEACS. This association was different according to frailty status.

  8. On Lok: a pioneering long-term care organization for the elderly (1971-2008).

    Science.gov (United States)

    Lehning, Amanda J; Austin, Michael J

    2011-01-01

    On Lok is a pioneering nonprofit organization that has delivered services to the frail and elderly since its founding in 1971. The agency began as a grassroots effort focused on improving the health care available to older adults living independently in the community. Over its 40-year history, On Lok has evolved into a $70 million nonprofit human service organization with a national reputation for innovation as a leading provider of care to frail elderly. The agency has developed its own model of care that has been replicated in cities around the country. The history of On Lok represents the important impact that donor and community support plays in an organization's long-term success.

  9. [Impact of frailty over the functional state of hospitalized elderly].

    Science.gov (United States)

    García-Cruz, Juan Carlos; García-Peña, Carmen

    2016-01-01

    Frailty in elderly results from impaired physiological reserve in multiple systems. Establishing if frail elderly inpatients develop more functional impairment at discharge, will allow the development of strategies for preventing or limiting the deterioration in this vulnerable group. Prospective cohort in 133 elderly inpatients. At admission, frailty, functional status, comorbidity and comprehensive geriatric evaluation were determined. The main outcome was functional state at hospital discharge. 64 patients presented frailty (48.1%) and 69 did not present that state (51.9%), with a mean age of 73 and 68 years, respectively. Mean decrement in functional state at discharge was -8.06 % (IC 95 % -10.38 to -5.74), from 97.97 % to 89.91 % (p model, frailty (beta -14.73, IC 95 % -19.39 to -10.07, p decrement. Frailty independently predicts functional impairment at hospital discharge.

  10. Elder Abuse and Help-Seeking Behavior in Elderly Chinese.

    Science.gov (United States)

    Yan, Elsie

    2015-09-01

    Elder abuse is a prevalent phenomenon resulting in physical, emotional, and social costs to individuals, families, and society. Timely and effective intervention is crucial because victims are often involved in relationships where re-victimization is common. Most elder abuse victims, however, are reluctant to seek help from outside their families. The aim of the present study is to explore factors associated with help-seeking behaviors among mistreated elders in Hong Kong. In-depth interviews were conducted with 40 elder abuse survivors. Although almost all of the participants could provide some examples of elder abuse, most denied that their own experience was abusive. Personal and professional social networks were important determinants of help seeking. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking. © The Author(s) 2014.

  11. Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Joana U. Viana

    2013-08-01

    Full Text Available BACKGROUND: Frailty and sarcopenia are frequent conditions in the elderly and are related to inactivity and functionality. However, little is known about the influence of the sarcopenia indicators on the frailty profile or their functional implications. OBJECTIVE: To evaluate whether the indirect indicators of sarcopenia and functionality influence the frailty profile in elderly subjects. METHOD : This was a cross-sectional study with 53 elderly subjects recruited by an active search in a secondary health care service. The indirect indicators of sarcopenia were body mass index (BMI, gait speed, Mini-Nutritional Assessment (MNA, Human Activity Profile (HAP, and handgrip strength. Frailty was characterized according to Fried's Frailty Phenotype. Functional capacity was assessed according to the Short Physical Performance Battery (SPPB. Physical activity level was assessed by HAP. Data were analyzed by analysis of variance (ANOVA and multiple regression. RESULTS: Overall, 75.5% of the subjects were women, with a mean age of 76.72 (±5.89 years; 15.1% were frail and 54.7% pre-frail; and the level of physical activity was the most prevalent indicator of sarcopenia. Significant differences (p<0.05 were observed in both the physical activity level and gait speed between the non-frail and pre-frail groups and between the non-frail and frail groups. In addition, some sarcopenia indicators were associated with functional capacity and geriatric depression score. CONCLUSION: The level of physical activity and gait speed appeared to be the most relevant factors in the development of frailty in the study sample, which may have functional implications.

  12. Mildly elevated serum total bilirubin is negatively associated with hemoglobin A1c independently of confounding factors among community-dwelling middle-aged and elderly persons

    Directory of Open Access Journals (Sweden)

    Ryuichi Kawamoto

    2017-08-01

    Full Text Available Abnormally high glycated hemoglobin (Hb (HbA1c is significantly associated with oxidative stress and an increased risk of cardiovascular disease (CVD. Serum total bilirubin (T-B may have a beneficial role in preventing oxidative changes and be a negative risk factor of CVD. Limited information is available on whether serum T-B is an independent confounding factor of HbA1c. The study subjects were 633 men aged 70 ± 9 (mean ± standard deviation (SD years and 878 women aged 70 ± 8 years who were enrolled consecutively from among patients aged ≥40 years through a community-based annual check-up process. We evaluated the relationship between various confounding factors including serum T-B and HbA1c in each gender. Multiple linear regression analysis pertaining to HbA1c showed that in men, serum T-B ( β = −0.139 as well as waist circumference ( β = 0.099, exercise habit ( β = 0.137, systolic blood pressure (SBP ( β = 0.076, triglycerides ( β = 0.087, and uric acid ( β = −0.123 were significantly and independently associated with HbA1c, and in women, serum T-B ( β = −0.084 as well as body mass index ( β = 0.090, smoking status ( β = −0.077, SBP ( β = 0.117, diastolic blood pressure (DBP ( β = −0.155, low-density lipoprotein cholesterol ( β = 0.074, prevalence of antidyslipidemic medication ( β = 0.174, and uric acid ( β = 0.090 were also significantly and independently associated with HbA1c. Multivariate-adjusted serum HbA1c levels were significantly high in subjects with the lowest serum T-B levels in both genders. Serum T-B is an independent confounding factor for HbA1c among community-dwelling middle-aged and elderly persons.

  13. FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients.

    Science.gov (United States)

    Gleason, Lauren Jan; Benton, Emily A; Alvarez-Nebreda, M Loreto; Weaver, Michael J; Harris, Mitchel B; Javedan, Houman

    2017-12-01

    There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. Retrospective cohort study. Level 1 trauma center. A total of 175 consecutive patients over age 70 years admitted to co-managed orthopedic trauma and geriatrics services. The FRAIL scale (short 5-question assessment of fatigue, resistance, aerobic capacity, illnesses, and loss of weight) classified the patients into 3 categories: robust (score = 0), prefrail (score = 1-2), and frail (score = 3-5). Postoperative outcome variables collected were postoperative complications, unplanned intensive care unit admission, length of stay (LOS), discharge disposition, and orthopedic follow-up after surgery. Thirty-day outcomes measured were 30-day readmission and 30-day mortality. Analysis of variance (1-way) and Kruskal-Wallis tests were used to compare continuous variables across the 3 FRAIL categories. Fisher exact tests were used to compare categorical variables. Multiple regression analysis, adjusted by age, sex, and Charlson index, was conducted to study the association between frailty category and outcomes. FRAIL scale categorized the patients into 3 groups: robust (n = 29), prefrail (n = 73), and frail (n = 73). There were statistically significant differences between groups in terms of age, comorbidity, dementia, functional dependency, polypharmacy, and rate of institutionalization, being higher in the frailest patients. Hip fracture was the most frequent fracture, and it was more frequent as the frailty of the patient increased (48%, 61%, and 75% in robust, prefrail, and frail groups, respectively). The American

  14. [Physical and mental dimensions of quality of life of frail older people].

    Science.gov (United States)

    Gobbens, Robbert J J

    2017-09-01

    Frail older people have an increased risk of limitations in performing activities of daily living, hospitalization, nursing home admission, and premature death. In this study we determined the difference in experiencing quality of life between frail and non-frail older people. We also investigated the associations between physical, psychological and social components of frailty and the physical and mental dimensions of quality of life. 374 people of 75 years and older filled in a questionnaire, the Senioren Barometer. This questionnaire contained the Tilburg Frailty Indicator (TFI) to assess frailty and the SF-12 for assessing quality of life. The study showed that frail older people on average experience a lower quality of life than non-frail older people. A considerable part of the variance of the physical and mental dimensions of quality of life could be explained by the fifteen components of frailty, after controlling for the background characteristics of the respondents, 33.2% and 36.5%, respectively. The frailty components physical inactivity, physical tiredness, and depressive symptoms were associated with the physical dimension as well as the mental dimension of quality of life. The results confirm the importance of multidimensional assessment of frailty. In addition, they provide a direction to healthcare and welfare professionals in performing interventions with the aim of increasing the quality of life of older people.

  15. [Daily routine of informal caregivers-needs and concerns with regard to the discharge of their elderly family members from the hospital setting-a qualitative study].

    Science.gov (United States)

    Küttel, Cornelia; Schäfer-Keller, Petra; Brunner, Corinne; Conca, Antoinette; Schütz, Philipp; Frei, Irena Anna

    2015-04-01

    The care of an elderly frail and ill family member places a great responsibility on informal caregivers. Following discharge of the older person from the hospital setting it can be observed that caregivers are often inadequately informed about aspects such as health status, prognosis, complications, and care interventions. Concerns and needs of caregivers regarding their daily living and routine following hospital discharge has not been investigated and is considered important for an optimized discharge management. To explore personal needs and concerns of informal caregivers with regard to daily living prior to discharge of their family member. Eight narrative interviews were conducted with caregivers and were analysed using Mayring's content analysing method. All caregivers had concerns regarding the maintenance of a functional daily routine. As well as caring and household duties, this functional daily routine included negotiating one's own personal time off duties, the reality of the deteriorating health status of the family member and the associated sense of hope. The intensity of family ties affected the functional daily routine. Caregivers had different expectations with regard to their integration during the hospital period. To support caregivers in their situation it is advisable to assess the functional daily routine of caregivers. Their need for time off their household and caring duties and their informational and educational needs to pertaining to disease progression, possible sources of support and symptom management should be recognised. Further inquiries into caregiver's involvement and responsibilities in the discharge process are needed.

  16. Providing housing and care to elderly homeless men and women in Australia.

    Science.gov (United States)

    Lipmann, Bryan

    2003-01-01

    People who are unemployed and who lack the resources to buy adequate food, shelter, or basic health care services face an endless struggle to survive. It is frequently a degrading and humiliating experience. The elderly homeless, who are often frail and sick, are particularly disadvantaged in this struggle. Yet resources are often available to welfare providers to care for the aged homeless. All that is needed is a willingness for providers and government agencies to acknowledge the existence of homelessness among the elderly and be prepared to alleviate the problem.

  17. Frailty in elderly: a brief review.

    Science.gov (United States)

    Tabue-Teguo, Maturin; Simo, Nadine; Gonzalez-Colaço Harmand, Magali; Cesari, Matteo; Avila-Funes, Jose-Alberto; Féart, Catherine; Amiéva, Hélène; Dartigues, Jean-François

    2017-06-01

    The identification of frail older persons is a public health priority. Frailty is defined as an extreme vulnerability of the organism to endogenous and exogenous stressors, a syndrome that exposes the individual at higher risk of negative health-related outcomes as well as a transition phase between successful aging and disability. The theoretical concept of frailty is largely agreed, its practical translation still presents some limitations due to the existence of multiple tools and operational definition. In this brief review, we would like to clarify the frailty concept regarding scientific literature.

  18. Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans Las caídas en ancianos de América Latina y el Caribe y en ancianos mexicanoestadounidenses

    Directory of Open Access Journals (Sweden)

    Carlos A. Reyes-Ortiz

    2005-06-01

    Full Text Available OBJECTIVE: To estimate the prevalence of and risk factors for falls among community-dwelling elders in Latin America and the Caribbean and among elderly Mexican-Americans in the southwestern United States. METHODS: Data for the study came from a project called Health, Well-Being, and Aging in Latin America and the Caribbean (Salud, Bienestar y Envejecimiento en América Latina y el Caribe (the "SABE project" (surveys from seven cities, with a total of 9 765 subjects and from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE (1 483 subjects. RESULTS: The overall prevalence of falls across the seven SABE cities and the H-EPESE ranged from 21.6% in Bridgetown, Barbados, to 34.0% in Santiago, Chile. In multiple logistic regression analyses, female gender, increased age, high depressive symptoms, and having any functional limitations were significant independent risk factors for falls in most of the cities studied as well as among the elderly Mexican-Americans. In several of the cities, significant risk factors also included diabetes, urinary incontinence, and arthritis. CONCLUSIONS: The prevalence of falls had a large variation among the countries studied. Some of the risk factors that we identified could be modified so as to help prevent falls in older people in these populations. The factors deserving attention include depressive symptoms, functional limitations, diabetes, and urinary incontinence.OBJETIVO: Estimar la prevalencia de caídas y de sus factores de riesgo en ancianos que habitan en el seno de la comunidad en América Latina y el Caribe y en ancianos mexicanoestadounidenses que viven en la zona sudoeste de Estados Unidos. MÉTODOS: Los datos usados para el estudio procedieron del proyecto Salud, Bienestar y Envejecimiento en América Latina y el Caribe (proyecto "SABE" (encuestas en siete ciudades que abarcaron a un total de 9 765 personas y de las Poblaciones Hispanas Establecidas para Estudios

  19. Robots in Elderly Care

    Directory of Open Access Journals (Sweden)

    Alessandro Vercelli

    2018-03-01

    Full Text Available Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general perspective, robotics has the power to completely reshape the landscape of healthcare both in its structure and its operation. In fact, the long-term sustainability of healthcare systems could be addressed by automation powered by digital health technologies, such as artificial intelligence, 3D-printing or robotics. The latter could take over monotonous work from healthcare workers, which would allow them to focus more on patients and to have lesser workload. Robots might be used in elder care with several different aims. (i Robots may act as caregivers, i.e. assist the elderly, (ii they can provide remainders and instructions for activities of daily life and safety, and/or assist their carers in daily tasks; (iii they can help monitor their behaviour and health; and (iv provide companionship, including entertainment and hobbies, reminiscence and social contact. The use of Robots with human subjects/patients raise several sensitive questions. First of all, robots may represent information hubs, and can collect an incredible amount of data about the subjects and their environment. In fact, they record habits such as sleeping, exercising, third persons entering in the house, appointments. Communications may be continuously recorded. Moreover, by connecting with medical devices, they can store medical data. On one hand, this represents a very powerful tool to collect information about the single subject (precision medicine, about disease (thus eventually finding

  20. Participation of the elderly after vision loss

    NARCIS (Netherlands)

    Alma, M.A.; Mei, van der S.F.; Melis-Dankers, B.J.M.; Tilburg, van T.G.; Groothoff, J.W.; Suurmeijer, T.P.B.M.

    2011-01-01

    Purpose. To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. Method. This cross-sectional study included visually impaired elderly persons (≥55 years; n=173) who were referred to a low-vision rehabilitation centre.

  1. Leukocyte telomere dynamics in the elderly

    DEFF Research Database (Denmark)

    Steenstrup, Troels; Hjelmborg, Jacob V B; Mortensen, Laust H

    2013-01-01

    Limited data suggest that leukocytes of the elderly display ultra-short telomeres. It was reported that in some elderly persons leukocyte telomere length (LTL) shows age-dependent elongation. Using cross-sectional and longitudinal models, we characterized LTL dynamics in participants...

  2. Care and housing for vulnerable elderly

    NARCIS (Netherlands)

    M.M.Y. de Klerk

    2004-01-01

    Original title: Zorg en wonen voor kwetsbare ouderen. There is a general belief that old age automatically brings infirmities, though this is by no means always the case. This edition of the Report on the Elderly investigates which elderly people are vulnerable. They include older persons

  3. Síndrome da fragilidade no idoso comunitário com osteoartrite Frailty syndrome in the community-dwelling elderly with osteoarthritis

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Corrêa Miguel

    2012-06-01

    (OA, focusing on the frailty syndrome. METHOD: Cross-sectional study of the elderly with knee and/or hip OA, using a subsample from the study of frailty in the Brazilian elderly (FIBRA, assessing the following: sociodemographic characteristics, comorbidity, medications, depression, anthropomorphic data, falls, pain, stiffness, physical function, and frailty. The subjective assessment of health was also performed. RESULTS: The final sample comprised 58 elderly (mean age, 74 ± 5.5 years as follows: 17 (29.31% non-frail, 28 (48.28% pre-frail, and 13 (22.41% frail. The frail elderly received more medications than the non-frail ones (7.00 ± 2.00 and 4.00 ± 2.00, respectively; P = 0.001. The mean Body Mass Index was lower in the non-frail elderly as compared with those of the pre-frail and frail ones (27.00 ± 4.50 kg/m², 30.00 ± 4.00 kg/m², and 34.00 ± 8.00 kg/m², respectively; P = 0.018. Depression was more prevalent in the frail group. Compared to the previous year, there was a difference in the health status of the groups as follows: 64.3% of the pre-frail elderly and 46.2% of the frail ones believed their health deteriorated, and 52.9% of the non-frail elderly considered that their health status remained unchanged (P = 0.016. When comparing the current physical activity levels with those of the previous year, the pre-frail and frail elderly reported a worsening (P = 0.010. Regarding physical function and fall-related self-efficacy, the frail elderly were worse than the others (P = 0.023 and 0.017, respectively. There were no significant differences between the groups for the remaining items analyzed. CONCLUSION: The elderly with OA and frailty use more medications, are more obese and depressed, have a poorer perception of their own health and of their level of activity as compared with that of the previous year, have a worse fall-related self-efficacy, and worse physical function.

  4. The impact of oral health on body image and social interactions among elders in long-term care.

    Science.gov (United States)

    Donnelly, Leeann R; Clarke, Laura Hurd; Phinney, Alison; MacEntee, Michael I

    2016-12-01

    The objective of this study was to explore how social interactions and body image are influenced by perceived oral health among older people who live in long-term care facilities. Social interactions among frail elders in long-term care (LTC) facilities are limited, but to what extent body image and oral health influence their social relations is poorly understood. A positive body image and the perception of adequate oral health are linked to increased social contacts, as well as improved health and well-being irrespective of age. However, as frailty increases, it is unclear whether appearance and oral health priorities remain stable. Open-ended interviews were conducted with a purposefully selected group of cognitively intact, older men and women who exhibited varying degrees of frailty, social engagement and oral health conditions and lived in one of seven long-term care facilities. The interviews were analysed using a constant comparative technique, and a second interview with participants checked the trustworthiness of the analysis. Three major categories were expressed by the participants: (1) My mouth is fine; (2) It depends; and (3) Not that important. Within each category, there were several contributing and influencing factors. Social interactions among residents in LTC may be negatively impacted by poor oral health, but only if other personal and social issues are less bothersome than conditions with the mouth. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  5. The functional effects of physical exercise training in frail older people : a systematic review

    NARCIS (Netherlands)

    Chin A Paw, M.J.M.; van Uffelen, J.G.Z.; Riphagen, I.; van Mechelen, W.

    2008-01-01

    This systematic review describes the effect of exercise training on physical performance in frail older people. Randomized controlled trials were identified from searches in PubMed, EMBASE and CENTRAL from January 1995 through August 2007. Two reviewers independently screened the trials for

  6. Perceived control in health care: a conceptual model based on experiences of frail older adults

    NARCIS (Netherlands)

    Claassens, L; Widdershoven, G A; Van Rhijn, S C; Van Nes, F; Broese van Groenou, M I; Deeg, D J H; Huisman, M

    2014-01-01

    Frail older adults are increasingly encouraged to be in control of their health care, in Western societies. However, little is known about how they themselves perceive control in health care. Therefore, this study aims to investigate the concept of health care-related perceived control from the

  7. Concurrent 5-fluorouracil and radiotherapy in radical treatment of frail patients with deeply invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fellin, G.; Mussari, S.; Graffer, U.; Caffo, O.; Valduga, F.; Tomio, L.; Luciani, L. [S. Chiara Hospital, Trento (Italy)

    2004-11-01

    The radical treatment of deeply invasive bladder cancer with full dose radiotherapy and concomitant 5- fluorouracil continuous infusion is feasible even in frail patients, with an acceptable toxicity and a response rate comparable to that obtained using radiotherapy and simultaneous cisplatin. Many patients can retain a functioning bladder. (author)

  8. Implementing care programmes for frail older people: A project management perspective

    NARCIS (Netherlands)

    Bindels, J.; Cox, K.; Abma, T.A.; van Schayck, O.C.P.; Widdershoven, G.

    2015-01-01

    Objective: To examine the issues that influenced the implementation of programmes designed to identify and support frail older people in the community in the Netherlands. Methods: Qualitative research methods were used to investigate the perspectives of project leaders, project members and members

  9. The problem of Elder Abuse: review of foreign investigations

    Directory of Open Access Journals (Sweden)

    Gorfan Ya.Yu.

    2013-03-01

    Full Text Available The article analyzes the empirical findings obtained by foreign scholars and centered on the problem of Elder Abuse. It also contains the description of some elaborated strategies to resist the criminal victimization of the elderly. The article cites data about the crimes against the elderly persons in different countries. It also describes theoretical approaches to understanding the reasons for Elder Abuse. It then compares and analyzes the risk factors for some crimes committed against the elders which are disclosed by foreign scholars. With reference to conclusions drawn by the foreign investigators the author of the article indicates the possible ways of victimological prophylaxes of crimes against elders.

  10. Impact of acute geriatric care in elderly patients according to the Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria in northern France.

    Science.gov (United States)

    Frély, Anne; Chazard, Emmanuel; Pansu, Aymeric; Beuscart, Jean-Baptiste; Puisieux, François

    2016-02-01

    In France, over 20% of hospitalizations of elderly people are a result of adverse drug events, of which 50% are considered preventable. Tools have been developed to detect inappropriate prescriptions. The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria are innovative and adapted to French prescriptions. This is one of the first French prospective studies to evaluate the impact of acute geriatric care on prescriptions at discharge in elderly patients using the STOPP/START criteria. The evaluation of prescriptions according to STOPP/START was carried out on admission and at discharge of patients in acute geriatric units at three hospitals in the Nord-Pas de Calais region, France. A total of 202 elderly hospitalized patients were included during the 4.5 months of the study (1.5 months per center). The mean number of drugs was seven on admission and at discharge. Over half of the prescriptions at admission contained at least one potentially inappropriate medication or one potential prescription omission. The prescriptions at discharge contained significantly fewer potentially inappropriate medications than prescriptions on admission (P < 0.001). In contrast, there was no difference between prescriptions at discharge in terms of potential prescription omissions. Acute geriatric hospitalization in France improves prescriptions in terms of potentially inappropriate medication, but has no impact on potential prescription omissions. Further studies must be carried out to see if STOPP/START could be used as a tool in French prescription. © 2015 Japan Geriatrics Society.

  11. Flu shots and unvaccinated elderly Medicare beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths...

  12. Significados de violência familiar contra o idoso na perspectiva de profissionais da Atenção Primária à Saúde Meanings of family violence against the elderly from the standpoint of professionals in Primary Healthcare

    Directory of Open Access Journals (Sweden)

    Ana Claudia Nunes de Souza Wanderbroocke

    2012-08-01

    Full Text Available O presente estudo de cunho qualitativo buscou analisar os significados atribuídos à violência familiar contra o idoso, por profissionais que atuam na atenção primária à saúde. Participaram 10 profissionais com diferentes formações, de uma unidade de saúde de referencia para idosos, sendo os dados coletados por meio de entrevistas semiestruturadas e analisados segundo os princípios da Grounded Theory. Os dados foram integrados e organizados em categorias, subcategorias e elementos de análise. Os resultados evidenciaram que os participantes demonstraram a expectativa de que a família funcione como amparo e proteção e que a violência familiar é o que fere esse princípio. O significado de violência familiar contra o idoso mostrou-se alicerçado na ideia "do idoso frágil e dependente", limitando a visualização de casos que não se enquadram nesse perfil.This qualitative study sought to analyze the meanings attributed to domestic violence against the elderly by professionals in Primary Healthcare. A total of 10 health professionals from different backgrounds from a renowned health unit for care of the elderly took part, and the data was collected through semi-structured interviews. Taking the Grounded Theory as a benchmark, the data were integrated and organized into categories, subcategories and elements of analysis. The results revealed the participants' expectation that the family acts as support and protection for the elderly and that domestic violence violates this principle. The significance of abuse of the elder was found to be grounded in the idea "of the frail and dependent elderly person," limiting the viewing of cases that do not fit this profile.

  13. Effects of Horticulture on Frail and Prefrail Nursing Home Residents: A Randomized Controlled Trial.

    Science.gov (United States)

    Lai, Claudia K Y; Kwan, Rick Y C; Lo, Shirley K L; Fung, Connie Y Y; Lau, Jordan K H; Tse, Mimi M Y

    2018-05-24

    Frail nursing home residents face multiple health challenges as a result of their frail status. The aim of this study was to examine the effects of HT on the psychosocial well-being of frail and prefrail nursing home residents. Randomized controlled trial. Nursing homes. One hundred eleven participants were randomly allocated into the intervention [horticultural therapy (HT)] and control (social activities) conditions. HT group participants attended a weekly 60-minute session for 8 consecutive weeks. Control group activities were social in nature, without any horticulture components. The outcome measures include happiness, depressive symptoms, self-efficacy, well-being, social network, and social engagement. The time points of measurement were at baseline (T 0 ), immediately postintervention (T 1 ), and 12 weeks postintervention (T 2 ). A modified intention-to-treat approach was adopted. A multivariate general estimating equation was used to analyze the data. Forty-six and 50 participants received at least 1 session of the intervention and control condition protocol, respectively. A significant interaction effect between group and time was observed only on the happiness scale (β = 1.457, P = .036), but not on other outcome variables. In a follow-up cluster analysis of those who received HT, a greater effect on subjective happiness (mean difference = 6.23, P < .001) was observed for participants who were happier at baseline. HT was found to be effective in promoting subjective happiness for frail and prefrail nursing home residents. Its favorable effect suggests that HT should be used to promote the psychosocial well-being of those who are frail. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. Preventive home care of frail older people: a review of recent case management studies.

    Science.gov (United States)

    Hallberg, Ingalill Rahm; Kristensson, Jimmie

    2004-09-01

    Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal

  15. Prevalence of Potential and Clinically Relevant Statin-Drug Interactions in Frail and Robust Older Inpatients.

    Science.gov (United States)

    Thai, Michele; Hilmer, Sarah; Pearson, Sallie-Anne; Reeve, Emily; Gnjidic, Danijela

    2015-10-01

    A significant proportion of older people are prescribed statins and are also exposed to polypharmacy, placing them at increased risk of statin-drug interactions. To describe the prevalence rates of potential and clinically relevant statin-drug interactions in older inpatients according to frailty status. A cross-sectional study of patients aged ≥65 years who were prescribed a statin and were admitted to a teaching hospital between 30 July and 10 October 2014 in Sydney, Australia, was conducted. Data on socio-demographics, comorbidities and medications were collected using a standardized questionnaire. Potential statin-drug interactions were defined if listed in the Australian Medicines Handbook and three international drug information sources: the British National Formulary, Drug Interaction Facts and Drug-Reax(®). Clinically relevant statin-drug interactions were defined as interactions with the highest severity rating in at least two of the three international drug information sources. Frailty was assessed using the Reported Edmonton Frail Scale. A total of 180 participants were recruited (median age 78 years, interquartile range 14), 35.0% frail and 65.0% robust. Potential statin-drug interactions were identified in 10% of participants, 12.7% of frail participants and 8.5% of robust participants. Clinically relevant statin-drug interactions were identified in 7.8% of participants, 9.5% of frail participants and 6.8% of robust participants. Depending on the drug information source used, the prevalence rates of potential and clinically relevant statin-drug interactions ranged between 14.4 and 35.6% and between 14.4 and 20.6%, respectively. In our study of frail and robust older inpatients taking statins, the overall prevalence of potential statin-drug interactions was low and varied significantly according to the drug information source used.

  16. Psychological Effects of Light Exercise for Elderly Subjects

    OpenAIRE

    山田, 裕章; 峰松, 修; 冷川, 昭子; 吉川, 和利; 緒方, 道彦

    1987-01-01

    Psychological effects of light exercise were evaluated in healthy elderly, middle aged women and elderly with borderline hypertension. The exercises were walking and stretching for healthy elderly, elderly with hypertension and playing beginner's tennis for healty middle aged women. The subjects took exercise three hours a day, twice a week during three months period. Psychometric test battery was used Yatabe-Guilford Personality Inventry (Y-G test). Manifest Anxiety Scale (MAS), Maudsely Per...

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

    Directory of Open Access Journals (Sweden)

    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

  18. Two Principles of good elderly care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene; Eskelinen, Leena; Boll Hansen, Eigil

    ) which is a possibility for the elderly to choose a private provider. Stressing the self-determination of the elderly and the help provided as service is potentially at odds with one of the existing principles of elderly care, namely the professional principle of help-to-self help. It aims at activating...... the elderly person to manage as much as possible themselves and is based upon a socio-pedagogical culture, where the professional is teaching elderly people about the proper behavior. It’s based upon a formal knowledge of aging and upon different techniques to motivate and involve the elderly....... These are clearly different logics. However, no research has so far studied how these concepts are translated from a national to the municipal level to groups of home helpers and to individual home helpers. And how are these principles played out in different contexts of private firms and public providers...

  19. Dimensões de personalidade, qualidade de vida e depressão em idosas Dimensiones de personalidad, calidad de vida y depresión en ancianas Dimensions of personality, quality of life and depression in elderly women

    Directory of Open Access Journals (Sweden)

    Tatiana Quarti Irigaray

    2009-12-01

    assessment and the onset of depression in old age. The purpose of this study is to investigate the relationship among the personality factors, the quality of life and depression in the elderly. The sampling process used was the convenience method. One hundred three elderly women were assessed and asked about sociodemographic conditions, personality aspects (PFI, quality of life (WHOQOL-bref and depression (GDS. In general terms, the elderly women in this sample, showed median characteristics for all the PFI factors, having the aspects of high deference and low aggression been the most cited. The participants in this study did not show the presence of depression as a characteristic. The study highlights the existence of an association among the personality dimensions, the quality of life and depression in the elderly. Nevertheless, further studies are suggested.

  20. Rationale and design of a multicenter echocardiographic study to assess the relationship between cardiac structure and function and heart failure risk in a biracial cohort of community-dwelling elderly persons: the Atherosclerosis Risk in Communities study.

    Science.gov (United States)

    Shah, Amil M; Cheng, Susan; Skali, Hicham; Wu, Justina; Mangion, Judy R; Kitzman, Dalane; Matsushita, Kunihiro; Konety, Suma; Butler, Kenneth R; Fox, Ervin R; Cook, Nakela; Ni, Hanyu; Coresh, Josef; Mosley, Thomas H; Heiss, Gerardo; Folsom, Aaron R; Solomon, Scott D

    2014-01-01

    Heart failure is an important public health concern, particularly among persons>65 years of age. Women and blacks are critically understudied populations that carry a sizeable portion of the heart failure burden. Limited normative and prognostic data exist on measures of cardiac structure, diastolic function, and novel measures of systolic deformation in older adults living in the community. The Atherosclerosis Risk in Communities (ARIC) study is a large, predominantly biracial, National Heart, Lung, and Blood Institute-sponsored epidemiological cohort study. Between 2011 and 2013, ≈6000 surviving participants, now in their seventh to ninth decade of life, are expected to return for a fifth study visit during which comprehensive 2-dimensional, Doppler, tissue Doppler, and speckle-tracking echocardiography will be performed uniformly in all cohort clinic visit participants. The following objectives will be addressed: (1) to characterize cardiac structural and functional abnormalities among the elderly and to determine how they differ by sex and race/ethnicity, (2) to determine the relationship between ventricular and vascular abnormalities, and (3) to prospectively examine the extent to which these noninvasive measures associate with incident heart failure. We describe the design, imaging acquisition and analysis methods, and quality assurance metrics for echocardiography in visit 5 of the ARIC cohort. A better understanding of the differences in cardiac structure and function through the spectrum of heart failure stages in elderly persons generally, and between sexes and racial/ethnic groups specifically, will deepen our understanding of the pathophysiology driving heart failure progression in these at-risk populations and may inform novel prevention or therapeutic strategies.

  1. Occurrence of depressive tendency and associated social factors among elderly persons forced by the Great East Japan Earthquake and nuclear disaster to live as long-term evacuees: a prospective cohort study.

    Science.gov (United States)

    Kuroda, Yujiro; Iwasa, Hajime; Goto, Aya; Yoshida, Kazuki; Matsuda, Kumiko; Iwamitsu, Yumi; Yasumura, Seiji

    2017-09-03

    This study examined the incidence of depression and associated factors among elderly persons from Iitate village after the March 2011 earthquake. This was a prospective cohort study. As a baseline survey, in May 2010 a self-assessment Basic Checklist (BCL) was distributed to 1611 elderly villagers, of which 1277 responded. Of these respondents, 885 without a tendency to depression (69.3%) were given a follow-up survey in May 2013. The BCL was used to assess depression tendency, instrumental activities of daily living (IADL), physical function, nutritional status, oral function, homeboundness, cognitive function and social activities. Univariate analysis was used to examine differences in risk between those with a presence of depression tendency (PDT) and those without (non-PDT) depending on demographic and BCL variables. Variables found to be significant were analysed by Poisson regression analysis. Of the 438 respondents in the second survey, 163 (37.2%) showed depression tendency. PDT risk was significantly increased by female gender, age, history of diabetes and cognitive disorder. It was significantly reduced by increased IADL. Engagement in social activities decreased PDT risk in rental accommodation. Renters faced a higher risk of PDT than persons evacuated in groups to purpose-built housing. The inclusion of social activities in the multivariate Poisson regression analysis weakened this effect. Female gender, a history of diabetes, reduced IADL and a tendency to cognitive disorder each independently affected PDT risk. These findings may inform future responses to earthquakes and the technical disasters that may accompany them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial.

    NARCIS (Netherlands)

    Smulders, E.; Weerdesteijn, V.G.M.; Groen, B.E.; Duysens, J.E.J.; Eijsbouts, A.; Laan, R.F.J.M.; Lankveld, W.G.J.M. van

    2010-01-01

    OBJECTIVE: To evaluate the efficacy of the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis and a fall history in a randomized controlled trial. Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength. A decrease in the number of

  3. Elder abuse

    OpenAIRE

    1999-01-01

    Elder abuse takes many forms and occurs in a variety of settings; it is both under-recognised and under-reported. Despite a lack of statutory guidelines or legislation, effective management is possible. More could be done to recognise abuse, and healthcare workers need to be vigilant, paying attention to both the circumstances in which abuse occurs and its warning signs.

  4. Physical exercise to improve or maintain activities of daily living performance in frail institutionalized older persons

    NARCIS (Netherlands)

    Weening-Dijksterhuis, Betsy

    2014-01-01

    Dit proefschrift richt zich op het vermogen van kwetsbare ouderen, wonende in verzorgingshuizen, om zo onafhankelijk mogelijk te blijven. Kwaliteit van leven van ouderen hangt voor een groot deel af van of zij afhankelijk zijn van zorg of niet en in welke mate zij afhankelijk zijn. Vanuit het

  5. Frail aged persons residing in South African homes for the aged ...

    African Journals Online (AJOL)

    residents who: (t) owing to the severity of their physical or ..... they often require more physiotherapy and occupational therapy than is available; (iiz) their ... of these patients should be carried out in a geriatric assessment unit and should.

  6. Frail aged persons residing in South African' homes for the aged ...

    African Journals Online (AJOL)

    economic incomes (i.e. less than R450 per month) living in homes for the aged in rural areas who require more staff time and/or expertise and/or medical equipment than can be sup- plied in a home and who, consequently, would benefit by admission to a hospital, 29 rural homes for the aged in the. Orange Free State were ...

  7. A subacute model of geriatric care for frail older persons: the Tan Tock Seng Hospital experience.

    Science.gov (United States)

    Chong, Mei Sian; Empensando, Esmiller F; Ding, Yew Yoong; Tan, Thai Lian

    2012-08-01

    The subacute care unit in Tan Tock Seng Hospital (TTSH) was set up in May 2009. We examined its impact on the transitions at the nexus between hospital and community sectors, patients' discharge destination and functional performance. We studied patients admitted during the initial 6-month period (May to October 2009). Differences in demographics, length of stay (LOS), comorbidity and severity of illness measures, functional outcomes (modified Barthel Index (MBI)) according to discharge destinations were obtained. We also studied the impact of LOS on the geriatric department and the bill size over the pre- and post-subacute implementation periods. Majority of the subacute patients' hospital stay was in subacute care. Of these patients, 44.9% were discharged home, 24.2% to a slow stream rehabilitation (SSR) setting and 29.2% to nursing homes. 16.9% consisted of a subgroup of dementia patients requiring further behavioural and functional interventions, of which 50% managed to be discharged home. Functional gains were seen during subacute stay; with greatest gains observed in the SSR group. There were no differences in overall LOS nor total bill size (DRG-adjusted) for the geriatric medicine department during the first 6 months of operating this new subacute model compared with the prior 4-month period. We propose this subacute model of geriatric care, which allows right-siting of care and improved functional outcomes. It fulfills the role easing transitions between acute hospital and community sectors. In particular, it provides specialised care to a subgroup of dementia patients with challenging behaviours and is fiscally sound from the wider hospital perspective.

  8. Prevention of anxiety and depression in the age group of 75 years and over: a randomised controlled trial testing the feasibility and effectiveness of a generic stepped care programme among elderly community residents at high risk of developing anxiety and depression versus usual care [ISRCTN26474556

    NARCIS (Netherlands)

    Tazelaar, P.J.; van Marwijk, H.W.J.; van Oppen, P.C.; Nijpels, G.; van Hout, H.P.J.; Cuijpers, P.; Stalman, W.A.B.; Beekman, A.T.F.

    2006-01-01

    Background: In frail elderly, the effects of depression and anxiety are deep encroaching. Indicated prevention studies, aimed at subjects with subthreshold disorder, have shown that well designed interventions are capable of reducing the incidence of depression and anxiety. In this randomised

  9. The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care.

    Science.gov (United States)

    Grol, Sietske M; Molleman, Gerard R M; Kuijpers, Anne; van der Sande, Rob; Fransen, Gerdine A J; Assendelft, Willem J J; Schers, Henk J

    2018-03-10

    In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Our aim for this study was to unravel how GPs can play a successful role in elderly care, in particular in multidisciplinary teams, and to define key concepts for success. A mixed qualitative research model in four multidisciplinary teams for elderly care in the Netherlands was used. With these four teams, consisting of 46 health care and social service professionals, we carried out two rounds of focus-group interviews. Moreover, we performed semi-structured interviews with four GPs. We analysed data using a hybrid inductive/deductive thematic analysis. According to the health care and social service professionals in our study, the role of GPs in multidisciplinary teams for elderly care was characterized by the ability to 'see the bigger picture'. We identified five key activities that constitute a successful GP role: networking, facilitating, team building, integrating care elements, and showing leadership. Practice setting and phase of multidisciplinary team development influenced the way in which GPs fulfilled their roles. According to team members, GPs were the central professionals in care services for older people. The opinions of GPs about their own roles were diverse. GPs took an important role in successful care settings for older people. Five key concepts seemed to be important for best practices in care for frail older people: networking (community), facilitating (organization), team building (professional), integrating care elements (patient), and leadership (personal). Team members from primary care and social services indicated that GPs had an indispensable role in such teams. It would be advantageous for GPs to be aware of this attributed role. Attention to leadership competencies and to the

  10. Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial.

    Science.gov (United States)

    Smulders, Ellen; Weerdesteyn, Vivian; Groen, Brenda E; Duysens, Jacques; Eijsbouts, Agnes; Laan, Roland; van Lankveld, Wim

    2010-11-01

    To evaluate the efficacy of the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis and a fall history in a randomized controlled trial. Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength. A decrease in the number of falls therefore is expected to be particularly beneficial for these persons. Randomized controlled trial. Hospital. Persons with osteoporosis and a fall history (N=96; mean ± SD age, 71.0±4.7y; 90 women). After baseline assessment, participants were randomly assigned to the exercise (n=50; participated in the NFPP for persons with osteoporosis [5.5wk]) or control group (n=46; usual care). Primary outcome measure was fall rate, measured by using monthly fall calendars for 1 year. Secondary outcomes were balance confidence (Activity-specific Balance Confidence Scale), quality of life (QOL; Quality of Life Questionnaire of the European Foundation for Osteoporosis), and activity level (LASA Physical Activity Questionnaire, pedometer), assessed posttreatment subsequent to the program and after 1 year of follow-up. The fall rate in the exercise group was 39% lower than for the control group (.72 vs 1.18 falls/person-year; risk ratio, .61; 95% confidence interval, .40-.94). Balance confidence in the exercise group increased by 13.9% (P=.001). No group differences were observed in QOL and activity levels. The NFPP for persons with osteoporosis was effective in decreasing the number of falls and improving balance confidence. Therefore, it is a valuable new tool to improve mobility and independence of persons with osteoporosis. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. [Hypochondriasis and somatisation in elderly].

    Science.gov (United States)

    Thomas, Philippe; Hazif-Thomas, Cyril; Pareaud, Maurice

    2008-11-30

    Anxiety or masked depression are often associated with somatisation in elderly. Hypochondriasis is an excessive preoccupation or worry about having a serious illness. The DSM-IV defines it as a somatoform disorder. It affects about 3% of the population but has a heavy health care cost. Depression, obsessive-compulsive disorder generalized anxiety and somatization disorder are common in elderly and are the most common accompanying conditions in people with hypochondriasis. Old persons' unexplained medical symptoms in generalized anxiety and their relationship to the somatoform disorders are presented. Supportive care and psychotherapy are as necessary as antidepressant to help patients.

  12. Elder abuse telephone screen reliability and validity.

    Science.gov (United States)

    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.

  13. Which Frail Older People Are Dehydrated? The UK DRIE Study.

    Science.gov (United States)

    Hooper, Lee; Bunn, Diane K; Downing, Alice; Jimoh, Florence O; Groves, Joyce; Free, Carol; Cowap, Vicky; Potter, John F; Hunter, Paul R; Shepstone, Lee

    2016-10-01

    Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in UK long-term care and associated cognitive, functional, and health characteristics. The Dehydration Recognition In our Elders (DRIE) cohort study included people aged 65 or older living in long-term care without heart or renal failure. In a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested dehydration risk factors, general health, markers of continence, cognitive and functional health, nutrition status, and medications. Univariate linear regression was used to assess relationships between participant characteristics and serum osmolality, then associated characteristics entered into stepwise backwards multivariate linear regression. DRIE included 188 residents (mean age 86 years, 66% women) of whom 20% were dehydrated (serum osmolality >300 mOsm/kg). Linear and logistic regression suggested that renal, cognitive, and diabetic status were consistently associated with serum osmolality and odds of dehydration, while potassium-sparing diuretics, sex, number of recent health contacts, and bladder incontinence were sometimes associated. Thirst was not associated with hydration status. DRIE found high prevalence of dehydration in older people living in UK long-term care, reinforcing the proposed association between cognitive and renal function and hydration. Dehydration is associated with increased mortality and disability in older people, but trials to assess effects of interventions to support healthy fluid intakes in older people living in residential care are needed to enable us to formally assess causal direction and any health benefits of increasing fluid intakes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Benefits of physical exercise training on cognition and quality of life in frail older adults.

    Science.gov (United States)

    Langlois, Francis; Vu, Thien Tuong Minh; Chassé, Kathleen; Dupuis, Gilles; Kergoat, Marie-Jeanne; Bherer, Louis

    2013-05-01

    Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life. Whether frail older adults can show such benefits remains to be documented. A total of 83 participants aged 61-89 years were assigned to an exercise-training group (3 times a week for 12 weeks) or a control group (waiting list). Frailty was determined by a complete geriatric examination using specific criteria. Pre- and post-test measures assessed physical capacity, cognitive performance, and quality of life. Compared with controls, the intervention group showed significant improvement in physical capacity (functional capacities and physical endurance), cognitive performance (executive functions, processing speed, and working memory), and quality of life (global quality of life, leisure activities, physical capacity, social/family relationships, and physical health). Benefits were overall equivalent between frail and nonfrail participants. Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.

  15. Self-rated health and health-strengthening factors in community-living frail older people.

    Science.gov (United States)

    Ebrahimi, Zahra; Dahlin-Ivanoff, Synneve; Eklund, Kajsa; Jakobsson, Annika; Wilhelmson, Katarina

    2015-04-01

    The aim of this study was to analyse the explanatory power of variables measuring health-strengthening factors for self-rated health among community-living frail older people. Frailty is commonly constructed as a multi-dimensional geriatric syndrome ascribed to the multi-system deterioration of the reserve capacity in older age. Frailty in older people is associated with decreased physical and psychological well-being. However, knowledge about the experiences of health in frail older people is still limited. The design of the study was cross-sectional. The data were collected between October 2008 and November 2010 through face-to-face structured interviews with older people aged 65-96 years (N = 161). Binary logistic regression was used to analyse whether a set of explanatory relevant variables is associated with self-rated health. The results from the final model showed that satisfaction with one's ability to take care of oneself, having 10 or fewer symptoms and not feeling lonely had the best explanatory power for community-living frail older peoples' experiences of good health. The results indicate that a multi-disciplinary approach is desirable, where the focus should not only be on medical problems but also on providing supportive services to older people to maintain their independence and experiences of health despite frailty. © 2014 John Wiley & Sons Ltd.

  16. [Addictive behavior among the elderly].

    Science.gov (United States)

    Menecier, Pascal; Fernandez, Lydia

    2012-12-01

    Addictive behavior still persists among the elderly, mainly concerning substance abuse, such as alcohol, tobacco or psychotropic drugs and addictive practices such as gambling. Illegal substances or cyber-addictions appear much less often. The environment (place of residence or care) and/or economic factors may influence behavior and practices. The incidence of somatic illness or psychiatric disorders, such as cognitive impairment among the elderly patients, complicates even further the presentation of addictive disorders and their treatment. The age factor does not seem to lessen the suffering felt by the patient and care is required in an equal manner for all ages. Prevention (maintenance of personal autonomy and quality of life throughout the ageing process) plays an essential role along with the offer of care. The lack of scientific data such as the absence of validation for adult care among the elderly, leave wide scope for epidemiological, clinical and theoretical research. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  17. Postural control in elderly persons with osteoporosis: Efficacy of an intervention program to improve balance and muscle strength: a randomized controlled trial.

    Science.gov (United States)

    Burke, Thomaz Nogueira; França, Fábio Jorge Renovato; Ferreira de Meneses, Sarah Rúbia; Cardoso, Viviam Inhasz; Marques, Amélia Pasqual

    2010-07-01

    To assess the efficacy of an exercise program aiming to improve balance and muscular strength, for postural control and muscular strength of women with osteoporosis. Sample consisted of 33 women with osteoporosis, randomized into one of two groups: intervention group, in which exercises for balance and improvement of muscular strength of the inferior members were performed for 8 wks (n = 17, age 72.8 +/- 3.6 yrs); control group, which was women not practicing exercises (n = 16, age 74.4 +/- 3.7 yrs). At baseline and after 8 wks of treatment, postural control was assessed using a force plate (Balance Master, Neurocom), and muscular strength during ankle dorsiflexion, knee extension, and flexion was assessed by dynamometry. Adherence to the program was 82%. When compared with the control group, individuals in the intervention group significantly improved the center of pressure velocity (P = 0.02) in the modified clinical test of sensory interaction for balance test, center of pressure velocity (P control (P postural control and lower-limb strength in elderly women with osteoporosis.

  18. From perpetrator to victim in a violent situation in institutional care for elderly persons: exploring a narrative from one involved care provider.

    Science.gov (United States)

    Sandvide, Asa; Fahlgren, Siv; Norberg, Astrid; Saveman, Britt-Inger

    2006-09-01

    In order to reach a more comprehensive understanding of the dynamics in violent situations in institutional care for elderly people the aim of this study was to explore involved parties' positions, and to illuminate forces and moves related to these positions. One involved care provider's narrative was analysed using narrative analysis and positioning theory. In the narrative the involved parties' positions were fluid and often overlapping, and not exclusively as victim or perpetrator. Across the narrative the narrator altered the involved parties' positions by using available discourses. We understand that the altered positions were a salient way for the care provider to make sense of her experiences. By reading the care provider's narrative we further understand that she was much more than just a perpetrator, which was the origin for her narrative. This study led us to two assumptions important for implications in nursing practice. First, it is of significance how we position ourselves and others in narratives and conversations. Second, there is a difference between being categorised in advance and getting the opportunity to narrate one's own story.

  19. Lower blood pressure and apathy coincide in older persons with poorer functional ability: the Discontinuation of Antihypertensive Treatment in Elderly People (DANTE) Study Leiden.

    Science.gov (United States)

    Moonen, Justine E F; Bertens, Anne Suzanne; Foster-Dingley, Jessica C; Smit, Roelof A J; van der Grond, Jeroen; de Craen, Anton J M; de Ruijter, Wouter; van der Mast, Roos C

    2015-01-01

    To examine the association between blood pressure (BP) measures and symptoms of apathy and depression in older adults with various levels of functional ability. Cross-sectional study using baseline data from the Discontinuation of Antihypertensive Treatment in Elderly people (DANTE) Study Leiden. Primary care setting, the Netherlands. Community-dwelling individuals aged 75 and older (N = 430). Systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were measured during home visits. Symptoms of apathy and depression were assessed using the Apathy Scale and the Geriatric Depression Scale (GDS-15), respectively. Stratified linear regression was performed in participants with better and worse functional ability according to the median of the Groningen Activity Restriction Scale. In participants with lower functional ability, each 10-mmHg lower SBP, DBP, and MAP was associated with higher Apathy Scale scores (0.63, 0.92, and 0.94 points, respectively, all P < .005) but not with GDS-15 scores. In participants with higher functional ability, BP measures were not associated with Apathy Scale or GDS-15 scores. In older participants with poorer functional ability, lower BP was associated with more symptoms of apathy but not depression. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  20. The role of sex and autonomy-connectedness in internalizing and externalizing personality pathology, coping and axis-I pathology : Among psychiatric and healthy elderly

    NARCIS (Netherlands)

    Bachrach, N.; Croon, M.A.; Bekker, M.H.J.

    2017-01-01

    Objectives: In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age. Method: A path model was tested which was based on neo-analytical object relation,

  1. Características do apoio social oferecido a idosos de área rural assistida pelo PSF Characteristics of social support offered rural elderly persons assisted by PSF

    Directory of Open Access Journals (Sweden)

    José Leonel Gonçalves Pinto

    2006-09-01

    domiciles. Elevated mean support scores were identified, indicating a favorable situation among the elderly persons studied. In average terms, the category of support with the worst score was "positive social interaction". Bivariate analysis demonstrated a positive association between the affective support score and emotional support with the number of persons in the domicile and greater frequency of high social-interaction scores (3rd tercile in elderly men and those with a greater degree of formal education. The study also showed that lower social-support scores were more frequent in women, illiterates, widowers or single men, and elderly persons with income between one and two times the minimum salary.

  2. Elder Abuse: A Review of the Literature.

    Science.gov (United States)

    Giordano, Nan Hervig; Giordano, Jeffrey A.

    1984-01-01

    Reviews the literature on elder abuse and examines categories of abuse, the incidence of abuse, and characteristics of the typical abused person. Concluded that the abused person is characteristically a severely impaired woman, aged 75 and over, White, widowed, and living with relatives. (LLL)

  3. Elder Abuse: Some Questions for Policymakers.

    Science.gov (United States)

    Callahan, James J. Jr.

    1988-01-01

    Claims elder abuse is not clearly defined, affects relatively small numbers of older persons, is an under-funded area of social service and has weak political support. Recommends a broad-based service strategy for older persons. (Author/ABL)

  4. Food choice patterns among frail older adults: The associations between social network, food choice values, and diet quality.

    Science.gov (United States)

    Kim, Chang-O

    2016-01-01

    Social network type might affect an individual's food choice because these decisions are often made as a group rather than individually. In this study, the associations between social network type, food choice value, and diet quality in frail older adults with low socioeconomic status were investigated. For this cross-sectional study, 87 frail older adults were recruited from the National Home Healthcare Services in Seoul, South Korea. Social network types, food choice values, and diet quality were assessed using The Practitioner Assessment of Network Type Instrument, The Food Choice Questionnaire, and mean adequacy ratio, respectively. Results showed that frail older adults with close relationships with local family and/or friends and neighbors were less likely to follow their own preferences, such as taste, price, and beliefs regarding food health values. In contrast, frail older adults with a small social network and few community contacts were more likely to be influenced by their food choice values, such as price or healthiness of food. Frail older adults who tend to choose familiar foods were associated with low-quality dietary intake, while older adults who valued healthiness or use of natural ingredients were associated with a high-quality diet. The strength and direction of these associations were dependent on social network type of frail older adults. This study explored the hypothesis that food choice values are associated with a certain type of social network and consequently affect diet quality. While additional research needs to be conducted, community-based intervention intended to improve diet quality of frail older adults must carefully consider individual food choice values as well as social network types. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The interpretation practice of The European Court of Justice while judging the conflict between labelling applied as trademark with elderly right of another person

    Directory of Open Access Journals (Sweden)

    Hana Kelblová

    2010-01-01

    Full Text Available The article deals with the verification of the starting hypothesis of complementariness of the law of consumer protection and the law of intellectual property. In order to achieve that goal the author analyzes individual the Czech Trade Marks Act from the standpoint of protection of rights and interests of consumers.The article follows the categorical requirement of a public law rule, the Consumer Protection Act, which prohibits deceiving consumers and establishes that deceiving may also consist in offering products and services unjustified designated by misleading trade mark.The consumer is deceived most frequently when trade marks are used for designation of products and their promotion. The Trade Marks Act may be analyzed in relation to consumer protection first from the standpoint of consumer protection against trade marks misleading someone about the origin and quality of products and services designated by them. Then it is possible to examine the question whether requirements of a designation for being registered as a trade mark are at the same time those attributes of the trade mark which meet the declared intention of the lawmaker, i.e. that the trade mark should be a source of information for the consumer about the origin and quality of the product de­sig­na­ted by it.Especially, the article deals with an interpretation of the conception „Likelihood of Confusion“ as the fundamental conception while judging the conflict with elderly trademarks applying for the re­gi­stra­tion into the list of The Patent Office.A perception of an average consumer is a fundamental factor for a judgement of „Likelihood of Confusion“ as results from the decision practice of The Czech Patent Office, Czech courts and The European Court of Justice. This is proof of the conclusion that rules of the Trademark Law are rules of the Consumer protection Law.

  6. The use of outcome and process indicators to incentivize integrated care for frail older people: a case study of primary care services in Sweden

    Directory of Open Access Journals (Sweden)

    Anders Lars Anell

    2014-12-01

    Full Text Available Background: A number of reforms have been implemented in Swedish health care to support integrated care for frail older people and to reduce utilization of hospital care by this group. Outcomes and process indicators have been used in pay-for-performance (P4P schemes by both national and local governments to support developments.Objective: To analyse limitations in the use of outcome and process indicators to incentivize integrated care for elderly patients with significant health care needs in the context of primary care.Method: Data were collected from the Region Skåne county council. Eight primary care providers and associated community services were compared in a ranking exercise based on information from interviews and registered data. Registered data from 150 primary care providers were analysed in regression models.Results and conclusion: Both the ranking exercise and regression models revealed important problems related to risk-adjustment, attribution, randomness and measurement fixation when using indicators in P4P schemes and for external accountability purposes. Instead of using indicators in incentive schemes targeting individual providers, indicators may be used for diagnostic purposes and to support development of new knowledge, targeting local systems that move beyond organizational boundaries.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people.

    Science.gov (United States)

    Svensson, Bengt; Hansson, Lars

    2017-06-01

    Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Single group pre-test-post-test design. The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.

  9. [Living and dying with frailty : Qualitative interviews with elderly people in the domestic environment].

    Science.gov (United States)

    Klindtworth, Katharina; Geiger, Karin; Pleschberger, Sabine; Bleidorn, Jutta; Schneider, Nils; Müller-Mundt, Gabriele

    2017-02-01

    Frail older people are becoming an increasingly more important target group in healthcare provision. Little is known about patients' views on frailty and its various impacts, especially towards the end of life. This study was carried out to analyze the needs of frail elderly people at the end of life. A qualitative, longitudinal case study design was applied and included 31 frail older patients (≥ 70 year) with a Canadian study of health and aging (CSHA) clinical frailty scale (CFS) grade 6/7 from urban and rural areas within the region of Lower Saxony. The analysis was based on guided interviews and followed the principles of grounded theory. From the patients' perspective frailty is perceived as a process of increasing complexity of health problems, increased vulnerability and reduced ability to perform tasks. Frailty is experienced as various deficits including the physical, psychological, social and existential dimensions. Living and dying in a familiar environment and maintaining autonomy was identified as a core category. Key determinants were access to and quality of healthcare services as well as various individual and social resources. A palliative biopsychosocial care approach should be established early in the process of frailty, including advance care planning in order to meet the patients' needs of staying in a familiar environment. General practitioners as well as home care nursing personnel have to collaborate in order to balance issues of autonomy with increased care needs and the support of informal carers as key partners towards the end of life.

  10. Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study.

    Science.gov (United States)

    Okabe, Y; Furuta, M; Akifusa, S; Takeuchi, K; Adachi, M; Kinoshita, T; Kikutani, T; Nakamura, S; Yamashita, Y

    2016-01-01

    Malnutrition is a serious health concern for frail elderly people. Poor oral function leading to insufficient food intake can contribute to the development of malnutrition. In the present study, we explored the longitudinal association of malnutrition with oral function, including oral health status and swallowing function, in elderly people receiving home nursing care. Prospective observational cohort study with 1-year follow-up. Two mid-sized cities in Fukuoka, Japan from November 2010 to March 2012. One hundred and ninety-seven individuals, aged ≥ 60 years, living at home and receiving home-care services because of physical disabilities, without malnutrition. Oral health status, swallowing function, taking modified-texture diets such as minced or pureed foods, nutritional status, cognitive function, and activities of daily living were assessed at baseline. The associations between malnutrition at 1-year follow-up and these related factors were analyzed using a logistic regression model. Swallowing disorders [risk ratio (RR): 5.21, 95% confidence interval (95% CI): 1.65-16.43] were associated with malnutrition. On the other hand, oral health status did not have a direct association with malnutrition. Swallowing disorders may be associated with the incidence of malnutrition in elderly people receiving home-care. The findings indicate that maintaining swallowing function may contribute to the prevention of malnutrition in frail elderly people.

  11. Exercise for frail elders Exercise for frail elders Best-Martini Elizabeth Kim A Product Botenhagen-Di Genova Human Kinetics £24.50 0 73603 687 3 0736036873.

    Science.gov (United States)

    2003-09-01

    Department of Health Publications Free 208 pp This guide provides practical advice on how to obtain information, services and equipment. It is aimed at people who are older, disabled or who have mental health problems and those who support them. Copies are available in Braille, audio cassette, disk, large print and in a range of languages. Tel: 0800 555777. www.doh.gov.uk /disabledguide.

  12. The elderly patients' dignity

    DEFF Research Database (Denmark)

    Høy, Bente; Hall, E.O.C.; Wagner, L.

    2007-01-01

    the principles of nursing practice, protecting, enhancing and promoting the elderly patient's health potential. It is suggested that these themes of dignity provide a frame of reference in elder care; they shape the understanding of when health issues become a concern for health-promoting care for the elderly...... patient and what goals should be defined. Key words: Dignity, elderly patient, phenomenological hermeneutical method....

  13. Evaluating Photographs as a Replacement for the In-Person Physical Examination of the Scored Patient-Generated Subjective Global Assessment in Elderly Hospital Patients.

    Science.gov (United States)

    Miller, Michelle; Thomas, Jolene; Suen, Jenni; Ong, De Sheng; Sharma, Yogesh

    2018-05-01

    Undernourished patients discharged from the hospital require follow-up; however, attendance at return visits is low. Teleconsultations may allow remote follow-up of undernourished patients; however, no valid method to remotely perform physical examination, a critical component of assessing nutritional status, exists. This study aims to compare agreement between photographs taken by trained dietitians and in-person physical examinations conducted by trained dietitians to rate the overall physical examination section of the scored Patient Generated Subjective Global Assessment (PG-SGA). Nested cross-sectional study. Adults aged ≥60 years, admitted to the general medicine unit at Flinders Medical Centre between March 2015 and March 2016, were eligible. All components of the PG-SGA and photographs of muscle and fat sites were collected from 192 participants either in the hospital or at their place of residence after discharge. Validity of photograph-based physical examination was determined by collecting photographic and PG-SGA data from each participant at one encounter by trained dietitians. A dietitian blinded to data collection later assessed de-identified photographs on a computer. Percentage agreement, weighted kappa agreement, sensitivity, and specificity between the photographs and in-person physical examinations were calculated. All data collected were included in the analysis. Overall, the photograph-based physical examination rating achieved a percentage agreement of 75.8% against the in-person assessment, with a weighted kappa agreement of 0.526 (95% CI: 0.416, 0.637; Pexamination by trained dietitians achieved a nearly acceptable percentage agreement, moderate weighted kappa, and fair sensitivity-specificity pair. Methodological refinement before field testing with other personnel may improve the agreement and accuracy of photograph-based physical examination. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights

  14. A new time-series methodology for estimating relationships between elderly frailty, remaining life expectancy, and ambient air quality.

    Science.gov (United States)

    Murray, Christian J; Lipfert, Frederick W

    2012-01-01

    Many publications estimate short-term air pollution-mortality risks, but few estimate the associated changes in life-expectancies. We present a new methodology for analyzing time series of health effects, in which prior frailty is assumed to precede short-term elderly nontraumatic mortality. The model is based on a subpopulation of frail individuals whose entries and exits (deaths) are functions of daily and lagged environmental conditions: ambient temperature/season, airborne particles, and ozone. This frail susceptible population is unknown; its fluctuations cannot be observed but are estimated using maximum-likelihood methods with the Kalman filter. We used an existing 14-y set of daily data to illustrate the model and then tested the assumption of prior frailty with a new generalized model that estimates the portion of the daily death count allocated to nonfrail individuals. In this demonstration dataset, new entries into the high-risk pool are associated with lower ambient temperatures and higher concentrations of particulate matter and ozone. Accounting for these effects on antecedent frailty reduces this at-risk population, yielding frail life expectancies of 5-7 days. Associations between environmental factors and entries to the at-risk pool are about twice as strong as for mortality. Nonfrail elderly deaths are seen to make only small contributions. This new model predicts a small short-lived frail population-at-risk that is stable over a wide range of environmental conditions. The predicted effects of pollution on new entries and deaths are robust and consistent with conventional morbidity/mortality times-series studies. We recommend model verification using other suitable datasets.

  15. Calidad de vida y hábitos saludables en la alimentación de personas mayores (Quality of life and healthy food habits of elderly persons

    Directory of Open Access Journals (Sweden)

    Luis Vicente Amador Muñoz

    2015-05-01

    Full Text Available Resumen: El presente artículo realiza un estudio en el que se recogen los procesos más relevantes para conseguir una buena calidad de vida en las personas mayores. Principalmente se centra la relación entre el desarrollo de actividad física y la buena alimentación lograr  un envejecimiento lo más satisfactorio y saludable. Se concluye plantándose la necesidad de una educación centrada en el aprendizaje de hábitos saludables en la alimentación de las personas mayores a con el fin de mantener un estado nutricional adecuado para aumentar la longevidad y para mejorar la calidad de vida.Abstract: The present article realizes a study in which the most relevant processes are gathered to obtain a good quality of life in the major persons. Principally it centres on the relation between the development of physical activity and the good supply an aging achieves the most satisfactory and healthy thing. He concludes reaching the need of an education centred on the learning of healthy habits the supply of the major persons to in order to keep a nutritional condition adapted to increase the longevity and to improve the quality of life.

  16. Quality of Elderly\\'s Life in Shiraz, Jahandidegan Club

    Directory of Open Access Journals (Sweden)

    Mohammad Rafi' Bazrafshan

    2008-04-01

    Full Text Available Objectives: Aging is a personal and social experience. while experiences may cause happiness for some individuals, it may cause sadness or tedious in the others. Making decision and planning aimed to improve elderly quality of life among older people, require identification of their problems . Methods & Materials: This study was a cross–sectional study conduced in Jahandidegan Club Foundation for elderly in 2007. Participants were 232 elderly women aged 60–79 years old recruited through a random zed sampling. Data collection was conducted through LEIPAD questionnaire including two domains (essential domain and simplify domain. Data were analyzed using T-test, ANOVA and linear regression in SPSS. Results: The results indicated that there was a significant difference between QOL mean scores (in each of the two domains and total scoreand marital status (P<0.05, as singles had better scores in total than divorced and the other groups, Widowed and divorced elderly women had lower QOL scores than married. QOL scores (in each two domain and total score were strongly correlated with educational level however, only in essential domain a significant difference was observed (P=0.047. QOL mean score decreased with increasing age (P<0.05. There was a significant difference between QOL scores (in essential domain and total score with age of the elderly women, there was also a significant difference between QOL scores (in each two domain and total score with income (P<0.05, QOL mean increased with increasing income. There was a significant difference between QOL mean (in each two domain and total score with existence chronic disease (P<0.05. Conclusion: Results of this study demonstrated some factors such as disease, level of education, marital status, age, income and job may affect quality of elderly's life, Therefore these factors need to be considered in planning and solving older people's problems.

  17. Consumer panel study on elderly people's wishes concerning services.

    Science.gov (United States)

    Valkila, Noora; Litja, Heli; Aalto, Leena; Saari, Arto

    2010-01-01

    This study informs on the wishes and needs of elderly people themselves regarding services for the elderly. The data for the study were gathered using a consumer panel method. Elderly people desire assistance in heavy cleaning chores, in outdoor activities and in carrying out their personal business. Elderly people felt that there should be more recreational services available. Elderly people link aging with feelings of insecurity and loneliness. Becoming a service user for the first time is felt to be a very difficult step to take, and so this decision is postponed as long as possible. The elderly people desire a service for assessing their individual service needs in an organized, expert and objective fashion. The study indicates that elderly people value the human contact gained through service provision. The consumer panel method for collecting data was successful. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  18. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    OpenAIRE

    Ekerstad, Niklas; Karlson, Bj?rn W; Dahlin Ivanoff, Synneve; Landahl, Sten; Andersson, David; Heintz, Emelie; Husberg, Magnus; Alwin, Jenny

    2016-01-01

    Niklas Ekerstad,1,2 Björn W Karlson,3 Synneve Dahlin Ivanoff,4 Sten Landahl,5 David Andersson,6 Emelie Heintz,7 Magnus Husberg,2 Jenny Alwin2 1Department of Cardiology, NU (NÄL-Uddevalla) Hospital Group, Trollhattan, 2Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, 3Department of Molecular and Clinical Medicine, Institute of Medicine, 4Centre for Ageing and Health, AGECAP, Department of Health a...

  19. Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults.

    Science.gov (United States)

    Waters, D L; Vawter, R; Qualls, C; Chode, S; Armamento-Villareal, R; Villareal, D T

    2013-01-01

    To determine if long-term weight loss with associated improvement in physical and metabolic health can be maintained after lifestyle intervention in frail, obese older adults. Thirty-month follow-up pilot study of a 1-year lifestyle intervention trial. Community. Sixteen frail, obese (body mass index=36±2 kg/m2) older (71±1 yr.) adults. Body weight and composition, physical function, markers of the metabolic syndrome, glucose and insulin response to an oral glucose tolerance test, bone mineral density (BMD), liver and renal function tests, and food diaries. At 30-month follow-up, weight (101.5±3.8 vs. 94.5±3.9 kg) and BMI (36.0 ±1.7 vs. 33.5±1.7 kg/m2) remained significantly below baseline (all plean mass (24.1±1.0 vs. 24.1±1.1kg, all p>0.05) occurred between 12 months (end of trial) and 30 months. Improvements in the physical performance test (PPT 27±0.7 vs. 30.2±0.6), insulin sensitivity (4.1±0.8 vs. 3.0±0.6), and insulin area under the curve (12484±2042 vs. 9270±1139 min.mg/dl) remained at 30 months compared to baseline (all pmaintenance of clinically important weight loss is possible in frail, obese older adults. Weight maintenance appears to be achieved through continued caloric restriction. Larger, long-term studies are needed to follow up on these findings and investigate mechanisms and behaviors underlying maintenance of weight loss and physical function.

  20. Evaluation of the Frails' Fall Efficacy by Comparing Treatments (EFFECT) on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial

    OpenAIRE

    Kwok, Boon Chong; Mamun, Kaysar; Chandran, Manju; Wong, Chek Hooi

    2011-01-01

    Abstract Background Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contri...