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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. Criteria for drug selection in frail elderly persons

    NARCIS (Netherlands)

    Huisman-Baron, M.; van der Veen, L.; Jansen, P.A.F.; van Roon, E.N.; Brouwers, J.R.B.J.; van Marum, R.J.

    2011-01-01

    Background: Elderly patients with multiple morbidities and polypharmacy are at an increased risk of adverse drug events (ADEs). Appropriate prescribing, preserving the balance between drug effectiveness and safety, and treatment adherence may prevent these ADEs. In this study, we investigated which

  3. Distance to achieve steady state walking speed in frail elderly persons

    NARCIS (Netherlands)

    Lindemann, U.; Najafi, B.; Zijlstra, W.; Hauer, K.; Muche, R.; Becker, C.; Aminian, K.

    2008-01-01

    This study aims to determine the length of the gait initiation phase before achieving steady state walking in frail older people. Based on body fixed sensors, habitual walking was analysed in 116 community-dwelling older persons (mean age 83.1 years, 84% women). The start of steady state walking was

  4. Differences in Trunk Accelerometry Between Frail and Nonfrail Elderly Persons in Sit-to-Stand and Stand-to-Sit Transitions Based on a Mobile Inertial Sensor.

    Science.gov (United States)

    Galán-Mercant, Alejandro; Cuesta-Vargas, Antonio I

    2013-08-16

    Clinical frailty syndrome is a common geriatric syndrome, which is characterized by physiological reserve decreases and increased vulnerability. The changes associated to ageing and frailties are associated to changes in gait characteristics and the basic functional capacities. Traditional clinical evaluation of Sit-to-Stand (Si-St) and Stand-to-Sit (St-Si) transition is based on visual observation of joint angle motion to describe alterations in coordination and movement pattern. The latest generation smartphones often include inertial sensors with subunits such as accelerometers and gyroscopes, which can detect acceleration. Firstly, to describe the variability of the accelerations, angular velocity, and displacement of the trunk during the Sit-to-Stand and Stand-to-Sit transitions in two groups of frail and physically active elderly persons, through instrumentation with the iPhone 4 smartphone. Secondly, we want to analyze the differences between the two study groups. A cross-sectional study that involved 30 subjects over 65 years, 14 frail and 16 fit subjects. The participants were classified with frail syndrome by the Fried criteria. Linear acceleration was measured along three orthogonal axes using the iPhone 4 accelerometer. Each subject performed up to three successive Si-St and St-Si postural transitions using a standard chair with armrest. Significant differences were found between the two groups of frail and fit elderly persons in the accelerometry and angular displacement variables obtained in the kinematic readings of the trunk during both transitions. The inertial sensor fitted in the iPhone 4 is able to study and analyze the kinematics of the Si-St and St-Si transitions in frail and physically active elderly persons. The accelerometry values for the frail elderly are lower than for the physically active elderly, while variability in the readings for the frail elderly is also lower than for the control group.

  5. Intergenerational Neighborhood Networks: A Basis for Aiding the Frail Elderly.

    Science.gov (United States)

    Pynoos, Jon; And Others

    1984-01-01

    Describes LINC (Living Independently through Neighborhood Cooperation), which formed intergenerational helping networks in which the elderly served as donors as well as service recipients. The project's evaluation indicated that frail older persons received services, acted as volunteers, developed friendships, and increased life satisfaction. (JAC)

  6. Exercise and micronutrient enriched foods for functional improvement in frail elderly? A randomized controlled trail

    NARCIS (Netherlands)

    Chin a Paw, J.M.M.; Jong, de N.; Schouten, E.G.; Hiddink, G.J.; Kok, F.J.

    2001-01-01

    Objective: To examine the effects of an exercise program and an enriched food regimen on physical functioning of frail elderly persons. Design: A 17-week randomized, placebo-controlled trial. Setting: Community. Participants: One hundred fifty-seven independently living frail elderly (mean age, 78.7

  7. 45 CFR 1321.69 - Service priority for frail, homebound or isolated elderly.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Service priority for frail, homebound or isolated elderly. 1321.69 Section 1321.69 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE... Service priority for frail, homebound or isolated elderly. (a) Persons age 60 or over who are...

  8. Emerging Burden of Frail Young and Elderly Persons in Oman; For whom the bell tolls?

    Directory of Open Access Journals (Sweden)

    Hamed Al-Sinawi

    2012-05-01

    Full Text Available Recent improvements in health and an increased standard of living in Oman have led to a reduction in environment-related and infectious diseases. Now the country is experiencing an epidemiological transition characterised by a baby boom, youth bulge and increasing longevity. Common wisdom would therefore suggest that Omanis will suffer less ill health. However, a survey of literature suggests that chronic non-communicable diseases are unexpectedly becoming common. This is possibly fuelled by some socio-cultural patterns specific to Oman, as well as the shortcomings of the ‘miracle’ of health and rapid modernisation. Unfortunately, such new diseases do not spare younger people; a proportion of them will need the type of care usually reserved for the elderly. In addition, due to their pervasive and refractory nature, these chronic non-communicable diseases seem impervious to the prevailing ‘cure-oriented’ health care system. This situation therefore calls for a paradigm shift: a health care system that goes beyond a traditional cure-orientation to provide care services for the chronically sick of all ages.

  9. Frail Elderly: Assessment of Nutrition Needs.

    Science.gov (United States)

    Ludman, Elaine Kris; Newman, Jacqueline M.

    1986-01-01

    Revealed that 36 percent of 75 frail elderly individuals were on special diets, 60.7 percent had problems adhering to them, and 92 percent of diets were below the Recommended Dietary Allowance (RDA) for calcium. Findings suggest increasing dairy products, fruits, and vegetables; increasing nutrient dense foods while lowering caloric intake of…

  10. 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 cons

  11. Cardiac autonomic modulation in non-frail, pre-frail and frail elderly women: a pilot study.

    Science.gov (United States)

    Katayama, Pedro Lourenço; Dias, Daniel Penteado Martins; Silva, Luiz Eduardo Virgilio; Virtuoso-Junior, Jair Sindra; Marocolo, Moacir

    2015-10-01

    Frailty has been defined as a geriatric syndrome that results in high vulnerability to health adverse outcomes. This increased vulnerability state results from dysregulation of multiple physiological systems and its complex interactions. Thus, assessment of physiological systems integrity and of its dynamic interactions seems to be useful in the context of frailty management. Heart rate variability (HRV) analysis provides information about autonomic nervous system (ANS) function, which is responsible to control several physiologic functions. This study investigated the cardiac autonomic modulation by HRV analysis in community-dwelling elderly women classified as non-frail, pre-frail and frail. Twenty-three elderly women were assigned to the following groups: non-frail (n = 8), pre-frail (n = 8) and frail (n = 7). HRV assessment was performed through linear and non-linear analysis of cardiac interval variability. It was observed a higher sympathetic and lower parasympathetic modulation in frail when compared with non-frail and pre-frail groups (p elderly women present an autonomic imbalance characterized by a shift towards sympathetic predominance. Thus, monitoring ANS function in the context of frailty management may be an important strategy to prevention, diagnosis and treatment of this syndrome and its consequences.

  12. [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.

  13. Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495

    Directory of Open Access Journals (Sweden)

    Tybout Willemijn

    2005-09-01

    Full Text Available Abstract Background The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments; 2. to identify the need for home visits to elderly. Methods Main study: The main study concerns a randomized controlled in primary care practices (PCP with 18 months follow-up and blinded PCPs. Frail persons aged 75 years or older and living at home but neither terminally ill nor demented from 33 PCPs were eligible. Trained community nurses (1 visit patients at home and assess the care needs with the Resident Assessment Instrument-Home Care, a multidimensional computerized geriatric assessment instrument, enabling direct identification of problem areas; (2 determine the care priorities together with the patient; (3 design and execute interventions according to protocols; (4 and visit patients at least five times during a year in order to execute and monitor the care-plan. Controls receive usual care. Outcome measures are Quality of life, and Quality Adjusted Life Years; time to nursing home admission; mortality; hospital admissions; health care utilization. Pilot 1: Three brief postal multidimensional screening measures to identify frail health among elderly persons were tested on percentage complete item response (selected after a literature search: 1 Vulnerable Elders Screen, 2 Strawbridge's frailty screen, and 3 COOP-WONCA charts. Pilot 2: Three nurses visited elderly frail patients as identified by PCPs in a health center of 5400 patients and used an assessment protocol to identify psychosocial and medical problems. The needs and experiences of all participants were gathered by semi-structured interviews. Discussion The design holds several unique elements such as early identification of frail persons combined with case-management by

  14. Potentially inappropriate prescribing in a population of frail elderly people.

    Science.gov (United States)

    Récoché, Isabelle; Lebaudy, Cécile; Cool, Charlène; Sourdet, Sandrine; Piau, Antoine; Lapeyre-Mestre, Maryse; Vellas, Bruno; Cestac, Philippe

    2017-02-01

    Background Frailty is a clinical syndrome highly predictive of functional decline after a stress or a medical event, such as adverse drug events. Objective To describe the prevalence of potentially inappropriate prescribing in a population of frail elderly patients. Setting Geriatric day hospital for assessment of frailty and prevention of disability, Toulouse, France. Method A cross-sectional study performed from January to April 2014. Two pharmacists retrospectively analyzed the prescriptions of elderly patients who were sent to the day hospital to assess their frailty and to be given a personalized plan of care and prevention. Potentially inappropriate prescribing was defined by combining explicit criteria: Laroche list, screening tool of older people's prescriptions, and screening tool to alert to right treatment with an implicit method (drug utilization review for each medication). Prescriptions' optimizations were then suggested to the geriatricians of the day hospital and classified according to criteria defined by the French Society of Clinical Pharmacy. Main outcome measure Prevalence of potentially inappropriate prescribing. Results Among the 229 patients included, 71.2% had potentially inappropriate prescribing. 76 patients (33.2%) had at least one drug without any valid indication. 51 (22.3%) had at least one drug with an unfavorable benefit-to-risk ratio according to their clinical and biological data, 42 (18.3%) according to the Laroche list and 38 (16.6%) had at least one drug with questionable efficacy. Conclusion Our work shows that the incidence of PIP is high in the frail elderly and that, in most cases, it could be avoided with an adequate and regular reassessment of the prescriptions. In future, prescription optimization will be integrated into the personalized medical care plan to further prevent drug-related disability.

  15.  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

    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......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...

  16. Poetry Therapy with Frail Elderly in a Nursing Home.

    Science.gov (United States)

    Silvermarie, Sue

    1988-01-01

    Describes a poetry group which encouraged the expression of memories and imagination among frail elderly residents of a nursing home over a period of nine months. Shows how it facilitated peer friendship formation, increased expression of affect, resulted in improved staff treatment of residents, and ended with the publication of an anthology. (SR)

  17. Development of an exercise program for the frail elderly

    NARCIS (Netherlands)

    Paw, MJMCA; de Jong, N; Stevens, M; Bult, P

    2001-01-01

    The article describes the design and preliminary evaluation of a 17-week, twice-weekly, comprehensive, progressive exercise program for frail elderly adults. The main objective was to maintain or improve mobility and performance of daily activities essential for independent functioning. Strength, sp

  18. Development of an exercise program for frail elderly

    NARCIS (Netherlands)

    Chin A Paw, J.M.M.; Jong, de N.; Stevens, M.; Bult, P.; Schouten, E.G.

    2001-01-01

    The article describes the design and preliminary evaluation of a 17-week, twice-weekly, comprehensive, progressive exercise program for frail elderly adults. The main objective was to maintain or improve mobility and performance of daily activities essential for independent functioning. Strength, sp

  19. Development of an exercise program for the frail elderly

    NARCIS (Netherlands)

    Paw, MJMCA; de Jong, N; Stevens, M; Bult, P

    2001-01-01

    The article describes the design and preliminary evaluation of a 17-week, twice-weekly, comprehensive, progressive exercise program for frail elderly adults. The main objective was to maintain or improve mobility and performance of daily activities essential for independent functioning. Strength,

  20. Development of an exercise program for frail elderly

    NARCIS (Netherlands)

    Chin A Paw, J.M.M.; Jong, de N.; Stevens, M.; Bult, P.; Schouten, E.G.

    2001-01-01

    The article describes the design and preliminary evaluation of a 17-week, twice-weekly, comprehensive, progressive exercise program for frail elderly adults. The main objective was to maintain or improve mobility and performance of daily activities essential for independent functioning. Strength,

  1. 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.

  2. Needs of frail elderly people in informal settlements

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    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.

  3. Silver yoga exercises improved physical fitness of transitional frail elders.

    Science.gov (United States)

    Chen, Kuei-Min; Fan, Jue-Ting; Wang, Hsiu-Hung; Wu, Shu-Ju; Li, Chun-Huw; Lin, Huey-Shyan

    2010-01-01

    Promoting the health of transitional frail elders (e.g., through therapeutic-based yoga exercises) is essential to reduce healthcare expenditures caused by chronic health problems. The purpose of this study was to determine the efficacy of 24 weeks of the senior-tailored silver yoga (SY) exercise program for transitional frail elders. A convenience sample of 69 elders in assisted living facilities were assigned randomly to the SY group (n = 38) or to the control group (n = 31) on the basis of the facilities where they resided, and 55 of them completed this quasi-experimental pretest and posttest study. Intervention was conducted three times per week, 70 minutes per session, for 24 weeks. Physical fitness (body composition, cardiovascular-respiratory functions, body flexibility, muscle power and endurance, balance, and agility) were examined at baseline, at 12 weeks, and at the end of the 24th week of the study. At the end of the study, the physical fitness indicators of participants in the SY group had improved significantly, and they had better physical fitness than participants in the control group (all p values < .05). It was recommended that the SY exercises be incorporated as an activity program in assisted living facilities to promote the physical fitness of transitional frail elders.

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

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    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.

  5. Civil Liberties and the Frail Elderly

    Science.gov (United States)

    Cohen, Elias S.

    1978-01-01

    America's elderly are affected in very special ways by the law: some as a result of special legislation or court decisions, some deriving from the objective life-situation of certain old people, and some from the special prejudices that are visited upon the elderly. (Author)

  6. Inclusion of frail elderly patients in clinical trials : Solutions to the problems

    NARCIS (Netherlands)

    Hempenius, L.; Slaets, J.P.J.; Boelens, M.A.M.; van Asselt, D.Z.B.; de Bock, G.H.; Wiggers, T.; Leeuwen, van Barbara

    With the aging of the population, the interest in clinical trials concerning frail elderly patients has increased. Evidence-based practice for the elderly patient is difficult because elderly patients, especially the frail, are often excluded from clinical trials. To facilitate the participation of

  7. Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495

    NARCIS (Netherlands)

    Hout, van H.P.J.; Nijpels, M.G.A.A.M.; Marwijk, van H.W.J.; Jansen, A.P.D.; Veer, van 't P.J.; Tybout, W.; Stalman, W.A.B.

    2005-01-01

    BACKGROUND: The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments;

  8. Immunity in frail elderly : a randomized controlled trial of exercise and enriched foods

    NARCIS (Netherlands)

    Chin A Paw, M.J.M.; Jong, de N.; Pallast, E.G.M.; Kloek, G.; Schouten, E.G.; Kok, F.J.

    2000-01-01

    To examine the effects of 17-wk physical exercise and enriched foods on cellular immune response (CIR) in frail elderly. METHODS: A total of 112 independently living, frail elderly men and women (mean age 79.2 /- 5.9) received: twice weekly comprehensive, moderate intensity, progressive group exerci

  9. Immunity in frail elderly : a randomized controlled trial of exercise and enriched foods

    NARCIS (Netherlands)

    Chin A Paw, M.J.M.; Jong, de N.; Pallast, E.G.M.; Kloek, G.; Schouten, E.G.; Kok, F.J.

    2000-01-01

    To examine the effects of 17-wk physical exercise and enriched foods on cellular immune response (CIR) in frail elderly. METHODS: A total of 112 independently living, frail elderly men and women (mean age 79.2 /- 5.9) received: twice weekly comprehensive, moderate intensity, progressive group

  10. Progressive resistance muscle strength training of hospitalized frail elderly.

    Science.gov (United States)

    Sullivan, D H; Wall, P T; Bariola, J R; Bopp, M M; Frost, Y M

    2001-07-01

    To determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training. Muscle strength (one repetition maximum), functional abilities (sit-to-stand maneuver and 20-sec maximal safe gait speed), and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training. The nonrandomized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home. Participants included 19 recuperating elderly subjects (14 male, 5 female; 13 ambulatory, 6 nonambulatory) >64 yr (mean age, 82.8+/-7.9 yr). The one repetition maximum increased an average of 74%+/-49% (median, 70%; interquartile range, 38%-95%, and an average of 20+/-13 kg (P = 0.0001). Sit-to-stand maneuver times improved in 15 of 19 cases (79%). Maximum safe gait speeds improved in 10 of 19 cases (53%). Four of the six nonambulatory subjects progressed to ambulatory status. No subject experienced a complication. A carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses. A randomized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages, if any, over routine posthospital care that includes traditional low-intensity physical therapy.

  11. 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

  12. Orthostatic Hypotension and Mortality in Elderly Frail Patients

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    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

  13. The quest for integrated systems of care for frail older persons.

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    Kodner, Dennis L

    2002-08-01

    The challenge of an increasing elderly population, particularly with respect to frail older persons in need of long-term care, has coupled with ever-present budget constraints to make the financing, organization and delivery of elder care a major priority in North America, Europe and elsewhere in the developed world. Despite obvious cross-national differences in health and social care arrangements for the frail elderly, evidence of poorly coordinated services, disjointed care, less than optimum outcomes, system inefficiency, inadequate accountability, and uncontrolled costs can be found in all countries. There is a growing belief that more comprehensive approaches are needed to effectively address these problems. One such strategy, so-called integrated systems of care, shows great promise. The author critically examines the concept of integrated systems of care for the frail elderly, including the theoretical benefits and drawbacks of the model. At the policy and practice levels, descriptions are presented of, and evidence and lessons are summarized from a representative sample of such projects in the US (Social HMO and PACE), Canada (SIPA), Italy (Rovereto) and Australia (Coordinated Care Trials). The introduction of prototypes such as these raises a number of significant issues for policymakers, payers, providers, consumers and researchers. These are briefly examined in concluding remarks on the important potential of integrated systems of care for vulnerable older people.

  14. 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...... and evening). The intervention period was 12 wk, and saliva and plaque samples were collected at baseline and follow-up. The primary end point was prevalence of high Candida counts assessed from chairside tests. Secondary end points were levels of dental plaque and gingival inflammation. The groups were...... 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

  15. Stability and Change in the Informal Task Support Network of Frail Older Persons.

    Science.gov (United States)

    Miller, Baila; McFall, Stephanie

    1991-01-01

    Examined predictors of stability and change in informal support networks of frail elders and primary caregivers. Data from 1982 and 1984 National Long Term Care Surveys and 1982 Informal Caregivers Survey revealed that changes in network size and intensity of help occurred in response to changes in health and functional status of frail elder, not…

  16. Skin care in the frail, elderly, dependent, incontinent patient.

    Science.gov (United States)

    Jeter, K F; Lutz, J B

    1996-01-01

    Despite a plethora of recommendations, protocols and dictums in the nursing literature, no research studies have defined the basic elements of preventive skin care for incontinent patients, and the prevalence of skin problems associated with incontinence is unknown. Yet the importance of skin care for incontinent elderly or immobilized patients has long been acknowledged. This literature review sought to determine current practices and principles for skin care of frail, elderly, dependent, incontinent patients. Protocols vary widely. And although there is mounting evidence that incontinence, particularly fecal incontinence, is a primary risk factor for pressure ulcer development, most preventive efforts focus on pressure relief, repositioning, and nutrition, rather than incontinence care. More clinical trials are needed in this area. The design and analysis of these trials should take into account the frequency and manner in which skin is cleansed, products used for skin care, risks and benefits of absorbent products and devices, the presence of infection, and patients' concomitant medical conditions and degree of immobility.

  17. [Examination of effects of alfacalcidol vitamin D supplement and renal function on improvement in the physical fitness of pre-frail elderly persons attending a nursing care prevention class].

    Science.gov (United States)

    Okuno, Junko; Tomura, Shigeo; Fukasaku, Takako; Kim, Mi-Ji; Okura, Tomohiro; Tanaka, Kiyoji; Yanagi, Hisako

    2011-01-01

    A characteristic condition of pre-frail elderly people is decreased mobility, which is associated with vitamin D levels and renal function. The aim of this study was to examine the association between physical fitness improvement and vitamin D levels, vitamin D supplements, and renal function in pre-frail elderly people. We conducted a longitudinal study in 2 towns from June 2006 to December 2009. Subjects consisted of 177 community-dwelling pre-frail elderly people aged 65 years and over (mean±standard deviation [SD]: 76.4±5.5 yrs) who attended a nursing care prevention program for 3 months. An interview was conducted based on a questionnaire. Serum levels of intact parathyroid hormone (iPTH), 25-hydroxyvitamin D(25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)(2)D), creatinine, and calcium were measured. eGFR (ml/min/1.73 m(2)) was calculated using a new formula. Alfacalcidol 1 µg/day was administered to subjects for 3 months, and we assumed that the elderly who took vitamin D (VD) of more than 80% of the recommended daily allowance to be the VD group. Walking ability, balance, and muscle strength physical fitness tests were performed. The prevalence of eGFR <60.0 ml/min/1.73 m(2) was about 24.3%, and that of 25(OH)D <75 nmol/L was 86.4%. Pre-eGFR level and vitamin D supplementation with FR, pre-eGFR and pre 25(OH)D ≥45 nmol/L were associated with improvement in the timed up and go (TUG) test, pre-25(OH)D level (<50 nmol/L, ≥50 nmol/L) was associated with the tandem stance test, pre 25(OH)D level (<67.5 nmol/L, ≥67.5 nmol/L) was associated with the alternate step and 5 chair sit-to-stands tests, and post 1,25(OH)(2)D (<44 pg/ml, ≥44 pg/ml) was associated with the tandem walk tests. These results suggest that the assessment of renal function and maintenance of appropriate vitamin D levels are important for the independent living of pre-frail elderly people. Ideally, a 25(OH)D level greater than 67.5 nmol/L is preferable.

  18. Ejercicio físico como intervención eficaz en el anciano frágil Physical exercise as an efficient intervention in frail elderly persons

    Directory of Open Access Journals (Sweden)

    A. Casas Herrero

    2012-04-01

    Full Text Available El síndrome de la fragilidad define a los ancianos vulnerables que tienen un riesgo elevado de sufrir eventos adversos. Su fisiopatología y etiopatogenia es compleja, pero actualmente disponemos de medidas sencillas de capacidad funcional para su evaluación. La inactividad física, que frecuentemente asocia el envejecimiento, es uno de los factores fundamentales que contribuye a la aparición de sarcopenia, aspecto central de la fragilidad. Los programas de ejercicio físico multicomponente y, particularmente el entrenamiento de la fuerza, constituyen las intervenciones más eficaces para retrasar la discapacidad y otros eventos adversos. Así mismo, han demostrado su utilidad en otros dominios frecuentemente asociados a este síndrome como las caídas, el deterioro cognitivo y la depresión. Sin embargo, es necesario investigar cuáles son los componentes óptimos de un programa de fuerza en el frágil, así como la óptima relación dosis-respuesta que permita desarrollar guías clínicas específicas de actividad física para este grupo poblacional.Frailty is a state of vulnerability that involves an increased risk of adverse events in older adults. It is a condition with a complex etiology and pathophysiology. At present, there are functional tools for its assessment that are simple and reliable. Physical inactivity is a major risk factor for sarcopenia, a core aspect of frailty. Currently, mulicomponent exercise programs, and especially resistance exercise, are the most relevant interventions to slow down disability and other adverse outcomes. Moreover, these programs are valuable interventions in other frailty domains such as falls, cognitive decline and depression. However, in frail aged patients it is necessary to explore optimal resistance training components and develop specific clinical guides of physical activity for this target population.

  19. Quality of life evaluation of frail elderly in Campinas, São Paulo

    Directory of Open Access Journals (Sweden)

    Flávia Regina de Andrade Varela

    2015-10-01

    Full Text Available Summary Objective: describe the quality of life of frail elderly assisted by the Centro de Referência à Saúde do Idoso (CRI, Campinas, São Paulo, Brazil. Methods: the convenience sample included 122 frail elderly being treated from January 2010 to July 2011, out of a total of 668 frail elderly who were referred to the CRI after application of the brief evaluation form of the elderly, recommended by Ministry of Health, which identifies the elderly with some degree of frailty. Descriptive observational study collected data through sociodemographic questionnaire and quality of life questionnaires: WHOQOL-BREF, WHOQOLOLD and SF-36. Results: the study included 122 frail elderly. Of these, 74.6% (91 were female, mean age 73 years, 46.7% (57 were married, 51.6% (63 had less than 3 years of schooling and 87.7% (107 reported income of one to four minimum wages. The mean total score of the WHOQOL-BREF was 56.6, the WHOQOL-OLD 57.6 and SF-36 Physical Component Summary 34.5 and Mental Component Summary 43.6. Conclusion: knowledge of the impairment profile of quality of life among frail elderly is, therefore, essential for planning health care to this population.

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

    Science.gov (United States)

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

    2014-03-04

    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 transportational walking depends on the size of the area characteristics measured, and older person's frailty level. The study population consisted of 408 Dutch community-dwelling persons aged 65 years and older participating in the Elderly And their Neighborhood (ELANE) study in 2011-2012. Characteristics (aesthetics, functional features, safety, and destinations) of areas surrounding participants' residences ranging from a buffer of 400 meters up to 1600 meters (based on walking path networks) were linked with self-reported transportational walking using linear regression analyses. In addition, interaction effects between frailty level and area characteristics were tested. An increase in functional features (e.g. presence of sidewalks and benches) within a 400 meter buffer, in aesthetics (e.g. absence of litter and graffiti) within 800 and 1200 meter buffers, and an increase of one destination per buffer of 400 and 800 meters were associated with more transportational walking, up to 2.89 minutes per two weeks (CI 1.07-7.32; p < 0.05). No differences were found between frail and non-frail elderly. Better functional and aesthetic features, and more destinations in the residential area of community-dwelling older persons were associated with more transportational walking. The importance of area characteristics for transportational walking differs by area size, but not by frailty level. Neighbourhood improvements may increase transportational walking among older persons, thereby contributing to living longer independently.

  1. 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.

  2. 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.

  3. The assessment of ADL among frail elderly in an interview survey : Self-report versus performance-based tests and determinants of discrepancies

    NARCIS (Netherlands)

    Kempen, GIJM; Steverink, N; Ormel, J; Deed, DJH

    1996-01-01

    The impact of three sociodemographic, two cognitive, rico affective, and four personality measures on the discrepancies between self-reported and performance-based ADL in a sample of 753 frail elderly is studied by means of multiple regression analyses. Underestimation (i.e., lower self-reported lev

  4. Caregiver Objective Burden and Assessments of Patient-Centered, Family-Focused Care for Frail Elderly Veterans

    Science.gov (United States)

    Rose, Julia Hannum; Bowman, Karen F.; O'Toole, Elizabeth E.; Abbott, Katherine; Love, Thomas E.; Thomas, Charles; Dawson, Neal V.

    2007-01-01

    Purpose: There is a growing consensus that quality of care for frail elders should include family and be evaluated in terms of patient-centered, family-focused care (PCFFC). Family caregivers are in a unique and sometimes sole position to evaluate such care. In the context of caring for physically frail elders, this study examined the extent to…

  5. Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients.

    NARCIS (Netherlands)

    Iersel, M.B. van; Munneke, M.; Esselink, R.A.J.; Benraad, C.E.; Olde Rikkert, M.G.M.

    2008-01-01

    OBJECTIVE: To estimate clinically relevant changes in functional mobility tests and quantitative gait measures at group and individual level in frail elderly patients. STUDY DESIGN AND SETTING: This study was a cohort study of consecutively admitted frail elderly patients. Gait velocity,

  6. 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......The Tilburg Frailty Indicator is a questionnaire with a bio-psycho-social approach, which measures frailty by 15 questions. A questionnaire about frailty should be in alignment with experiences of frail elderly themselves as a target population is an important source of knowledge in content...... 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...

  7. Considering the use of a personal emergency response system: an experience of frail, older women.

    Science.gov (United States)

    Porter, Eileen J; Ganong, Lawrence H

    2002-01-01

    The individual considerations of frail women who are elderly as to the use of personal emergency response systems (PERS) are discussed within this article, and they derived from a larger longitudinal study that explores the home care experience of older widows. Participants were 11 frail women (aged 81-94) who perceived a risk of "falling and not being found" and did not have a PERS. A descriptive phenomenological method was used to analyze PERS-related data obtained during interviews with each woman in her home. With regard to considering the use of a PERS, experiences were structured variously by "getting by fine without it," "waiting to get it until I really need it," "convincing myself that I might get it later," and "borrowing no more trouble than I already have." Consistent interventions by home care professionals may perhaps be needed to increase PERS utilization rates. To develop effective interventions, further descriptive research is deemed necessary to explore drawbacks and barriers to PERS use by older frail women.

  8. Physical therapy intervention (PTI) increases plasma brain-derived neurotrophic factor (BDNF) levels in non-frail and pre-frail elderly women.

    Science.gov (United States)

    Coelho, F M; Pereira, D S; Lustosa, L P; Silva, J P; Dias, J M D; Dias, R C D; Queiroz, B Z; Teixeira, A L; Teixeira, M M; Pereira, L S M

    2012-01-01

    Biomarkers are important factors in the identification of the frail elderly (higher risk of developing disease) and in assessing the impact of PTI. On the other hand, BDNF has been related to neuroprotection in a series of central nervous system diseases in older age. The levels of BDNF in groups of elderly women classified according to Fried phenotype (non-frail and pre-frail) were compared. We assessed the impact of a PTI on BDNF levels. A convenience sample of 48 elderly women was randomly selected. The PTI group was composed by 20 elderly women selected from this group. Plasma neurotrophic factors, such as BDNF, glial-derived neutrophic factor (GDNF), and nerve growth factor (NGF) were measured by enzyme-linked immunosorbent assay (ELISA). Timed-up-and-go (TUG) test, hand-grip and work/body weight were evaluated before and after the intervention. Plasma concentrations of BDNF were significantly higher in non-frail in comparison to pre-frail elderly women. After the PTI, higher levels of BDNF were found in elderly women (before 351±68 pg/ml and after 593±79 pg/ml; pelderly women suggest that this neurotrophic factor may be a key pathophysiological mediator in the syndrome of frailty. The fact that PTI increased BDNF levels in both groups suggests that it may be possible to modify this phenotype.

  9. Validity of an Accelerometer-Based Activity Monitor System for Measuring Physical Activity in Frail Elderly

    NARCIS (Netherlands)

    Hollewand, Anne M; Spijkerman, Anouk G; Bilo, Henk J; Kleefstra, Nanne; Kamsma, Yvo; van Hateren, Kornelis J

    2016-01-01

    This study aimed to investigate the validity of the accelerometer-based DynaPort system to detect physical activity in frail elderly subjects. Eighteen home-dwelling subjects (Groningen Frailty Indicator (GFI) score ≥4, ≥75 years) were included. Activities in their home environment were simultaneous

  10. Hospital Care for Frail Elderly Adults: From Specialized Geriatric Units to Hospital-Wide Interventions

    NARCIS (Netherlands)

    Bakker, F.C.; Olde Rikkert, M.G.M.

    2015-01-01

    Much of the acute care provided in hospitals is for elderly people. Frailty is a common clinical condition among these patients. Frail patients are vulnerable to undergoing adverse events, to developing geriatric syndromes and to experiencing functional decline during or due to hospitalization. The

  11. Wife Caregivers of Frail Elderly Veterans: Correlates of Caregiver Satisfaction and Caregiver Strain.

    Science.gov (United States)

    Dorfman, Lorraine T.; And Others

    1996-01-01

    Investigated correlates of satisfaction and strain in 80 wife caregivers of frail elderly veterans. Support from spouse was the strongest positive predictor of satisfaction with caregiving and the strongest negative predictor of caregiver strain. Self efficacy was the strongest predictor of caregiver life satisfaction. (Author)

  12. The role of anthropometry in the assessment of malnutrition in the hospitalized frail elderly.

    Science.gov (United States)

    Lansey, S; Waslien, C; Mulvihill, M; Fillit, H

    1993-01-01

    Although common among the hospitalized frail elderly, malnutrition is often unrecognized by clinicians, and its identification is fought with difficulty due to inadequate nutritional assessment methods and standards. This study compared the use of percent ideal body weight (%IBW) and anthropometry in the assessment of malnutrition in the hospitalized frail elderly. Approximaty 45% of patients studied had at least two anthropometric measurements below the 5th percentile, a level reflecting severe malnutrition. However, only 28% of patients were found to be less than 90% IBW, a level reflecting only mild to severe changes in body weight. Serum albumin was below normal (total lymphocyte count was below normal (malnutrition, anthropometry appeared more sensitive than %IBW as a measure of malnutrition in the hospitalized frail elderly. Furthermore, acute illness causes changes in commonly employed blood measures which make them unreliable in the assessment of malnutrition in this population. Anthropometry may prove to be the most stable, easily performed, and sensitive measure of malnutrition in the hospitalized frail elderly. However, further studies are clearly needed, including the development of appropriate anthropometric reference standards for the very old, a population that commonly suffers malnutrition.

  13. 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

  14. Therapeutic Processes in Professional and Peer Counseling of Family Caregivers of Frail Elderly People.

    Science.gov (United States)

    Smith, Mary F.; And Others

    1992-01-01

    Assessed therapeutic processes used by peer and professional counselors during brief, problem-focused individual intervention program with 51 daughters and daughters-in-law who were caring for frail elder. Findings indicated that professionals were significantly warmer and friendlier, engaged in greater exploration, and gave more and different…

  15. 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

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

    NARCIS (Netherlands)

    Hempenius, Liesbeth; Slaets, Joris; van Asselt, Dieneke; de Bock, Truuske H; Wiggers, Theo; van Leeuwen, Barbara L

    2016-01-01

    Background 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

  17. 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.

  18. 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

    UNLABELLED: The Tilburg Frailty Indicator is a questionnaire with a bio-psycho-social approach, which measures frailty by 15 questions. A questionnaire about frailty should be in alignment with experiences of frail elderly themselves as a target population is an important source of knowledge in c...

  19. 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

    UNLABELLED: The Tilburg Frailty Indicator is a questionnaire with a bio-psycho-social approach, which measures frailty by 15 questions. A questionnaire about frailty should be in alignment with experiences of frail elderly themselves as a target population is an important source of knowledge in c...

  20. 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

  1. The design of the Dutch EASYcare study: a randomised controlled trial on the effectiveness of a problem-based community intervention model for frail elderly people [NCT00105378

    Directory of Open Access Journals (Sweden)

    van Achterberg Theo

    2005-10-01

    Full Text Available Abstract Background Because of their complex clinical presentations and needs frail elderly people require another approach than people who age without many complications. Several inpatient geriatric health services have proven effectiveness in frail persons. However, the wish to live independently and policies that promote independent living as an answer to population aging call for community intervention models for frail elderly people. Maybe models such as preventive home visits, comprehensive geriatric assessment, and intermediate care qualify, but their efficacy is controversial, especially in frail elderly persons living in the community. With the Dutch EASYcare Study Geriatric Intervention Programme (DGIP we developed a model to study effectiveness of problem based community intervention models in frail elderly people. Methods/Design DGIP is a community intervention model for frail elderly persons where the GP refers elderly patients with a problem in cognition, mood, behaviour, mobility, and nutrition. A geriatric specialist nurse applies a guideline-based intervention with a limited number of follow up visits. The intervention starts with the application of the EASYcare instrument for geriatric screening. The EASYcare instrument assesses (instrumental activities of daily life, cognition, mood, and includes a goal setting item. During the intervention the nurse regularly consults the referring GP and a geriatrician. Effects on functional performance (Groningen Activity Restriction Scale, health related quality of life (MOS-20, and carer burden (Zarit Burden Interview are studied in an observer blinded randomised controlled trial. 151 participants were randomised over two treatment arms – DGIP and regular care – using pseudo cluster randomisation. We are currently performing the follow up visits. These visits are planned three and six months after inclusion. Process measures and cost measures will be recorded. Intention to treat

  2. Nutrient-dense foods and exercise in frail elderly: effects on B vitamins, homocysteine, methylmalonic acid, and neuropsychological functioning

    NARCIS (Netherlands)

    Jong, de N.; Chin A Paw, M.J.M.; Groot, de C.P.G.M.; Rutten, R.A.M.; Swinkels, D.W.; Kok, F.J.; Staveren, van W.A.

    2001-01-01

    Frail elders are at risk of suboptimal micronutrient status, functional decline, and neurologic disorders. The influence of oral multimicronutrients in physiologic doses and of moderately intense physical exercise on homocysteine (Hcy), methylmalonic acid (MMA), and neurologic functioning have not y

  3. Changes in the physical functions of pre-frail elderly women after participation in a 1-year preventative exercise program.

    Science.gov (United States)

    Sugimoto, Hiroe; Demura, Shinichi; Nagasawa, Yoshinori; Shimomura, Masaaki

    2014-10-01

    The present study clarifies the effects of participation in a preventative health classroom program (exercise program) for 1 year on the physical functions of pre-frail elderly individuals in comparison with healthy elderly individuals. Participants in the study included 28 elderly pre-frail female participants and 28 elderly healthy female participants. Participants engaged in the exercise program for 1 year. There was no significant age or physical differences between both groups. Before and after the exercise program, the following physical function tests were carried out: grip strength, one-legged balance with eyes open, 5-m walking time and a timed up & go (TUG). The pre-frail elderly group tested significantly lower in the one-legged balance with eyes open test and the TUG test compared with the healthy elderly group. The 5-m walking time test improved significantly in both groups, but the TUG improved only in the pre-frail elderly group. Conversely, the grip strength and one-legged balance with eyes open tests remained unchanged. Improvements in the TUG and 5-m walking time tests were found in the pre-frail elderly group after the 1-year exercise program. Their results in the TUG test might be greater than those among the healthy elderly individuals. © 2013 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Jane Andreasen

    2015-06-01

    Full Text Available 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 in everyday life,” and “Handling everyday life.” These categories affected the way the frail elderly experienced daily life and these elements resulted in a general feeling of well-being or non-well-being. The transition to home was experienced as unsafe and troublesome especially for the more frail participants, whereas the less frail experienced this less. Conclusion and discussion: Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged. Stakeholders should evaluate present practice to seek to improve care across health care sectors.

  5. Vitamin B12 status is associated to bone mineral content and bone mineral density in frail elderly women, but not in men

    NARCIS (Netherlands)

    Dhonukshe-Rutten, R.A.M.; Lips, M.; Jong, N.; Chin A Paw, M.J.M.; Hiddink, G.J.; Dusseldorp, van M.; Groot, de C.P.G.M.; Staveren, van W.A.

    2003-01-01

    Subclinical vitamin B-12 deficiency is common in the elderly. Encouraged by early indications, we investigated the plasma vitamin B-12 status in association with bone mineral content (BMC) and bone mineral density (BMD) in frail elderly people. Data of 194 free-living Dutch frail elderly (143 women

  6. Vitamin B12 status is associated to bone mineral content and bone mineral density in frail elderly women, but not in men

    NARCIS (Netherlands)

    Dhonukshe-Rutten, R.A.M.; Lips, M.; Jong, N.; Chin A Paw, M.J.M.; Hiddink, G.J.; Dusseldorp, van M.; Groot, de C.P.G.M.; Staveren, van W.A.

    2003-01-01

    Subclinical vitamin B-12 deficiency is common in the elderly. Encouraged by early indications, we investigated the plasma vitamin B-12 status in association with bone mineral content (BMC) and bone mineral density (BMD) in frail elderly people. Data of 194 free-living Dutch frail elderly (143 women

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

    DEFF Research Database (Denmark)

    Knudstrup, Mary-Ann

    2011-01-01

    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-being el......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......-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...

  8. Development of radar-based system for monitoring of frail home-dwelling persons: A healthcare perspective

    Science.gov (United States)

    Sudmann, Tobba T.; Børsheim, Ingebjørg T.; Øvsthus, Knut; Ciamulski, Tomasz; Miękina, Andrzej; Wagner, Jakub; Mazurek, Paweł; Jacobsen, Frode F.

    2016-11-01

    This interdisciplinary project aims to develop and assess the functional potential of radar technology in the care services. The project mainly has an exploratory character where the technological and functional potential of impulse-radar sensor are tested out in monitoring of elderly and disabled people living in their own home. Designing a non-invasive system for monitoring of movements of frail persons living at home is the main goal, with the intent of assessing health and functional status through monitoring of activities of daily life (ADL) and detecting potentially dangerous situations, not the least related to a long lie following falls.

  9. Relationship between Coronary Risk Factors, C-Reactive Protein, Bone Mineral Density and Carotid Circulation Among Frail Elderly

    Directory of Open Access Journals (Sweden)

    Moatassem S. Amer1, Tamer M. Farid1, Ekrami E. Abdel-rahman1,

    2014-06-01

    Full Text Available Background: Frailty may now be regarded as a geriatric syndrome of decreased reserve and resistance to stressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability to adverse health outcomes including falls, hospitalisation, institutionalisation and mortality. The inflammatory mediators as C-reactive protein have been associated with the development of the geriatric frailty. Several studies have pointed out increased level of homocystiene in frail elderly Increasing frailty was associated with lower bone mineral density, as both bone mass and muscle strength decrease during ageing and this has also been associated with higher risk of osteoporotic fractures in frail elderly. Objective: To compare frail and non-frail elderly regarding Bone mineral density, carotid circulation and serum levels of Homocysteine, coronary risk factors and CRP. Methods: 104 elderly patients, who were assigned to 2 groups. Group A (52 frail participants: diagnosed by Fried’s criteria as applied by Avila-Funes et al., 2008. Group B (52 non-frail participants.All participants were subjected to the following: through history, physical examination, ADL, IADL assessment, MMSE ,GDS, laboratory investigations including; CRP, homocystiene and total lipid profile, measurement of bone mineral density by DEXA and carotid intima-media thickness by carotid duplex. Results: There was no statistically significant difference in age, sex, among both groups.Frail participants had higher ADL and IADL dependence, higher incidence of depression, cognitive impairment and osteoprosis.They also had higher levels of homocystiene , CRP , CIMT and lower levels of HDL cholesterol. Conclusion: Osteoporosis is more prevalent among frail elderly also frailty is associated with more ADL & IADL dependence, higher GDS scores & lower MMSE score in addition to higher mean level of homocystiene, CRP & triglycerides in addition to low serum HDL & higher CIMT

  10. 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

    age and frailty implies impressive and expressive challenges, the nursing assessment of basic needs requires well developed nursing skills to create a facilitating setting that involves the frail older person. The nurse elicits patiently the older person's voice, and listens empathically to piece...... if they are suffering from chronic diseases and complex functional impairments. A starting point for an exploration of this complexity is the identification of frail older persons' basic needs Aim: To explore the challenges in nursing assessment of basic needs when the older persons' frailty also implies impressive......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...

  11. [Relationships between nutritional status and the effects of exercise training in frail elderly people].

    Science.gov (United States)

    Arai, Takeshi; Obuchi, Shuichi

    2011-01-01

    The objectives of this study were to examine the relationship between nutritional status indicators such as body mass index (BMI) and serum albumin, and the effects of exercise intervention in community-dwelling frail elderly people. We enrolled 44 subjects aged 65 years and older (average age 73.9±5.1 years) in this study. The subjects participated in exercise intervention, including muscle strength training twice a week for 3 months. We evaluated various functional performance measures at the start and end of the intervention, and calculated the measurement differences. We then evaluated any relationships between nutritional status and the amount of changes. Some physical functions improved after exercise intervention, even in participants with under-nutritional status. There were no significant differences or relationships found between nutritional status and improvements in physical function. These results suggest that the physical functions of frail elderly people can improve regardless of their nutritional status. Further study is necessary to evaluate the influence of nutritional status on exercise effects, and the optimal method of applying exercise interventions, primarily for community-dwelling frail older people.

  12. 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

  13. DB 02-2 STRICT CONTROL OF HYPERTENSION IN THE FRAIL ELDERLY: IS IT BENEFICIAL? (CON).

    Science.gov (United States)

    Rakugi, Hiromi

    2016-09-01

    European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment. NICE guidelines at 2011 and guidelines by the American Society of Hypertension and the International Society of Hypertension at 2013 indicate similar target BP with ESH-ESC2013 on principle, although patients aged less than 80 years old are recommended elderly, such as subjects who are unable to accomplish 6 m walking. Regarding target BP, patients aged 65-74 years old are recommended reducing BPpeople including the elderly is elderly, or patients with LV hypertrophy, systolic or diastolic LV dysfunction, diabetes mellitus or chronic kidney disease depending on the results of randomized clinical trials (eg, Systolic Blood Pressure Intervention Trial [SPRINT]). SPRINT showed significant evidence that targeting SBP elderly and frail hypertensive patients.

  14. 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.

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

    Science.gov (United States)

    Hempenius, Liesbeth; Slaets, Joris P. J.; van Asselt, Dieneke; de Bock, Truuske H.; Wiggers, Theo; van Leeuwen, Barbara L.

    2016-01-01

    Background 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. Methods 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. Results 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). Conclusions 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. Trial Registration Nederlands Trial Register, Trial ID NTR 823

  16. [Securing the financing of care for the frail elderly: problems and solutions].

    Science.gov (United States)

    Theuws, A J; Paulus, A T G; van Steenkiste, B; Widdershoven, G A M; van der Weijden, T; Hobma, S O

    2014-04-01

    Projects within the Dutch National Program for Elderly Care (NPO) have been experimenting since 2008 to increase coherence in care for the frail elderly. Invest-NPO explored the problems and solutions to secure the financing of these innovative projects. Problems were expected with coordination because there was not yet a structural reimbursement for such an activity for the frail elderly. There where doubts about the adequacy of reimbursement for multidisciplinary consultation and certain structural conditions. The existing fragmentation across multiple domains and reimbursement rules made it difficult to achieve an integrated approach and creativeness in care. The principles of bundled payment can be helpful in problems concerning multidisciplinary consultation, structural conditions and coordination because joint agreements are needed. According to many, capitation is even a better solution if properly applied, because there are fewer boundaries in deciding how care is organized. Initiatives from entrepreneurs may represent first steps in the right direction. The findings of Invest-NPO may contribute to the development of further steps.

  17. Peer support via video-telephony among frail elderly people living at home.

    Science.gov (United States)

    Ezumi, Hiromichi; Ochiai, Noriko; Oda, Mikiko; Saito, Shigeko; Ago, Minae; Fukuma, Noriko; Takenami, Setsuko

    2003-01-01

    We evaluated the effect of a video-phone network on peer support among frail elderly people living at home. We conducted a one-year trial of network formation among 14 people (five men and nine women, age range 78-85 years) through coordinator intervention and the use of ISDN video-phones. The purpose of the intervention was to support and improve the functional independence of frail elderly people at home and to widen their social network. During the study, the subjects made 1400 video-calls, lasting a total of 25,867 min. One subject made no calls. There was greater use of video-phones by those living outside the central city area. Calls between men and women were infrequent. The men generally had shorter call times and made fewer calls. The participants could be categorized into three groups: those using video-phones every day; those using them once per week; and those using them once per month. All subjects in the first group clearly expressed their satisfaction with the video-phone. A video-phone network appears to be helpful for elderly people in their peer support relationships.

  18. Blood transfusion and overall quality of life after hip fracture in frail elderly patients--the transfusion requirements in frail elderly randomized controlled trial.

    Science.gov (United States)

    Gregersen, Merete; Borris, Lars Carl; Damsgaard, Else Marie

    2015-09-01

    We examined possible associations between different red blood cell (RBC) transfusion strategies, overall quality of life (OQoL), and recovery of activities of daily living (ADL) in operated frail elderly hip fracture patients, and the possibility that OQoL was related to ADL recovery. A prospective, assessor-blinded, randomized controlled trial was carried out among 157 elderly residents (≥65 years) from nursing homes and sheltered housing facilities with Mini-Mental State Examination scores ≥5 points. Patients were assigned to either a restrictive RBC transfusion strategy [hemoglobin (Hb) < 9.7 g/dL, 6 mmol/L] or a liberal strategy (Hb < 11.3 g/dL, 7 mmol/L) during the first 30 days after surgery. An interview-based questionnaire, the depression list (DL) assessing OQoL, and the modified Barthel Index (MBI) assessing ADL performance, were conducted on day 30 and 1 year after hip fracture surgery. Sum-scores of DL, MBI, and their changes from day 30 until 1 year (expressing recovery) were compared between RBC transfusion groups. Possible associations between changes of DL and MBI sum-scores were tested for across total patient population. There was no association between OQoL and RBC transfusion strategies on day 30 or at 1 year. The DL sum-score changes were similar for both groups, (ie, 1.06 points) [95% confidence interval (CI) -0.62, 2.76)] P = .21. The MBI sum-scores increased at 1 year following the liberal transfusion strategy (ie, by 6.86 points) (95% CI 0.41, 13.3) P = .03. Recoveries of OQoL and ADL were associated: β = -0.06 (95% CI -0.11, -0.01) P = .02. According to our Hb threshold criteria, OQoL and RBC transfusion strategies for frail elderly hip fracture patients are not associated. However, for survivors with less severe dementia, ADL recovery after 1 year is greater following a liberal transfusion strategy than a restrictive strategy. OQoL progress and ADL recovery were associated. Copyright © 2015 AMDA – The

  19. Antimicrobial treatment of bacterial infections in frail elderly patients: the difficult balance between efficacy, safety and tolerability.

    Science.gov (United States)

    Pea, Federico

    2015-10-01

    The elderly population is increasing worldwide and shows an increasing prevalence of frailty. Frailty is recognized as an important factor for inappropriate drug prescribing in elderly patients. Appropriate drug prescription, either in terms of drug choice or in terms of drug dosage, is of paramount importance among the frail elderly patients, this requiring the need of a difficult balance between efficacy, safety and tolerability. Bacterial infections are quite frequent among the elderly, and use of antimicrobials may be associated with severe adverse events in this population, especially when in presence of co-medications and/or of co-morbidities. The aim of this paper is to argue about the most recent published evidences on how to prevent major adverse events whenever antimicrobials should be co-prescribed in frail elderly patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation program?

    Directory of Open Access Journals (Sweden)

    Huang Allen R

    2010-11-01

    Full Text Available Abstract Background The optimal patient selection of frail elderly persons undergoing rehabilitation in Geriatric Day Hospital (GDH programs remains uncertain. This study was done to identify potential predictors of rehabilitation outcomes for these patients. Methods This study is a retrospective cohort analysis of patients admitted to the rehabilitation program of our GDH, in Montreal, Canada, over a five year period. The measures considered were: Barthel Index, Older Americans Resources and Services, Folstein Mini Mental Status Exam, Timed Up & Go (TUG, 6-minute walk test (6 MWT, Gait speed, Berg Balance, grip strength and the European Quality of life - 5 Dimensions. Successful improvement with rehabilitation was defined as improvement in three or more tests of physical function. Logistic regression analysis using the Bayesian Information Criterion (BIC was employed to select the optimal model for making predictions of rehabilitation success. Results A total of 335 patients were studied, but only 233 patients had a complete data set suitable for the predictive model. Average age was 81 years and patients attended the GDH an average of 24 visits. Significant changes were found in several measures of physical performance for many patients ranging from improved gait speed in 21.3% to improved TUG in 62.7% of the cohort. Fifty-eight percent of patients attained successful improvement with rehabilitation by our criteria. This group was characterized by lower test scores on admission. Using BIC, the best predictor model was the 6 MWT [OR: 0.994 per meter walked (95% CI: 0.990-0.997]. Conclusions The GDH rehabilitation program is effective in improving patients' physical performance. Although no single measure was found to be sufficiently predictive to help target candidates appropriately, the 6 MWT showed a trend to significance. Further research will be done to elucidate the utility of a composite 'rehab appropriateness index' and the role of

  1. Use of goal attainment scaling in measuring clinically important change in the frail elderly.

    Science.gov (United States)

    Rockwood, K; Stolee, P; Fox, R A

    1993-10-01

    The selection of appropriate outcome measures is important in evaluating specialized geriatric programs, but how the various measures compare, and which are most appropriate, are matters still largely unexplored. We compared several outcome measures, including goal attainment scaling, to assess their sensitivity to changes in the health status of frail elderly patients admitted to two geriatric medicine wards. GAS is a measurement approach which accommodates multiple individual patient goals, and has a scoring system which allows for comparisons between patients. Forty-five patients (mean age 81 years, 30 females) received comprehensive assessments. GAS yielded a mean 5 goals per patient. The mean gain in the GAS score was 22 points (SD = 7) which was compared with the change in the Barthel Index (r = 0.59), the Functional Independence Measure (r = 0.45), the Physical Self-Maintenance Scale (r = 0.54), the Katz Activities of Daily Living Index (r = 0.49) and the Spitzer Quality of Life Index (r = 0.38). The inter-rater reliability of scoring the GAS follow-up guides was 0.91. Using a relative efficiency statistic, GAS proved more efficient than any other measure. The effect size statistic also demonstrated an increased responsiveness to change of GAS compared with standard measures. GAS is an individualized measurement approach which shows promise as a responsive measure in frail elderly patients.

  2. Pro and con arguments in using alternative dialysis regimens in the frail and elderly patients.

    Science.gov (United States)

    Chazot, Charles; Farrington, Ken; Nistor, Ionut; Van Biesen, Wim; Joosten, Hanneke; Teta, Daniel; Siriopol, Dimitrie; Covic, Adrian

    2015-11-01

    In the last decade, an increasing number of patients over 75 years of age are starting renal replacement therapy. Frailty is highly prevalent in elderly patients with end-stage renal disease (ESRD) in the context of the increased prevalence of some ESRD-associated conditions: protein-energy wasting, inflammation, anaemia, acidosis or hormonal disturbances. There are currently no hard data to support guidance on the optimal duration of dialysis for frail/elderly ESRD patients. The current debate is not about starting dialysis or managing conservatory frail ESRD patients, but whether a more intensive regimen once dialysis is initiated (for whatever reasons and circumstances) would improve patients' outcome. The most important issue is that all studies performed with extended/alternative dialysis regimens do not specifically address this particular type of patients and therefore all the inferences are derived from the general ESRD population. Care planning should be responsive to end-of-life needs whatever the treatment modality. Care in this setting should focus on symptom control and quality of life rather than life extension. We conclude that, similar to the general dialysed population, extensive application of more intensive dialysis schedules is not based on solid evidence. However, after a thorough clinical evaluation, a limited period of a trial of intensive dialysis could be prescribed in more problematic patients.

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

    DEFF Research Database (Denmark)

    Hansen, Tina; Faber, Jens Oscar

    2012-01-01

    .0%). When adjusting for frailty status, difficulties in self-feeding and texture management were related to prolonged LOS, and difficulties in positioning and liquid ingestion were related to discharge to institutional care. Conclusion : Ingestive skill difficulties among acutely-hospitalized frail elderly...... patients were frequent and characterized by great complexity. This necessitates a broad range of management strategies related to the patients’ ability in positioning, self-feeding skills, as well as oropharyngeal sensorimotor skills. Read More: http://informahealthcare.com/doi/full/10.3109/02703181.2012.736019......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...

  4. Crossing boundaries: the design of an interdisciplinary training program to improve care for the frail elderly.

    Science.gov (United States)

    Kolomitro, Klodiana; Stockley, Denise; Egan, Rylan; MacDonald, Michelle L

    2015-01-01

    The Technology Evaluation in the Elderly Network (TVN) was funded in July 2012 under the Canadian Networks of Centres of Excellence program. This article highlights the development and preliminary evaluation of the TVN Interdisciplinary Training Program. This program is based on an experiential learning approach that crosses a multitude of disciplines including health sciences, law, social sciences, and ethical aspects of working with the frail elderly. Opportunities within the program include mentorship, interdisciplinary online collaborative projects, external placements, academic products, pre-grant submission, trainee-driven requirements, Network meetings, online modules/webinars, and most importantly active involvement with patients, families, and their support systems. The authors have 120 trainees from approximately 23 different disciplines including law, ethics, public policy, social work, and engineering engaged in the program. Based on our evaluation this program has been perceived as highly valuable by the participants and the community.

  5. 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

    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...... trial (GERICO) is designed to investigate whether comprehensive geriatric assessment and intervention before and during treatment with chemotherapy in frail elderly patients with stages II-IV CRC will increase the number of patients completing chemotherapy. All patients ≥70 years in whom chemotherapy...... 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...

  6. 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

  7. 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

    disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged...

  8. A Study of Teleconferencing as a Medium for Improving the Quality of Life of the Frail Elderly.

    Science.gov (United States)

    Swindell, Rick; And Others

    Two studies were carried out in 1991-92 in Brisbane, Australia on the effects on frail elderly people of cognitive challenge by teleconference. In the first study, 20 residents of aged care centers watched specified programs on television. Later, they discussed the content over the telephone using conference link equipment. The study found that…

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

    NARCIS (Netherlands)

    Schoone, M.; Dusseldorp, E.; Akker-van Marle, M.E. van den; Doornebosch, A.J.; Bal, R.; Meems, A.; Oderwald, M.P.; Balen, R. van

    2011-01-01

    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 nursi

  10. 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 physic

  11. The Israeli Long-Term Care Insurance Law: selected issues in providing home care services to the frail elderly.

    Science.gov (United States)

    Schmid, Hillel

    2005-05-01

    The paper describes and analyses selected issues related to the provision of home care services to frail elderly people following the Israeli Long-Term Care Insurance Law (1988). The goals and principles of the Law, which mandates the provision of home care services to frail elderly people, are presented. The paper also evaluates its contribution toward enhancing the well-being of elderly clients. Several major dilemmas that arose following implementation of the Law are analysed and evaluated in comparison with other countries that have enacted and implemented similar laws. These dilemmas are community vs institutional care; services in kind vs monetary allowances; service provision through contracting out with nongovernmental agencies; unstable and unskilled labour force; and service quality. Finally, policy implications are discussed, mainly in the following areas: investment in human resources as a condition for achieving high service quality, and the need for coordination between the agencies that provide long-term care services to elderly people.

  12. Design of a randomized controlled study of a multi-professional and multidimensional intervention targeting frail elderly people

    Directory of Open Access Journals (Sweden)

    Gosman-Hedström Gunilla

    2011-05-01

    Full Text Available Abstract Background Frail elderly people need an integrated and coordinated care. The two-armed study "Continuum of care for frail elderly people" is a multi-professional and multidimensional intervention for frail community-dwelling elderly people. It was designed to evaluate whether the intervention programme for frail elderly people can reduce the number of visits to hospital, increase satisfaction with health and social care and maintain functional abilities. The implementation process is explored and analysed along with the intervention. In this paper we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. Methods/design The study is a randomised two-armed controlled trial with follow ups at 3, 6 and 12 months. The study group includes elderly people who sought care at the emergency ward and discharged to their own homes in the community. Inclusion criteria were 80 years and older or 65 to 79 years with at least one chronic disease and dependent in at least one activity of daily living. Exclusion criteria were acute severely illness with an immediate need of the assessment and treatment by a physician, severe cognitive impairment and palliative care. The intention was that the study group should comprise a representative sample of frail elderly people at a high risk of future health care consumption. The intervention includes an early geriatric assessment, early family support, a case manager in the community with a multi-professional team and the involvement of the elderly people and their relatives in the planning process. Discussion The design of the study, the randomisation procedure and the protocol meetings were intended to ensure the quality of the study. The implementation of the intervention programme is followed and analysed throughout the whole study, which enables us to generate knowledge on the process of implementing complex interventions. The

  13. Experience with dedicated geriatric surgical consult services: Meeting the need for surgery in the frail elderly

    Directory of Open Access Journals (Sweden)

    Rosemarie E Hardin

    2009-01-01

    Full Text Available Rosemarie E Hardin1, Thierry Le Jemtel2, Michael E Zenilman11Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA; 2Department of Medicine, Tulane Medical Center, New Orleans, LA, USABackground: Surgeons are increasingly faced with consultation for intervention in residents of geriatric centers or in patients who suffer from end stage medical disease. We review our experience with consult services dedicated to the needs of these frail patients.Study design: Patients were prospectively followed after being evaluated by three different geriatric surgical consult services: Group 1 was based at a geriatric center associated with a tertiary medical center, Group 2 was based at a community geriatric center, and Group 3 was based with an hospital-based service for ambulatory patients with end stage congestive heart failure.Results: A total of 256 frail elderly patients underwent of 311 general surgical procedures ranging from major abdominal and vascular procedures to minor procedures such as debridement of decubitus ulcers, long-term intravenous access, enterostomy and enteral tube placement. Almost half of the surgical volume in Group 1 and 3 were ‘maintenance’ (decubitus debridement, long term intravenous or stomal or tube care; all of Group 2 were for treatment of decubiti. There was minimal morbidity and mortality from surgery itself, and overall one year survival for Groups 1, 2, and 3 was 46%, 60%, and 79%, respectively. Multivariate analysis showed that each group had its own unique indicators of decreased survival: Group 1 dementia and coronary artery disease, in Group 2 gender and coronary artery disease, and Group 3, gender alone. Age, number of comorbid illnesses, and type of surgery (major vs minor were not significant indicators.Conclusions: This is the first review of the role of dedicated surgical consult services which focused on residents of geriatric centers and frail elderly. Conditions routinely encountered

  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.

    2015-01-01

    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. Financing long-term care for frail elderly in France: the ghost reform.

    Science.gov (United States)

    Chevreul, Karine; Berg Brigham, Karen

    2013-08-01

    Like many welfare states, France is faced with increasing demand for long term care (LTC) services. Public LTC coverage has evolved over the past 15 years, reaching a coverage depth of 70%. Nonetheless, it does not provide adequate and equitable financial protection for the growing number of frail elderly individuals, who are expected to constitute 3% of the population by the year 2060. Since 2005, various financing reform proposals have been debated, ranging from a newly covered risk under the social security system to targeted subsidies for private LTC insurance. However, to date no reform measure has been enacted. This article provides a brief history of publicly financed LTC in France in order to provide a context for the ongoing debate, including the positions and relative political power of the various stakeholders and the doubtful short-term prospect for reform.

  16. A communication framework for dialysis decision-making for frail elderly patients.

    Science.gov (United States)

    Schell, Jane O; Cohen, Robert A

    2014-11-07

    Frail elderly patients with advanced kidney disease experience many of the burdens associated with dialysis. Although these patients constitute the fastest-growing population starting dialysis, they often suffer loss of functional status, impaired quality of life, and increased mortality after dialysis initiation. Nephrology clinicians face the challenges of helping patients decide if the potential benefits of dialysis outweigh the risks and preparing such patients for future setbacks. A communication framework for dialysis decision-making that aligns treatment choices with patient goals and values is presented. The role of uncertainty is highlighted, and the concept of a goal-directed care plan is introduced. This plan incorporates a time-limited trial that promotes frequent opportunities for reassessment. Using the communication skills presented, the clinician can prepare and guide patients for the dialysis trajectory as it unfolds.

  17. 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

  18. Neuromuscular electrical stimulation leads to physiological gains enhancing postural balance in the pre-frail elderly.

    Science.gov (United States)

    Mignardot, Jean-Baptiste; Deschamps, Thibault; Le Goff, Camille G; Roumier, François-Xavier; Duclay, Julien; Martin, Alain; Sixt, Marc; Pousson, Michel; Cornu, Christophe

    2015-07-01

    Physiological aging leads to a progressive weakening of muscles and tendons, thereby disturbing the ability to control postural balance and consequently increasing exposure to the risks of falls. Here, we introduce a simple and easy-to-use neuromuscular electrical stimulation (NMES) training paradigm designed to alleviate the postural control deficit in the elderly, the first hallmarks of which present as functional impairment. Nine pre-frail older women living in a long-term care facility performed 4 weeks of NMES training on their plantarflexor muscles, and seven nontrained, non-frail older women living at home participated in this study as controls. Participants were asked to perform maximal voluntary contractions (MVC) during isometric plantarflexion in a lying position. Musculo-tendinous (MT) stiffness was assessed before and after the NMES training by measuring the displacement of the MT junction and related tendon force during MVC. In a standing position, the limit of stability (LoS) performance was determined through the maximal forward displacement of the center of foot pressure, and related postural sway parameters were computed around the LoS time gap, a high force requiring task. The NMES training induced an increase in MVC, MT stiffness, and LoS. It significantly changed the dynamics of postural balance as a function of the tendon property changes. The study outcomes, together with a multivariate analysis of investigated variables, highlighted the benefits of NMES as a potential tool in combating neuromuscular weakening in the elderly. The presented training-based strategy is valuable in alleviating some of the adverse functional consequences of aging by directly acting on intrinsic biomechanical and muscular properties whose improvements are immediately transferable into a functional context.

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

    Energy Technology Data Exchange (ETDEWEB)

    Mc Laughlin, Patrick; Mc Sweeney, Sean; Mc Williams, Sebastian; O' Regan, Kevin; Kelly, Denis; Maher, Michael M. [Cork University Hospital, Department of Radiology, Cork (Ireland); Eustace, Joseph; O' Connor, Michael [Cork University Hospital, Department of Medicine, Cork (Ireland)

    2010-03-15

    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. Patients aged over 70 years considered at risk of complication during SPS-MC administration by a physician specialised in care of the elderly were included in this retrospective study. Biochemical parameters pre- and post-CTC and the presence of co-morbidities were recorded. Imaging findings and quality of bowel preparation at CTC were graded by consensus by two radiologists. Of the 72 patients 56% had co-morbidities that caution the use of SPS-MC. No significant changes in serum urea, sodium, potassium or estimated glomerular filtration rate (eGFR) occurred post-CTC (p > 0.10). Serum magnesium increased by 0.11 mmol/L in 14 patients (p = 0.03) without clinical sequelae. Good overall preparation was achieved in 88% of patients, allowing confident identification of signs of colonic neoplasia in 20 patients (27%). A mild increase in serum magnesium but no other significant biochemical disturbance was observed. In our group CTC with SPS-MC was safe and effective; however, we advise an alternate preparation be considered in patients with decreased renal function due to decreased magnesium clearance. (orig.)

  20. 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.

  1. 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

    2016-01-01

    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. PMID:27746669

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. [End-of-life care in emergency settings in the super-aged society: withholding CPR from frail elderly with severe ADL impairment].

    Science.gov (United States)

    Aita, Kaoruko

    2013-06-01

    Emergency and intensive care unit demographics have changed with the advent of the super-aged society in Japan. Japan has the highest population aging rate in the world. It is now predicted that an increasing number of people will die at higher age. The oldest old individuals show increasing frailty, with an excess vulnerability to stressors. It is believed that frail elderly would receive limited benefit from highly invasive emergency treatment and advanced intensive care which, on the contrary, could bring about harmful effects on frail elderly. So far a number of frail oldest-old nursing home residents with cardiopulmonary arrest have been taken by ambulance to emergency medical centers to receive cardio-pulmonary resuscitation in vain in Japan. Now is the time to stop the harmful ritual. Withholding CPR from frail elderly with severe ADL impairment would not constitute an act of ageism but the act of humanity based on medical evidence.

  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. Nutrition and aging: assessment and treatment of compromised nutritional status in frail elderly patients.

    Science.gov (United States)

    Wells, Jennie L; Dumbrell, Andrea C

    2006-01-01

    Nutrition is an important determinant of health in persons over the age of 65. Malnutrition in the elderly is often underdiagnosed. Careful nutritional assessment is necessary for both the successful diagnosis and development of comprehensive treatment plans for malnutrition in this population. The purpose of this article is to provide clinicians with an educational overview of this essential but often underecognized aspect of geriatric assessment. This article will review some common issues in nutrition for the elderly in both hospital and community settings. The complexity and impact of multiple comorbidities on the successful nutritional assessment of elderly patients is highlighted by using case scenarios to discuss nutritional issues common to elderly patients and nutritional assessment tools. Three case studies provide some context for an overview of these issues, which include the physiology of aging, weight loss, protein undernutrition, impaired cognition, malnutrition during hospitalization, screening procedures, and general dietary recommendations for patients 65 years of age and older.

  10. Caring for the frail elderly at home: toward a theoretical explanation of the dynamics of poor quality family caregiving.

    Science.gov (United States)

    Phillips, L R; Rempusheski, V F

    1986-07-01

    Using the grounded theory approach, 39 family caregivers were theoretically sampled using newspaper advertising to explore their perceptions of providing home care for frail elders and to generate a theoretical model that describes the dynamics of good quality and poor quality family caregiving; explains the relationships among certain contextual and perceptual variables and the behaviors exchanged by elders and caregivers; and identifies points where interventions by nurses could be effective. The model consists of five constructs that were identified from the data and were staged within the framework provided by symbolic interactionism and social exchange theory. The five constructs and two related driving forces provide a partial explanation for the quality of family caregiving and a beginning explanation for the phenomenon of elder abuse.

  11. Positive effects of resistance training in frail elderly patients with dementia after long-term physical restraint.

    Science.gov (United States)

    Cadore, Eduardo L; Moneo, Ana B Bays; Mensat, Marta Martinez; Muñoz, Andrea Rozas; Casas-Herrero, Alvaro; Rodriguez-Mañas, Leocadio; Izquierdo, Mikel

    2014-04-01

    This study investigated the effects of a multicomponent exercise intervention on muscle strength, incidence of falls and functional outcomes in frail elderly patients with dementia after long-term physical restraint, followed by 24 weeks of training cessation. Eighteen frail elderly patients with mild dementia (88.1 ± 5.1 years) performed a multicomponent exercise program, which consisted of 4 weeks of walking, balance and cognitive exercises, followed by 4 weeks of resistance exercise performed twice weekly [8-12 repetitions at 20-50 % of the one-repetition maximum (1RM)], combined with walking, balance and cognitive exercises. Before and after training, as well as after 24 weeks of training cessation, strength outcomes, Barthel Index, balance, gait ability, rise from a chair ability, dual task performance, incidence of falls and Mini-Mental State Examination were assessed. After the first 4 weeks of training, there was a significant improvement only in the balance test, whereas no additional changes were observed. However, after the second part of the training, the participants required significantly less time for the time-up-and-go test (P < 0.05), and improved the isometric hand grip, hip flexion and knee extension strength, as well as the leg press 1RM (P < 0.01). A significant reduction was also observed in the incidence of falls (P < 0.01). After 24 weeks of training cessation, abrupt decreases were observed in nearly all of the physical outcomes (P < 0.05). The exercise intervention improved strength, balance and gait ability in frail elderly patients with dementia after long-term physical restraint, and these benefits were lost after training cessation.

  12. A philosophical analysis of the concept empowerment; the fundament of an education-programme to the frail elderly.

    Science.gov (United States)

    Hage, Anne Merete; Lorensen, Margarethe

    2005-10-01

    The word 'empowerment' has become a popular term, widely used as an important claim, also within the health services. In this paper the concept's philosophical roots are traced from Freire and his 'Pedagogy of the Oppressed' to the philosophical thoughts of Hegel, Habermas, and Sartre. An understanding of the concept, as a way to facilitate coping and well-being in patients through reflection and dialogue, emerges. Within an empowerment strategy the important claim on the nurse and the patient will be to reveal the patient's own resources and limitations in times with sickness and reduced functionality to promote the patient's choice to act and cope. From this point of view an education-programme for the frail elderly is outlined. If the nurse wants to empower the elderly patient she has to be willing to be educated through the dialogue with the patient, and to look for the patient's own meaning of being frail and elderly. The coping and self-care solutions for the patient may then even be different from the preferences of the nurse, and this does not mean that the empowerment strategy is a failure or that the patient then has to continue without the assistance from the nurse. Within an empowerment strategy, in the Freirerian sense, the important thing is that both the patient and the nurse together critically reflect on the meanings of the sickness so that the patient can be able to make his own conscious choices.

  13. Effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly: secondary analysis of a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    van de Rest, Ondine; van der Zwaluw, Nikita L; Tieland, Michael; Adam, Jos J; Hiddink, Gert Jan; van Loon, Luc J C; de Groot, Lisette C P G M

    2014-01-01

    Physical activity has been proposed as one of the most effective strategies to prevent cognitive decline. Protein supplementation may exert an additive effect. The effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly people was assessed in a secondary analysis. Two 24-week, double-blind, randomized, placebo-controlled intervention studies were carried out in parallel. Subjects performed a resistance-type exercise program of two sessions per week (n=62) or no exercise program (n=65). In both studies, subjects were randomly allocated to either a protein (2×15 g daily) or a placebo drink. Cognitive functioning was assessed with a neuropsychological test battery focusing on the cognitive domains episodic memory, attention and working memory, information processing speed, and executive functioning. In frail and pre-frail elderly, resistance-type exercise training in combination with protein supplementation improved information processing speed (changes in domain score 0.08±0.51 versus -0.23±0.19 in the non-exercise group, p=0.04). Exercise training without protein supplementation was beneficial for attention and working memory (changes in domain scores 0.35±0.70 versus -0.12±0.69 in the non-exercise group, p=0.02). There were no significant differences among the intervention groups on the other cognitive tests or domain scores.

  14. 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.

  15. 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.

  16. 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

    NARCIS (Netherlands)

    W.M. Looman (Willemijn); I.N. Fabbricotti (Isabelle); R. Huijsman (Robbert)

    2014-01-01

    markdownabstract__Abstract__ 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 w

  17. Gender issues and Japanese family-centered caregiving for frail elderly parents or parents-in-law in modern Japan: From the sociocultural and historical perspectives

    OpenAIRE

    2000-01-01

    This paper presents a sociocultural and historical literature review of gender related issues associated with family-centered caregiving for frail, elderly relatives in modern Japan. Issues addressed from a Japanese perspective are (a) women and social norms of caregiving, (b) feminine identity and caregiving, (c) women in the workforce, and (d) women and caregiving. Implications for research are also discussed.

  18. 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

  19. Gender issues and Japanese family-centered caregiving for frail elderly parents or parents-in-law in modern Japan: from the sociocultural and historical perspectives.

    Science.gov (United States)

    Hashizume, Y

    2000-01-01

    This paper presents a sociocultural and historical literature review of gender related issues associated with family-centered caregiving for frail, elderly relatives in modern Japan. Issues addressed from a Japanese perspective are (a) women and social norms of caregiving, (b) feminine identity and caregiving, (c) women in the workforce, and (d) women and caregiving. Implications for research are also discussed.

  20. Personality in recovered depressed elderly.

    Science.gov (United States)

    Schneider, L S; Zemansky, M F; Bender, M; Sloane, R B

    1992-01-01

    Personality traits in euthymic elderly subjects with and without past histories of major depressive episodes were assessed using the Structured Clinical Interview for DSM-III-R and the Social Adjustment Scale-SR. Recovered depressed subjects were characterized by significantly more personality traits from DSM-III-R Clusters B and C than controls, and they exhibited differences in social adjustment, as well. Subjects who have recovered from depressive episodes may show significant differences in personality and social adjustment that might represent residua of past depression, a trait characteristic, or a risk factor for recurrence.

  1. 'Start to finish trans-institutional transdisciplinary care': a novel approach improves colorectal surgical results in frail elderly patients.

    Science.gov (United States)

    Chia, C L K; Mantoo, S K; Tan, K Y

    2016-01-01

    The frail elderly surgical patient is at increased risk of morbidity after major surgery. A transdisciplinary Geriatric Surgery Service (GSS) has been shown to produce consistently positive results in our institution. A trans-institutional transdisciplinary Start to Finish (STF) programme was initiated incorporating seamless prehabilitation and rehabilitation to enhance the outcome further. Patients who underwent major colorectal resection in Khoo Teck Puat Hospital and were managed under the GSS from January 2007 to December 2014 were included in this prospective study. The STF programme was initiated from January 2012. The surgical outcome of patients managed under the GSS before the initiation of STF was compared with that after its implementation. There were 57 patients after the initiation of the STF programme compared with 60 patients managed before STF. There were 26.4% and 25% of frail patients in the STF group compared with the non-STF group (P = 0.874). The mean length of hospital stay was significantly shorter in the STF group (8.4 days vs 11.0 days, P = 0.029). Functional recovery in patients available for follow-up at 6 weeks showed 100% (46/46) recovery in the elective STF group who received prehabilitation and 95.7% (45/47) in the elective non-STF group who did not (P = 0.157). There were no significant differences in a Clavien-Dindo complication score of Grade 3 or more and 30-day mortality between the two groups. Through a trans-institutional transdisciplinary approach, we managed to achieve a significantly shorter hospital stay in frail patients having colorectal surgery. All elective patients who received prehabilitation achieved full functional recovery. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  2. Depression among caregivers of the frail elderly in Japan before and after the introduction of the Public Long-Term Care Insurance System.

    Science.gov (United States)

    Oura, A; Washio, M; Arai, Y; Ide, S; Yamasaki, R; Wada, J; Kuwahara, Y; Mori, M

    2007-04-01

    Cross sectional studies were conducted in five towns in Japan before and after the introduction of the Long-term Care Insurance System (LTCIS), in order to evaluate the factors relating to depression among family caregivers for the frail elderly. Depressive caregivers were more likely to consult with their doctors, to be in poor health, to care for demented elderly with behavioral disturbances than the non-depressive caregivers both before and after the LTCIS. Before LTCIS, depressive caregivers were more likely to attend to the elderly for more than 16 hours per day than their counterparts. After the LTCIS, depressive caregivers were more likely to be a spouse, to care for a frail elderly male, and less likely to be able to go out without accompanying the elderly than their counterparts. Even after the introduction of LTCIS, half of the caregivers were depressive. It is suggested that a government agency should be created to support not only the frail elderly but also their caregivers.

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

    OpenAIRE

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

    2015-01-01

    Background 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. Objective Our objectives are to (1) develop a technological solution designed to support active aging of frail olde...

  4. 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.

  5. 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

    . 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...... reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives...

  6. 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

    . 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...... reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives...

  7. 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)

  8. Evaluation of a technology-enhanced integrated care model for frail older persons: protocol of the SPEC study, a stepped-wedge cluster randomized trial in nursing homes.

    Science.gov (United States)

    Kim, Hongsoo; Park, Yeon-Hwan; Jung, Young-Il; Choi, Hyoungshim; Lee, Seyune; Kim, Gi-Soo; Yang, Dong-Wook; Paik, Myunghee Cho; Lee, Tae-Jin

    2017-04-18

    Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate. The multifaceted SPEC intervention, a geriatric care model guided by the chronic care model, consists of five components: comprehensive geriatric assessment for need/risk profiling, individual need-based care planning, interdisciplinary case conferences, person-centered care coordination, and a cloud-based information and communications technology (ICT) tool supporting the intervention process. The primary outcome is quality of care for older residents using a composite measure of quality indicators from the interRAI LTCF assessment system. Outcome assessors and data analysts will be blinded to group assignment. Secondary outcomes include quality of life, healthcare utilization, and cost. Process evaluation will be also conducted. This study is expected to provide important new evidence on the effectiveness, cost-effectiveness, and implementation process of an ICT-supported chronic care model for older persons with multiple chronic illnesses. The SPEC intervention is also unique as the first registered trial implementing an integrated care model using technology to promote person-centered care for frail older nursing home residents in South Korea, where formal LTC was recently introduced. ISRCTN11972147.

  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

    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 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). Conclusion 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

  10. Postoperative red blood cell transfusion strategy in frail anemic elderly with hip fracture. A randomized controlled trial.

    Science.gov (United States)

    Gregersen, Merete

    2016-04-01

    Hip fracture in the elderly is associated with poor recovery from physical disability and mortality. Perioperative blood loss is common, and anemia might be fatal in the frail elderly. Red blood cell transfusions might increase the risk of infection. In an observational study, a liberal transfusion strategy with hemoglobin (Hb) target of 7 mmol/l (11.3 g/dl) seemed to improve survival in nursing home residents with hip fracture compared to the recommended restrictive strategy with a Hb target of 6 mmol/l (9.7 g/dl) according to the Danish Health Authority. Our aim was to compare these two strategies in the frail elderly in a randomized controlled trial on the outcomes: recovery from physical disabilities, mortality, infection, infection biomarkers, and overall Quality of Life (OQoL). We included 284 elderly admitted to hospital for surgical hip fracture repair from nursing homes or sheltered housing facilities. The anemic patients were assigned postoperatively to the liberal or the restrictive transfusion strategy. Randomization divided each transfusion group into two equal blocks with regard to type of the residence. Hb was measured daily during the first three postoperative days, at least once during the following 4-6 days, then at least once a week during the subsequent three weeks. The transfusions were administered according to group assignments, but no later than 24 hours after the Hb determination, one unit at a time, and no more than two units per day. The intervention lasted for 30 days after surgery. Outcome measurements were performed on days 10, 30, 90, and 365. Blinded assessors evaluated physical performance and OQoL. The liberal transfusion strategy did not improve recovery from physical disabilities, mortality, infection rate, or OQoL compared to the restrictive strategy. However, in nursing home residents, 90-day mortality rate (20%) following the liberal strategy was statistically significantly lower than that (36%) after the restrictive strategy

  11. The CareWell-primary care program: design of a cluster controlled trial and process evaluation of a complex intervention targeting community-dwelling frail elderly

    Directory of Open Access Journals (Sweden)

    Ruikes Franca GH

    2012-12-01

    Full Text Available Abstract Background With increasing age and longevity, the rising number of frail elders with complex and numerous health-related needs demands a coordinated health care delivery system integrating cure, care and welfare. Studies on the effectiveness of such comprehensive chronic care models targeting frail elders show inconclusive results. The CareWell-primary care program is a complex intervention targeting community-dwelling frail elderly people, that aims to prevent functional decline, improve quality of life, and reduce or postpone hospital and nursing home admissions of community dwelling frail elderly. Methods/design The CareWell-primary care study includes a (cost- effectiveness study and a comprehensive process evaluation. In a one-year pragmatic, cluster controlled trial, six general practices are non-randomly recruited to adopt the CareWell-primary care program and six control practices will deliver ‘care as usual’. Each practice includes a random sample of fifty frail elders aged 70 years or above in the cost-effectiveness study. A sample of patients and informal caregivers and all health care professionals participating in the CareWell-primary care program are included in the process evaluation. In the cost-effectiveness study, the primary outcome is the level of functional abilities as measured with the Katz-15 index. Hierarchical mixed-effects regression models / multilevel modeling approach will be used, since the study participants are nested within the general practices. Furthermore, incremental cost-effectiveness ratios will be calculated as costs per QALY gained and as costs weighed against functional abilities. In the process evaluation, mixed methods will be used to provide insight in the implementation degree of the program, patients’ and professionals’ approval of the program, and the barriers and facilitators to implementation. Discussion The CareWell-primary care study will provide new insights into the (cost

  12. Evidence summary: why is access to dental care for frail elderly people worse than for other groups?

    Science.gov (United States)

    Caines, Beth

    2010-02-13

    In August 2009, members of the newly redeveloped Primary Care Dentistry Research Forum (http://www.dentistryresearch.org) took part in an online vote to identify questions in day-to-day practice that they felt most needed to be answered with conclusive research. The question which received the most votes formed the subject of a critical appraisal of the relevant literature. Each month a new round of voting will take place to decide which further questions will be reviewed. Dental practitioners and dental care professionals are encouraged to take part in the voting and submit their own questions to be included in the vote by joining the website.This paper details a summary of the findings of the first critical appraisal. In conclusion, the critical appraisal has identified that primary research is needed to look at the subject of access to dental care for frail elderly people. Similar barriers to accessing care for this group of people are still being reported today as they were 20 years ago.

  13. 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

  14. The impact of protein supplementation on cognitive performance in frail elderly

    NARCIS (Netherlands)

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

    2014-01-01

    Purpose Maintenance of cognitive abilities is important for elderly to stay independent. With the aging of the population, the call for modifiable factors is emerging. Dietary protein might improve cognitive performance; however, this has hardly been studied. Therefore, we studied the impact of 24-w

  15. Pro and con arguments in using alternative dialysis regimens in the frail and elderly patients

    NARCIS (Netherlands)

    Chazot, Charles; Farrington, Ken; Nistor, Ionut; Van Biesen, Wim; Joosten, Hanneke; Teta, Daniel; Siriopol, Dimitrie; Covic, Adrian

    2015-01-01

    In the last decade, an increasing number of patients over 75 years of age are starting renal replacement therapy. Frailty is highly prevalent in elderly patients with end-stage renal disease (ESRD) in the context of the increased prevalence of some ESRD-associated conditions: protein-energy wasting,

  16. 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.

  17. 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. T

  18. Effects and feasibility of exercise therapy combined with branched-chain amino acid supplementation on muscle strengthening in frail and pre-frail elderly people requiring long-term care: a crossover trial.

    Science.gov (United States)

    Ikeda, Takashi; Aizawa, Junya; Nagasawa, Hiroshi; Gomi, Ikuko; Kugota, Hiroyuki; Nanjo, Keigo; Jinno, Tetsuya; Masuda, Tadashi; Morita, Sadao

    2016-04-01

    This study examined the effects and feasibility of a twice-weekly combined therapy of branched-chain amino acids (BCAAs) and exercise on physical function improvement in frail and pre-frail elderly people requiring long-term care. We used a crossover design in which the combination of exercise and nutritional interventions was carried out twice a week during cycles A (3 months) and B (3 months) and the exercise intervention alone was performed during the washout period. The exercise intervention entailed the following 5 training sets: 3 sets of muscle training at 30% of maximum voluntary contraction, 1 set of aerobic exercise, and 1 set of balance training. For the nutritional intervention, 6 g of BCAAs or 6 g of maltodextrin was consumed 10 min before starting the exercise. We determined upper and lower limb isometric strength, performance on the Functional Reach Test (FRT) and the Timed Up and Go test, and activity level. In the comparison between the BCAA group and the control group after crossover, the improvement rates in gross lower limb muscle strength (leg press, knee extension) and FRT performance were significantly greater (by approximately 10%) in the BCAA group. In the comparison between different orders of BCAA administration, significant effects were shown for the leg press in both groups only when BCAAs were given. The combination of BCAA intake and exercise therapy yielded significant improvements in gross lower limb muscle strength and dynamic balance ability.

  19. 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 required

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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

  2. Minimal-preparation abdomino-pelvic CT in frail and elderly patients: prognostic value of colonic and extracolonic findings

    Energy Technology Data Exchange (ETDEWEB)

    Ng, C.S. [Department of Radiology, University of Texas M.D. Anderson Cancer Center, Houston (United States)], E-mail: cng@mdanderson.org; Wei, W. [Departments of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston (United States); Doyle, T.C. [Department of Medicine, University of Otago, Dunedin (New Zealand); Courtney, H.M.; Dixon, A.K.; Freeman, A.H. [Department of Radiology, Cambridge University, Teaching Hospitals NHS Foundation Trust, Cambridge (United Kingdom)

    2008-04-15

    Aim: To examine the overall survival of patients who had had been referred for minimal preparation abdomino-pelvic computed tomography (MPCT), and to assess the prognostic value of the colonic and extracolonic findings detected. Methods and materials: The survival of a cohort of 1029 elderly and frail patients, with clinical symptoms and signs suspicious for colorectal cancer (CRC), who had undergone MPCT between 1995 and 1998 was investigated. Univariate and multivariate survival analyses were undertaken according to the presence of CRC and extracolonic abnormalities (ECA). Results: The median age of the 1029 patients was 79.4 years. The overall median survival following MPCT was 5.4 years; and 6.6 years if no abnormality was detected. On multivariate analysis, age, sex, CRC status, and number of ECAs were significant factors in overall survival. Median survival for those with confirmed CRC [n = 91 (prevalence, 8.8%)] was 1.1 years, compared with 5.9 years without CRC (p < 0.0001); and 2.4 years for those with one or more ECA [n = 245 (prevalence, 23.8%)], compared with 6.1 years without ECA (p < 0.0001). Survival was progressively shorter for increasing numbers of ECAs; and shorter for previously unknown non-CRC malignancies (n = 24) compared with CRC (p < 0.0001). Conclusions: MPCT appears to have prognostic potential in this patient population, with significant reductions in survival if a CRC or ECA is detected. The detection of ECA would appear to have at least as important an impact on the usefulness of the examination as the detection of CRC.

  3. 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.

  4. Qualitative study on the impact of falling in frail older persons and family caregivers: foundations for an intervention to prevent falls.

    NARCIS (Netherlands)

    Faes, M.C.; Reelick, M.F; Joosten-Weyn Banningh, L.W.A.; Gier, M.; Esselink, R.A.J.; Olde Rikkert, M.G.M.

    2010-01-01

    OBJECTIVES: The primary aim of this study was to explore the impact of falling for frail community-dwelling older persons with and without cognitive impairments who have experienced a recent fall and their primary family caregivers. The secondary aim was to define components for a future fall

  5. 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.

    2011-01-01

    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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Development of quality indicators for monitoring outcomes of frail elderly hospitalised in acute care health settings: Study Protocol

    OpenAIRE

    Travers Catherine M; Morris John N; Jones Richard N; Wright Olivia; Martin-Khan Melinda; Brand Caroline A; Tropea Joannne; Gray Leonard C

    2011-01-01

    Abstract Background Frail older people admitted to acute care hospitals are at risk of a range of adverse outcomes, including geriatric syndromes, although targeted care strategies can improve health outcomes for these patients. It is therefore important to assess inter-hospital variation in performance in order to plan and resource improvement programs. Clinical quality outcome indicators provide a mechanism for identifying variation in performance over time and between hospitals, however to...

  11. Effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly: Secondary analysis of a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

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

    2014-01-01

    Physical activity has been proposed as one of the most effective strategies to prevent cognitive decline. Protein supplementation may exert an additive effect. The effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail

  12. Effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly: Secondary analysis of a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

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

    2014-01-01

    Physical activity has been proposed as one of the most effective strategies to prevent cognitive decline. Protein supplementation may exert an additive effect. The effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elde

  13. [Coordination in case management practices in the context of integrated home care networks devoted to the frail elderly, a qualitative exploratory analysis].

    Science.gov (United States)

    Carrier, Sébastien

    2013-09-01

    The objective of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, we describe practical coordination processes. We conducted a qualitative exploratory study using an embedded case study design. Our study covers three health and social service centers in Québec. We noted that coordination produces convention in case management practices through a process of bringing together different types of compromise in home care situations where multidimensionality appears to be more or less important. We constructed four different types of compromise-producing convention with regard to coordination in case management practices: compromise at the interface, scheduling compromise, compromise of opportunity, and compromising change.

  14. The predictive validity of three self-report screening instruments for identifying frail older people in the community

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    Daniels Ramon

    2012-01-01

    Full Text Available Abstract Background If brief and easy to use self report screening tools are available to identify frail elderly, this may avoid costs and unnecessary assessment of healthy people. This study investigates the predictive validity of three self-report instruments for identifying community-dwelling frail elderly. Methods This is a prospective study with 1-year follow-up among community-dwelling elderly aged 70 or older (n = 430 to test sensitivity, specificity, and positive and negative predicted values of the Groningen Frailty Indicator, Tilburg Frailty Indicator and Sherbrooke Postal Questionnaire on development of disabilities, hospital admission and mortality. Odds ratios were calculated to compare frail versus non-frail groups for their risk for the adverse outcomes. Results Adjusted odds ratios show that those identified as frail have more than twice the risk (GFI, 2.62; TFI, 2.00; SPQ, 2,49 for developing disabilities compared to the non-frail group; those identified as frail by the TFI and SPQ have more than twice the risk of being admitted to a hospital. Sensitivity and specificity for development of disabilities are 71% and 63% (GFI, 62% and 71% (TFI and 83% and 48% (SPQ. Regarding mortality, sensitivity for all tools are about 70% and specificity between 41% and 61%. For hospital admission, SPQ scores the highest for sensitivity (76%. Conclusion All three instruments do have potential to identify older persons at risk, but their predictive power is not sufficient yet. Further research on these and other instruments is needed to improve targeting frail elderly.

  15. The effect of exercise intervention on frail elderly in need of care: half-day program in a senior day-care service facility specializing in functional training

    Science.gov (United States)

    Sakamoto, Ryota; Miura, Yasushi

    2016-01-01

    [Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care. PMID:27512243

  16. 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

  17. 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 < 0.05). After 3 mo, participants in the LD + MCT group had a 13.1% increase in right-hand grip strength (1.2 ± 1.0 kg, P < 0.01), a 12.5% increase in walking speed (0.078 ± 0.080 m/s, P < 0.05), a 68.2% increase in a 10-s leg open-and-close test performance (2.31 ± 1.68 n/10 s, P < 0.001), and a 28.2% increase in peak expiratory flow (53 ± 59 L/min, P < 0.01). No significant improvements in muscle mass, strength, or function were observed in the LD + LCT or control groups. The combined supplementation of MCTs (6 g), leucine-rich amino acids, and cholecalciferol at dinner may improve muscle strength and function in frail elderly individuals. This trial was registered at the University Hospital Medical Information Network Clinical Trials Registry as UMIN000017567. © 2016 American Society for Nutrition.

  18. The cost-effectiveness of a new disease management model for frail elderly living in homes for the elderly, design of a cluster randomized controlled clinical trial

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    Ribbe Miel W

    2008-07-01

    Full Text Available Abstract Background The objective of this article is to describe the design of a study to evaluate the clinical and economic effects of a Disease Management model on functional health, quality of care and quality of life of persons living in homes for the elderly. Methods This study concerns a cluster randomized controlled clinical trial among five intervention homes and five usual care homes in the North-West of the Netherlands with a total of over 500 residents. All persons who are not terminally ill, are able to be interviewed and sign informed consent are included. For cognitively impaired persons family proxies will be approached to provide outcome information. The Disease Management Model consists of several elements: (1 Trained staff carries out a multidimensional assessment of the patients functional health and care needs with the interRAI Long Term Care Facilities instrument (LTCF. Computerization of the LTCF produces immediate identification of problem areas and thereby guides individualized care planning. (2 The assessment outcomes are discussed in a Multidisciplinary Meeting (MM with the nurse, primary care physician, nursing home physician and Psychotherapist and if necessary other members of the care team. The MM presents individualized care plans to manage or treat modifiable disabilities and risk factors. (3 Consultation by an nursing home physician and psychotherapist is offered to the frailest residents at risk for nursing home admission (according to the interRAI LTCF. Outcome measures are Quality of Care indicators (LTCF based, Quality Adjusted Life Years (Euroqol, Functional health (SF12, COOP-WONCA, Disability (GARS, Patients care satisfaction (QUOTE, hospital and nursing home days and mortality, health care utilization and costs. Discussion This design is unique because no earlier studies were performed to evaluate the effects and costs of this Disease Management Model for disabled persons in homes for the elderly on

  19. The cost-effectiveness of a new disease management model for frail elderly living in homes for the elderly, design of a cluster randomized controlled clinical trial.

    Science.gov (United States)

    Boorsma, Marijke; van Hout, Hein P J; Frijters, Dinnus H; Ribbe, Miel W; Nijpels, Giel

    2008-07-07

    The objective of this article is to describe the design of a study to evaluate the clinical and economic effects of a Disease Management model on functional health, quality of care and quality of life of persons living in homes for the elderly. This study concerns a cluster randomized controlled clinical trial among five intervention homes and five usual care homes in the North-West of the Netherlands with a total of over 500 residents. All persons who are not terminally ill, are able to be interviewed and sign informed consent are included. For cognitively impaired persons family proxies will be approached to provide outcome information. The Disease Management Model consists of several elements: (1) Trained staff carries out a multidimensional assessment of the patients functional health and care needs with the interRAI Long Term Care Facilities instrument (LTCF). Computerization of the LTCF produces immediate identification of problem areas and thereby guides individualized care planning. (2) The assessment outcomes are discussed in a Multidisciplinary Meeting (MM) with the nurse, primary care physician, nursing home physician and Psychotherapist and if necessary other members of the care team. The MM presents individualized care plans to manage or treat modifiable disabilities and risk factors. (3) Consultation by an nursing home physician and psychotherapist is offered to the frailest residents at risk for nursing home admission (according to the interRAI LTCF). Outcome measures are Quality of Care indicators (LTCF based), Quality Adjusted Life Years (Euroqol), Functional health (SF12, COOP-WONCA), Disability (GARS), Patients care satisfaction (QUOTE), hospital and nursing home days and mortality, health care utilization and costs. This design is unique because no earlier studies were performed to evaluate the effects and costs of this Disease Management Model for disabled persons in homes for the elderly on functional health and quality of care. TRAIL

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

    DEFF Research Database (Denmark)

    Esbensen, Bente Appel; Thomé, Bibbi

    2010-01-01

    The aim of the study was to illuminate the experience of life as next of kin to an elderly person with cancer.......The aim of the study was to illuminate the experience of life as next of kin to an elderly person with cancer....

  1. A person-centred segmentation study in elderly care: towards efficient demand-driven care.

    Science.gov (United States)

    Eissens van der Laan, M R; van Offenbeek, M A G; Broekhuis, H; Slaets, J P J

    2014-07-01

    Providing patients with more person-centred care without increasing costs is a key challenge in healthcare. A relevant but often ignored hindrance to delivering person-centred care is that the current segmentation of the population and the associated organization of healthcare supply are based on diseases. A person-centred segmentation, i.e., based on persons' own experienced difficulties in fulfilling needs, is an elementary but often overlooked first step in developing efficient demand-driven care. This paper describes a person-centred segmentation study of elderly, a large and increasing target group confronted with heterogeneous and often interrelated difficulties in their functioning. In twenty-five diverse healthcare and welfare organizations as well as elderly associations in the Netherlands, data were collected on the difficulties in biopsychosocial functioning experienced by 2019 older adults. Data were collected between March 2010 and January 2011 and sampling took place based on their (temporarily) living conditions. Factor Mixture Model was conducted to categorize the respondents into segments with relatively similar experienced difficulties concerning their functioning. First, the analyses show that older adults can be empirically categorized into five meaningful segments: feeling vital; difficulties with psychosocial coping; physical and mobility complaints; difficulties experienced in multiple domains; and feeling extremely frail. The categorization seems robust as it was replicated in two population-based samples in the Netherlands. The segmentation's usefulness is discussed and illustrated through an evaluation of the alignment between a segment's unfulfilled biopsychosocial needs and current healthcare utilization. The set of person-centred segmentation variables provides healthcare providers the option to perform a more comprehensive first triage step than only a disease-based one. The outcomes of this first step could guide a focused and

  2. 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.

  3. The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly

    NARCIS (Netherlands)

    Boshuizen, H.C.; Stemmerik, L.; Westhoff, M.H.; Hopman-Rock, M.

    2005-01-01

    Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 N · m were randomized to different versions of a strength-training program for the knee-extensors: to a high-guidance group (HG; two group sessions supervised by a physical therapist and o

  4. Prediction of early mortality following hip fracture surgery in frail elderly : The Almelo Hip Fracture Score (AHFS)

    NARCIS (Netherlands)

    Nijmeijer, W. S.; Folbert, E. C.; Vermeer, M.; Slaets, J. P.; Hegeman, J. H.

    2016-01-01

    Background: Hip fractures are common in the elderly and have a high risk of early mortality. Identification of patients at high risk of early mortality could contribute to enhanced quality of care. A simple scoring system is essential for preoperative identification of patients at high risk of early

  5. The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study

    Directory of Open Access Journals (Sweden)

    Leung DYP

    2015-02-01

    ward group showed a greater significant reduction in the number of unplanned emergency hospital readmissions (-1.41±1.23 versus -0.77±1.31; P=0.049 and a significant improvement in their overall QOL (n=18; 0.60±0.56 versus 0.07±0.56; P=0.02, but there was no significant difference in the number of emergency attendances (-1.51±1.25 versus -1.08±1.48; P=0.29.Conclusion: The study results support the effectiveness of the virtual ward service in reducing unplanned emergency medical readmissions and in improving the QOL in frail older patients after discharge. Keywords: elderly, emergency attendance, emergency medical readmission, emergency services utilization, quality of life, virtual ward

  6. Serum anticholinergic activity and cerebral cholinergic dysfunction: An EEG study in frail elderly with and without delirium

    Directory of Open Access Journals (Sweden)

    Driessen Martin

    2008-09-01

    Full Text Available Abstract Background Delirium increases morbidity, mortality and healthcare costs especially in the elderly. Serum anticholinergic activity (SAA is a suggested biomarker for anticholinergic burden and delirium risk, but the association with cerebral cholinergic function remains unclear. To clarify this relationship, we prospectively assessed the correlation of SAA with quantitative electroencephalography (qEEG power, delirium occurrence, functional and cognitive measures in a cross-sectional sample of acutely hospitalized elderly (> 80 y with high dementia and delirium prevalence. Methods 61 consecutively admitted patients over 80 years underwent an extensive clinical and neuropsychological evaluation. SAA was determined by using radio receptor assay as developed by Tune, and standard as well as quantitative EEGs were obtained. Results 15 patients had dementia with additional delirium (DD according to expert consensus using DSM-IV criteria, 31 suffered from dementia without delirium (D, 15 were cognitively unimpaired (CU. SAA was clearly detectable in all patients but one (mean 10.9 ± 7.1 pmol/ml, but was not associated with expert-panel approved delirium diagnosis or cognitive functions. Delirium-associated EEG abnormalities included occipital slowing, peak power and alpha decrease, delta and theta power increase and slow wave ratio increase during active delirious states. EEG measures correlated significantly with cognitive performance and delirium severity, but not with SAA levels. Conclusion In elderly with acute disease, EEG parameters reliable indicate delirium, but SAA does not seem to reflect cerebral cholinergic function as measured by EEG and is not related to delirium diagnosis.

  7. [Urinary function integrity in the elderly person].

    Science.gov (United States)

    Roy, O; Rancourt, K

    1998-01-01

    How can nurses help preserve the integrity of elimination in the elderly? Further, what new perspectives must they bring to practice? First, health professionals must rid themselves of their misconceptions, especially the belief that incontinence is "normal" in the aging process. The authors provide avenues for reflection and action, with a view to arriving at a dynamic clinical practice focusing on quality of life and the well-being of the individual. In terms of new perspectives, nurses are encouraged to stop limiting themselves to assisting with personal hygiene because this deprives the client of possible recourse to a better adaptation. Nurses must no longer dispense comfort by reassuring the incontinent person that "there's no harm done". This message ignores the real-life experience associated with the problem and reinforces the idea of normality. Assessment of the client's condition must go beyond the superficial and instead target interventions that lead to a resolution. Updating the caregiver's and the client's knowledge, enhancing the nurse's role in prevention and treatment, combining various approaches to care and improving communication are good places to start.

  8. Development of quality indicators for monitoring outcomes of frail elderly hospitalised in acute care health settings: Study Protocol

    Directory of Open Access Journals (Sweden)

    Travers Catherine M

    2011-10-01

    Full Text Available Abstract Background Frail older people admitted to acute care hospitals are at risk of a range of adverse outcomes, including geriatric syndromes, although targeted care strategies can improve health outcomes for these patients. It is therefore important to assess inter-hospital variation in performance in order to plan and resource improvement programs. Clinical quality outcome indicators provide a mechanism for identifying variation in performance over time and between hospitals, however to date there has been no routine use of such indicators in acute care settings. A barrier to using quality indicators is lack of access to routinely collected clinical data. The interRAI Acute Care (AC assessment system supports comprehensive geriatric assessment of older people within routine daily practice in hospital and includes process and outcome data pertaining to geriatric syndromes. This paper reports the study protocol for the development of aged care quality indicators for acute care hospitals. Methods/Design The study will be conducted in three phases: 1. Development of a preliminary inclusive set of quality indicators set based on a literature review and expert panel consultation, 2. A prospective field study including recruitment of 480 patients aged 70 years or older across 9 Australian hospitals. Each patient will be assessed on admission and discharge using the interRAI AC, and will undergo daily monitoring to observe outcomes. Medical records will be independently audited, and 3. Analysis and compilation of a definitive quality indicator set, including two anonymous voting rounds for quality indicator inclusion by the expert panel. Discussion The approach to quality indicators proposed in this protocol has four distinct advantages over previous efforts: the quality indicators focus on outcomes; they can be collected as part of a routinely applied clinical information and decision support system; the clinical data will be robust and will

  9. 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....... SETTING: Two urban districts of Gothenburg, Sweden. PARTICIPANTS: Four hundred fifty-nine communityliving adults aged 80 and older not dependent on the municipal home help service. INTERVENTION: A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit...... dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated. CONCLUSION: Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention...

  10. 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.

  11. Functional Capacity, Muscle Fat Infiltration, Power Output, and Cognitive Impairment in Institutionalized Frail Oldest Old

    Science.gov (United States)

    Casas-Herrero, Alvaro; Cadore, Eduardo L.; Zambom-Ferraresi, Fabricio; Idoate, Fernando; Millor, Nora; Martínez-Ramirez, Alicia; Gómez, Marisol; Rodriguez-Mañas, Leocadio; Marcellán, Teresa; de Gordoa, Ana Ruiz; Marques, Mário C.

    2013-01-01

    Abstract This study examined the neuromuscular and functional performance differences between frail oldest old with and without mild cognitive impairment (MCI). In addition, the associations between functional capacities, muscle mass, strength, and power output of the leg muscles were also examined. Forty-three elderly men and women (91.9±4.1 years) were classified into three groups—the frail group, the frail with MCI group (frail+MCI), and the non-frail group. Strength tests were performed for upper and lower limbs. Functional tests included 5-meter habitual gait, timed up-and-go (TUG), dual task performance, balance, and rise from a chair ability. Incidence of falls was assessed using questionnaires. The thigh muscle mass and attenuation were assessed using computed tomography. There were no differences between the frail and frail+MCI groups for all the functional variables analyzed, except in the cognitive score of the TUG with verbal task, which frail showed greater performance than the frail+MCI group. Significant associations were observed between the functional performance, incidence of falls, muscle mass, strength, and power in the frail and frail+MCI groups (r=−0.73 to r=0.83, p<0.01 to p<0.05). These results suggest that the frail oldest old with and without MCI have similar functional and neuromuscular outcomes. Furthermore, the functional outcomes and incidences of falls are associated with muscle mass, strength, and power in the frail elderly population. PMID:23822577

  12. Sepsis in frail patient

    Directory of Open Access Journals (Sweden)

    Andrea Beltrame

    2016-12-01

    Full Text Available Frailty is defined as a clinical syndrome in which three or more of the following criteria are present: unintentional weight loss, self-reported exhaustion, weakness (grip strength, slow walking speed and low physical activity. Sepsis is defined as an inflammatory response to infection, with severe sepsis and septic shock being the most severe forms. The incidence of severe sepsis increases with older age and several studies have shown that there are many risk factors that predispose the elderly to a higher incidence of sepsis. Pre-existing co-morbidities such as cancer, diabetes, obesity, human immunodeficiency virus, and renal or pulmonary disease can cause sepsis, but other factors including poor lifestyle habits (i.e., smoking, drug or alcohol abuse, malnutrition, and endocrine deficiencies, which are frequent in the elderly, may also predispose to severe infections. Other risk factors for sepsis include recurrent hospitalization, especially in the Intensive Care Unit, and nursing home residence, where interventions such as urinary catheterization or multiple drug use are quite frequent and many studies reported that people above 65 years of age are three times more likely to be admitted to hospital than those aged 16-64 years, and have a higher risk of prolonged hospital stays, institutionalization and death. Clinical evaluation of the frail patient with sepsis poses some challenges. The immune response becomes progressively less efficient with increasing age thereby causing an altered response to infection and it is important to know that the clinical evaluation of the so-called fragile patient with severe infection should take into account the sometimes unusual signs and symptoms that, if identified, can lead to early diagnosis. Laboratory diagnostics can also be of great help in this setting. The treatment of sepsis in the fragile patient can be empirical or based on microbiological culture. Moreover, frail patient population presents

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

    NARCIS (Netherlands)

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

    2017-01-01

    Objective: 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

  14. Functional Capacity, Muscle Fat Infiltration, Power Output, and Cognitive Impairment in Institutionalized Frail Oldest Old

    OpenAIRE

    Casas-Herrero, Alvaro; Eduardo L. Cadore; Zambom-Ferraresi, Fabricio; Idoate, Fernando; Millor, Nora; Martínez-Ramirez, Alicia; Gómez, Marisol; Rodriguez-Mañas, Leocadio; Marcellán, Teresa; de Gordoa, Ana Ruiz; Mário C. Marques; Izquierdo, Mikel

    2013-01-01

    This study examined the neuromuscular and functional performance differences between frail oldest old with and without mild cognitive impairment (MCI). In addition, the associations between functional capacities, muscle mass, strength, and power output of the leg muscles were also examined. Forty-three elderly men and women (91.9±4.1 years) were classified into three groups—the frail group, the frail with MCI group (frail+MCI), and the non-frail group. Strength tests were performed for upper ...

  15. Occupational Role Performance and Life Satisfaction in Elderly Persons.

    Science.gov (United States)

    Elliott, Marjorie S.; Barris, Roann

    1987-01-01

    The authors examined the relationship between the number and meaningfulness of roles performed and life satisfaction in a sample of 112 noninstitutionalized elderly persons. Results suggest a positive, significant relationship between life satisfaction and the number of roles performed and the level of involvement in meaningful roles. (Author/CH)

  16. The Meaning of Cherished Personal Possessions for the Elderly

    Science.gov (United States)

    Sherman, Edmund; Newman, Evelyn S.

    1977-01-01

    In this exploratory study, 94 elderly persons, in seven senior service centers and one nursing home, were interviewed to identify and ascertain the meaning of cherished possessions in later years. Lack of cherished possessions was associated with low life satisfaction scores, a suggested indicator of poor adjustment to old age. (Author)

  17. 447 Clothing for Elderly Persons: Management and Caring Strategies

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... so, the need and desire for food, and probably for fashion. The taste and choice of clothing among the elderly is believed to be tied with the individual .... other factors, this disease could cause a person to become so insensitive to ... location of older people and the role of consumer culture in age identities.

  18. 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...

  19. Video Surveillance System for Elderly Person Living Alone by Person Tracking and Fall Detection

    Science.gov (United States)

    Doi, Motonori; Inoue, Hiroshi; Aoki, Yutaro; Oshiro, Osamu

    The detection of accidents on elderly person living alone and the communication between the elderly person and his/her family are very important. This paper describes a new method for tracking and fall detection of elderly person using omni-directional image sensor, and the Itawari-kan communication system that supports their communications and gives alarms for detected accidents on the elderly person. This system tracks the person's head position in real-time by image processing on images captured by some omni-directional image sensor. Then, the system transmits the information of the detected head position to another site. The computer of recipient site generates the computer graphics animation of the tracked person and displays the animation on a monitor. When the system detects an accident from the head position, the system gives an alarm. This method reduces traffic on network and keeps the privacy for the tracked person. We made a prototype system of the Itawari-kan communication system. Experiments on the system showed good feasibility of the proposed system.

  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 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. A phase 2 study of three low-dose intensity subcutaneous bortezomib regimens in elderly frail patients with untreated multiple myeloma.

    Science.gov (United States)

    Larocca, A; Bringhen, S; Petrucci, M T; Oliva, S; Falcone, A P; Caravita, T; Villani, O; Benevolo, G; Liberati, A M; Morabito, F; Montefusco, V; Passera, R; De Rosa, L; Omedé, P; Vincelli, I D; Spada, S; Carella, A M; Ponticelli, E; Derudas, D; Genuardi, M; Guglielmelli, T; Nozzoli, C; Aghemo, E; De Paoli, L; Conticello, C; Musolino, C; Offidani, M; Boccadoro, M; Sonneveld, P; Palumbo, A

    2016-06-01

    This phase 2 trial evaluated three low-dose intensity subcutaneous bortezomib-based treatments in patients ⩾75 years with newly diagnosed multiple myeloma (MM). Patients received subcutaneous bortezomib plus oral prednisone (VP, N=51) or VP plus cyclophosphamide (VCP, N=51) or VP plus melphalan (VMP, N=50), followed by bortezomib maintenance, and half of the patients were frail. Response rate was 64% with VP, 67% with VCP and 86% with VMP, and very good partial response rate or better was 26%, 28.5% and 49%, respectively. Median progression-free survival was 14.0, 15.2 and 17.1 months, and 2-year OS was 60%, 70% and 76% in VP, VCP, VMP, respectively. At least one drug-related grade ⩾3 non-hematologic adverse event (AE) occurred in 22% of VP, 37% of VCP and 33% of VMP patients; the discontinuation rate for AEs was 12%, 14% and 20%, and the 6-month rate of toxicity-related deaths was 4%, 4% and 8%, respectively. The most common grade ⩾3 AEs included infections (8-20%), and constitutional (10-14%) and cardiovascular events (4-12%); peripheral neuropathy was limited (4-6%). Bortezomib maintenance was effective and feasible. VP, VCP and VMP regimens demonstrated no substantial difference. Yet, toxicity was higher with VMP, suggesting that a two-drug combination followed by maintenance should be preferred in frail patients.

  2. [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.

  3. 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.

  4. A mobile phone-based Communication Support System for elderly persons.

    Science.gov (United States)

    Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Caldwell, W Morton

    2007-01-01

    A mobile phone-based communication support system has been developed for assisting elderly people to communicate by mobile phone. The system consists of a low power mobile phone (PHS phone) having a large liquid crystal screen. When an elderly person telephones, they then choose a communication person from registered support personnel pictures displayed on the liquid crystal screen. The PHS phone dials that person automatically. The elderly person can therefore easily recognize and verify the person. The newly-developed communication support system assists a significant percentage of elderly people with poor eyesight and memory, which frequently cause communication problems, such as dialing a wrong number.

  5. [The profile of fragility and associated factors among the elderly registered in a Family Health Unit].

    Science.gov (United States)

    Santos, Patrícia Honório Silva; Fernandes, Marcos Henrique; Casotti, Cezar Augusto; Coqueiro, Raildo da Silva; Carneiro, José Ailton Oliveira

    2015-06-01

    The scope of this study was to identify the profile of fragility and associated factors among the elderly registered in a Family Health Unit. It involved an observational, exploratory, household -based and cross-sectional study conducted with 139 elderly individuals. The data were collected using a structured questionnaire requesting the following information: personal history, family and self-reported diseases, socio-demographic information, level of physical activity, behavior variables, number of falls in the last year, depressive symptoms, unintentional weight loss and fatigue. Anthropometric measurements (weight and height) were also taken and the body mass index (BMI) was calculated. Descriptive analyses and Pearson's chi-square test or Fisher's exact test were performed, with a significance level of p fragility among the elderly was: frail (16.9%), pre-frail (61.8%) and non-frail (21.3%), respectively. The fragility profile was associated with: age (p factors associated with this syndrome.

  6. La valoración geriátrica integral en el anciano frágil hospitalizado: revisión sistemática Comprehensive geriatric assessment in the frail elderly hospitalized: systematic revision

    Directory of Open Access Journals (Sweden)

    Engracia Fernández

    2013-03-01

    Full Text Available Introducción: el envejecimiento poblacional y la dependencia son términos de mucha preocupación en los países desarrollados. La atención hospitalaria al paciente anciano mediante el modelo tradicional no permite abordar todos sus problemas. La atención a este tipo de pacientes requiere de un instrumento que contemple su estado de salud físico, funcional, social y mental. Las evidencias científicas y los expertos sanitarios coinciden en que la valoración geriátrica integral (VGI es la herramienta básica y fundamental en la priorización de problemas e intervención en la atención al anciano frágil y geriátrico. Objetivo: describir y analizar los componentes de la valoración geriátrica integral en el ámbito sanitario para mejorar la detección y prevención del declive funcional en el anciano frágil hospitalizado. Método: este estudio se lleva a cabo mediante una revisión bibliográfica en las principales bases de datos: PubMed, Cochrane Library, Joanna Brings, Cinahl, Cuiden, Cuidatge, Lilacs, IME, Enfispo, en el periodo de diciembre del 2009 a enero del 2012. Conclusiones: la revisión bibliográfica demuestra la utilidad de la VGI en la atención al paciente frágil. La enfermera, como parte del equipo interdisciplinar y como gestora directa de los cuidados, requiere de formación específica para proporcionar la mejor calidad asistencial.Background: population aging and dependency are terms of great concern in developed countries. Hospital care for elderly patients using the traditional model can not address all their problems. Attention to this type of patient requires an instrument providing for their physical health status, functional, social and mental health. The scientific evidence and health experts agree that the Comprehensive Geriatric Assessment (CGA is the basic and fundamental tool in the prioritization of problems and intervention for the care of frail elderly and geriàtric patients. Objective: to describe and

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

    NARCIS (Netherlands)

    Weening-Dijksterhuis, Elizabeth; Greef, E. de; Krijnen, W.; Schans, C.P. van der

    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 adj

  8. 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

  9. First-line single-agent panitumumab in frail elderly patients with wild-type KRAS metastatic colorectal cancer and poor prognostic factors: A phase II study of the Spanish Cooperative Group for the Treatment of Digestive Tumours.

    Science.gov (United States)

    Sastre, J; Massuti, B; Pulido, G; Guillén-Ponce, C; Benavides, M; Manzano, J L; Reboredo, M; Rivera, F; Grávalos, C; Safont, M J; Martínez Villacampa, M; Llovet, P; Dotor, E; Díaz-Rubio, E; Aranda, E

    2015-07-01

    Frail elderly patients with metastatic colorectal cancer (mCRC) are not candidates for chemotherapy. Monotherapy with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies may be an option for these patients with few systemic toxic effects. Single-arm, multicentre, phase II trial including patients ⩾ 70y ears with wild-type (WT) KRAS (exon 2) mCRC, Eastern Cooperative Oncology Group (ECOG) status ⩽ 3, KPC (Köhne Prognostic Classification)--defined intermediate or high risk status, frailty and/or ineligibility for chemotherapy. Patients received panitumumab until progression or unacceptable toxicity. The primary end-point was progression free survival (PFS) rate at 6 months. The study included 33 patients (intention-to-treat (ITT) population). Median age: 81 years; sex: 66.7% male; high-risk KPC status: 45.4%. Median treatment duration was 14 weeks and 6-month PFS rate was 36.4% (95% confidence interval (CI): 20.0-52.8). The objective response rate: 9.1% (95% CI: 0-18.9) (all partial responses), and there were 18 stable diseases (54.5%). Median PFS was 4.3 months (95% CI: 2.8-6.4) and median overall survival (OS) was 7.1 months (95% CI: 5.0-12.3). There were no deaths or grade 4-5 adverse events (AEs) related to panitumumab and the most common grade 3-related AE was rash acneiform (15.2%). A significant association between clinical response and RAS status was observed (P=0.037). In the WT RAS subgroup (WT exons 2, 3, and 4 of KRAS and NRAS, N = 15), 6-month PFS rate was 53.3% (95% CI: 30.1-75.2) and median PFS and OS were 7.9 and 12.3 months, respectively. Single-agent panitumumab is active and well tolerated and may be a therapeutic option for high-risk frail elderly patients with WT RAS tumours considered not candidates for chemotherapy (clinicaltrials.gov identifier NCT01126112). Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Effect (Comparison between Elderly Person and Youth) of the Break in the Touch Typing Learning Comparison

    OpenAIRE

    Yamaguchi Yumi

    2016-01-01

    The technical education using the information appliance of the old worker is required. However, an elderly person is negative about the utilization of the information appliance. I experimented on, this study about an appropriate break to suppress fatigue of the elderly person, and to learn a touch typing technology effectively and made it clear. The experiment performed two kinds of touch typing learning by the Computer Based Training software. I performed an experiment of elderly person and ...

  11. 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

  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 p

  13. Elder Disability as an Explanation for Racial Differences in Informal Home Care

    Science.gov (United States)

    Li, Lydia W.; Fries, Brant E.

    2005-01-01

    Purpose: Adjusting for sociodemographic characteristics and disability levels, this study examines whether differences exist in the structure and function of community-dwelling Black and White frail elders' informal care networks. Design and Methods: Data from in-person assessments of Michigan's Home and Community-Based Medicaid Waiver applicants…

  14. 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

  15. 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 f

  16. Fostering Insight into Personal Conceptions of the Elderly: A Simulation Exercise.

    Science.gov (United States)

    Wight, Randall D.

    1989-01-01

    Describes a class in human development where students took on roles of the elderly by simulating physical constraints and aging. Depicts their reactions to the conditions and behaviors of the elderly. Allows students to examine their personal conceptions of the elderly. Finds study fostered empathy with senior adults. (Author/NL)

  17. 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

    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......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...... 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...

  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 st

  19. 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

  20. Effectiveness of an Innovative Pulsed Electromagnetic Fields Stimulation in Healing of Untreatable Skin Ulcers in the Frail Elderly: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Fabio Guerriero

    2015-01-01

    Full Text Available Introduction. Recalcitrant skin ulcers are a major burden in elderly patients. Specifically, chronic wounds result in significant morbidity and mortality and have a profound economic impact. Pulsed electromagnetic fields (PEMFs have proved to be a promising therapy for wound healing. Here we describe the first reported case of an innovative PEMF therapy, Emysimmetric Bilateral Stimulation (EBS, used to successfully treat refractory skin ulcers in two elderly and fragile patients. Case Presentation. Two elderly patients developed multiple chronic skin ulcerations. Despite appropriate treatment, the ulcers showed little improvement and the risk of amputation was high. Both patients underwent daily EBS therapy and standard dressing. After few weeks of treatment, major improvements were observed and all ulcers had healed. Conclusion. In patients with refractory ulceration, EBS therapy may be of real benefit in terms of faster healing. This case supports the supportive role for PEMFs in the treatment of skin ulceration in diabetes and is suggestive of a potential benefit of EBS in this clinical condition.

  1. 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.

  2. 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...

  3. Memory complaints and test performance in healthy elderly persons

    Directory of Open Access Journals (Sweden)

    Mattos Paulo

    2003-01-01

    Full Text Available In order to compare the use of a structured self-report questionnaire with direct questioning about memory problems, 71 healthy and independent aged individuals (63 women from the community without risk factors for cognitive deficits were objectively asked about subjective memory complaints (SMC, given the Memory Complaint Questionnaire (MAC-Q and then submitted to the Rey Auditory Verbal Learning Test (RAVLT. SMC positively correlated with higher scores on MAC-Q, although a significant percentage of the sample had SMC and lower scores on MAC-Q and also no SMC and higher scores on MAC-Q. Performance on RAVLT was significantly worse (p<0.05 for the group presenting SMC but not for the group with higher scores on the MAC-Q. We conclude that direct questioning maybe more clinically significant than a self report questionnaire, at least for elderly persons from the community without risk factors for cognitive decline or depression.

  4. Dialysis or conservative care for frail older patients: ethics of shared decision-making.

    Science.gov (United States)

    Muthalagappan, Seetha; Johansson, Lina; Kong, Wing May; Brown, Edwina A

    2013-11-01

    Increasing numbers of frail elderly with end-stage renal disease (ESRD) and multiple comorbidities are undertaking dialysis treatment. This has been accompanied by increasing dialysis withdrawal, thus warranting investigation into why this is occurring and whether a different approach to choosing treatment should be implemented. Despite being a potentially life-saving treatment, the physical and psychosocial burdens associated with dialysis in the frail elderly usually outweigh the benefits of correcting uraemia. Conservative management is less invasive and avoids the adverse effects associated with dialysis, but unfortunately it is often not properly considered until patients withdraw from dialysis. Shared decision-making has been proposed to allow patients active participation in healthcare decisions. Through this approach, patients will focus on their personal values to receive appropriate treatment, and perhaps opt for conservative management. This may help address the issue of dialysis withdrawal. Moreover, shared decision-making attempts to resolve the conflict between autonomy and other ethical principles, including physician paternalism. Here, we explore the ethical background behind shared decision-making, and whether it is genuinely in the patient's best interests or whether it is a cynical solution to encourage more patients to consider conservative care, thus saving limited resources.

  5. Association of personality traits with elder self-neglect in a community-dwelling population.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

    2011-08-01

    Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are as follows: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Population-based study conducted from 1993 to 2005 of community-dwelling older adults (N = 9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N = 1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity, and information processing. Logistic and linear regressions were used to assess these associations. In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Neuroticism, extraversion, rigidity, and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders.

  6. Association of Personality Traits with Elder Self-Neglect in a Community Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

    2010-01-01

    Objective Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Methods Population-based study conducted from 1993–2005 of community-dwelling older adults (N=9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N=1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity and information processing. Logistic and linear regressions were used to assess these associations. Results In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Conclusion Neuroticism, extraversion, rigidity and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders. PMID:21788924

  7. Improving Decision making On Location of Care with the frail Elderly and their caregivers (the DOLCE study): study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Légaré, France; Brière, Nathalie; Stacey, Dawn; Bourassa, Henriette; Desroches, Sophie; Dumont, Serge; Fraser, Kimberly; Freitas, Adriana; Rivest, Louis-Paul; Roy, Lise

    2015-02-12

    One of the toughest decisions faced by elderly people is whether to stay at home or move to a care facility. This study seeks to evaluate the impact of training interprofessional home-care teams in shared decision making combined with a decision aid on the proportion of elderly people who report being active in the decision-making process regarding whether to stay at home or move to a care facility. We propose a multicenter cluster randomized trial conducted with home-care interprofessional teams in the Province of Quebec with 2 data collection phases: before and after the intervention. Units of randomization will be centers for primary healthcare and social services. We will enroll 16 of these and ask each to provide one home-care interprofessional team involved in decisions and care planning with eligible clients. Clients will be included if they i) are aged ≥65; ii) are receiving care from the participating home-care interprofessional team; iii) have faced the decision about staying at home or moving to a care facility in the past 3 to 6 months; iv) are able to read, understand and write French or English; and v) are able to give informed consent. If clients are unable to provide informed consent, their primary caregiver who was involved in the decision-making process will be eligible to participate. The intervention arm will receive training in shared decision making and use of a decision aid. The control arm will receive 'usual care'. The primary outcome of interest is the assumed role in the decision-making process as assessed in clients or caregivers with a modified version of the Control Preferences Scale. Multilevel modeling will be used to take the hierarchical structure of the data into account. The study has obtained full ethical approval. The trial will comply with CONSORT guidelines adapted for cluster randomized trials. Home care is a rapidly growing sector and this study will lay the foundations of a national strategy to ensure that IP home

  8. Improvement in appearance of colors for elderly persons using lightness transform

    Science.gov (United States)

    Ueda, Chiaki; Azetsu, Tadahiro; Suetake, Noriaki; Uchino, Eiji

    2016-09-01

    The color of an object appears to be different for elderly and young persons. This is because human visual features vary with on age. In general, the spectral transmittance of the crystalline lens of an elderly person is lower than that of a young person. The low spectral transmittance decreases the brightness of the visual field. This phenomenon affects the color appearance of an image in human visual perception. In this paper, a lightness transform method is proposed to improve the color appearance of images for elderly persons. In the proposed method, colors that are difficult for an elderly person to see are transformed into colors that are easy to see by adding lightness contrast. The performance of the proposed method is confirmed in experiments using digital images.

  9. Improvement in appearance of colors for elderly persons using lightness transform

    Science.gov (United States)

    Ueda, Chiaki; Azetsu, Tadahiro; Suetake, Noriaki; Uchino, Eiji

    2016-12-01

    The color of an object appears to be different for elderly and young persons. This is because human visual features vary with on age. In general, the spectral transmittance of the crystalline lens of an elderly person is lower than that of a young person. The low spectral transmittance decreases the brightness of the visual field. This phenomenon affects the color appearance of an image in human visual perception. In this paper, a lightness transform method is proposed to improve the color appearance of images for elderly persons. In the proposed method, colors that are difficult for an elderly person to see are transformed into colors that are easy to see by adding lightness contrast. The performance of the proposed method is confirmed in experiments using digital images.

  10. 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.

  11. Effect (Comparison between Elderly Person and Youth of the Break in the Touch Typing Learning Comparison

    Directory of Open Access Journals (Sweden)

    Yamaguchi Yumi

    2016-01-01

    Full Text Available The technical education using the information appliance of the old worker is required. However, an elderly person is negative about the utilization of the information appliance. I experimented on, this study about an appropriate break to suppress fatigue of the elderly person, and to learn a touch typing technology effectively and made it clear. The experiment performed two kinds of touch typing learning by the Computer Based Training software. I performed an experiment of elderly person and “Consecutive learning short break models” “Massed practice long break models” which changed the interval of learning and the break by the touch typing software for youths. I performed a questionnaire to a subject to collect the subjective data of fatigue and the learning burden at the same time. As a result, I knew the thing that “the elderly person controlled fatigue by a learning method to put a break in diligently for a short time in this experiment, and could learn a touch typing skill” “having a long it than a youth as for the time to be concerned with the touch typing of the elderly person.” that “the elderly person can learn a touch typing skill early by enjoying CBT learning.”

  12. The Effects of Group Work with Institutionalized Elderly Persons

    Science.gov (United States)

    Duyan, Veli; Sahin-Kara, Gülay; Camur Duyan, Gülsüm; Özdemir, Burcu; Megahead, Hamido A.

    2017-01-01

    Objectives: This research article aims to measure the effects of group therapy on institutionalized elderly in terms of reducing depression and improving psychosocial functioning. Methods: Thirty elderly nursing home residents were recruited, and 16 of them elected to receive group treatment for depression and 14 declined treatment. The…

  13. Caregiver and environmental variables related to difficult behaviors in institutionalized, demented elderly persons.

    Science.gov (United States)

    Burgener, S C; Jirovec, M; Murrell, L; Barton, D

    1992-07-01

    This study describes the relationship between caregiver and elder behavior in institutionalized, cognitively impaired, elderly persons. A repeated-measures design was used to observe interactive behaviors between caregivers and demented elders within three caregiving situations (dressing, toileting, and bathing) and an interpersonal contact in two long-term care facilities. During observations, the caregiver's behaviors were rated using the Interaction Behavior Measure and Health Professional's-Geriatric Patient Behavior Rating scale, whereas the elder's behaviors were rated using a modified version of the Interaction Behavior Measure. The study included 116 subjects (58 elders and 58 caregivers), with each unique caregiver/elder pair being observed in the four situations. All elder behaviors varied according to situation type, with the most difficult elder behaviors occurring during bathing. Ten of the 12 caregiver behaviors included in the analysis varied by situation type. Significant relationships were systematically found between the caregiver's relaxed and smiling behavior and the elder's calm/functional behaviors, r = .42 (dressing) to r = .46 (toileting) for caregiver relaxed behavior and r = .34 (bathing) to r = .58 (dressing) for smiling. The elder's behavior did not vary by type of nursing unit (special dementia unit or general nursing unit), or interruptions to the interaction.

  14. 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.

  15. Strontium ranelate and risk of vertebral fractures in frail osteoporotic women.

    Science.gov (United States)

    Rolland, Yves; Abellan Van Kan, Gabor; Gillette-Guyonnet, Sophie; Roux, Christian; Boonen, Steven; Vellas, Bruno

    2011-02-01

    Therapies to treat osteoporosis remain underutilized and minimally evaluated in frail elderly patients. Our study determined and compared the risk of vertebral fractures in frail, intermediate and robust older patients being treated with strontium ranelate vs. placebo. Data were obtained from the SOTI (Spinal Osteoporosis Therapeutic Intervention) and TROPOS (Treatment Of Peripheral Osteoporosis) studies which randomized participants to receive either strontium ranelate or placebo over 3 years. Frail, intermediate and robust patients were identified using adapted Fried's criteria. Analyses were performed according to the intention-to-treat principle utilizing 1- and 3-year study follow-up data. 2346 robust, 2472 intermediate and 264 frail women were identified. At 3 years, the risk for vertebral fractures was reduced by 30% (Relative Risk [RR], 0.70; 95% confidence interval [CI], 0.57-0.86) in the robust, by 45% (RR, 0.55; 95%CI, 0.46-0.67) in the intermediate and by 58% (RR, 0.42; 95%CI, 0.24-0.74) in the frail patients compared to those assigned to placebo (p<0.01 for all three groups; p=0.11 for trend). Risk of vertebral fracture was significantly reduced within 1 year in all three groups. Numbers of subjects needed to be treated to prevent one new vertebral fracture over 3 years were 13, 9 and 5 in the robust, intermediate and frail groups, respectively. Adverse event profiles and medication compliance were similar across the 3 groups. The imperative to treat osteoporosis appears to be greatest in frail patients since similar relative risk reductions would avert more fractures in frail than in non-frail elderly patients. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Myelodysplastic Syndromes in the Elderly: Treatment Options and Personalized Management.

    Science.gov (United States)

    Burgstaller, Sonja; Wiesinger, Petra; Stauder, Reinhard

    2015-11-01

    Myelodysplastic syndromes (MDS) are typical diseases of the elderly, with a median age of 68-75 years at initial diagnosis. Demographic changes producing an increased proportion of elderly in our societies mean the incidence of MDS will rise dramatically. Considering the increasing number of treatment options, ranging from best supportive care to hematopoietic stem cell transplantation (HSCT), decision making is rather complex in this cohort of patients. Moreover, aspects of the aging process also have to be considered in therapy planning. Treatment of elderly MDS patients is dependent on the patient's individual risk and prognosis. Comorbidities play an essential role as predictors of survival and therapy tolerance. Age-adjusted models and the use of geriatric assessment scores are described as a basis for individualized treatment algorithms. Specific treatment recommendations for the different groups of patients are given. Currently available therapeutic agents, including supportive care, erythropoiesis-stimulating agents (ESAs), immune-modulating agents, hypomethylating agents, and HSCT are described in detail and discussed with a special focus on elderly MDS patients. The inclusion of elderly patients in clinical trials is of utmost importance to obtain data on efficacy and safety in this particular group of patients. Endpoints relevant for the elderly should be integrated, including maintenance of quality of life and functional activities as well as evaluation of use of healthcare resources.

  17. Frailty, body composition and nutritional status in non-institutionalised elderly.

    Science.gov (United States)

    São Romão Preto, Leonel; Dias Conceição, Maria do Carmo; Figueiredo, Telma Martins; Pereira Mata, Maria Augusta; Barreira Preto, Pedro Miguel; Mateo Aguilar, Ester

    2017-07-28

    Frailty is a clinical syndrome characterized, among other signs, by involuntary weight loss and decreased muscle strength. The aim of this study was to analyse associations between frailty, body composition and nutritional status in non-institutionalised elderly people in the municipality of Alfândega (Braganza-Portugal). Observational, prevalence and association study involving 220 elderly (mean 75.8±6.8 years of age; 68.8% women). Frailty was assessedt according to Fried criteria, body composition by bioelectrical impedance analysis and nutritional status using the Mini Nutritional Assessment Short-Form. The prevalence of frailty was 23.6%. Frail participants had, on average, lower total muscle mass and lower segmental muscle mass (arms and legs) than pre-frail and non-frail (p <.001). From the elderly at risk of malnutrition or undernourished (n=24), the majority (n=13) had frailty syndrome. It was observed that 41.2% of the elderly with low weight were frail. This syndrome prevailed only in 17.1% of the eutrophic persons, increasing again to 22.4% in the overweight group (p <.001). The phenotypic profile of frail elderly was characterised by lower muscle mass. The results of our study suggest that both underweight and overweight may be associated with frailty. There is the need to prevent and manage frailty, not only taking into account possible treatable medical causes, but also by intervening in important pillars, such as physical activity, dietary and nutritional problems. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  18. An evaluation of the effectiveness of a multi-modal intervention in frail and pre-frail older people with type 2 diabetes--the MID-Frail study: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Rodríguez-Mañas, Leocadio; Bayer, Antony J; Kelly, Mark; Zeyfang, Andrej; Izquierdo, Mikel; Laosa, Olga; Hardman, Timothy C; Sinclair, Alan J; Moreira, Severina; Cook, Justin

    2014-01-24

    Diabetes, a highly prevalent, chronic disease, is associated with increasing frailty and functional decline in older people, with concomitant personal, social, and public health implications. We describe the rationale and methods of the multi-modal intervention in diabetes in frailty (MID-Frail) study. The MID-Frail study is an open, randomised, multicentre study, with random allocation by clusters (each trial site) to a usual care group or an intervention group. A total of 1,718 subjects will be randomised with each site enrolling on average 14 or 15 subjects. The primary objective of the study is to evaluate, in comparison with usual clinical practice, the effectiveness of a multi-modal intervention (specific clinical targets, education, diet, and resistance training exercise) in frail and pre-frail subjects aged ≥70 years with type 2 diabetes in terms of the difference in function 2 years post-randomisation. Difference in function will be measured by changes in a summary ordinal score on the short physical performance battery (SPPB) of at least one point. Secondary outcomes include daily activities, economic evaluation, and quality of life. The MID-Frail study will provide evidence on the clinical, functional, social, and economic impact of a multi-modal approach in frail and pre-frail older people with type 2 diabetes. ClinicalTrials.gov: NCT01654341.

  19. Association between risk factors for injurious falls and new benzodiazepine prescribing in elderly persons

    OpenAIRE

    2009-01-01

    Abstract Background Benzodiazepines are frequently prescribed to elderly patients' despite concerns about adverse effects leading to injurious falls. Previous studies have not investigated the extent to which patients with pre-existing risk factors for falls are prescribed benzodiazepines. The objective of this study is to assess if some of the risk factors for falls are associated with new benzodiazepine prescriptions in elderly persons. Methods Using provincial administrative databases, eld...

  20. The effects of hippotherapy on elderly persons' static balance and gait.

    Science.gov (United States)

    Kim, Seong Gil; Lee, Chae-Woo

    2014-01-01

    [Purpose] The aim of this study was to examine the effects of hippotherapy on elderly persons' static balance and gait. [Subjects and Methods] Twenty-two elderly persons residing in the community were randomly divided into a hippotherapy group and a treadmill group and they conducted exercise for eight weeks. [Results] Step lengths increased significantly, and step time and sway path lengths significantly decreased in both groups. A comparison of sway path lengths after the intervention between the two groups revealed that the hippotherapy group showed larger decreases than the treadmill group. [Conclusion] The results of this study indicate that hippotherapy may improve the static balance and gait of elderly persons residing in the community.

  1. The prevalence and correlates of fear of falling in elderly persons living in the community.

    Science.gov (United States)

    Arfken, C L; Lach, H W; Birge, S J; Miller, J P

    1994-04-01

    Fear of falling has been recognized as a potentially debilitating consequence of falling in elderly persons. However, the prevalence and the correlates of this fear are unknown. Prevalence of fear of falling was calculated from the 1-year follow-up of an age- and gender-stratified random sample of community-dwelling elderly persons. Cross-sectional associations of fear of falling with quality of life, frailty, and falling were assessed. The prevalence of fear increased with age and was greater in women. After adjustment for age and gender, being moderately fearful of falling was associated with decreased satisfaction with life, increased frailty and depressed mood, and recent experience with falls. Being very fearful of falling was associated with all of the above plus decreased mobility and social activities. Fear of falling is common in elderly persons and is associated with decreased quality of life, increased frailty, and recent experience with falls.

  2. Elderly Persons with Intellectual Disability: A Study of Clinical Characteristics, Functional Status, and Sensory Capacity

    Directory of Open Access Journals (Sweden)

    Eli Carmeli

    2003-01-01

    Full Text Available Longer life expectancy is resulting in increasing numbers of elderly adults with intellectual disability (ID. There has been the question whether persons with ID demonstrate early signs of aging before the general population. The aim of this study was to determine if persons with ID (with and without Down syndrome showed premature aging changes compared with a control group. Elderly persons (n = 24, average age of 61 from one residential care center in Israel and younger adults from another center (n = 37, average age of 45 were compared with elderly residents without ID in an independent living facility. The study considered demographic data, medical data, anthropometric measurements, body fat and body mass index, flexibility, and sensorimotor function tests. The results showed that the persons with ID had basically similar body composition to that of persons without ID, however, the functional performance of elderly adults with ID was more impaired. We postulate that the slower functioning responses may be explained by a less physically active lifestyle, that may accelerate the onset of disease and result in symptoms associated with aging that are detrimental to health. It is therefore important that persons with ID participate in physical activity and exercises in order to promote health and prevent disease.

  3. Disability and quality of life among elderly persons with mental illness.

    Science.gov (United States)

    Ramaprasad, Dharitri; Rao, N Suryanarayana; Kalyanasundaram, S

    2015-12-01

    The present study was undertaken to understand the level of disability and quality of life of elderly persons with chronic and persistent mental illnesses and to compare it with those who were elderly but well with no illness. For the purpose 200 elderly persons with mental illness (PMI), attending psychiatric services were included in the study. A comparison group of 103 well elderly persons was drawn from the same study area as control group (CG). They were assessed using WHO-DAS and WHOQOL-BREF. Results revealed that PMI experienced higher disability compared to the CG. Deficits in the domain of moving around, getting along with people, engaging in life activities and participation in society contributed most to the high level of disability in the PMI group. PMI from rural area had higher disability compared to the urban group. As for QOL, elderly PMI had a poor quality of life compared to the CG. Quality of life was found to be negatively associated with level of disability. Higher the level of disability, lower was the quality of life. The authors opine that persons with chronic mental illness continue to experience psychiatric disability in old age and this cannot be attributed to normal aging. Level of disability has a negative impact on their quality of life. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. 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.

  5. 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…

  6. PSYCHOMETRIC PROPERTIES OF BRADBURN AFFECT BALANCE SCALE AMONG ELDERLY PERSONS

    NARCIS (Netherlands)

    KEMPEN, GIJM

    Some psychometric properties of the Affect Balance Scale have been tested on a random sample of 354 elderly people in the Netherlands. Internal reliability estimates were comparable with prior ones, and the 8-wk. test-retest reliability is reasonable for these 5-item measures.

  7. 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…

  8. 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.

  9. Malnutrition among the elderly.

    OpenAIRE

    Rauscher, C.

    1993-01-01

    Nutrition is a significant determinant of health. Undernutrition presenting as malnutrition is a serious health concern for frail elderly people with many health problems. Understanding the risk factors for malnutrition helps physicians assess and manage the condition. Primary care physicians are in an excellent position to screen, educate, and manage their elderly malnourished patients.

  10. Malnutrition among the elderly.

    OpenAIRE

    1993-01-01

    Nutrition is a significant determinant of health. Undernutrition presenting as malnutrition is a serious health concern for frail elderly people with many health problems. Understanding the risk factors for malnutrition helps physicians assess and manage the condition. Primary care physicians are in an excellent position to screen, educate, and manage their elderly malnourished patients.

  11. Sufficient competence in community elderly care? Results from a competence measurement of nursing staff

    OpenAIRE

    Bing-Jonsson, Pia C; Hofoss, Dag; Kirkevold, Marit; Bjørk, Ida T; Foss, Christina

    2016-01-01

    Background Multi-morbidity, poly-pharmacy and cognitive impairment leave many old patients in a frail condition with a high risk of adverse outcomes if proper health care is not provided. Knowledge about available competence is necessary to evaluate whether we are able to offer equitable and balanced health care to older persons with acute and/or complex health care needs. This study investigates the sufficiency of nursing staff competence in Norwegian community elderly car...

  12. 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.

  13. 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......Jette Lauritzen, Senior Lecturer, MScN, MHA, RNT, DipHE/N, CRNA. Liu Suzhen, Professor, Ph.d., Karen Bro Aaen, lecturer, MSA, RNT, RN. Feng Xianqiong, Associated professor, ph.d. A research collaboration between VIA University College,Department of Nursing in Aarhus, Denmark and West China Medical...... 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...

  14. [The diet of the elderly person undergoing dialysis].

    Science.gov (United States)

    Gourc, Christophe; Ramade, Nathalie

    2016-01-01

    The elderly patient undergoing dialysis is often at risk of undernutrition. The condition may already be present at the pre-dialysis stage and can worsen once dialysis starts. Aside from the impact on the patient's quality of life and general health status, undernutrition exposes them to serious risk of complications and can be life-threatening. It is therefore essential that it is diagnosed early. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Screening Tool for Older Persons' Appropriate Prescriptions for Japanese: Report of the Japan Geriatrics Society Working Group on "Guidelines for medical treatment and its safety in the elderly".

    Science.gov (United States)

    Kojima, Taro; Mizukami, Katsuyoshi; Tomita, Naoki; Arai, Hiroyuki; Ohrui, Takashi; Eto, Masato; Takeya, Yasushi; Isaka, Yoshitaka; Rakugi, Hiromi; Sudo, Noriko; Arai, Hidenori; Aoki, Hiroaki; Horie, Shigeo; Ishii, Shinya; Iwasaki, Koh; Takayama, Shin; Suzuki, Yusuke; Matsui, Toshifumi; Mizokami, Fumihiro; Furuta, Katsunori; Toba, Kenji; Akishita, Masahiro

    2016-09-01

    In 2005, the Japan Geriatrics Society published a list of potentially inappropriate medication that was an extract from the "Guidelines for medical treatment and its safety in the elderly 2005." The 2005 guidelines are due for a revision, and a new comprehensive list of potentially inappropriate medications is required. A total of 15 diseases, conditions and special areas related to their clinical care were selected. We originated clinical questions and keywords for these 15 areas, carried out a systematic review using these search criteria, and formulated guidelines applying the Grading of Recommendations Assessment, Development and Evaluation system advocated by Minds2014. If we did not find good evidence despite the drug being clinically important, we looked for evidence of efficacy and for disease-specific guidelines, and incorporated them into our guidelines. We selected 2098 articles (140 articles per area), and extracted another 186 articles through a manual search. We further added guidelines based on disease entity and made two lists, one of "drugs to be prescribed with special caution" and the other of "drugs to consider starting," primarily considering individuals aged 75 years or older or those who are frail or in need of special care. New lists of potentially inappropriate medications and potential prescribing omissions called "Screening Tool for Older Person's Appropriate Prescriptions for Japanese" were constructed. We anticipate that future studies will highlight more evidence regarding the safety of high-quality drugs, further improving the provision of appropriate medical care for the elderly. Geriatr Gerontol Int 2016: 16: 983-1001. © 2016 Japan Geriatrics Society.

  16. Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans.

    Science.gov (United States)

    Reyes-Ortiz, Carlos A; Al Snih, Soham; Markides, Kyriakos S

    2005-01-01

    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. 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). 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. 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.

  17. 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)

  18. 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.…

  19. 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.

  20. 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 par

  1. Personal Meaning, Optimism, and Choice: Existential Predictors of Depression in Community and Institutional Elderly.

    Science.gov (United States)

    Reker, Gary T.

    1997-01-01

    Examines the unique, combined, and interactive contribution of existential variables and traditional measures as predictors of depression in institutionalized and community-residing older adults. Results show that choice-responsibleness, social resources, and physical health predicted depression in community elderly; personal meaning, optimism,…

  2. 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)

  3. Sobrecarga de trabalho em cuidadores de idosos fragilizados que vivem no domicílio Sobrecarga de trabajo en cuidadores de ancianos frágiles que viven en el domicilio Burden of work in caregivers of frail elders living at home

    Directory of Open Access Journals (Sweden)

    Renata Stackfleth

    2012-01-01

    de Fragilidad de Edmonton, la Medida de la Independencia Funcional para los ancianos y la Escala Zarit Burden Interview, para los cuidadores. Para el análisis fueron empleados la estadística descriptiva y el test de Pearson. RESULTADOS: La mayoría de los cuidadores era del sexo femenino (75%, casados (58,3% y, 45% eran hijos. En cuanto a la sobrecarga, 31,7% respondieron que raramente se sentían sobrecargados. Sin embargo, hubo correlación entre la fragilidad y la sobrecarga, o sea, cuanto mayor el nivel de fragilidad, mayor la sobrecarga del cuidador. CONCLUSIÓN: Se evidenció que la mayoría de los cuidadores era del sexo femenino y cuanto mayor el grado de dependencia funcional, mayor el grado de fragilidad lo cual eleva el nivel de sobrecarga del cuidador.OBJECTIVES: To assess the burden of caregivers of frail elders living at home; to characterize elderly that are considered frail and their caregivers; to assess the degree of dependency of the elderly according to the level of frailty and to correlate it with the burden of work of their caregivers. METHODS: A transversal study with a sample of 60 caregivers and frail elderly who lived at home. Data collection was conducted in the home with frail elders and their caregivers. We used the sociodemographic profile of the elderly and the caregiver instruments, the Edmonton Frail Scale, the Functional Independence Measure for the elderly, and the Zarit Burden Interview Scale for the caregivers. Descriptive statistics and the Pearson test were employed for data analysis. RESULTS: The majority of caregivers were female (75%, married (58.3% and were children of the elderly (45%. Regarding the burden, 31.7% said they rarely felt burdened. However, a correlation was found between frailty and burden: the higher the level of frailty, the greater the caregiver burden. CONCLUSION: It was found that the majority of caregivers were female and the greater the degree of functional dependence, the greater the degree of

  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......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...... at time of diagnosis (baseline), and again 3 and 6 months after the diagnosis. The study also aimed to investigate which of the aforementioned factors predicted deteriorated QoL in elderly persons with cancer from baseline to the 6-month investigation. At baseline, the sample consisted of 101 individuals...

  5. 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...... at time of diagnosis (baseline), and again 3 and 6 months after the diagnosis. The study also aimed to investigate which of the aforementioned factors predicted deteriorated QoL in elderly persons with cancer from baseline to the 6-month investigation. At baseline, the sample consisted of 101 individuals...... 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...

  6. ABHIVYAKTI: A Vision Based Intelligent System for Elder and Sick Persons

    CERN Document Server

    Chaudhary, Ankit

    2011-01-01

    This paper describes an intelligent system ABHIVYAKTI, which would be pervasive in nature and based on the Computer Vision. It would be very easy in use and deployment. Elder and sick people who are not able to talk or walk, they are dependent on other human beings and need continuous monitoring, while our system provides flexibility to the sick or elder person to announce his or her need to their caretaker by just showing a particular gesture with the developed system, if the caretaker is not nearby. This system will use fingertip detection techniques for acquiring gesture and Artificial Neural Networks (ANNs) will be used for gesture recognition.

  7. Physical activity in non-frail and frail older adults.

    Directory of Open Access Journals (Sweden)

    F Marijke Jansen

    Full Text Available Physical activity (PA is important for healthy ageing. Better insight into objectively measured PA levels in older adults is needed, since most previous studies employed self-report measures for PA assessment, which are associated with overestimation of PA.This study aimed to provide insight in objectively measured indoor and outdoor PA of older adults, and in PA differences by frailty levels.Data were collected among non-frail (N = 74 and frail (N = 10 subjects, aged 65 to 89 years. PA, measured for seven days with accelerometers and GPS-devices, was categorized into three levels of intensity (sedentary, light, and moderate-to-vigorous PA.Older adults spent most time in sedentary and light PA. Subjects spent 84.7%, 15.1% and 0.2% per day in sedentary, light and moderate-to-vigorous PA respectively. On average, older adults spent 9.8 (SD 23.7 minutes per week in moderate-to-vigorous activity, and 747.0 (SD 389.6 minutes per week in light activity. None of the subjects met the WHO recommendations of 150 weekly minutes of moderate-to-vigorous PA. Age-, sex- and health status-adjusted results revealed no differences in PA between non-frail and frail older adults. Subjects spent significantly more sedentary time at home, than not at home. Non-frail subjects spent significantly more time not at home during moderate-to-vigorous activities, than at home.Objective assessment of PA in older adults revealed that most PA was of light intensity, and time spent in moderate-to-vigorous PA was very low. None of the older adults met the World Health Organization recommendations for PA. These levels of MVPA are much lower than generally reported based on self-reported PA. Future studies should employ objective methods, and age specific thresholds for healthy PA levels in older adults are needed. These results emphasize the need for effective strategies for healthy PA levels for the growing proportion of older adults.

  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. Safety vs. privacy: elderly persons' experiences of a mobile safety alarm.

    Science.gov (United States)

    Melander-Wikman, Anita; Fältholm, Ylva; Gard, Gunvor

    2008-07-01

    The demographic development indicates an increased elderly population in Sweden in the future. One of the greatest challenges for a society with an ageing population is to provide high-quality health and social care. New information and communication technology and services can be used to further improve health care. To enable elderly persons to stay at home as long as possible, various kinds of technology, such as safety alarms, are used at home. The aim of this study was to describe the experiences of elderly persons through testing a mobile safety alarm and their reasoning about safety, privacy and mobility. The mobile safety alarm tested was a prototype in development. Five elderly persons with functional limitations and four healthy elderly persons from a pensioner's organisation tested the alarm. The mobile alarm with a drop sensor and a positioning device was tested for 6 weeks. This intervention was evaluated with qualitative interviews, and analysed with latent content analysis. The result showed four main categories: feeling safe, being positioned and supervised, being mobile, and reflecting on new technology. From these categories, the overarching category 'Safety and mobility are more important than privacy' emerged. The mobile safety alarm was perceived to offer an increased opportunity for mobility in terms of being more active and as an aid for self-determination. The fact that the informants were located by means of the positioning device was not experienced as violating privacy as long as they could decide how to use the alarm. It was concluded that this mobile safety alarm was experienced as a tool to be active and mobile. As a way to keep self-determination and empowerment, the individual has to make a 'cost-benefit' analysis where privacy is sacrificed to the benefit of mobility and safety. The participants were actively contributing to the development process.

  10. Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons

    Science.gov (United States)

    Harada, Eriko; Moriya, Shingo; Murata, Ayumi; Muramatsu, Masumi; Kashiwazaki, Haruhiko; Kobayashi, Kunihiko; Notani, Kenji; Inoue, Nobuo

    2012-01-01

    Objectives The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors. PMID:21306431

  11. 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.

  12. 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.

  13. Frailty decreases physical health domain of quality of life in nursing home elderly

    Directory of Open Access Journals (Sweden)

    Yvonne Suzy Handajani

    2016-04-01

    The percentages of respondents with pre-frail, frail, and non-frail status were 30.4%, 52.2%, and 17.4%, respectively. A decline in QOL scores of pre-frail and frail respondents was found for almost all QOL domains (physical, psychological and environment domains, except social relationships. The subdomains most influenced were “energy and fatigue” in the physical health domain, “thinking, learning, memory and concentration” in psychological health, and “opportunities for acquiring new information and skills” in the environment domain. CONCLUSIONS More than half of the nursing home elderly were frail and one-third were pre-frail. The main factor of frailty was weakness. The frailty syndrome in the elderly has a negative impact on QOL, especially in the physical health, psychological and environment domains in nursing home elderly.

  14. Selecting services for a service robot: evaluating the problematic activities threatening the independence of elderly persons.

    Science.gov (United States)

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

    2013-06-01

    Sustaining independent living for the elderly is desirable both for the individual as well as for societies as a whole. Substantial care interventions are provided to citizens supporting their independent living. Currently, such interventions are primarily based on human care provision, but due to demographic changes the demand for such support is continuously increasing. Assistive Robotics has the potential to answer this growing demand. The notions research towards service robots that support the independence of elderly people has been given increased attention. The challenge is to develop robots that are able to adequately support with those activities that pose the greatest problems for elderly people seeking to remain independent. In order to develop the capabilities of the Care-O-bot 3 in the ACCOMPANY project, problematic activities that may threaten continued independent living of elderly people were studied. Focus groups were conducted in the Netherlands, UK, and France and included three separate user groups: (1) elderly (N=41), (2) formal caregivers (N=40), and (3) informal caregivers (N=32). This resulted in a top 3 of problematic activity domains that received the highest priority: (1) Mobility, (2) Self-care, and (3) Social isolation. The findings inform the further development of the Care-O-bot. In the ACCOMPANY project the Care-O-bot 3 will be developed further to enable it to support independently living older persons in one of these domains.

  15. 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.

  16. 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

  17. Personal and environmental relationships among the elderly living in residential settings.

    Science.gov (United States)

    Fernández-Ballesteros, R; Montorio, I; Fernández de Trocóniz, M I

    1998-01-01

    There is strong empirical evidence to support the influence of environmental and social factors in health and behavior among the institutionalized elderly. In order to assess personal and environmental relationships, 32 residential centers for the elderly and 1403 of their inhabitants were assessed using the Sistema de Evaluación de Residencias de Ancianos (SERA). Our principal findings were as follows: (1) relationships between individual variables (e.g. objective and subjective health, depression) and subjective variables (e.g. satisfaction); (2) the predictive power of the environment characteristics (e.g. policy choice) on the subjects functioning (e.g. level of activity); (3) residential satisfaction is the product of several personal variables (e.g. objective and perceived health), as well as of social environmental factors (e.g. physical comfort); and (4) very weak relationships were found between social climate dimensions and other environmental factors.

  18. Residential moves by elderly persons to U.S. central cities, suburbs, and rural areas.

    Science.gov (United States)

    Golant, S M

    1987-09-01

    The 1975-1980 migration stream and net migration patterns of persons younger than 65 and 65 + were examined using data from the 1980 U.S. Census. Central cities and suburbs of metropolitan areas (SMSAs) and nonmetropolitan areas (NonSMSAs) were distinguished as origins and destinations. Most elderly movers relocated within a fairly limited geographic context and revealed strong preferences for metropolitan living. Suburban locations were more favored than central city locations. Net migration findings may provide misleading interpretations of older movers' locational choices. The migration patterns of the 65 + population were similar to those of the 45- to 64-year-old population but differed from those of the more youthful U.S. populations. These findings highlight migration streams of elderly movers who likely have experienced changed in their life styles or personal resources.

  19. Felt and enacted stigma in elderly persons with epilepsy: A qualitative approach.

    Science.gov (United States)

    Sleeth, Carolyn; Drake, Kendra; Labiner, David M; Chong, Jenny

    2016-02-01

    Stigma is a common psychological consequence of chronic diseases, including epilepsy; however, little research has been done to determine the effect of stigma on persons with epilepsy, especially the elderly. We interviewed 57 older adults with epilepsy to discover the extent and consequences of, and reasons for, epilepsy-related stigma in their lives. Felt stigma was more frequently reported than enacted stigma, with over 70% having experienced this form of stigma. Participants described ignorance and fear of the disease as the foundation of epilepsy-related stigma. The most common response to stigmatizing events was a decrease in epilepsy disclosure to family or friends. Results from this study could inform interventions designed for elderly persons with epilepsy and their support networks, as well as educational campaigns for the general public.

  20. Progressive and imaginal relaxation training for elderly persons with subjective anxiety.

    Science.gov (United States)

    Scogin, F; Rickard, H C; Keith, S; Wilson, J; McElreath, L

    1992-09-01

    Elders exposed to either progressive or imaginal relaxation procedures reported significant relaxation effects and showed improvement on measures of personal functioning. The results of the Physical Assessment Scale of the Relaxation Inventory indicated that relaxation responses were acquired within and across sessions. Large, consistent changes in relaxation occurred in all 4 sessions. The Symptom Checklist-90-R, which measures self-reported personal adjustment, showed significant positive changes following relaxation training and at 1-month follow-up. Elders who imagined muscle tension release profited as much as those engaged in actual muscle tension-release activities. This finding is of importance for older adults who may experience physical limitations that contraindicate muscle-tension-release procedures.

  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. Cognitive plasticity as a modulating variable on the effects of memory training in elderly persons.

    Science.gov (United States)

    Calero, M Dolores; Navarro, Elena

    2007-01-01

    Cognitive plasticity is a topic of interest since it allows us to analyse the potential cognitive modifiability of a person. Previous research has demonstrated the existence of plasticity in old age [Baltes, P. B. (1987). Theoretical propositions of life-span developmental psychology: On the dynamics between growth and decline. Developmental Psychology, 23(5), 611-626] regardless of presence or absence of cognitive deterioration [Calero, M. D., & Navarro, E. (2004). Relationship between plasticity, mild cognitive impairment and cognitive decline. Archives of Clinical Neuropsychology, 19, 653-660]. In this context, the present study was designed to analyse the presence of plasticity in elderly persons who seemed to present cognitive deterioration, and to explore the relation between cognitive plasticity and the results obtained from a memory training programme. One hundred and thirty-three elderly persons participated in the study and were evaluated by means of a cognitive plasticity test (Position test) and various tests for measuring the effects of the training. Part of the elderly population received the memory training, whose effects were measured immediately after the training and again after 9 months. The results demonstrate that the programme significantly improves cognitive performance, while plasticity is shown to be an important modulating variable on the improvement achieved.

  4. Intake and urinary amounts of biotin in Japanese elementary school children, college students, and elderly persons.

    Science.gov (United States)

    Shibata, Katsumi; Tsuji, Tomiko; Fukuwatari, Tsutomu

    2013-01-01

    Biotin enzymes such as pyruvate carboxylase and acetyl-CoA carboxylase are involved with the most basic metabolism. Thus, it is very important to monitor the biotin nutritional status for maintaining good health. We examined urinary excretion and the intake of biotin in a Japanese sample population of 60 boys and 36 girls (10-12 y), 37 male and 135 female college students (18-27 y), and 35 female elderly persons (70-84 y) living freely. All food consumed, and the corresponding weighing, for 4 consecutive days were recorded. A 24-hour urine sample was collected on the fourth day, and the urine biotin was measured. The urine biotin at the fourth day was 57.8, 50.9, 81.0, 66.2, and 82.3 nmol/day in boys, girls, male students, female students, and elderly persons, respectively. The average intake of biotin for 4 consecutive days was 35, 31, 28, 26, and 32 μg/day in boys, girls, male students, female students, and elderly persons, respectively.

  5. Exploring the within-person coupling of reading vision and cognition in the elderly.

    Science.gov (United States)

    Weatherbee, Sarah R; Gamaldo, Alyssa A; Allaire, Jason C

    2009-11-01

    This study examined the within-person relationship between reading vision and cognitive functioning. Analysis was conducted on 36 community-dwelling elderly (age range = 60-87) who completed a reading vision task and three cognitive tests (i.e., Rey Auditory Verbal Learning Task (AVLT), Letter Series, and Number Comparison) twice a day over 60 consecutive days. Significant within-person variability was found for the reading vision measure. Additionally, a main effect was found for reading vision and performance on the AVLT and Number Comparison task; such that on occasions when reading vision was poor, cognitive performance suffered.

  6. Sleep disorders and their impacts on healthy, dependent, and frail older adults.

    Science.gov (United States)

    Cochen, V; Arbus, C; Soto, M E; Villars, H; Tiberge, M; Montemayor, T; Hein, C; Veccherini, M F; Onen, S H; Ghorayeb, I; Verny, M; Fitten, L J; Savage, J; Dauvilliers, Y; Vellas, B

    2009-04-01

    Sleep disorders differ widely in the heterogeneous older adult population. Older adults can be classified into three groups based upon their overall level of disability: healthy, dependent, and frail. Frailty is an emerging concept that denotes older persons at increased risk for poor outcomes. The aim of this consensus review is to describe the sleep disorders observed in healthy and dependent older adults and to discuss the potential sleep disorders associated with frailty as well as their potential consequences on this weakened population. A review task force was created including neurologists, geriatricians, sleep specialists and geriatric psychiatrists to discuss age related sleep disorders depending on the three categories of older adults. All published studies on sleep in older adults on Ovid Medline were reviewed and 106 articles were selected for the purpose of this consensus. Many healthy older adults have complains about their sleep such as waking not rested and too early, trouble falling asleep, daytime napping, and multiple nocturnal awakenings. Sleep architecture is modified by age with an increased percentage of time spent in stage one and a decreased percentage spent in stages three and four. Insomnia is frequent and its mechanisms include painful medical conditions, psychological distress, loss of physical activity and iatrogenic influences. Treatments are also involved in older adults' somnolence. The prevalence of primary sleep disorders such as restless legs syndrome, periodic limb movements and sleep disordered breathing increases with age. Potential outcomes relevant to these sleep disorders in old age include mortality, cardiovascular and neurobehavioral co-morbidities. Sleep in dependent older adults such as patients with Alzheimer Disease (AD) is disturbed. The sleep patterns observed in these patients are often similar to those observed in non-demented elderly but alterations are more severe. Nocturnal sleep disruption and daytime

  7. 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...... 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......) 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...

  8. A Case of Buccal Abscess from an Impacted Wisdom Tooth in an Elderly Person with Malnutrition

    Directory of Open Access Journals (Sweden)

    Yuki Kojima

    2016-01-01

    Full Text Available We report a case of buccal abscess caused by an impacted wisdom tooth in an extremely elderly person with malnutrition. The patient was a 94-year-old man, who complained that he had found it hard to open his mouth and that his cheek had been swollen for the previous 2 weeks. He had a shallow oral wound caused by an improperly fitting denture; however, the wound became infected. We performed incisional drainage of the abscess under local anesthesia. The swelling disappeared and he was able to open his mouth 55 mm. The elderly have a high risk of healing failure of injuries and it has been reported that infection in a host in a compromised state is severely intractable. This elderly patient was in a compromised state because of malnutrition. Cases such as this one will increase as the elderly population increases. Dentists need to consider the quality of life of patients with a longer life expectancy and should offer patients several treatment options before their general condition deteriorates.

  9. Relation Between Frailty and Common Geriatric Problems in Elderly

    Directory of Open Access Journals (Sweden)

    Moatassem S Amer*, Sarah A Hamza*, Tamer M Farid*, Samia A AbdelRahman*, Hoda M Farid*, Heba G Saber*,Enas R Mohamed*, Randa A Mabrouk

    2013-07-01

    Full Text Available Background: There is a high prevalence of common geriatric problems (falls, urinary incontinence, visual and hearing impairment among frail elderly leading to more disability and functional impairment. Objectives: The aim of this study is to compare the prevalence of common geriatric problems between frail and non-frail elderly. Design: A Case control study. Participants: 90 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 2 groups: Group A (30 frail elderly females and 30 frail elderly males and Group B (30 healthy elderly subjects; 15 males and 15 females.Measurements: Comprehensive geriatric assessment, including detailed history of common geriatric problems as mentioned above, physical examination, and also assessment of frailty using modified Fried criteria ].Results: Hearing impairment, incontinence and falls were more prevalent in frail elderly with a highly difference between the two groups, with p values< (0.001,0.009,0.006 consequently, visual impairment was statistically significant in cases more than controls with p value (0.012. Conclusion: There is a significant positive relationship and high prevalence of common geriatric problems especially falls, urinary incontinence, visual and hearing impairment among frail elderly.

  10. [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.

  11. Presence redefined: The reciprocal nature of engagement between elder-clowns and persons with dementia.

    Science.gov (United States)

    Kontos, Pia; Miller, Karen-Lee; Mitchell, Gail Joyce; Stirling-Twist, Jan

    2015-04-23

    Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. We examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.

  12. Relationships between elderly care recipients and their migrant live-in home care workers in Israel.

    Science.gov (United States)

    Porat, Irit; Iecovich, Esther

    2010-01-01

    In Israel more than 54,000 immigrant live-in home care workers are providing personal care to frail elders. These home care workers emigrate from various countries and different cultures, speak other languages, and have other religions. The purposes of this study were: (a) to examine the patterns of the interpersonal relationships that develop between disabled elderly persons who were being cared for by migrant live-in home care workers, and (b) to explore the factors that best explain the patterns of these relationships. A convenience sample that included 100 frail elderly people was selected and respondents were face-to-face interviewed at their homes, using a structured questionnaire. The findings showed that the relationships that developed between migrant live-in home care workers and elderly care recipients were close and that language was not a significant barrier in establishing close relationships between them. Further, the findings showed that perceived similarity in personal qualities played the most significant role in determining the extent to which the relationships between them will be close. A similar cultural background such as ethnicity, and nonverbal and good understanding, rather than speaking a common language, were significant factors in facilitating close relationships.

  13. Effect of parietal transcranial magnetic stimulation on spatial working memory in healthy elderly persons--comparison of near infrared spectroscopy for young and elderly.

    Directory of Open Access Journals (Sweden)

    Kaori Yamanaka

    Full Text Available In a previous study, we succeeded in improving the spatial working memory (WM performance in healthy young persons by applying transcranial magnetic stimulation (TMS to the parietal cortex and simultaneously measuring the oxygenated hemoglobin (oxy-Hb level using near-infrared spectroscopy (NIRS. Since an improvement in WM was observed when TMS was applied to the right parietal cortex, the oxy-Hb distribution seemed to support a model of hemispheric asymmetry (HA. In the present study, we used the same study design to evaluate healthy elderly persons and investigated the effect of TMS on WM performance in the elderly, comparing the results with those previously obtained from young persons. The application of TMS did not affect WM performance (both reaction time and accuracy of 38 elderly participants (mean age = 72.5 years old. To investigate the reason for this result, we conducted a three-way ANOVA examining oxy-Hb in both young and elderly participants. For the right parietal TMS site in the elderly, TMS significantly decreased the oxy-Hb level during WM performance; this result was the opposite of that observed in young participants. An additional three-way ANOVA was conducted for each of the 52 channels, and a P value distribution map was created. The P value maps for the young participants showed a clearly localized TMS effect for both the WM and control task, whereas the P map for the elderly participants showed less significant channels and localization. Further analysis following the time course revealed that right-side parietal TMS had almost no effect on the frontal cortex in the elderly participants. This result can most likely be explained by age-related differences in HA arising from the over-recruitment of oxy-Hb, differentiation in the parietal cortex, and age-related alterations of the frontal-parietal networks.

  14. [The impact of frailty on the oral care behaviour and dental service use of elderly people

    NARCIS (Netherlands)

    Niesten, D.; Sanden, W.J.M. van der; Gerritsen, A.E.

    2015-01-01

    In order to explore how the level of frailty and various frailty factors affect the dental service use and oral self-care behaviour of frail elderly people, 51 frail elderly people were interviewed. Additional information on age, gender, living situation, prosthetic status, self-reported health and

  15. 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.

  16. 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; pbalance 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. PMID:23940592

  17. Signaling proteins that influence energy intake may affect unintentional weight loss in elderly persons.

    Science.gov (United States)

    Wernette, Catherine M; White, B Douglas; Zizza, Claire A

    2011-06-01

    After age 70 to 75 years, average body weight decreases both in ailing and healthy people because of a loss of appetite that results in reduced energy intake and the loss of body fat and lean muscle tissue. This so-called anorexia of aging predisposes elderly people to continued pathologic weight loss and malnutrition-major causes of morbidity and mortality. Health care professionals must understand the many factors involved in the anorexia of aging to help older adults prevent unintentional weight loss. Psychological, social, and cultural factors are important effectors; however, physiological factors are emphasized here because they are not thoroughly understood and they make it inherently difficult for most people to alter their body weight. Monoamines, steroid hormones (glucocorticoids and mineralocorticoids), endocannabinoids, and proteins all influence body weight. This review is an analysis of proteins from the brain, pancreas, adipose tissue, and gastrointestinal tract that are known to affect energy intake and energy balance, with an attempt to identify those factors that may change with aging. The articles included in this review were obtained by a PubMed database search using the keywords mouse OR rat OR human AND aged OR aging OR older OR elderly AND adult AND anorexia OR "unintentional weight loss," and each of the individual proteins discussed, as well as from the reference lists of those articles. The results reveal that some proteins may be important in the development of unintentional weight loss in elderly persons, whereas others may not have a significant role. However, many of the proteins that could conceivably have a role in unintentional weight loss have not yet been studied with that question in mind. Preventing unintentional weight loss in older adults is an important goal and further research on the role of proteins important for the maintenance of energy balance and the development of unintentional weight loss in elderly persons is

  18. Effect of prebiotics on the human gut microbiota of elderly persons.

    Science.gov (United States)

    Toward, Ruth; Montandon, Samantha; Walton, Gemma; Gibson, Glenn R

    2012-01-01

    The colonic microbiota undergoes certain age related changes that may affect health. For example, above the age of 55-65 y, populations of bifidobacteria are known to decrease markedly. Bifidobacteria are known inhibitors of pathogenic microbes and a decrease in their activities may increase susceptibility to infections. There is therefore interest in trying to reverse their decline in aged persons. As the gut microbiota responds to dietary intervention, both probiotics and prebiotics have been tested in this regard. Probiotics are live microbes in the diet, whereas prebiotics are fermentable ingredients that specifically target components of the indigenous microbiota seen to be beneficial. We have published a recent paper demonstrating that prebiotic galactooligosaccharides can exert power effects upon bifidobacteria in the gut flora of elderly persons (both in vivo and in vitro). This addendum summarizes research that led up to this study and discusses the possible impact of prebiotics in impacting upon the gut health of aged persons.

  19. 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.

  20. 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......-month follow-up. From the perspective of QoL, nurses need to address more specifically the most vulnerable elderly cancer patients: those who are dependent in instrumental activities of daily living, those who perceive reduced economic ability, and those who need assistance to discover new strategies...

  1. Social desirability and the measurement of psychological well-being in elderly persons.

    Science.gov (United States)

    Carstensen, L L; Cone, J D

    1983-11-01

    The discriminant validity of two commonly used measures of life satisfaction was investigated. The Philadelphia Geriatric Center Morale Scale, the Life Satisfaction Index-B, and two theoretically unrelated self-report measures were completed by 60 alumni of West Virginia University, aged 66 to 86 years. Convergent validity of the Philadelphia Geriatric Center Morale Scale and the Life Satisfaction Index-B was established (r = .64, p less than .0001), but both also correlated significantly with a measure of social desirability (r = .70 and .58, respectively, p less than .0001). The need for more basic work on measurement of life satisfaction in elderly persons was discussed.

  2. Art-therapy as a method for mobilizing personal resources in the elderly.

    Directory of Open Access Journals (Sweden)

    Glozman J.M.

    2014-09-01

    Full Text Available Aging can be viewed as a continuation of development and an active interaction with the environment during which regressive changes are combined with progressive new formations. It is believed that the self-determining nature of subjectivity in the elderly mediates self-awareness and favors self-acceptance as an active agent that determines the outcomes of one’s own life at this age as an autonomous self-regulating subject of one’s own activity. A formative experience proved the efficiency of using art therapy as a method for mobilizing personal resources during aging.

  3. Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Kronborg, Christian; Puggaard, Lis

    2008-01-01

    BACKGROUND AND AIMS: Home-based exercise is a viable solution for frail elderly individuals with difficulties in reaching exercise facilities outside home. The aim of this study was to determine the effects of a home-based video exercise program on physiological performance, functional capacity...

  4. The effects of Tai Chi on the balance control of elderly persons with visual impairment: a randomised clinical trial.

    Science.gov (United States)

    Chen, Ellen W; Fu, Amy S N; Chan, K M; Tsang, William W N

    2012-03-01

    balance control is a major problem for older individuals with poor vision. There are limitations, however, for visually impaired elderly persons wishing to participate in exercise programmes. The benefits of Tai Chi for balance control, muscle strength and preventing falls have been demonstrated with sighted elderly subjects. This study was designed to extend those findings to elderly persons with visual impairment. to investigate the effects of Tai Chi on the balance control of elderly persons with visual impairment. randomised clinical trial. residential care homes. forty visually impaired persons aged 70 or over. the participants were randomly divided into Tai Chi and control groups and assessed pre- and post-intervention using three tests: (i) passive knee joint repositioning to test knee proprioception; (ii) concentric isokinetic strength of the knee extensors and flexors and (iii) a sensory organisation test to quantify an individual's ability to maintain balance in a variety of complex sensory conditions. after intervention, the Tai Chi participants showed significant improvements in knee proprioception and in their visual and vestibular ratios compared with the control group. practicing Tai Chi can improve the balance control of visually impaired elderly persons.

  5. Association between risk factors for injurious falls and new benzodiazepine prescribing in elderly persons

    Directory of Open Access Journals (Sweden)

    Sylvestre Marie-Pierre

    2009-01-01

    Full Text Available Abstract Background Benzodiazepines are frequently prescribed to elderly patients' despite concerns about adverse effects leading to injurious falls. Previous studies have not investigated the extent to which patients with pre-existing risk factors for falls are prescribed benzodiazepines. The objective of this study is to assess if some of the risk factors for falls are associated with new benzodiazepine prescriptions in elderly persons. Methods Using provincial administrative databases, elderly Quebec residents were screened in 1989 for benzodiazepine use and non-users were followed for up to 5 years. Logistic regression models were used to evaluate potential predictors of new benzodiazepine use among patient baseline characteristics. Results In the 252,811 elderly patients who had no benzodiazepine prescription during the baseline year (1989, 174,444 (69% never filled a benzodiazepine prescription and 78,367 (31% filled at least one benzodiazepine prescription. In the adjusted analysis, several risk factors for falls were associated with statistically significant increases in the risk of receiving a new benzodiazepine prescription including the number of prescribing physicians seen at baseline (OR: 1.12; 95% CI 1.11–1.13, being female (OR: 1.20; 95% CI 1.18–1.22 or a diagnosis of arthritis (OR: 1.11; 95% CI 1.09–1.14, depression (OR: 1.42; 95% CI 1.35–1.49 or alcohol abuse (OR: 1.24; 95% CI 1.05–1.46. The strongest predictor for starting a benzodiazepine was the use of other medications, particularly anti-depressants (OR: 1.85; 95% CI 1.75–1.95. Conclusion Patients with pre-existing conditions that increase the risk of injurious falls are significantly more likely to receive a new prescription for a benzodiazepine. The strength of the association between previous medication use and new benzodiazepine prescriptions highlights an important medication safety issue.

  6. Chronic disease management: implementation and coordination of healthcare systems for depressed elderly persons.

    Science.gov (United States)

    Severinsson, Elisabeth; Holm, Anne Lise

    2014-12-01

    The aim of this study was to evaluate the implementation of the research-based Chronic Care Model (CCM), discuss methods and summarise research recommendations for improving the care of depressed elderly persons. Interviews were conducted and state-of-the-art reviews employed. Three important areas emerged: (1) barriers to and facilitating factors in the implementation of the CCM; (2) the challenges involved in re-designing the delivery system and interdisciplinary team collaboration; and (3) empirical evidence pertaining to self-management support and how older persons manage to live with depressive ill-health. In conclusion, implementation research requires evidence-based knowledge, staff involvement and familiarity with the context in which development occurs.

  7. Childhood adversity, attachment and personality styles as predictors of anxiety among elderly caregivers.

    Science.gov (United States)

    Prigerson, H G; Shear, M K; Bierhals, A J; Zonarich, D L; Reynolds, C F

    1996-01-01

    The purpose of this study was to examine the ways in which childhood adversity, attachment and personality styles influenced the likelihood of having an anxiety disorder among aged caregivers for terminally ill spouses. We also sought to determine how childhood adversity and attachment/personality styles jointly influenced the likelihood of developing an anxiety disorder among aged caregivers. Data were derived from semistructured interviews with 50 spouses (aged 60 and above) of terminally ill patients. The Childhood Experience of Care and Abuse (CECA) record provided retrospective, behaviorally based information on childhood adversity. Measures of attachment and personality styles were obtained from self-report questionnaires, and the Structured Clinical Interview for the DSM-III-R (SCID) was used to determine diagnoses for anxiety disorders. Logistic regression models estimated the effects of childhood adversity, attachment/personality disturbances, and the interaction between the two on the likelihood of having an anxiety disorder. Results indicated that childhood adversity and paranoid, histrionic and self-defeating styles all directly increase the odds of having an anxiety disorder as an elderly spousal caregiver. In addition, childhood adversity in conjunction with borderline, antisocial and excessively dependent styles increased the likelihood of having an anxiety disorder. The results indicate the need to investigate further the interaction between childhood experiences and current attachment/personality styles in their effects on the development of anxiety disorders.

  8. [Functional classification of the elderly in primary health care: proposed method].

    Science.gov (United States)

    Benítez del Rosario, M A; Hernández Estévez, P; de Armas, J; Barreto, J; Rodríguez Morales, H

    1995-05-31

    To develop a method of functional classification of the elderly (FCE) in Primary Health Care and to define the age limit for considering someone "a frail elderly person." A descriptive study in two phases: a) the method's design by means of "brainwriting" and b) the evaluation of the method in a descriptive crossover study. A rural medical consulting-room. The research team, in the design of the method; and the elderly population attending for health care (n = 131), in the method's evaluation. The FCE method was based on the Katz (IK) and Lawton-Brodie (IL-B) indices and classified the patients as independent and at different levels of disability. Urinary incontinence (UI) was excluded from the IK. 85.4% of the patients were independent, which bore relation to age (p < 0.001), but not to gender. When UI was included in the IK, the number of people classified as disabled increased by 32% (CI 95%, 23-41%) over when it was not included. Yet 80% of patients with UI were independent. No differences in the percentage of disabled patients were observed when the cut-off age for detecting disabled patients varied from 75 to 80. The inclusion of UI as a negative factor in the IK gives rise to overestimates of the number of disabled people. In our study the data suggested that the age for considering an elderly person as 'frail' should be 80.

  9. Does denture-wearing status in edentulous South Korean elderly persons affect their nutritional intakes?

    Science.gov (United States)

    Han, Sun Young; Kim, Cheoul Sin

    2016-06-01

    The aim of this cross-sectional study was to determine whether denture-wearing status in edentulous South Korean elders affected their nutritional intakes, using the 2008-2010 data from the Korean National Health and Nutrition Examination Survey (KNHANES). Good nutritional status is a requirement for healthy aging in the elders. Tooth loss is the key to lead to low masticatory ability and alterative food choice, which may increase the risks of systemic disease. Therefore, denture treatment is important to improve general health of edentulous persons. From KNHANES data, 1168 edentulous older people were selected as the participants of the present study. Nutrient intake data collected via participants' 24-h dietary recalls were used to determine the ratio of nutrient intake to the Recommended Dietary Allowance for Koreans, the percentage of individuals with inadequate nutrient and the effects of denture wearing on the risk of undernourishment. The results showed that compared to denture wearers, edentulous persons without dentures had lower intakes of potassium, niacin and vitamin C. In addition, the distribution of inadequate nutrient intake among participants without dentures was higher than among participants with dentures; the risk of undernourishment was 1.89 times that of denture wearers. [Correction made on 21 March 2014, after first online publication: "[…] participants with dentures was higher than among participants without dentures" was corrected to "[…] participants without dentures was higher than among participants with dentures"] Denture wearing was seen to have a significant effect on the level of nutrient intake in edentulous elders. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  10. 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.

  11. 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...

  12. THE UNIVERSITY FOR SENIOR, ELDERLY PERSON. -THE STATE OF FUTURE LIFELONG LEARNING-

    OpenAIRE

    白井, 真理子; SHIRAI, Mariko

    2014-01-01

    In the society which an aging society progresses, and elderly people increase in number, elderly people's knowledge of life is property for society. The university of senior is a lifelong learning institution which can return elderly people's knowledge to society.

  13. Quality of private personal care for elderly people with a disability living at home: correlates and potential outcomes.

    Science.gov (United States)

    Bilotta, Claudio; Vergani, Carlo

    2008-07-01

    To investigate correlates of the quality of private personal care for community-dwelling elderly people, this cross-sectional study enrolled 100 elderly outpatients living at home, along with their private aides and 88 informal caregivers, from May 2005 to January 2007. Cases were stratified according to the quality of private care as was described by both elderly participants and informal caregivers. In cases where the elderly person was suffering from overt cognitive impairment, only the opinions of the informal caregivers were taken into account. A comparison was made between the 'poor or fair care' group (n = 16), the 'intermediate care' group (n = 39) and the 'optimal care' group (n = 45). Considering the characteristics of private aides, there was a significant trend across the three groups in terms of language skills (P = 0.002) and level of distress with life conditions (P = 0.020). A statistical analysis performed on elderly participants without an overt cognitive impairment (n = 59) and informal caregivers showed an increase in the European Quality of Life Visual Analogue Scale score in the elderly group [mean +/- standard deviation (SD) were, respectively, 45 +/- 23.2, 63.7 +/- 19.7 and 68.8 +/- 21.6; P = 0.007], and a decrease in the Caregiver Burden Inventory score (mean +/- SD were, respectively, 34.9 +/- 25.3, 26 +/- 17.7 and 17.6 +/- 14.6; P = 0.020) across the three groups. We found no significant difference between elderly people in the three groups in terms of social variables, functional and cognitive status, prevalence of depressive disorders and morbidity. Therefore, good language skills and non-distressing life conditions of private aides appeared to be correlates of an optimal quality of care for community-dwelling elderly people with a disability, and also a better quality of life for them and less distress for their informal caregivers appeared to be potential outcomes of the quality of personal care.

  14. Revisiting a population-dynamic model of air pollution and daily mortality of the elderly in Philadelphia.

    Science.gov (United States)

    Murray, Christian J; Lipfert, Frederick W

    2010-05-01

    Epidemiological studies find that elderly, susceptible, and previously impaired individuals are more sensitive to transient air pollution exposures than healthy persons. However, any associated changes in life expectancy remain largely unresolved. Murray and Nelson published a model of daily mortality and air pollution that addresses mortality displacement or harvesting by directly considering population dynamics on the basis of the assumption that a period of illness or frailty precedes most elderly deaths. The underlying concept is that a person's response to an environmental exposure also depends on his/her physiological ability to withstand stress at that time. They used Kalman filtering to estimate an unobservable quantity--the size of the frail subpopulation from which elderly (ages > or = 65 yr) nontraumatic deaths are assumed to derive. They found a small subpopulation, relatively robust to environmental variations over 14 yr, with remaining life expectancies of 8-31 days in this frail status. Here, this model and dataset are expanded to examine the ramifications in more detail (including seasonality), to consider peak ozone as an additional pollutant, and to consider remaining life expectancies of the this frail subpopulation on a daily basis. Previous studies of mortality displacement and of Philadelphia mortality-air-pollution associations are also summarized in general, and agreement with the Murray-Nelson model was found, thus supporting its validity. The estimated additional mortality associated with a given environmental exposure persists for a few days at most but is not always compensated by subsequent mortality deficits. It is concluded that the pollution-associated mortality increases of a few percent in this dataset are consistent with losses of remaining life expectancy of up to a few days. It is also recommended that a more complex population-dynamic model be implemented to examine the extent to which previous short-term environmental

  15. 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.…

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

    Science.gov (United States)

    Luciano, Michelle; Lopez, Lorna M; de Moor, Marleen H M; Harris, Sarah E; Davies, Gail; Nutile, Teresa; Krueger, Robert F; Esko, Tõnu; 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

    2012-03-01

    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 and IPIP inventories) plus related mood states of anxiety and depression. Seventy single nucleotide polymorphisms (SNPs) in six brain expressed, longevity candidate genes (AFG3L2, FRAP1, MAT1A, MAT2A, SYNJ1, and SYNJ2) were typed in over 1,000 70-year old participants from the Lothian Birth Cohort of 1936 (LBC1936). No SNPs were associated with the personality and psychological distress traits at a Bonferroni corrected level of significance (P scale scores of 0.25 points, and 0.67 points in the restricted analysis of elderly cohorts (most aged >60 years). Because we selected a specific set of longevity genes based on functional genomics findings, further research on other longevity gene candidates is warranted to discover whether they are relevant candidates for personality and psychological distress traits. Copyright © 2011 Wiley Periodicals, Inc.

  17. Associations of the 24-h activity rhythm and sleep with cognition : a population-based study of middle-aged and elderly persons

    NARCIS (Netherlands)

    Luik, Annemarie I; Zuurbier, Lisette A; Hofman, Albert; Van Someren, Eus J W; Ikram, M Arfan; Tiemeier, Henning

    2015-01-01

    BACKGROUND: Cognitive functioning changes with age, sleep, and the circadian rhythm. We investigated whether these factors are independently associated with different cognitive domains assessed in middle-aged and elderly persons. METHODS: In 1723 middle-aged and elderly persons (age 62 ± 9.4 years,

  18. Representation of elderly persons and women in published randomized trials of acute coronary syndromes.

    Science.gov (United States)

    Lee, P Y; Alexander, K P; Hammill, B G; Pasquali, S K; Peterson, E D

    2001-08-08

    Elderly persons and women were underrepresented in randomized controlled trials (RCTs) prior to 1990. Since then, efforts have been made to correct these biases, but their effect is unclear. To determine whether the percentage of elderly persons and women in published clinical trials of acute coronary syndromes has increased and how this enrollment compared with disease prevalence. The MEDLINE and Cochrane databases were searched for English-language articles from January 1966 to March 2000 regarding myocardial infarction, unstable angina, or acute coronary syndromes. Additional data sources included meta-analyses, review articles, and cardiology textbooks. Estimates of community-based myocardial infarction rates came from the National Registry of Myocardial Infarction and the Worcester Heart Study. Published RCTs of acute coronary syndrome patients were included and trials enrolling 50 patients or fewer, those without clinical end points, papers published in a language other than English, and unpublished manuscripts were excluded. Of 7645 studies identified, 593 RCTs were selected for review. The RCTs were abstracted by 2 of the authors for year of publication, source of support (ie, funding), pharmacotherapy, study phase, number of study sites, trial location, number of patients, mean age of the study population, and any age exclusion criteria for enrollment. The number of published RCTs with explicit age exclusions has declined from 58% during 1966-1990 to 40% during 1991-2000. Trial enrollment of patients aged 75 years or older increased from 2% for studies published during 1966-1990 to 9% during 1991-2000, but remains well below their representation among all patients with myocardial infarction (37%) in the United States. Enrollment of women has risen from 20% for studies published between 1966-1990 to 25% during 1991-2000, but remains well below their proportion of all patients with myocardial infarction (43%) in the United States. Attempts at making

  19. The association between anger-related personality trait and cardiac autonomic response abnormalities in elderly subjects.

    Science.gov (United States)

    Narita, Kosuke; Murata, Tetsuhito; Takahashi, Tetsuya; Hamada, Toshihiko; Kosaka, Hirotaka; Yoshida, Haruyoshi; Wada, Yuji

    2007-09-01

    Cardiac autonomic response abnormality associated with trait anger has been recognized to elevate blood pressure in daily life, leading to atherosclerotic progression and cardiovascular disease. To clarify the relationship between anger-related personality traits and cardiac autonomic response in healthy elderly subjects, 54 volunteers consisting of 30 male (mean age 62.2+/-5.4) and 24 female (mean age 58.4+/-4.6) subjects underwent testing of heart rate variability (HRV) with head-up tilt. For the evaluation of trait anger, we used a questionnaire corresponding to the trait anger score taken from the State and Trait Anger Expression Inventory. Furthermore, we measured carotid intima-medial thickness (IMT) to evaluate atherosclerotic progression in subjects with anger trait. In female subjects, higher trait anger was positively associated with elevated carotid IMT and the suppression of HRV vagal attenuation from the supine to head-up position, and negatively associated with the HRV sympathetic activity in the head-up position and also with the HRV sympathetic response from the supine to head-up position. In male subjects, trait anger was not significantly associated with carotid IMT or any HRV component with or without head-up tilt testing. We conclude that a simple noninvasive measure, short-term HRV with head-up tilt testing, could be a useful method to investigate the association between cardiac autonomic imbalance and increased risk of atherosclerosis associated with trait anger in healthy elderly subjects.

  20. 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.

  1. The patient as 'teacher': learning in the care of elderly persons with dementia.

    Science.gov (United States)

    Skog, M; Grafström, M; Negussie, B; Winblad, B

    2000-05-01

    In 1996 HM Queen Silvia of Sweden started a non-governmental education programme with an integrated day-care unit devoted to elderly persons with dementia. A total of 18 Licensed Practical Nurses (LPN) from various parts of Sweden took part in the year theoretical and practical education in dementia care. The purpose was to develop specialized skills in the particular field and more generally to develop mentor capabilities. The aim of the study was to examine the experiences of the trainees, gained from following a single patient during their entire practical training period in the school's integrated day-care unit. The study was based on a combination of participant observations, interviews, diaries and recorded data and used an ethnographic approach. The results showed that themes such as 'personal guide', 'creating a relationship', 'reducing the working pace' and 'investigative mealtimes' were of major importance for the trainees' learning. In their role as 'personal guides', the trainees fell into six categories with different educational focuses. In their relationships with the patients, the trainees were able to form their own impressions of the patients' present and former lives. By training their ability to adapt the pace at which they worked, they had time to observe symptoms and be aware of the patients' needs, as well as the patients' signs of appreciation. The results also indicated that 'investigative mealtimes' can be an important element in the trainee's education in dementia care.

  2. 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…

  3. Associations between delusion proneness and personality structure in non-clinical participants: Comparison between young and elderly samples

    NARCIS (Netherlands)

    Laroi, F.; Van der Linden, M.; DeFruyt, F.; Van Os, J.; Aleman, A.

    2006-01-01

    Background: Few studies have explored the prevalence of delusions in the non-clinical, elderly population. In addition, the association between personality structure and delusions remains poorly investigated. The aims of the present study were, first, to explore the relation between age and the prev

  4. Associations between delusion proneness and personality structure in non-clinical participants : Comparison between young and elderly samples

    NARCIS (Netherlands)

    Laroi, Frank; Van der Linden, Martial; DeFruyt, Filip; van Os, Jim; Aleman, Andre

    2006-01-01

    Background: Few studies have explored the prevalence of delusions in the non-clinical, elderly population. In addition, the association between personality structure and delusions remains poorly investigated. The aims of the present study were, first, to explore the relation between age and the prev

  5. 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…

  6. 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.

  7. 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.

  8. 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 E

    2017-08-07

    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. Respondents completed eight choice tasks where they were asked to choose which of two referral scenarios should be prioritized for services. Scenarios varied in terms of four attributes reflecting competing issues that come into play in waiting list prioritization: the person's ability to shower, ability to enter and exit the home, history of falls and time already spent on the waiting list. The survey was mailed to occupational therapists working in home care and community-dwelling elderly or disabled persons. Not applicable. 241 home-based occupational therapists, 226 elderly persons from a bank of research participants and 247 adults with physical disabilities recruited through community organizations. The dependent variable was whether the referral scenario was prioritized or not in each question. Results were analyzed through logistic regression using conditional logit models. Prioritization preferences differed between groups (p Occupational therapists most strongly prioritized people who had had a few falls (OR vs. no falls = 48.9) whereas elderly people and adults with disabilities most strongly prioritized people who were unable to enter and exit the home (OR vs. no difficulty entering and exiting the home = 30.8 for elderly people and 16.9 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. Published by Elsevier Inc.

  9. Nutritional strategies for frail older adults.

    Science.gov (United States)

    Posthauer, Mary Ellen; Collins, Nancy; Dorner, Becky; Sloan, Colleen

    2013-03-01

    The objectives of this continuing education article are to analyze the aging process and its effect on the nutritional status of frail older adults; determine how sarcopenia, anorexia, malnutrition, and Alzheimer disease increase the risk for pressure ulcer development and impact the healing process; and to apply evidence-based nutrition guidelines and implement practical solutions for wound healing.

  10. Frail Older People as Participants in Research

    Science.gov (United States)

    Peel, Nancye M.; Wilson, Cecilia

    2008-01-01

    This article describes the experience of interviewing frail older people in a research project investigating hip fracture risk factors. Specific methodological strategies to maximize participation and data quality and to facilitate the interview process related to participant inclusion criteria, initial approach, questionnaire format, and…

  11. Reliable integrative assessment of health care needs in elderly persons : The INTERMED for the Elderly (IM-E)

    NARCIS (Netherlands)

    Wild, Beate; Lechner, Sabine; Maatouk, Imad; Wesche, Daniela; Raum, Elke; Mueller, Heiko; Brenner, Hermann; Slaets, Joris; Huyse, Frits; Soellner, Wolfgang; Herzog, W.

    2011-01-01

    Objective: With the increasing prevalence of multiple conditions in older age, the high prevalence of mental disorders, and the many social challenges facing elderly people, a high-risk patient group in need of interdisciplinary (biological, psychological, and social) care is emerging. The INTERMED

  12. Spectral analysis of heart rate dynamics in elderly persons with postprandial hypotension

    Science.gov (United States)

    Ryan, S. M.; Goldberger, A. L.; Ruthazer, R.; Mietus, J.; Lipsitz, L. A.

    1992-01-01

    Prior studies suggest that postprandial hypotension in elderly persons may be due to defective sympathetic nervous system activation. We examined autonomic control of heart rate (HR) after a meal using spectral analysis of HR data in 13 old (89 +/- 6 years) and 7 young (24 +/- 4 years) subjects. Total spectral power, an index of overall HR variability, was calculated for the frequency band between 0.01 and 0.40 Hz. Relatively low-frequency power, associated with sympathetic nervous system and baroreflex activation, was calculated for the 0.01 to 0.15 Hz band. High-frequency power, representing parasympathetic influences on HR, was calculated for the 0.15 to 0.40 Hz band. Mean arterial blood pressure declined 27 +/- 8 mm Hg by 60 minutes after the meal in elderly subjects, compared with 9 +/- 8 mm Hg in young subjects (p less than or equal to 0.0001, young vs old). The mean change in low-frequency HR power from 30 to 50 minutes after the meal was +19.4 +/- 25.3 U in young subjects versus -0.1 +/- 1.5 U in old subjects (p less than or equal to 0.02). Mean change in total power was also greater in young (19.0 +/- 26.6 U) subjects compared with old subjects (0.0 +/- 1.6 U, p greater than or equal to 0.02). Mean ratio of low:high-frequency power increased 3.1 +/- 3.3 U in young subjects vs 0.5 +/- 2.7 U in old subjects (p less than or equal to 0.01). The increase in low-frequency HR power and in the low:high frequency band ratio in young subjects is consistent with sympathetic activation in the postprandial period.(ABSTRACT TRUNCATED AT 250 WORDS).

  13. [Personal meaning in the elderly: sources of meaning, welfare, coping and attitude to death].

    Science.gov (United States)

    Ranst, N V; Marcoen, A

    1996-02-01

    There are many different ways to experience one's life and aging as meaningful. The present study looks for different patterns of personal meaning in the elderly. Respondents were 376 older adults (221 women and 155 men), their mean age was 65.9 years. They completed several standardized questionnaires including measures of sources of meaning (SOMP), ultimate meaning (PMI), life satisfaction (LSIA), depression (SRDS), anxiety (STAI), coping orientations (COAP), and death attitudes (DAP-R). A cluster analysis performed on the sources of meaning revealed three groups each with a different pattern of meaning. The smallest group I (n=23) found most meaning in values that indicate self-preoccupation. Self-transcendent sources of meaning were on the top of the hierarchy of values of the second group II (n=123). The third and largest group III (n=230) valued self-transcendent sources of meaning as well as sources of meaning that indicate self-realisation. The three clusters also differed with regard to ultimate meaning (group I having the highest and group III the lowest score), well-being (group I reporting more depressive feelings and more feelings of anxiety than group II and group III), coping with aging (group III reporting most instrumental coping), and death attitude (group II having the most positive attitude).

  14. Recall responses to tetanus and diphtheria vaccination are frequently insufficient in elderly persons.

    Directory of Open Access Journals (Sweden)

    Birgit Weinberger

    Full Text Available 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

  15. 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

  16. Cuidadores del adulto mayor residente en asilos Caretakers of elderly persons living in asylums

    Directory of Open Access Journals (Sweden)

    Zoila Edith Hernández Zamora

    2006-06-01

    Full Text Available Se reitera el incremento que en los últimos años ha tenido la población de adultos mayores, hecho que repercute en el número también cada vez más alto de personas residentes en asilos para ancianos, lugares que por lo regular dependen del estado y cuyas características tanto materiales como su infraestructura en cuanto a personal especializado para atender a las personas que ahí viven, deja mucho que desear. Este último aspecto es el punto cardinal de este trabajo, ya que los cuidadores, trátese de enfermeras, psicólogo, médicos, trabajadoras sociales, entre otros, realizan un papel crucial en el funcionamiento de tales instituciones. El cuidador, al igual que los residentes, es un ser humano, con una carga inherente a la labor que realiza y que, además, transita por todas las emociones o conflictos que implica desempeñar su puesto, al igual que los que cuida, necesita ser cuidado y atendido para el logro del bienestar de ambos.This article underlines the increase in the population of elderly persons that has occurred in recent years and has resulted in ever-increasing numbers of residents living in asylums for the aged, or old people’s homes. Such institutions are generally dependent on the state, and their material characteristics as well as their infrastructure in regard to the specialized personnel for attending to the people residing there leave much to be desired. This last aspect is the central point of this work since the caretakers, be they nurses, psychologists, doctors, social workers or others, perform a crucial role in the functioning of such institutions. The caretaker, like the residents, is a human being with a duty that is inherent in his/her work and who, in addition, is subject to all the emotions or conflicts that the job implies. Just like the persons under his care, he requires care and attention in order to maintain the well-being of all those concerned.

  17. 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

  18. 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

  19. Diagnostic laparoscopy for pneumatosis intestinalis in a very elderly patient: A case report

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    Shuhei Ito

    2017-09-01

    Conclusion: Diagnostic laparoscopy may be a useful option for definitively ruling out the lethal conditions associated with pneumatosis intestinalis in frail elderly patients with severe conditions in the emergency setting.

  20. Sport for All Frail Bodies

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    Jespersen Ejgil

    2015-03-01

    Full Text Available Sport for All is a universal Olympic idea adopted by supranational institutions such as the Council of Europe, UNESCO, and the UN. Measures that need to be taken to ensure that all people have an equal opportunity to be included in sport are analyzed and discussed based upon a survey of sports and exercise participation in Denmark with a special focus upon people with impairments. The prevailing point of view is a special needs approach to sports participation, whether it is oriented towards separate or integrated forms of organization. It is often unclear whether this approach is aiming for equality of outcome, equality of chance or just a minimum threshold for sports and exercise activity. However, if we adopt a universal approach to Sport for all, then the focus is not on differences among people, but upon the commonalities among human beings in light of their diversity. This approach is associated with the understanding of “universal design” in the UN‟s Convention of the Rights of Persons with Disabilities and the WHO‟s International Classification of Functioning, Disability, and Health. In conclusion, it is highlighted that a more inclusive Sport for All movement is preferable to a segregated or integrated disability sport, provided the persons concerned have a say in every case.

  1. Communication between the elderly person and the Family Health Team: is there integrality?

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    Rita Tereza de Almeida

    2013-07-01

    Full Text Available OBJECTIVE: to verify the forms of communication used in four Primary Health Units with Family Health Program teams in Porto Feliz, São Paulo, and how they impact in the care and control of the health of elderly people. METHOD: this qualitative study sought to capture the communication between elderly people and healthcare professionals. Interviews were conducted with 20 elderly people of both sexes. RESULTS: from the discourses and observations, assertive communication and blocked communication emerged as the central analysis themes, the verbal and nonverbal elements of which, unveiled subjectivity of the communication process, of the local culture and of the psychosocial factors positively and negatively contributing to the healthcare for elderly people. The nursing teams of the Family Health Strategy showed forms of communication that favored the adherence of the elderly people to the care and control of their health. Negatives aspects did not have completely prejudicial consequences, however, should be avoided, in order to facilitate integral care to elderly people. CONCLUSION: it is worth reinforcing the need for improvement of the nursing team and other healthcare professionals regarding health communication as an innovative technology, bringing credibility to the health promotion and prevention programs with elderly users.

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

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    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

  3. Positive effects on life satisfaction following health-promoting interventions for frail older adults: a randomized controlled study

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    Katarina Wilhelmson

    2013-03-01

    Full Text Available Life satisfaction among older adults is known to decrease over time and with deteriorated health. The aim of this study was to analyze the effects of the health-promoting intervention study Elderly Persons in the Risk Zone on life satisfaction. A randomized, three-armed, single-blind, and controlled trial with follow-ups at 3 months, 1 and 2 years. A total of 459 community-dwelling persons at risk of frailty, 80-years or older were included. The participants were independent of help from others in ADL and cognitively intact. The two interventions were i four weekly multi-professional senior group meetings including a follow-up home visit or ii one preventive home visit. Life satisfaction was measured with eight questions from LiSat-11. Analyses were made in accordance with the intention-to-treat principle. Life satisfaction decreased over time, with a lower decrease in the intervention groups than in the control group. The proportion of satisfied persons was significantly higher in the intervention group of senior group meetings compared to the control group for five of the eight life satisfaction variables at one year and for all variables at the two-year follow-up. For preventive home visits, there was a significant difference compared to the control group at the one-year follow-up for three of the life satisfaction variables, and at the two-year follow-up for seven variables. We can conclude that a health-promoting intervention can delay the decline in life satisfaction among older adults (aged 80 or older who are at risk of becoming frail.

  4. 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.

  5. 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

  6. A Method for Increasing Elders' Use of Advance Directives.

    Science.gov (United States)

    Luptak, Marilyn K.; Boult, Chad

    1994-01-01

    Studied effectiveness of intervention to help frail elders to record advance directives (ADs). In collaboration with physicians and lay volunteer, social worker provided information/counseling to elderly subjects, families, and proxies in series of visits to geriatric evaluation and management clinic. Seventy-one percent of subjects recorded ADs.…

  7. Frailty and Delirium in the Elderly Surgical Patient

    OpenAIRE

    Raats, Jelle

    2017-01-01

    markdownabstractThe aims of the research in this thesis were to explore the role of conservative therapies in frail elderly patients in need for (extensive) surgery. Also, delirium incidence and predictive factors of delirium in elderly patients having surgery were examined.

  8. 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

  9. 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 knowledg

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...... completing the survey, 1718 (41%) had received an influenza vaccination. Vaccinated persons had more comorbidity than unvaccinated persons (aPR for high comorbidity level: 1.51 95% CI 1.24–1.84), were less likely to never have smoked (aPR: 0.88, 95% CI 0.80–0.97), and had a higher prevalence of physical...

  11. Utilization of health promotion resources and control of health condition among healthy elderly people

    OpenAIRE

    Kuwajima, Daisuke

    2011-01-01

    In Japan, the world’s most rapidly aging country, health promotion services are often provided for elderly people, especially frail elderly and disabled people. However, in 2010, more than 60% of elderly people considered themselves to be “healthy” (Cabinet Office, white paper on aging society, 2010). It is therefore also necessary to enhance services for health promotion among these healthy elderly people. Previous studies have reported the needs of healthy elderly people with respect to hea...

  12. Mildly elevated serum bilirubin levels are negatively associated with carotid atherosclerosis among elderly persons.

    Directory of Open Access Journals (Sweden)

    Ryuichi Kawamoto

    Full Text Available 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, p < 0.001, systolic blood pressure (β = 0.104, p = 0.046, diastolic blood pressure (β = -0.148, p = 0.004, prevalence of antihypertensive medication (β = 0.126, p = 0.004, fasting plasma glucose (β = 0.135, p = 0.003, GGT (β = -0.104, p = 0.032, estimated glomerular filtration rate, serum bilirubin (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.

  13. Falls are associated with stroke, arthritis and multiple medications among community-dwelling elderly persons in Japan.

    Science.gov (United States)

    Mizukami, Satoshi; Arima, Kazuhiko; Abe, Yasuyo; Kanagae, Mitsuo; Kusano, Yosuke; Niino, Naoakira; Aoyagi, Kiyoshi

    2013-01-01

    Falls are a major public health problem and the second leading cause of death due to unintentional accidental injury after road traffic accidents. Inactive, older individuals with several chronic illnesses fall more frequently than older individuals who are active and healthy. No population-based study has addressed the association of stroke, arthritis, hypnotic and other prescription medications with falls among the elderly simultaneously in a single population in Japan. We examined the prevalence of falls among community-dwelling elderly Japanese individuals, whom we randomly selected from a list of inhabitants aged ≥ 65 years compiled from the resident registration, and the associations between falls and each of stroke, arthritis, and hypnotic and other prescription medications. We interviewed 295 men and 307 women, and collected information about the number of falls during the latest one year, hemiplegia due to stroke, arthritis in the legs, and the number of hypnotic and other medications. We found that 46 men (16%) and 67 women (22%) had fallen at least once during the latest one year. Logistic regression analysis adjusted for age showed that hemiplegia due to stroke (p falls in men. Arthritis in the legs (p = 0.05) and taking at least four daily prescription medications (p falls in women. Treatment of fall-related diseases and medication management are important strategies for reducing falls among elderly persons.

  14. Automatic and effortful memory processes in elderly persons with organic brain pathology.

    Science.gov (United States)

    Rohling, M L; Ellis, N R; Scogin, F

    1991-07-01

    This study investigated the automatic and effortful memory encoding model of Hasher and Zacks (1979) and the potential it may hold for aiding in the differentiation between aging-related memory decline and dementia. College students, normal elders, and dementia patients were compared on a 96-item picturebook task utilizing measures of free recall, recognition accuracy, memory for location, and memory for frequency. There were no differences between students and elders on any of the dependent measures. However, differences were found between elders and patients on each measure, and a discriminant function correctly classified the two groups with 93.3% accuracy. Subsequent discriminant analysis found patients could be correctly classified into diagnostic subgroups, i.e., dementia of the Alzheimer's type (DAT), multi-infarct dementia (MID), and Korsakoff's disease (KD) with 80.8% accuracy. The model holds promise as a guide for clinicians who are asked to make differential diagnoses of memory-impaired individuals.

  15. 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.

  16. Implementation of an innovative web-based conference table for community-dwelling frail older people, their informal caregivers and professionals: a process evaluation

    Directory of Open Access Journals (Sweden)

    Robben Sarah HM

    2012-08-01

    Full Text Available Abstract Background Due to fragmentation of care, continuity of care is often limited in the care provided to frail older people. Further, frail older people are not always enabled to become involved in their own care. Therefore, we developed the Health and Welfare Information Portal (ZWIP, a shared Electronic Health Record combined with a communication tool for community-dwelling frail older people and primary care professionals. This article describes the process evaluation of its implementation, and aims to establish (1 the outcomes of the implementation process, (2 which implementation strategies and barriers and facilitators contributed to these outcomes, and (3 how its future implementation could be improved. Methods Mixed methods study, consisting of (1 a survey among professionals (n = 118 and monitoring the use of the ZWIP by frail older people and professionals, followed by (2 semi-structured interviews with purposively selected professionals (n = 12. Results 290 frail older people and 169 professionals participated in the ZWIP. At the end of the implementation period, 55% of frail older people and informal caregivers, and 84% of professionals had logged on to their ZWIP at least once. For professionals, the exposure to the implementation strategies was generally as planned, they considered the interprofessional educational program and the helpdesk very important strategies. However, frail older people’s exposure to the implementation strategies was less than intended. Facilitators for the ZWIP were the perceived need to enhance interprofessional collaboration and the ZWIP application being user-friendly. Barriers included the low computer-literacy of frail older people, a preference for personal communication and limited use of the ZWIP by other professionals and frail older people. Interviewees recommended using the ZWIP for other target populations as well and adding further strategies that may help frail older people to

  17. 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.

  18. [THE EROTICISM OF PERSONS WITH DEMENTIA IN NURSING HOMES FOR THE ELDERLY].

    Science.gov (United States)

    Iacub, Ricardo; Rodríguez, Rosa

    2015-01-01

    The objective of this paper is to present the models used by the Residences for Elderly People to organize the eroticism of their residents, especially for people with dementia. It will be shown the different institutional models and their theoretical perspectives over the eroticism of demented people to define the possible interventions with these people.

  19. 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.

  20. An Exploratory Study of the Relationship of Valued Activities to the Life Satisfaction of Elderly Persons.

    Science.gov (United States)

    Maguire, Gail Hills

    1983-01-01

    Describes a survey that collected information about perceived activity participation levels, health status, income, social supports, and life satisfaction of participants in a nutritional lunch program for the elderly. Results showed that perceptions of the above factors were significant predictors of life satisfaction. (NJ)

  1. Correlates of Changes in Desired Control Scores and in Life Satisfaction Scores among Elderly Persons.

    Science.gov (United States)

    Ziegler, Michael; Reid, David W.

    1983-01-01

    Describes the correlates of life satisfaction and desired control among 79 elderly residents by assessing residents at three points in time. Both life satisfaction and desired control were intercorrelated and related to other indices of psychological well-being at all three points in time. (Author/RC)

  2. [The availability of particular types of medical social care to persons of elderly and senile age].

    Science.gov (United States)

    Shigabutdinov, A F

    2012-01-01

    The article presents the results of sociological survey of respondents of elderly and senile age living with their families or in senior centers. The comparative analysis was applied to availability of particular types of medical social care of contingent of interest depending on place of its residence. The age and ability of self-support of respondents were taken into account.

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

    Directory of Open Access Journals (Sweden)

    Lepir Ljubo

    2010-01-01

    Full Text Available 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 topic of great importance both for theoreticians and the practitioners in the social sector area. This research analyzes the management functions and the roles of managers in running social protection of the elderly in the example of the social welfare system in the Republic of Srpska. A decentralized system, such as the one existing in the Republic of Srpska, brings along a number of organizational problems which points out to a need to apply the theoretical bases of managerial processes. The results obtained via empirical analyses indicate a number of deficiencies and obstacles in the implementation of social protection of the elderly in the social welfare system of the Republic of Srpska which are result of the insufficient and inconsistent application of the basic managerial elements. The obstacles emerging from this analysis indicate that there are chances and opportunities to improve the system and enhance the development of new forms of protection by applying managerial theories. .

  4. The Attribution of Universal or Personal Helplessness in Nondepressed and Depressed Elderly Females.

    Science.gov (United States)

    Maiden, Robert J.

    The potential for feelings of hopelessness and depression in the aged is well documented. Although studies have examined the role of perceived control in ameliorating depression in the institutionalized elderly, no research has actually measured the perceived causal attributions among depressed, hopeless and/or institutionalized elderly…

  5. Elderly patients with multiple myeloma: towards a frailty approach?

    Science.gov (United States)

    Zweegman, Sonja; Engelhardt, Monika; Larocca, Alessandra

    2017-09-01

    To describe how to better identify frail multiple myeloma patients and to treat them appropriately. Proteasome inhibitors, such as bortezomib, carfilzomib, and ixazomib, and immunomodulatory agents (IMiDs), such as thalidomide, lenalidomide, and pomalidomide, have significantly improved the outcome of multiple myeloma patients in the last decade. However, both in clinical trials and in daily clinical practice, elderly multiple myeloma patients have shown lesser benefit. This is mainly due to less stringent use of proteasome inhibitors and IMiDs, increased toxicity, and subsequent early discontinuation of therapy in elderly. Multiple myeloma typically affects elderly patients. Approximately one-third of patients are older than 75 years at diagnosis. Moreover, at least 30% are frail, both due to disease-related symptoms and (age-related) decline in physical capacity, presence of comorbidities, frailty, polypharmacy, nutritional status, and cognitive impairment. Treatment regimens that are investigated in clinical trials for transplant-ineligible patients have largely been investigated in fit, rather than frail patients, the latter being typically excluded or highly underrepresented therein. Data on the feasibility and efficacy of current standards of care are therefore lacking in frail patients. Preliminary data suggest a higher toxicity and discontinuation rate, loss of efficacy, and impaired quality of life in frail patients. Geriatric assessment helps to identify frail patients according to their functional and cognitive status. Both the International Myeloma Working Group (IMWG)-frailty index and Revised Myeloma Comorbidity Index constitute recently proposed algorithms that easily identify intermediate-fit and frail patients. Ongoing and future clinical trials, specifically designed for frail patients, will hopefully define frailty-directed treatment selection.

  6. Correlation between physical function, cognitive function, and health-related quality of life in elderly persons

    OpenAIRE

    Kim, DeokJu

    2016-01-01

    [Purpose] This study aimed to assess the quality of life of elderly people related to physical function, cognitive function, and health, and devised methods to enhance their health-related quality of life. [Subjects and Methods] This study was conducted from November 2014 to January 2015 in 140 people over 65 registered at welfare centers. Those with a functional psychological disorder or difficulty communicating were excluded. Data were collected for physical function, cognitive function, an...

  7. 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…

  8. Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh.

    Science.gov (United States)

    Ferdous, Tamanna; Cederholm, Tommy; Razzaque, Abdur; Wahlin, Ake; Nahar Kabir, Zarina

    2009-07-01

    To investigate the impact of nutritional status on self-reported as well as performance-based indicators of physical function in a rural elderly population in Bangladesh. A cross-sectional study conducted in Matlab, Bangladesh, included 457 randomly selected community-living elderly persons aged 60 years or more (60-92 years; 69 +/- 7 years). Mobility, activities of daily living (ADL), performance tests, handgrip strength, the Mini Nutritional Assessment (MNA) and a structured questionnaire were used to assess physical function, nutritional status, socioeconomic status and health status, respectively. Descriptive and linear hierarchical regression analyses were applied. Seven per cent of the participants reported limitations in mobility, and 8% reported limitations in ADL. However, more than half of the participants had difficulties in performing one or more items in the performance tests. According to the MNA, 26% of the participants were undernourished and 62% were at risk of malnutrition. More undernourished participants than well-nourished participants reported limited mobility, impaired ADL and difficulties in the performance tests. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, higher MNA scores, indicating better nutritional status, were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socioeconomic and health status differences. Good nutritional status is important for the physical function of elderly people, even after controlling for possible confounders. Performance tests indicated a higher degree of functional impairment than that observed by self-reported estimation.

  9. Gender-specific impact of personal health parameters on individual brain aging in cognitively unimpaired elderly subjects

    Directory of Open Access Journals (Sweden)

    Katja eFranke

    2014-05-01

    Full Text Available Aging alters brain structure and function. Personal health markers and modifiable lifestyle factors are related to individual brain aging as well as to the risk of developing Alzheimer’s disease (AD. This study uses a novel magnetic resonance imaging (MRI-based biomarker to assess the effects of 17 health markers on individual brain aging in cognitively unimpaired elderly subjects. By employing kernel regression methods, the expression of normal brain-aging patterns forms the basis to estimate the brain age of a given new subject. If the estimated age is higher than the chronological age, a positive brain age gap estimation (BrainAGE score indicates accelerated atrophy and is considered a risk factor for developing AD. Within this cross-sectional, multi-center study 228 cognitively unimpaired elderly subjects (118 males completed an MRI at 1.5T, physiological and blood parameter assessments. The multivariate regression model combining all measured parameters was capable of explaining 39% of BrainAGE variance in males (p < 0.001 and 32% in females (p < 0.01. Furthermore, markers of the metabolic syndrome as well as markers of liver and kidney functions were profoundly related to BrainAGE scores in males (p < 0.05. In females, markers of liver and kidney functions as well as supply of vitamin B12 were significantly related to BrainAGE (p < 0.05. In conclusion, in cognitively unimpaired elderly subjects several clinical markers of poor health were associated with subtle structural changes in the brain that reflect accelerated aging, whereas protective effects on brain aging were observed for markers of good health. Additionally, the relations between individual brain aging and miscellaneous health markers show gender-specific patterns. The BrainAGE approach may thus serve as a clinically relevant biomarker for the detection of subtly abnormal patterns of brain aging probably preceding cognitive decline and development of AD.

  10. Gait Variability Related to Muscle Quality and Muscle Power Output in Frail Nonagenarian Older Adults.

    Science.gov (United States)

    Martinikorena, Ion; Martínez-Ramírez, Alicia; Gómez, Marisol; Lecumberri, Pablo; Casas-Herrero, Alvaro; Cadore, Eduardo L; Millor, Nora; Zambom-Ferraresi, Fabricio; Idoate, Fernando; Izquierdo, Mikel

    2016-02-01

    Frailty has become the center of attention of basic, clinical, and demographic research because of its incidence level and the gravity of adverse outcomes with age. Moreover, with advanced age, motor variability increases, particularly in gait. Muscle quality and muscle power seem to be closely associated with performance on functional tests in frail populations. Insight into the relationships among muscle power, muscle quality, and functional capacity could improve the quality of life in this population. In this study, the relationship between the quality of the muscle mass and muscle strength with gait performance in a frail population was examined. Twenty-two institutionalized frail elderly individuals (93.1 ± 3.6) participated in this study. Muscle quality was measured by segmenting areas of high- and low-density fibers as observed in computed tomography images. The assessed functional outcomes were leg strength and power, velocity of gait, and kinematic gait parameters obtained from a tri-axial inertial sensor. Our results showed that a greater number of high-density fibers, specifically those of the quadriceps femoris muscle, were associated with better gait performance in terms of step time variability, regularity, and symmetry. Additionally, gait variability was associated with muscle power. In contrast, no significant relationship was observed between gait velocity and either muscle quality or muscle power. Gait pattern disorders could be explained by a deterioration of the lower limb muscles. It is known that an impaired gait is an important predictor of falls in older populations; thus, the loss of muscle quality and power could underlie the impairments in motor control and balance that lead to falls and adverse outcomes. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  11. Samuel Beckett's "Rockaby": dramatizing the plight of the solitary elderly at life's end.

    Science.gov (United States)

    Groninger, Hunter; Childress, Marcia Day

    2007-01-01

    Irish playwright Samuel Beckett's spare, compact, and provocative play Rockaby (1981) is a study in old age, isolation, and disengagement from life. In it, an elderly woman rocks in a chair while the audience hears a distant voice remembering her lifelong search for human contact or communion. The play dramatizes the woman's intense physical and psychological isolation and the last sputterings of her impulse to narrate. Such radical isolation may be a necessary precondition for a person relinquishing the narrating that Beckett equates with being, and surrendering unto death. Despite its apparent simplicity, the play powerfully explores the nature of aging in contemporary society, quality-of-life issues for the frail, solitary elderly in our communities and health-care institutions, and how the elderly prepare for life's end in a death-denying culture. Rockaby is thus a text that can help clinicians and other caregivers appreciate the predicament of solitary elderly persons nearing life's end and better understand how we all must manage one day the lonely, self-abnegating yet also paradoxically self-assertive act of dying.

  12. Development of a Knee-gap Force Measurement Device to Evaluate Quantitative Lower Limb Muscular Strength of the Elderly

    Science.gov (United States)

    Yamashita, Kazuhiko; Imaizumi, Kazuya; Iwakami, Yumi; Sato, Mitsuru; Nakajima, Sawako; Ino, Shuichi; Koyama, Hironori; Kawasumi, Masashi; Ifukube, Toru

    Falling is one of the most serious problems for the elderly. It is thought that lower limb muscular strength greatly affects falls of the elderly. The aim of this study is to develop a safe, easy-to-use and quantitative device of knee-gap force measurement for evaluation of the lower limb muscular strength, and additionally, we examined it for efficiency. We examined from the three viewpoints. In the results, 1. the knee-gap force is clearly associated with the strength of muscle contraction estimated by electromyogram in each muscle for the hip joint adductors. Therefore, the proposed device for the measurement of knee-gap force correctly estimates the activity of the hip joint adductors, which is closely related with the activities of daily living. 2.The results of knee-gap force measured from 170 people aging from middle age to elderly, including some persons who are suffering from physical frailness on a clinical estimation. In the group of healthy elderly knee-gap force was decreased by 16%, while that of the physically frail elderly was decreased by 34% in comparison to middle age.3. Furthermore, the correlation coefficient between the knee-gap force and 10m obstacle walking time was found to be -0.57 (negative correlation). It means that the ambulatory ability is decreased along with the knee-gap force being decreased. This indicates a possibility easily to estimate risk of falling by the knee-gap force, because the decrease of lower limb muscular strength and ambulatory ability is a factor of increased falling risk.

  13. 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

    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...... 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......, 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...

  14. 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.

  15. Knowledge, uptake and availability of health and social services among Asian Gujarati and white elderly persons.

    Science.gov (United States)

    Lindesay, J; Jagger, C; Hibbett, M J; Peet, S M; Moledina, F

    1997-01-01

    To investigate factors affecting the uptake of health and social services by elderly Asian Gujarati. Four hundred and five Hindu Gujaratis and 381 whites aged 65 years and over residing in Leicester were randomly sampled from the Leicestershire District FHSA list by a computerized method based on linguistic analysis of the patient's name. One hundred and fifty Hindu Gujaratis and 152 whites were interviewed with response rates of 72% for the Asian Gujaratis and 80% for the white groups. The outcome measures were the activities of daily living (ADLs), incontinence, auditory/ visual deficits, cardiovascular disease, cognitive impairment (measured by the Mini-mental State Examination), depression, use of GP and hospital services, knowledge of community health and social services, willingness to use, suitability and cultural accessibility. The poorer uptake of services by elderly Asian Gujarati could not be explained by better health. They were significantly more likely to be dependent in six of the 14 ADLs and had higher rates of diabetes and impaired vision. Significantly more Asian Gujaratis than whites lived with others (84 versus 52%, p Gujarati group; fewer Asian Gujaratis knew how to apply for services and of those applying, fewer had been successful. Where services had been obtained, the levels of dissatisfaction were higher in the Gujarati group. The literacy rates were low in the Gujarati sample with 79% being unable to read or write in English and 27% unable to read or write in their mother tongue. The lower uptake of services by elderly Asian Gujarati is not the result of better health but may be explained by greater family support together with a lack of knowledge of and dissatisfaction with what is available. Health services will need to reappraise and revise some of their practices if they are to cater adequately for this growing population with many needs as yet unmet.

  16. A person-centred segmentation study in elderly care : Towards efficient demand-driven care

    NARCIS (Netherlands)

    Eissens-van der Laan, Monique; van Offenbeek, Marjolein; Broekhuis, Manda; Slaets, Joris

    2014-01-01

    Providing patients with more person-centred care without increasing costs is a key challenge in healthcare. A relevant but often ignored hindrance to delivering person-centred care is that the current segmentation of the population and the associated organization of healthcare supply are based on di

  17. Oral mixing ability and cognition in elderly persons with dementia: a cross-sectional study

    NARCIS (Netherlands)

    Weijenberg, R.A.F.; Lobbezoo, F.; Visscher, C.M.; Scherder, E.J.A.

    2015-01-01

    Masticatory performance has been positively associated with cognitive ability in both animals and healthy humans. We hypothesised that there would also be a positive correlation between masticatory performance and cognition in older persons suffering from dementia. Older persons suffering from demen

  18. 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

    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......-month follow-up. From the perspective of QoL, nurses need to address more specifically the most vulnerable elderly cancer patients: those who are dependent in instrumental activities of daily living, those who perceive reduced economic ability, and those who need assistance to discover new strategies...

  19. Does informal care reduce public care expenditure on elderly care? Estimates based on Finland's Age Study.

    Science.gov (United States)

    Kehusmaa, Sari; Autti-Rämö, Ilona; Helenius, Hans; Rissanen, Pekka

    2013-08-15

    To formulate sustainable long-term care policies, it is critical first to understand the relationship between informal care and formal care expenditure. The aim of this paper is to examine to what extent informal care reduces public expenditure on elderly care. Data from a geriatric rehabilitation program conducted in Finland (Age Study, n = 732) were used to estimate the annual public care expenditure on elderly care. We first constructed hierarchical multilevel regression models to determine the factors associated with elderly care expenditure. Second, we calculated the adjusted mean costs of care in four care patterns: 1) informal care only for elderly living alone; 2) informal care only from a co-resident family member; 3) a combination of formal and informal care; and 4) formal care only. We included functional independence and health-related quality of life (15D score) measures into our models. This method standardizes the care needs of a heterogeneous subject group and enabled us to compare expenditure among various care categories even when differences were observed in the subjects' physical health. Elder care that consisted of formal care only had the highest expenditure at 25,300 Euros annually. The combination of formal and informal care had an annual expenditure of 22,300 Euros. If a person received mainly informal care from a co-resident family member, then the annual expenditure was only 4,900 Euros and just 6,000 Euros for a person living alone and receiving informal care. Our analysis of a frail elderly Finnish population shows that the availability of informal care considerably reduces public care expenditure. Therefore, informal care should be taken into account when formulating policies for long-term care. The process whereby families choose to provide care for their elderly relatives has a significant impact on long-term care expenditure.

  20. Changes in Oxidative Stress and Inflammatory Biomarkers in Fragile Adults over Fifty Years of Age and in Elderly People Exclusively Fed Enteral Nutrition

    National Research Council Canada - National Science Library

    Mesa, Maria D; Olza, Josune; Gonzalez-Anton, Carolina; Aguilera, Concepcion M; Moreno-Torres, Rosario; Jimenez, Africa; Perez de la Cruz, Antonio; Ruperez, Azahara I; Gil, Angel

    2015-01-01

    ...) affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects...

  1. Reduced health-related quality of life in elders with frailty: a cross-sectional study of community-dwelling elders in Taiwan.

    Directory of Open Access Journals (Sweden)

    Cheng-Chieh Lin

    Full Text Available PURPOSE: Exploring the domains and degrees of health-related quality of life (HRQOL that are affected by the frailty of elders will help clinicians understand the impact of frailty. This association has not been investigated in community-dwelling elders. Therefore, we examined the domains and degree of HRQOL of elders with frailty in the community in Taiwan. METHODS: A total of 933 subjects aged 65 years and over were recruited in 2009 from a metropolitan city in Taiwan. Using an adoption of the Fried criteria, frailty was defined by five components: shrinking, weakness, poor endurance and energy, slowness, and low physical activity level. HRQOL was assessed by the short form 36 (SF-36. The multiple linear regression model was used to test the independent effects of frailty on HRQOL. RESULTS: After multivariate adjustment, elders without frailty reported significantly better health than did the pre-frail and frail elders on all scales, and the pre-frail elders reported better health than did the frail elders for all scales except the scales of role limitation due to physical and emotional problems and the Mental Component Summary (MCS. The significantly negative differences between frail and robust elders ranged from 3.58 points for the MCS to 22.92 points for the physical functioning scale. The magnitude of the effects of frail components was largest for poor endurance and energy, and next was for slowness. The percentages of the variations of these 10 scales explained by all factors in the models ranged from 11.1% (scale of role limitation due to emotional problems to 49.1% (scale of bodily pain. CONCLUSIONS: Our study demonstrates that the disabilities in physical health inherent in frailty are linked to a reduction in HRQOL. Such an association between clinical measures and a generic measure of the HRQOL may offer clinicians new information to understand frailty and to conceptualize it within the broader context of disability.

  2. Prevalence of depressive symptoms and suicidal thoughts among elderly persons in rural Bangladesh.

    Science.gov (United States)

    Wahlin, Åke; Palmer, Katie; Sternäng, Ola; Hamadani, Jena D; Kabir, Zarina Nahar

    2015-12-01

    Depression, if broadly defined, is the commonest late-life mental disorder. We examined the distribution of depressive symptoms and suicidal thoughts, across age, sex, literacy, and marital status, among elderly individuals residing in rural Bangladesh and participating in a population-based study on health and aging. Prevalence figures of depressive symptoms were assessed with SRQ20 (n = 625), and possible social network and economic associations were examined. Morbidity accounts of depressive symptoms and suicidal thoughts were examined for a subsample that also underwent complete medical examination (n = 471). We selected for analyses the items that corresponded to DSM-IV criteria and constructed a dichotomous variable. The prevalence was 45%, and most pronounced among the oldest women (70%). The overall prevalence of suicidal thoughts was 23%. Being a woman, illiterate or single were all risk factors for depressive symptoms and suicidal thoughts. These associations remained unaccounted for by the social network and economic variables. Co-residing with a child and having a high quality of contact were protective of both depressive symptoms and suicidal thoughts. The main findings were replicated in the subsample, where it was found that morbidities were also associated with the outcomes, independently of the four main predictors. Prevalence figures for depressive symptoms among elderly in rural Bangladesh are high. Demographic, social network, and morbidity factors are independently associated with both depressive symptoms and suicidal thoughts. This is the first study to report prevalence figures for depressive symptoms in this population.

  3. Effects of a Visual Distracter Task on the Gait of Elderly versus Young Persons

    Directory of Open Access Journals (Sweden)

    Otmar Bock

    2011-01-01

    Full Text Available Seniors show deficits of dual-task walking when the second task has high visual-processing requirements. Here, we evaluate whether similar deficits emerge when the second task is discrete rather than continuous, as is often the case in everyday life. Subjects walked in a hallway, while foot proprioception was either perturbed by vibration or unperturbed. At unpredictable intervals, they were prompted to turn their head and perform a mental-rotation task. We found that locomotion of young subjects was not affected by this distracter task with or without vibration. In contrast, seniors moved their legs after the distraction at a slower pace through smaller angles and with a higher spatiotemporal variability; the magnitude of these changes was vibration independent. We conclude that the visual distracter task degraded the gait of elderly subjects but completely spared young ones, that this effect is not due to degraded proprioception, and that it rather might reflect the known decline of executive functions in the elderly.

  4. 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 familiar songs from long ago 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 hopotheses are - that singing has an influence on persons with dementia - 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...

  5. 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...

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

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2001-01-01

    . My hopotheses are - that singing has an influence on persons with dementia - 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 signs - that music therapy has an influence on aspects in residential daily life for the person with dementia. Data collection has been based on video recording, heart rate measurements, day-to-day questionnaires, case descriptions and music therapist's log.......The focus of this research in progress is my clinical work with persons suffering from dementia, where we sing familiar songs from long ago in the music therapy. In an exploratory case study approach I have made systematic observations of 6 individual residents living in a gerontopsychological unit...

  7. Effects of horseback riding exercise therapy on hormone levels in elderly persons

    Science.gov (United States)

    Cho, Sung-Hyoun; Kim, Jin-Woo; Kim, Seon-Rye; Cho, Byung-Jun

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of riding exercise on hormone levels in normal elderly people who were taught horseback riding for 8 weeks. [Subjects] Subjects were classified into an exercise group (n=10) and control group (n=10). [Methods] The two groups, horseback riding exercise group of 10 and control group of 10, were each tested for 15 minutes, 3 times, over 8 weeks. Post-exercise tests were implemented in both groups in the same way as pre-study tests. [Results] The horseback riding group showed a significant difference in the pre- and post-exercise serotonin and cortisol levels. Additionally, serotonin and cortisol levels showed significant differences between the two groups. [Conclusion] Serotonin and cortisol levels significantly increased in the experimental group, suggesting that horseback riding exercise is effective for improving the levels of these hormones. PMID:26311966

  8. 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.

  9. 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 ne

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    O.N. Domashenko

    2016-11-01

    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

  12. Health care provision for older persons: the interplay between ageism and elder neglect.

    Science.gov (United States)

    Band-Winterstein, Tova

    2015-04-01

    The aim of this study was to explore the link between neglect and ageism in health care provision for older persons. Semistructured in-depth interviews were conducted with 30 registered nurses with at least 2 years' experience in 10 long-term care facilities in Israel. Interviews were digitally recorded and transcribed verbatim. Data analysis was performed according to the qualitative method. Three main themes emerged: ageism and neglect as the everyday routine (neglect is built into institution life on the platform of ageism); how the institutional system promotes neglect--between institutional and personal ageism (the ways institutions promote neglect in the shadow of ageism); from vision to reality--how neglect can be prevented in an ageist reality. The attempt to demonstrate the link between ageism and neglect and suggesting how to include them as interrelated phenomena in health care provision programs could promote older persons' quality of life.

  13. Kinematic analysis of motor strategies in frail aged adults during the Timed Up and Go: how to spot the motor frailty?

    Science.gov (United States)

    Hassani, Asma; Kubicki, Alexandre; Brost, Vincent; Mourey, France; Yang, Fan

    2015-01-01

    The purpose of this work was to analyze and compare the movement kinematics of sit-to-stand (STS) and back-to-sit (BTS) transfers between frail aged adults and young subjects, as well as to determine the relationship between kinematic changes and functional capacities. We analyzed the Timed Up and Go (TUG) movements by using a 3D movement analysis system for real-time balance assessment in frail elderly. Ten frail aged adults (frail group [FG]) and ten young subjects (young group [YG]) performed the TUG. Seven spatiotemporal parameters were extracted and compared between the two groups. Moreover, these parameters were plotted with TUG test duration. The experiments revealed that there were significant differences between FG and YG in trunk angle during both STS and BTS, and in TUG duration. The trunk angle of the young subjects was more than two times higher than that of the FG. As expected, the TUG duration was higher in the FG than in YG. Trunk angles during both transfers were the most different parameters between the groups. However, the BTS trunk angle and STS ratio were more linked to functional capacities. There was a relationship between kinematic changes, representing the motor planning strategies, and physical frailty in these aged adults. These changes should be taken into account in clinical practice.

  14. [Features of arterial blood pressure in elderly persons of different ethnic groups in Yakutsk].

    Science.gov (United States)

    Nikitin, Iu P; Tatarinova, O V; Neustroeva, V N; Shcherbakova, L V; Sidorov, A S

    2013-01-01

    The differences in arterial blood pressure in the sample of population in the age of 60 and older of different ethnic groups in Yakutsk, as well as its connection with the other cardiovascular diseases risk factors have been analyzed. It was shown that the average values of systolic and diastolic blood pressure in subsample of the Yakuts appeared to be lower than in Caucasoid gerontic persons. The average values of systolic arterial blood pressure both in the Yakuts and in the Caucasoids were detected higher than normal values in all age-dependent subgroups. The average values of diastolic blood pressure in both ethnic groups were within the limits of high normal level. From 60 to 90 years and older the decrease in systolic and diastolic arterial blood pressure was detected; it was more marked in Caucasoid gerontic persons. The average values of pulse pressure in the Yakuts and in the Caucasoids appeared to be higher than the existing standard and didn't have any differences in ethnic groups. In both ethnical subsamples, pulse pressure values increase was observed in persons of 60-89 years old and its decrease after 90. Persons with overweight, obesity, central (abdominal) obesity, dyslypoproteidemias irrespective of belonging to ethnical group were characterized as having higher levels of arterial blood pressure. Statistically significant differences in the levels of arterial blood pressure in the Yakuts and in the Caucasoids depending on hyperglycemia, smoking, the presence of burdened anamnesis, educational level, marital status was not detected.

  15. Fear of Crime and the Elderly: Personal, Social, and Environmental Factors.

    Science.gov (United States)

    Ward, Russell A.; And Others

    Despite low levels of criminal victimization, older people often express greater fear of crime than others. To examine the causes and consequences of such fear, 1,185 adults aged 60 and over, were interviewed about their personal characteristics, social resources, environment, subjective well-being, and lifestyle. Results showed that older people…

  16. A Genetic Variant (COMT) Coding Dopaminergic Activity Predicts Personality Traits in Healthy Elderly.

    Science.gov (United States)

    Kotyuk, Eszter; Duchek, Janet; Head, Denise; Szekely, Anna; Goate, Alison M; Balota, David A

    2015-08-01

    Association studies between the NEO five factor personality inventory and COMT rs4680 have focused on young adults and the results have been inconsistent. However, personality and cortical changes with age may put older adults in a more sensitive range for detecting a relationship. The present study examined associations of COMT rs4680 and personality in older adults. Genetic association analyses were carried out between the NEO and the targeted COMT rs4680 in a large, well-characterized sample of healthy, cognitively normal older adults (N = 616, mean age = 69.26 years). Three significant associations were found: participants with GG genotype showed lower mean scores on Neuroticism (p = 0.039) and higher scores on Agreeableness (p = 0.020) and Conscientiousness (p = 0.006) than participants with AA or AG genotypes. These results suggest that older adults with higher COMT enzymatic activity (GG), therefore lower dopamine level, have lower Neuroticism scores, and higher Agreeableness and Conscientiousness scores. This is consistent with a recent model of phasic and tonic dopamine release suggesting that even though GG genotype is associated with lower tonic dopamine release, the phasic release of dopamine might be optimal for a more adaptive personality profile.

  17. Dilemmas in Decision Making for Caregivers of Cognitively Impaired Elderly Persons.

    Science.gov (United States)

    Weisensee, Mary G.; Kjervik, Diane K.

    1989-01-01

    The decision-making dilemmas faced by caregivers of older persons, coordination necessary among decision makers, legal criteria for incompetency, and caregiver stress are examined. The need for clarification of incompetency criteria for improved coordination among caregivers is suggested. (Author/MLW)

  18. 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.

  19. Fear of falling in elderly persons: association with falls, functional ability, and quality of life.

    Science.gov (United States)

    Li, Fuzhong; Fisher, K John; Harmer, Peter; McAuley, Edward; Wilson, Nicole L

    2003-09-01

    This study examined heterogeneity in response patterns of the participants of the Survey of Activities and Fear of Falling in the Elderly (SAFFE) and their relationships to falls, functional ability, quality of life, and activity restriction measures in a cohort of 256 older people (mean age = 77.5 years). Participants recruited from local primary care clinics were administered the SAFFE instrument, an activity restriction measure, a combination of self-reported and performance-based functional ability tests, and quality-of-life measures. Latent class analyses identified two classes: Class 1 (n = 209), which had a low SAFFE fear of falling, and Class 2 (n = 47), which had a high SAFFE fear of falling. Subsequent analyses of variance indicated that the two-class (low fear and high fear) SAFFE fear of falling profiles discriminated fallers from nonfallers, and low and high levels of functional ability, activity restriction, and quality of life. The findings from this study suggest that variations in the SAFFE response patterns on a single dimension of fear of falling and that high levels of fear of falling measured by the SAFFE are linked to a range of adverse health consequences.

  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.

  1. Staging of mobility, transfer and walking functions of elderly persons based on the codes of the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Okochi, Jiro; Takahashi, Tai; Takamuku, Kiyoshi; Escorpizo, Reuben

    2013-02-15

    The International Classification of Functioning, Disability and Health (ICF) was introduced by the World Health Organization as a common taxonomy to describe the burden of health conditions. This study focuses on the development of a scale for staging basic mobility and walking functions based on the ICF. Thirty-three ICF codes were selected to test their fit to the Rasch model and their location. Of these ICF items, four were used to develop a Guttman- type scale of "basic mobility" and another four to develop a"walking" scale to stage functional performance in the elderly. The content validity and differential item functioning of the scales were assessed. The participants, chosen at random, were Japanese over 65 years old using the services of public long-term care insurance, and whose functional assessments were used for scale development and scale validation. There were 1164 elderly persons who were eligible for scale development. To stage the functional performance of elderly persons, two Guttman-type scales of "basic mobility" and "walking" were constructed. The order of item difficulty was validated using 3260 elderly persons. There is no differential item functioning about study location, sex and age-group in the newly developed scales. These results suggested the newly developed scales have content validity. These scales divided functional performance into five stages according to four ICF codes, making the measurements simple and less time-consuming and enable clear descriptions of elderly functioning level. This was achieved by hierarchically rearranging the ICF items and constructing Guttman-type scales according to item difficulty using the Rasch model. In addition, each functional level might require similar resources and therefore enable standardization of care and rehabilitation. Illustrations facilitate the sharing of patient images among health care providers. By using the ICF as a common taxonomy, these scales could be used internationally as

  2. 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....

  3. Oral mixing ability and cognition in elderly persons with dementia: a cross-sectional study.

    Science.gov (United States)

    Weijenberg, R A F; Lobbezoo, F; Visscher, C M; Scherder, E J A

    2015-07-01

    Masticatory performance has been positively associated with cognitive ability in both animals and healthy humans. We hypothesised that there would also be a positive correlation between masticatory performance and cognition in older persons suffering from dementia. Older persons suffering from dementia (n = 114) and receiving institutionalised care were studied in a cross-sectional design. The assessments included masticatory performance, which was measured objectively with a two-colour gum mixing ability test, and cognition, which was assessed with a multidomain neuropsychological test battery. Significant relationships were observed between masticatory performance and general cognition and between masticatory performance and verbal fluency. Hierarchical regression analysis revealed that the correlation with general cognition was influenced by the scores for dependency in activities of daily living. The association between verbal fluency and masticatory performance was not significantly affected by secondary variables. An unexpected limitation of this study was the high dropout rate for the mixing ability test. The clinical implications of these findings are profound; care professionals should endeavour to maintain and stimulate mastication in older persons with dementia in an attempt to preserve cognition. © 2015 John Wiley & Sons Ltd.

  4. Perceptions, expectations, and informal supports influence exercise activity in frail older adults

    OpenAIRE

    Louise Broderick; Ruth McCullagh; Eleanor Bantry White; Eileen Savage; Suzanne Timmons

    2015-01-01

    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 int...

  5. Dementia and delirium, the outcomes in elderly hip fracture patients

    NARCIS (Netherlands)

    Mosk, C.A. (Christina A.); Mus, M. (Marnix); Vroemen, J.P.A.M. (Jos P. A. M.); T. van der Ploeg (Tjeerd); D.I. Vos (Dagmar); Elmans, L.H.G.J. (Leon H. G. J.); L. van der Laan (Lyckle)

    2017-01-01

    textabstractBackground: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to

  6. An outbreak of calicivirus associated gastroenteritis in an elderly persons home. A possible zoonosis?

    Science.gov (United States)

    Humphrey, T. J.; Cruickshank, J. G.; Cubitt, W. D.

    1984-01-01

    An outbreak of gastroenteritis caused by calicivirus began amongst residents and staff of an old persons home 24 hours after the proprietor's dog had been sick. Serological evidence suggests that the calicivirus isolated from one of the cases may be capable of infecting dogs as well as man. The virus strain responsible for this outbreak differs antigenically from those associated with two other outbreaks in the U.K. and one in Japan. The characteristic morphology of calicivirus is lost if stool is stored at -70 degrees C. Images Fig. 2 Fig. 3 PMID:6094667

  7. 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, Anita

    2017-01-01

    OBJECTIVE: To 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 METHODS

  8. Self-maintenance Habits and Preferences in Elderly (SHAPE): reliability of reports of self-care preferences in older persons.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Jensen, Barbara

    2007-02-01

    Self-care preferences can be used in designing programs of care. Yet little has been documented concerning the self-care habits and preferences of older adults. This study assessed the reliability of reports of self-care preferences and their importance among older adults using the Self-maintenance Habits and Preferences in Elderly (SHAPE) instrument. Twenty community-dwelling seniors completed the SHAPE questionnaire twice within a one- to two-week interval. Percent agreement, both exact and close/partial, was computed to assess the reliability of preference content, and intra-class correlations (ICCs) were used for preference importance. Test and subject factors affecting reliability were also investigated. Exact agreement rate for item content was 73%, and that for close/partial agreement was 93%. Mean ICC for item importance was 0.72. Reliability was greater for dichotomous items than for either ordinal or categorical questions. Reliability of item content varied with number of response options and importance reliability varied with age and IADL status. Information from SHAPE about self-care preferences can be used to plan services for seniors and to individualize care for older persons, especially those transitioning to new living environments or those receiving home care.

  9. Micronutrients supplementation and nutritional status in cognitively impaired elderly persons: a two-month open label pilot study.

    Science.gov (United States)

    von Arnim, Christine A F; Dismar, Stephanie; Ott-Renzer, Cornelia S; Noeth, Nathalie; Ludolph, Albert C; Biesalski, Hans K

    2013-11-15

    Malnutrition is a widespread problem in elderly people and is associated with cognitive decline. However, interventional studies have produced ambiguous results. For this reason, we wanted to determine the effect of micronutrient supplementation on blood and tissue levels and on general nutritional status in persons with mild or moderate cognitive impairment. We performed a 2-month, open-label trial, administering a daily micronutrient supplement to 42 memory clinic patients with mild cognitive deficits. Blood levels of antioxidants, zinc, and B vitamins were determined before and after supplementation. In addition, we assessed metabolic markers for B vitamins and intracellular (buccal mucosa cell [BMC]) antioxidant levels. Nutritional status was assessed by using the Mini Nutritional Assessment (MNA). Blood levels of B vitamins, folic acid, lutein, β-carotene, α-carotene, and α-tocopherol increased significantly. Decreases in homocysteine levels and the thiamine pyrophosphate effect and an increase in holotranscobalamin were observed. We found no increase in intracellular antioxidant levels of BMC. The MNA score in subjects at risk for malnutrition increased significantly, mainly owing to better perception of nutritional and overall health status. Micronutrient supplementation improved serum micronutrient status, with improved metabolic markers for B vitamins but not for intracellular antioxidant status, and was associated with improved self-perception of general health status. Our data underline the necessity of determining micronutrient status and support the use of additional assessments for general health and quality of life in nutritional supplementation trials.

  10. Vital Sign and Location/Attitude Monitoring with Sensor Networks for the Proposed Rescue System for Disabled and Elderly Persons Who Need a Help in Evacuation from Disaster Areas

    Directory of Open Access Journals (Sweden)

    Kohei Arai

    2014-01-01

    Full Text Available Method and system for vital sign (Body temperature, blood pressure, bless, Heart beat pulse rate, and consciousness and location/attitude monitoring with sensor network for the proposed rescue system for disabled and elderly persons who need a help in evacuation from disaster areas is proposed. Experimental results show that all of vital signs as well as location and attitude of the disabled and elderly persons are monitored with the proposed sensor networks.

  11. Engagement in elderly persons with dementia attending animal-assisted group activity.

    Science.gov (United States)

    Olsen, Christine; Pedersen, Ingeborg; Bergland, Astrid; Enders-Slegers, Marie-José; Ihlebæk, Camilla

    2016-09-02

    The need for meaningful activities that enhance engagement is very important among persons with dementia (PWDs), both for PWDs still living at home, as well as for PWDs admitted to a nursing home (NH). In this study, we systematically registered behaviours related to engagement in a group animal-assisted activity (AAA) intervention for 21 PWDs in NHs and among 28 home-dwelling PWDs attending a day care centre. The participants interacted with a dog and its handler for 30 minutes, twice a week for 12 weeks. Video-recordings were carried out early (week 2) and late (week 10) during the intervention period and behaviours were categorized by the use of an ethogram. AAA seems to create engagement in PWDs, and might be a suitable and health promoting intervention for both NH residents and participants of a day care centre. Degree of dementia should be considered when planning individual or group based AAA.

  12. 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

  13. 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

  14. Team Performance and Risk-Adjusted Health Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

    Science.gov (United States)

    Mukamel, Dana B.; Temkin-Greener, Helena; Delavan, Rachel; Peterson, Derick R.; Gross, Diane; Kunitz, Stephen; Williams, T. Franklin

    2006-01-01

    Purpose: The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. The purpose of this study was to examine the…

  15. [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

    2017-06-07

    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.

  16. [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.

  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. Low-trauma fractures indicate increased risk of hip fracture in frail older people.

    Science.gov (United States)

    Chen, Jian Sheng; Cameron, Ian D; Simpson, Judy M; Seibel, Markus J; March, Lyn M; Cumming, Robert G; Lord, Stephen R; Sambrook, Philip N

    2011-02-01

    This study aims to investigate the risk of subsequent fractures after low-trauma fracture in frail older people. A total of 1412 elderly residents (mean age 86.2 years, SD 7.0 years, female 77%) were recruited from aged care facilities in Australia. Residents were assessed and then followed for any fracture for 2 years and hip fractures for at least 5 years. Residents with and without a newly acquired fracture in the first 2 years were compared for risk of subsequent hip fracture. Residents with a nonhip fracture in the first 2 years had an increased risk of subsequent hip fracture for about 2.5 years, whereas those with a hip fracture had a similar risk over the whole period compared with those with no fracture. During these 2.5 years, 60, 28, and 6 subsequent hip fractures occurred in the nonfracture group (n = 953), the nonhip fracture group (n = 194), and the hip fracture group (n = 101), respectively, resulting in the probability of subsequent hip fracture of 8.0%, 19.9%, and 10.4%, respectively. Compared with the nonfracture group, the hazard ratio (HR) was 2.82 [95% confidence interval (CI) 1.73-4.59; p < .001] for the nonhip fracture group and 1.48 (95% CI 0.63-3.49, p = .37) for the hip fracture group after adjusting for age, sex, residence type, calcaneal broadband ultrasound attenuation, fracture history, weight, lower leg length, immobility, cognitive function, and medications. Frail institutionalized older people with newly acquired fractures are at increased risk of subsequent hip fracture for the next few years. Accordingly, despite their advanced age, they are a high-priority target group to investigate interventions that might reduce the risk of hip fracture.

  19. Elder Abuse and Substance Abuse

    Science.gov (United States)

    ... Culture in Elder Abuse Mental capacity, consent, and undue influence The relationship between elder abuse and substance abuse ... older person's financial resources and to wield significant ... financially or, in the case of illegal drug use, less likely to report. ...

  20. 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.

  1. Age-Related Changes in Auditory and Cognitive Abilities in Elderly Persons with Hearing Aids Fitted at the Initial Stages of Hearing Loss.

    Science.gov (United States)

    Obuchi, C; Harashima, T; Shiroma, M

    2011-05-10

    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.

  2. Association between muscular strength and inflammatory markers among elderly persons with cardiac disease: results from the KORA-Age study.

    Science.gov (United States)

    Volaklis, K A; Halle, M; Koenig, W; Oberhoffer, R; Grill, E; Peters, A; Strasser, B; Heier, M; Emeny, R; Schulz, H; Ladwig, K H; Meisinger, C; Thorand, B

    2015-11-01

    Little is known about the association between muscle strength and inflammation in diseased individuals and particularly in cardiac patients. Thus, our purpose was to examine the association of muscular strength with the inflammatory status in older adults with and without cardiac disease. The cross-sectional analysis was based on 1079 adults aged 65-94 years, who participated in the KORA-Age study. Participants underwent an interview and extensive physical examinations including anthropometric measurements, registration of diseases and drug intake, determination of health-related behaviors, collection of blood samples for measurements of interleukin-6 and hs-CRP and muscle strength measurement using hand-grip dynamometry. Cardiac patients (n = 323) had higher levels of IL-6 and poorer muscle strength compared with older adults without cardiac disease. Among persons with cardiac diseases, muscle strength in the lower tertile compared to the upper tertile was significantly associated with increased odds of having elevated IL-6 levels (OR 3.53, 95 % CI 1.18-10.50, p = 0.024) after controlling for age, gender, body fat, alcohol intake, smoking status, diseases, medications and physical activity, whereas the association between muscle strength and hs-CRP remained borderline significant (OR 2.80, 95 % CI 0.85-9.24, p = 0.092). The same trends, with slightly lower odds ratios, were also observed in older adults without cardiac disease. Lower levels of muscular strength are associated with higher concentrations of IL-6 and hs-CRP in elderly individuals with and without cardiac disease suggesting a significant contribution of the muscular system in reducing low-grade inflammation that accompanies cardiac disease and aging.

  3. 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.

  4. 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.

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

    Science.gov (United States)

    Hjelmar, Ulf; Hendriksen, Carsten; Hansen, Kirsten

    2011-07-01

    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. 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, and district nurses. 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. 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 programmes in order to fully exploit the potential health benefits.

  6. The heterogeneous health latent classes of elderly people and their socio-demographic characteristics in Taiwan.

    Science.gov (United States)

    Liu, Li-Fan; Tian, Wei-Hua; Yao, Hui-Ping

    2014-01-01

    The health care needs of elderly people were influenced by their heterogeneity. This study aimed to identify the health latent classes of elderly people by using latent class analysis to deal with heterogeneity and examine their socio-demographic characteristics. Data came from the 2005 National Health Interview Survey (NHIS) in Taiwan. In total, 2449 elderly individuals with available health indicators were examined in latent class analysis (LCA), and 2217 elderly community-dwellings with complete socio-demographic data were analyzed by multinomial logistic regression. Four health latent classes were identified which included 1066 (43.5%) people in the High Comorbidity (HC), 152 (6.2%) in the Functional Impairment (FI), 252 (10.3%) in the Frail (FR), and 979 (40.0%) in the Relatively Healthy (RH) group. Multinomial logistic regressions revealed socio-demographic characteristics among health classes. The variables associated with an increased likelihood of being in the FR group were age, female, and living with families. They were also correlated to ethnicity and educations. Apart from age and gender, the Functional Impairment group was less likely to be ethnicity of Hakka, more likely to live with others than were the RH group. The HC group tended to be younger, with higher educations, and more likely to live in urban area than the Functional Impairment group. The correlations between health classes and socio-demographic factors were discussed. The health status of elderly people includes a variety of health indicators. A person-centered approach is critical to identify the health heterogeneity of elderly people and manage their care needs by targeting differential aging.

  7. 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

  8. Efficacy of a trunk orthosis with joints providing resistive force on low-back load in elderly persons during static standing.

    Science.gov (United States)

    Katsuhira, Junji; Matsudaira, Ko; Yasui, Tadashi; Iijima, Shinno; Ito, Akihiro

    2015-01-01

    Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO) in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force) as a preventive method against abnormal posture and low-back pain in healthy elderly persons. Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES), left internal abdominal oblique, and right gluteus medius muscles. Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these results were not significant compared to no orthosis. Thorax extension angle and thorax angle on pelvis coordinate system significantly increased while wearing the ORF compared to the other two conditions. ES activity significantly decreased while wearing the ORF compared to the other two conditions. Internal oblique activity was significantly smaller while wearing the LSO than with no orthosis. Center of pressure did not significantly differ among the conditions. The ORF significantly improved trunk alignment and decreased ES activity in healthy

  9. Prevalence of Osteoarthritis of Knee Among Elderly Persons in Urban Slums Using American College of Rheumatology (ACR) Criteria

    OpenAIRE

    2014-01-01

    Background: The prevalence of osteoarthritis among elderly is high and it majorly affects the quality of life. Knee osteoarthritis is the most common form of osteoarthritis. Timely diagnosis using clinical criteria and effective intervention is of utmost importance.

  10. Costs of formal care for frail older people in England: the resource implications study of the MRC cognitive function and ageing study (RIS MRC CFAS).

    Science.gov (United States)

    McNamee, P; Gregson, B A; Buck, D; Bamford, C H; Bond, J; Wright, K

    1999-02-01

    The aim of this paper is to quantify service use and costs of supporting frail older people at home in the community, using data collected in a longitudinal multicentre stratified randomised study for 1055 mentally frail, physically frail, and mentally and physically frail subjects. Average costs per person per week were found to total 64.45 Pounds Sterling, with a small number of services accounting for a large proportion of the total costs. The level of services offered by the nonstatutory voluntary and private sectors was found to be small. To highlight issues for policy makers, the extent of cost variations between a number of different subgroups were calculated. These bivariate analyses revealed substantial variation in costs, especially according to household structure, type of frailty, whether admission to continuing care accommodation occurred and survival. Multiple regression analysis demonstrated that 26% of the variation in log average weekly costs could be explained by a number of socio-demographic and health status variables. A particularly close relationship was observed between costs and whether admission to continuing care accommodation occurred, highlighting a need for policy-makers to examine the nature and scale of provision of alternative community based care packages. The results demonstrate that descriptive cost data such as those presented can provide information useful to the planning process, enabling more informed choices to be made over the provision of services for particular groups of people.

  11. 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.

  12. Hand tactile discrimination, social touch and frailty criteria in elderly people: A cross sectional observational study.

    Science.gov (United States)

    Vieira, Ana Isabel; Nogueira, Dália; de Azevedo Reis, Elisabeth; da Lapa Rosado, Maria; Vânia Nunes, Maria; Castro-Caldas, Alexandre

    2016-01-01

    Frailty is a common syndrome among elderly and sensory decline may exacerbate functional decline. The hand function, the manual dexterity, the performance of the daily living skills and the social interactions are determined, in a large degree, by sensory integrity. However, hand tactile sensory deterioration has been little explored in frailty. We performed a cross sectional observational study with 181 of institutionalized elders. From the initial sample we selected 50 subjects (68-99 years) who met the inclusion/exclusion criteria. Our goals were (1) to analyse the relationship between tactile discrimination (TD) of the hand, avoidance behaviours and attitudes towards social touch (BATST) and phenotype frailty criteria (unintentional weight loss, self-perception of exhaustion, decrease grip strength - GS, slow walking speed, low level of physical activity), (2) to explore whether other variables can contribute to explain the differences between pre-frail and frail elders. The results showed that increasing age is related to decline of TD of the hand (p=0.021) and to decrease in GS (p=0.025); women have significantly lower level of GS (p=0.001); TD decrease is correlated with higher avoidance BATST (p=0.000) and with lower GS (p=0.000); Lower GS corresponds to more avoidance BATST (p=0.003). Hand TD also can differentiate frail and pre-frail elderly subjects in this sample (p=0.037). Decreased TD of the hand may have implications on the functionality and on interpersonal relationships. TD of the hand also explains frailty levels in this sample. Hand TD should be used in assessment and intervention protocols in pre-frail and frail elders.

  13. 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.

  14. Beyond Ageism: The Life History Approach Educates and Empowers Health Care Providers To Improve the Quality of Life of Elderly Patients.

    Science.gov (United States)

    Muller, Lucienne; Steinberg, Marsha

    In this proposed training model for caregivers working with the frail elderly, the focus is first on encouraging participants to construct and share fragments of their lived experiences with elderly people and their beliefs about the aging process. Next, participants are asked to bring back written observations of their own work styles and working…

  15. The survey of quality of care for disabled elderly persons in ethnic areas%民族地区残疾老人照顾质量的调查

    Institute of Scientific and Technical Information of China (English)

    何作顺; 李鸿; 张迪; 张态; 刘建园

    2013-01-01

    Objective To understand the quality of care for disabled elderly persons in ethnic areas and its influencing factors.Methods A questionnaire survey was carried out using multi-stage stratified random cluster sampling method for the disabled elderly persons in ethnic minority areas,and the relevant factors affecting the quality of care were analyzed.Results The object with different regions,ethnicity,marital status,residence and social support condition,education degrees,health status,the degree of disabilities affecting their life,occupations,income showed different scores in each dimension of care quality.Multiple linear regression analysis showed that other ethnic people with disabilities,unmarried,unemployed/laidoff people with disabilities,disabilities extremely influenced the quality of life affected the total score of care quality.Conclusions To improve the financial aid for disabled elderly people in ethnic areas,attach great importance to the physical and mental care of unmarried disabled elderly people,perfect and establish effective handicapped rehabilitation mechanism,can improve the care quality of disabled elderly people.%目的 了解民族地区残疾老人的照顾质量及其影响因素.方法 采用多阶段分层随机整群抽样对该民族地区残疾老人进行问卷调查,并分析影响照顾质量的相关因素.结果 不同地区、民族、婚姻状况、居住和社会支持情况、文化程度、健康状况、残疾影响生活程度、职业、收入、健康状况的调查对象间照顾质量维度的得分比较差异有统计学意义;多因素逐步回归分析显示,其他民族、未婚、失业/下岗和待业中、残疾极严重影响生活对残疾老人照顾质量总分有影响.结论 提高对民族地区残疾老人的经济补助,重视未婚残疾老人的身心照护,完善并建立有效的残疾老人康复机制,可以提高残疾老人的照顾质量.

  16. 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.; Sneyers, B; Little, A.; Rose, L.; Hunt, Cindy; Ennis, Naomi; Ouchterlony, Donna; McNeil, Heather; Elliott, Jacobi; Stolee, Paul; Pope, Karen

    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...

  17. 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; Sneyers, B; Little, A.; Rose, L; Hunt, Cindy; Ennis, Naomi; Ouchterlony, Donna; McNeil, Heather; Elliott, Jacobi; Stolee, Paul; Pope, Karen

    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...

  18. Risk of falling among elderly persons living in the community: assessment by the Timed up and go test.

    Science.gov (United States)

    Bretan, Onivaldo; Silva Júnior, José Elias; Ribeiro, Odilon R; Corrente, José Eduardo

    2013-01-01

    The risk of falling in elderly can be analyzed by a simple mobility test. To assess the balance of elderly subjects through the 'Timed up and go' test. Subjects were timed for the moment they got up from a chair, walked for three meters, and came back to the chair. They also answered questions on imbalance, dizziness, and falls. Approximately 69% of the subjects completed the test in up to 19 seconds. There was a significant correlation between imbalance, time spent in the test, dizziness, and falls. Most of the elderly subjects performed well in the test, thus attesting to their good level of functional mobility. However, a significant number of poor-performers is probably more prone to falling and to depending on others to perform activities of daily living.

  19. V(H)3 antibody response to immunization with pneumococcal polysaccharide vaccine in middle-aged and elderly persons.

    Science.gov (United States)

    Serpa, Jose A; Valayam, Josemon; Musher, Daniel M; Rossen, Roger D; Pirofski, Liise-anne; Rodriguez-Barradas, Maria C

    2011-03-01

    Pneumococcal disease continues to cause substantial morbidity and mortality among the elderly. Older adults may have high levels of anticapsular antibody after vaccination, but their antibodies show decreased functional activity. In addition, the protective effect of the pneumococcal polysaccharide vaccine (PPV) seems to cease as early as 3 to 5 years postvaccination. Recently, it was suggested that PPV elicits human antibodies that use predominantly V(H)3 gene segments and induce a repertoire shift with increased V(H)3 expression in peripheral B cells. Here we compared V(H)3-idiotypic antibody responses in middle-aged and elderly subjects receiving PPV as initial immunization or revaccination. We studied pre- and postvaccination sera from 36 (18 vaccine-naïve and 18 previously immunized subjects) middle-aged and 40 (22 vaccine-naïve and 18 previously immunized subjects) elderly adults who received 23-valent PPV. Concentrations of IgGs to four individual serotypes (6B, 14, 19F, and 23F) and of V(H)3-idiotypic antibodies (detected by the monoclonal antibody D12) to the whole pneumococcal vaccine were determined by enzyme-linked immunosorbent assay (ELISA). PPV elicited significant IgG and V(H)3-idiotypic antibody responses in middle-aged and elderly subjects, regardless of whether they were vaccine naïve or undergoing revaccination. Age did not influence the magnitude of the antibody responses, as evidenced by similar postvaccination IgG and V(H)3 antibody levels in both groups, even after stratifying by prior vaccine status. Furthermore, we found similar proportions (around 50%) of elderly and middle-aged subjects experiencing 2-fold increases in V(H)3 antibody titers after vaccination. Age or repeated immunization does not appear to affect the V(H)3-idiotypic immunogenicity of PPV among middle-aged and elderly adults.

  20. DEVELOPMENT OF QUESTIONNAIRE FOR MEASURING FACTORS OF SIGNIFICANCE OF AN ELDERLY PERSON AS ANOTHER FOR THE YOUNGER GENERATION

    OpenAIRE

    KHALINA Natalia V.; Stanislav A. POZDNIAKOV

    2015-01-01

    Social and political processes of the present time, actualize in the minds of the younger generation of Russians importance for the development of the country. But it would be wrong to assume no significant experience in the elderly and to consider identity apart from family ties. Relevance to this key acts the process of intergenerational transmission, when the younger generation can assimilate the experience of close, meaningful elderly. The paper drew attention to the dedicated A.V. Petrov...

  1. Riskiness in the Elderly: Attitudes of Young and Elderly Adults.

    Science.gov (United States)

    Feldstein, Jerome H.; Feldman, Barbara

    Risk-taking attitudes and behaviors among young and elderly adults were investigated. Elderly subjects, from both a nursing home and the community, and college students responded to choice dilemmas involving aged central characters. Each subject responded twice, once under "self" instructions, and once as the "average elderly person" would…

  2. 北京市某社区老年人跌倒风险及其影响因素分析%Analysis of factors influencing fall risk of elderly persons living in a community in Beijing

    Institute of Scientific and Technical Information of China (English)

    张庆来; 张慧; 金娜; 李增辉; 张莹; 耿建春

    2012-01-01

    Objective: To investigate the fall risk of elderly persons living in one community in Beijing and analyze the factors influencing fall risk of the elderly persons. Methods: A questionnaire (FRQ) survey to 221 elderly persons was conducted. Results: The average score of FRQ is 28.12±7.47; 43.44% elderly persons have fell risk with the score above 30. Old female have much more risks than male; elderly persons with more urinary frequency and urgent urination have higher risk than others; the elderly people using walkers have higher risk than those with none; elderly persons with chronic disease have much more risk than those without chronic disease; doing physical exercise is a protection factor, elderly people had falls before have a higher fall risk. Conclusion: The elderly persons living in the community have higher fall risk. The prevention and intervention should focus on the relevant factors for falls.%目的:调查北京市某社区老年人跌倒风险现状,并对社区老年人跌倒风险的相关因素进行分析,为采取有效的预防和干预措施提供依据.方法:采用“跌倒风险评估量表”对北京市某社区221名老年人进行跌倒风险的评估.结果:该社区老年人跌倒风险评估量表平均得分为(28.12±7.47)分,有跌倒风险的老年人(得分≥30分者)占该人群的43.44%.性别、是否有尿频尿急等情况、是否使用助行器、是否患慢性疾病、是否进行体育锻炼、是否有跌倒史等因素与跌倒风险相关(P<0.05).结论:该社区老年人跌倒风险较高,应针对跌倒风险的相关因素采取有效的预防和干预措施,并在今后的研究中加大对跌倒风险的评估以预防跌倒的发生.

  3. 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

  4. 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.

  5. DEVELOPMENT OF QUESTIONNAIRE FOR MEASURING FACTORS OF SIGNIFICANCE OF AN ELDERLY PERSON AS ANOTHER FOR THE YOUNGER GENERATION

    Directory of Open Access Journals (Sweden)

    Natalia V. KHALINA

    2015-01-01

    Full Text Available Social and political processes of the present time, actualize in the minds of the younger generation of Russians importance for the development of the country. But it would be wrong to assume no significant experience in the elderly and to consider identity apart from family ties. Relevance to this key acts the process of intergenerational transmission, when the younger generation can assimilate the experience of close, meaningful elderly. The paper drew attention to the dedicated A.V. Petrovsky importance of interpersonal factors: credibility (reference, attraction (emotional state, institutionalized role (power status. On the basis of the three-factor model proposed by the author's questionnaire for measuring factors like the importance of an elderly as a significant Another for the younger generation. The authors conducted a tested methodology for determining the significance of an old man for youth. The statistical analysis survey was conducted using a Rasch model, which is an important feature of the subjective objectivity of assessments. It shows the process of correction of the questionnaire based on the theory of measurement of latent variables. Designed questionnaire contains twenty-four judgments, respondents were asked to express the degree of agreement with these judgments in four grades. Thus, twenty-four indicator variables actually measure the latent variable "importance of the elderly as a significant Another for the younger generation", and are compatible with each other, enabling them to measure the factors, the importance of the elderly as a significant Another for the younger generation: the authority of the (reference, attraction (emotional status institutionalized the role of (status of power.

  6. 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.

  7. Efficacy of a trunk orthosis with joints providing resistive force on low-back load in elderly persons during static standing

    Directory of Open Access Journals (Sweden)

    Katsuhira J

    2015-09-01

    Full Text Available Junji Katsuhira,1 Ko Matsudaira,2 Tadashi Yasui,3 Shinno Iijima,4 Akihiro Ito4 1Department of Nursing and Rehabilitation Science at Odawara, International University of Health and Welfare, Odawara, Kanagawa, 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 3Kawamura-Gishi Company, Ltd., Daito-shi, Osaka, 4Graduate School of International University of Health and Welfare, Otawara, Tochigi, Japan Purpose: Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force as a preventive method against abnormal posture and low-back pain in healthy elderly persons. Patients and methods: Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES, left internal abdominal oblique, and right gluteus medius muscles. Results: Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these

  8. Prevention of progression to dementia in the elderly: rationale and proposal for a health-promoting memory consultation (an IANA Task Force).

    Science.gov (United States)

    Gillette Guyonnet, S; Abellan Van Kan, G; Andrieu, S; Aquino, J P; Arbus, C; Becq, J P; Berr, C; Bismuth, S; Chamontin, B; Dantoine, T; Dartigues, J F; Dubois, B; Fraysse, B; Hergueta, T; Hanaire, H; Jeandel, C; Lagleyre, S; Lala, F; Nourhashemi, F; Ousset, P J; Portet, F; Ritz, P; Robert, P; Rolland, Y; Sanz, C; Soto, M; Touchon, J; Vellas, B

    2008-10-01

    Alzheimer's disease (AD) is the most frequent form of dementia and according to the most recent estimation it affects nearly 27 million people in the world. The onset of the disease is generally insidious. It is becoming increasingly evident that the underlying pathophysiological mechanisms are active long before the appearance of the clinical symptoms of the disease. In the current context, it is important to develop strategies to delay the onset of cognitive decline. Delaying the onset by 5 years would reduce the prevalence by half at term, and a delay of 10 years would reduce it by three-quarters. The effectiveness of currently suggested preventive approaches remains to be confirmed, but certain strategies could be applied straight away to at-risk subjects. We propose that a health-promoting memory consultation should be set up for elderly persons who have attended a specialized memory consultation and in whom the diagnosis of dementia and of AD in particular, has not been established by standardized tools. Through this consultation, they would be offered full multidimensional investigation of all aspects of their health status, follow-up could be organized, general practitioners in private practice could be made more conscious of this population and the elderly could be made more aware of the risk factors to which they are exposed. The development of an information policy for the elderly would meet a present need. In our reflection, we must take into account the question of how to give this preventive consultation its due place in the healthcare pathway of the elderly person in order to ensure coordinated follow-up with all the other health professionals involved. The principle of the health-promoting memory consultation is undergoing validation in a large French multicentre preventive trial in 1200 frail elderly persons aged 70 years followed for three years, the Multidomain Alzheimer Preventive Trial (MAPT).

  9. Different approaches of self-management facilitation for elderly in the community.

    NARCIS (Netherlands)

    Uitdehaag, M.J.; Bergsma, A.; Bolscher-Niehuis, M.J.T. van het; Vocht, H.M. de; Ouden, M.E.M. den; Francke, A.L.; Kerkhof, Y.J.F.; Graff, M.J.L.; Droës, R.M.; Vonk-Klaassen, S.M.; Schuurmans, M.J.; Keurhorst, M.N.; Geerink, G.G.M.

    2016-01-01

    Introduction: An expanding group (frail) older people strives to live independently at home as long as possible. This change is caused by the fact that elderly nowadays take more responsibility and control over their health and environment on the one hand, and to the dismantling of the welfare state

  10. A Taxonomy of Well-Being for Small-Town Elderly: A Case for Rural Diversity.

    Science.gov (United States)

    Scheidt, Rick J.

    1984-01-01

    Describes the development of a taxonomy of social and psychological well-being for 900 elderly small town residents. Compares the four largest groups (partially engaged, fully engaged, disengaged, and frail) in terms of mental and physical health, contact with others, and activity. (JAC)

  11. An analyse of quality of life of elderly person in community and influencing factors%社区老人生命质量及影响因素

    Institute of Scientific and Technical Information of China (English)

    汤军克; 李惠英; 陈林利; 尤佳恺; 赵耐青

    2009-01-01

    Objective To understand the quality of life of elderly person living at community,and to find out the related influencing factors and thus to provide references for policies makers to improve the of life quality of the elderly person.Methods To investigate quality of life for elderly person living at community in Minhang district of Shanghai by adopting SF-36 form. Meanwhile,to find out the principal influencing factors on quality of life by adopting both single-factor and multiple-factor analysis.Results The score of life quality of senior citizen in local was as following 71.94±23.29(Physical Function),73.64±43.03(Role Physical),80.24±20.25(Bodily Pain),53.20±19.07(General Health),70.40±15.67(Vitality),83.79±20.24(Social Function),81.13±37.16(Role Emotional),78.14±15.43(Mental Health),74.06±17.49(Weighted average).There were two aspects of the factors that influencing elderly persons' the quality of life:disease-related (coronary heart disease,arthritis,diabetes mellitus,cerebrovascular accident,cataract,gall-stone and chronic bronchitis) and non-disease-related (habitation,physical exercise,age,gender,entertainment and record of employment). Conclusions The controllable factors that impact on quality of life of elderly living at community is habitation,physical exercise,entertainment and disease.%目的 了解社区老人生命质量及其影响因素,为有关部门提高老年人生命质量提供决策依据.方法 采用健康状况调查问卷中文版(SF-36)调查上海市闵行区社区老人生命质量,采用单因素、多因素统计方法进行数据处理.结果 老年人生命质量情况为:躯体功能(71.94±23.29)分,躯体角色(73.64±43.03)分,肌体疼痛(80.24±20.25)分,一般健康状况(53.20±19.07)分,生命力(70.40±15.67)分,社会功能(83.79±20.24)分,情感角色(81.13±37.16)分,心理健康(78.14±15.43)分,加权平均分为(74.06±17.49)分.影响社区老人生命质量的因素有疾病(冠心病、关节炎、

  12. Treatment of a Frail Older Patient with Diffuse Large B-Cell Lymphoma on Maintenance Dialysis: Attenuated Immunochemotherapy and Adapted Care Plan

    Directory of Open Access Journals (Sweden)

    Luciola de Barros Pontes

    2013-04-01

    Full Text Available Purpose of the Study: Diffuse large B-cell lymphoma (DLBCL is the most common lymphoid malignancy worldwide. Its incidence increases with age and about 40% of cases occur in patients over 70 years. Herein, we describe a case of a frail elderly patient with renal insufficiency and DLBCL treated with R-mini-CHOP. Case Report: A 77-year-old man on maintenance hemodialysis started experiencing persistent fatigue. He was diagnosed with a large mass on the left lobe of the lung. Biopsy demonstrated a DLBCL, CD20 positive. The patient was assigned clinical stage IIBX, with a high age-adjusted international prognosis index. A proper geriatric assessment revealed a frail patient. Thus, an adapted chemotherapy regimen was proposed which consisted of R-mini-CHOP every 21 days, with a reduction of 10% in the doses of doxorubicin and cyclophosphamide. During the treatment, the patient went through regular dialysis sessions, 3 times per week, with an extra session performed 12 h after each chemotherapy administration. The patient experienced no adverse events or grade 3/4 toxicities. After 6 cycles of R-mini-CHOP, the patient achieved unconfirmed complete remission, and consolidation radiotherapy was performed. At the last follow-up, he was still in unconfirmed complete remission, with a progression-free survival of 11.3 months. Conclusions: R-mini-CHOP represented a reasonable treatment option for this patient with renal failure. The oncogeriatric approach led to a successful management of this frail patient, highlighting that an adapted plan of care is a key issue to improve the outcomes of elderly cancer patients.

  13. Oral health care and aspiration pneumonia in frail older people: a systematic literature review

    NARCIS (Netherlands)

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

    2013-01-01

    OBJECTIVE: To systematically review the literature on oral health care interventions in frail older people and the effect on the incidence of aspiration pneumonia. BACKGROUND: Oral health care seems to play an important role in the prevention of aspiration pneumonia in frail older people. METHODS: P

  14. Pesos, frailes y conventos (méxico 1771)

    OpenAIRE

    Vizuete Mendoza, J. Carlos

    2013-01-01

    Desde los años finales del siglo XVI en España son muchas las voces que en distintos ámbitos señalan que los clérigos, y especialmente los regulares, son muchos. La política de los ilustrados del siglo XVIII intentará reducir el número de los frailes aplicando postulados regalistas. Este fue uno de los objetivos del IV Concilio Provincial Mexicano, que para conocer la realidad del clero regular en Nueva España, solicitó una serie de informes a los superiores de las órdenes religiosas allí imp...

  15. Pesos, frailes y conventos (méxico 1771)

    OpenAIRE

    Vizuete Mendoza, J. Carlos

    2013-01-01

    Desde los años finales del siglo XVI en España son muchas las voces que en distintos ámbitos señalan que los clérigos, y especialmente los regulares, son muchos. La política de los ilustrados del siglo XVIII intentará reducir el número de los frailes aplicando postulados regalistas. Este fue uno de los objetivos del IV Concilio Provincial Mexicano, que para conocer la realidad del clero regular en Nueva España, solicitó una serie de informes a los superiores de las órdenes religiosas allí imp...

  16. Restless Legs Syndrome/Willis-Ekbom Disease and Periodic Limb Movements in Sleep in the Elderly with and without Dementia.

    Science.gov (United States)

    Figorilli, Michela; Puligheddu, Monica; Ferri, Raffaele

    2015-09-01

    There is great interest in the study of sleep in healthy and cognitively impaired elderly. Sleep disorders have been related to quality of aging. Sleep-related movements are a frequent cause of disordered sleep and daytime sleepiness. Restless legs syndrome/Willis-Ekbom disease (RLS/WED) is often unrecognized in the elderly. This review explores RLS/WED in the elderly population. The elderly population may be subdivided into 3 groups: healthy, dependent, and frail. The RLS/WED could be a predictor for lower physical function; its burden on quality of life and health care-related costs, in the elderly, should be an important clinical and public health concern.

  17. Personality.

    Science.gov (United States)

    Funder, D C

    2001-01-01

    Personality psychology is as active today as at any point in its history. The classic psychoanalytic and trait paradigms are active areas of research, the behaviorist paradigm has evolved into a new social-cognitive paradigm, and the humanistic paradigm is a basis of current work on cross-cultural psychology. Biology and evolutionary theory have also attained the status of new paradigms for personality. Three challenges for the next generation of research are to integrate these disparate approaches to personality (particularly the trait and social-cognitive paradigms), to remedy the imbalance in the person-situation-behavior triad by conceptualizing the basic properties of situations and behaviors, and to add to personality psychology's thin inventory of basic facts concerning the relations between personality and behavior.

  18. 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.

  19. Comparative Analysis between the Urban and Rural Elderly Persons in Southern Jiangsu Area by Physique Test%苏南地区城市与农村的中老年人体质测试比较分析

    Institute of Scientific and Technical Information of China (English)

    白海波; 姚唯众

    2011-01-01

    运用体质测试法以苏南地区城市与农村三个不同年龄段的中老年1500人为研究对象,对其进行了体质测试与比较分析。结果表明城市中老年人呈现出随着年龄的增长皮褶厚度随之增厚的趋势;60-64岁城市男性中老年人和65-69岁城市男、女性以及农村男性中老年人的测试均值已接近临界高血压值的水平;4项身体素质指标的比较,无论是男性中老年人还是女性中老年人,均呈现出身体素质指标农村好于城市的趋势。%1500 urban and rural elderly persons in southern Jiangsu area which are distinguished in three age groups are physique tested and comparative analyzed as the object of study.The result indicated that the urban elderly people present the tendency that skin fold increased along with age growth;the average blood pressure test index of the 60-64 years old of urban masculine elderly people,65-69 years old of urban male,feminine as well as rural male elderly persons has already been close to critical hypertension value level test average value.Besides it is also demonstrated that whatever the male or the female elderly persons,the fitness Index of the rural elderly people are better than the urban elderly people by the comparison of the four item of physical quality target.

  20. Atrial structure, function and arrhythmogenesis in aged and frail mice

    Science.gov (United States)

    Jansen, Hailey J.; Moghtadaei, Motahareh; Mackasey, Martin; Rafferty, Sara A.; Bogachev, Oleg; Sapp, John L.; Howlett, Susan E.; Rose, Robert A.

    2017-01-01

    Atrial fibrillation (AF) is prevalent in aging populations; however not all individuals age at the same rate. Instead, individuals of the same chronological age can vary in health status from fit to frail. Our objective was to determine the impacts of age and frailty on atrial function and arrhythmogenesis in mice using a frailty index (FI). Aged mice were more frail and demonstrated longer lasting AF compared to young mice. Consistent with this, aged mice showed longer P wave duration and PR intervals; however, both parameters showed substantial variability suggesting differences in health status among mice of similar chronological age. In agreement with this, P wave duration and PR interval were highly correlated with FI score. High resolution optical mapping of the atria demonstrated reduced conduction velocity and action potential duration in aged hearts that were also graded by FI score. Furthermore, aged mice had increased interstitial fibrosis along with changes in regulators of extracellular matrix remodelling, which also correlated with frailty. These experiments demonstrate that aging results in changes in atrial structure and function that create a substrate for atrial arrhythmias. Importantly, these changes were heterogeneous due to differences in health status, which could be identified using an FI. PMID:28290548

  1. Share A Fare: a user-side subsidy transportation program for elderly and handicapped persons in Kansas City, Missouri. Final report, May 1977-December 1978

    Energy Technology Data Exchange (ETDEWEB)

    Dorosin, E.; Phillips, J.

    1979-07-01

    Documentation of the Share A Fare, Kansas City, Missouri's user-side subsidy transportation broken project for elderly and handicapped persons, during its first 20 months of operation is presented. The project was designed and implemented by the city; it is totally funded from a 1/2 cent city sales tax designated for transportation purposes. Transportation service is provided by profit and not-for-profit carriers and by city owned and operated vans. The operation of the project is described and key features and their impacts on program success are identified. Data are presented on project design and planning; operating characteristics; and on the project's impact on service providers, users, and city sponsor.

  2. Personalized absolute benefit of statin treatment for primary or secondary prevention of vascular disease in individual elderly patients.

    Science.gov (United States)

    Stam-Slob, Manon C; Visseren, Frank L J; Wouter Jukema, J; van der Graaf, Yolanda; Poulter, Neil R; Gupta, Ajay; Sattar, Naveed; Macfarlane, Peter W; Kearney, Patricia M; de Craen, Anton J M; Trompet, Stella

    2017-01-01

    To estimate the absolute treatment effect of statin therapy on major adverse cardiovascular events (MACE; myocardial infarction, stroke and vascular death) for the individual patient aged ≥70 years. Prediction models for MACE were derived in patients aged ≥70 years with (n = 2550) and without (n = 3253) vascular disease from the "PROspective Study of Pravastatin in Elderly at Risk" (PROSPER) trial and validated in the "Secondary Manifestations of ARTerial disease" (SMART) cohort study (n = 1442) and the "Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm" (ASCOT-LLA) trial (n = 1893), respectively, using competing risk analysis. Prespecified predictors were various clinical characteristics including statin treatment. Individual absolute risk reductions (ARRs) for MACE in 5 and 10 years were estimated by subtracting on-treatment from off-treatment risk. Individual ARRs were higher in elderly patients with vascular disease [5-year ARRs: median 5.1 %, interquartile range (IQR) 4.0-6.2 %, 10-year ARRs: median 7.8 %, IQR 6.8-8.6 %] than in patients without vascular disease (5-year ARRs: median 1.7 %, IQR 1.3-2.1 %, 10-year ARRs: 2.9 %, IQR 2.3-3.6 %). Ninety-eight percent of patients with vascular disease had a 5-year ARR ≥2.0 %, compared to 31 % of patients without vascular disease. With a multivariable prediction model the absolute treatment effect of a statin on MACE for individual elderly patients with and without vascular disease can be quantified. Because of high ARRs, treating all patients is more beneficial than prediction-based treatment for secondary prevention of MACE. For primary prevention of MACE, the prediction model can be used to identify those patients who benefit meaningfully from statin therapy.

  3. 24-hour pattern of falls in hospitalized and long-term care institutionalized elderly persons: A systematic review of the published literature.

    Science.gov (United States)

    López-Soto, Pablo Jesús; Manfredini, Roberto; Smolensky, Michael H; Rodríguez-Borrego, María Aurora

    2015-05-01

    Falls are common among the elderly > 65 years of age and can result in both serious trauma and costly medical care. The epidemiology of falls in the elderly typically focuses on identifying contributory exogenous environmental and endogenous age-related physical, cognitive and other health status factors; however, one potentially important variable seldom considered is time of fall. We sought to determine if falls in hospitalized/institutionalized elderly persons exhibit 24 h and other temporal patterns, since knowledge of such could be useful in their prevention. We conducted a systematic review of the published literature to critically appraise and synthesize the methods and findings of previous reports addressing clock-time, day-of-week and month-of-year fall patterns of institutionalized elderly cohorts. Medline, SCOPUS, Ovid SP and Web of Knowledge were systematic assessed, entering search terms of "accidental fall", "circadian rhythm", "biological clocks", "circadian clocks", "activity cycles", "periodicity", and with databases accepting an age limiter, "age of 65(+) years". Methodological quality was assessed by STROBE and CONSORT checklists, respectively, in observational and clinical studies. Publications were reviewed if meeting inclusion criteria of: (i) being an empirical study, (ii) adopting circadian and/or other period rhythmicity as a fall risk, and (iii) focusing on hospitalized/institutionalized falls in those ≥ 65 years of age; plus exclusion criteria of: (i) cohort fall incidents; the few that did varied in quality, institutional setting, and patient type, i.e. medical diagnoses. Overall, findings suggest a single or double-peak 24 h pattern of fall incidence, with time of greatest incidence seemingly associated with circadian rhythm-dependent differences in the symptom intensity of dominating medical diagnoses (e.g. heart failure versus Alzheimer syndrome) among sample cohorts plus location (e.g. bathroom versus hallway) of occurrence

  4. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

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    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

  5. 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

  6. Markers of Mineral Metabolism Are Not Associated With Aortic Pulse Wave Velocity in Community-Living Elderly Persons: The Health Aging and Body Composition Study

    Science.gov (United States)

    Madero, Magdalena; Wassel, Christina L.; Peralta, Carmen A.; Najjar, Samer S.; Sutton-Tyrrell, Kim; Fried, Linda F.; de Boer, Ian H.; Shlipak, Michael G.; Newman, Anne B.; Hausman, Dorothy; Sarnak, Mark J.; Kritchevsky, Stephen B.; Ix, Joachim H.

    2011-01-01

    BACKGROUND Disorders in mineral metabolism are associated with risk for cardiovascular disease (CVD) events in patients with kidney disease as well as in the general population. This risk is thought to be mediated, in part, through the mechanism of stiffening of the arteries. METHODS The objective of this study was to evaluate the relationships between serum calcium, phosphorus, intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D levels and arterial pulse wave velocity (aPWV) among 2,229 community-dwelling elderly persons participating in the Health Aging and Body Composition (Health ABC) study. RESULTS The mean age of the participants was 72 years; 52% were woman, 39% were black, and 17% had chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2). In parallel unadjusted analyses, the following associations were observed: 2.86% greater aPWV per 12 ng/ml (s.d.) lower 25-hydroxyvitamin D (95% confidence interval −4.38%, −1.31%), 3.04% greater aPWV per 28 pg/ml (s.d.) higher iPTH (95% confidence interval 1.42–4.68%), and 2.37% lower aPWV per 0.5 mg/dl (s.d.) higher phosphorus (95% confidence interval −3.90% to − 0.81%). Except for phosphorus, these associations were attenuated and rendered no longer statistically significant after adjustment for demographic risk factors, clinical site, season, medications and other CVD risk factors. The results were similar in men and women and were not dependent on the presence of CKD. CONCLUSIONS Among well-functioning community-dwelling elderly persons, only serum phosphorus was associated with aPWV; and this association was in the opposite direction of the one hypothesized. Factors other than vascular stiffening may mediate the relationship between disordered mineral metabolism and CVD events in community-living elders. PMID:21436791

  7. Influence of personality characteristics on spectrum of catecholamines and course of ischemic heart disease in elderly patients

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    Zarubina Е.G.

    2012-12-01

    Full Text Available Purpose: the study of interrelation between characteristics of psychological profile of elderly patients, level of stress hormones in blood serum and character of IHD course. Materials and Methods. The level of catecholamines and cortisol in blood was investigated in two groups of elderly patients (379 patients formed according to their psychological profile with the help of Cattell questionnaire. Multispiral coronarography was conducted in patients suffering IHD. Results. The established differences of stress level correlated with the characteristics of the course of IHD at all the examined patients. In spite of various levels and reactions of adaptive hormones on stress situations the prevalence of IHD appeared to be the same in both groups although manifestation and clinical severity of coronary insufficiency varied in patients of different groups. The number of patients suffered myocardial infarction, among them with Q-wave, occurred to be higher in one of the groups despite the fact that changes in their coronary arteries were less expressed. Conclusion. The character of psychological profile causes different stress resistance of patients and leads to various levels of stress hormones in blood serum. Depression can become a marker of severe course of cardiovascular pathology. The character of psychological profile influences the course of IHD.

  8. Influence of galacto-oligosaccharide mixture (B-GOS) on gut microbiota, immune parameters and metabonomics in elderly persons.

    Science.gov (United States)

    Vulevic, Jelena; Juric, Aleksandra; Walton, Gemma E; Claus, Sandrine P; Tzortzis, George; Toward, Ruth E; Gibson, Glenn R

    2015-08-28

    It is recognised that ageing induces various changes to the human colonic microbiota. Most relevant is a reduction in bifidobacteria, which is a health-positive genus. Prebiotics, such as galacto-oligosaccharides (GOS), are dietary ingredients that selectively fortify beneficial gut microbial groups. Therefore, they have the potential to reverse the age-related decline in bifidobacteria and modulate associated health parameters. We assessed the effect of GOS mixture (Bimuno (B-GOS)) on gut microbiota, markers of immune function and metabolites in forty elderly (age 65-80 years) volunteers in a randomised, double-blind, placebo (maltodextrin)-controlled, cross-over study. The intervention periods consisted of 10 weeks with daily doses of 5·5 g/d with a 4-week washout period in between. Blood and faecal samples were collected for the analyses of faecal bacterial populations and immune and metabolic biomarkers. B-GOS consumption led to significant increases in bacteroides and bifidobacteria, the latter correlating with increased lactic acid in faecal waters. Higher IL-10, IL-8, natural killer cell activity and C-reactive protein and lower IL-1β were also observed. Administration of B-GOS to elderly volunteers may be useful in positively affecting the microbiota and some markers of immune function associated with ageing.

  9. As representações sociais de "pessoa velha" construídas por idosos Social representations of "old person" built by elderly

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    Verônica Braga dos Santos

    2013-03-01

    Full Text Available De forma a contribuir para a compreensão de como as pessoas pensam, elaboram, articulam saberes, e agem acerca dos aspectos relacionados ao envelhecimento humano, o estudo objetivou apreender os sentidos atribuídos à "pessoa velha" construídos por idosos. Com base na teoria das representações sociais, na abordagem estrutural, realizou-se um teste de evocação livre de palavras com a expressão "pessoa velha"; além disso, aplicou-se um questionário que fez a caracterização sociodemográfica e incluía perguntas abertas acerca de crenças, atitudes, normas, valores e práticas relacionadas ao envelhecimento e ao idoso.. Participaram 70 pessoas maiores de 60 anos, ex-alunos de uma instituição federal de ensino do Rio de Janeiro, com idade entre 60 e 83 anos (média de 65,4 anos e maioria do sexo feminino (51,4%. Experiência compôs o sistema central. O sistema periférico foi constituído por Carinho, Sabedoria, Saúde, Pai-Mãe-Tia, Dificuldade, Abandono, Alegria, Respeito, Excluída, Aposentado, Cansada, Cuidado e Exercícios; o sistema intermediário foi formado por Doença, Idoso, Dedicação, Preconceito, Tristeza, Paciência, Avô, Discriminação, Rabugenta, Solidão, Ultrapassada. Foi identificada na representação construída uma dimensão psicossocial, referindo-se criticamente ao tratamento que os participantes compreendem que a sociedade direciona ou deveria direcionar a pessoa velha, e a forma passiva ou ativa de atuação da pessoa considerada velha. Possivelmente, os idosos construíram uma representação com a qual não se identificam ou não querem se identificar em todos os seus sentidos, representam um outro, a pessoa velha.This study focused on the social representations of "old person" built by elderly, in order to help the understanding of how people think, develop, articulate knowledge and act. Based on a structural approach, a test of words' free evocation was triggered by the expression "old person"; a

  10. Efficacy and Safety of Single Dose Zoledronic Acid for Osteoporosis in Frail Seniors: A Randomized Clinical Trial

    Science.gov (United States)

    Greenspan, Susan L.; Perera, Subashan; Ferchak, Mary Anne; Nace, David A.; Resnick, Neil M.

    2016-01-01

    Importance 85% of institutionalized elderly have osteoporosis, with fracture rates 8–9 fold higher than observed among community-dwelling elderly. Yet most are untreated and excluded from pivotal osteoporosis trials. Objective Determine the efficacy and safety of zoledronic acid in frail elderly women. Design 2-year, randomized, placebo-controlled, double-blinded study conducted between December 2007 and March 2012. Setting Nursing home and assisted living facilities. Participants 181 women ≥ age 65 with osteoporosis including those with cognitive impairment, immobility, and multimorbidity. Intervention One 5 mg dose of zoledronic acid or placebo IV and daily calcium and vitamin D. Main Outcomes (1) Hip and spine bone mineral density (BMD) at 12 and 24 months and (2) adverse events. Results There were no baseline differences in age (mean=85.4±0.6 years), BMD, or functional or cognitive status, but the treatment group included more subjects with frailty, falls history, diabetes, and anticonvulsant use. BMD was available for 87% of participants at 12 months and 73% at 24 months. BMD changes were greater in the treatment group (p< 0.01): 3.2 ± 0.7 and 3.9 ± 0.7 percentage point differences (mean ± SE) in the total hip at 12 and 24 months respectively, and 1.8 ± 0.7 and 3.6 ± 0.7 at the spine (p<0.01); adjusted analyses were similar. The treatment and placebo groups’ fracture rates were 20% and 16%, respectively (OR=1.30; 95% CI=0.61–2.78); mortality rates were 16% and 13% (OR=1.24; 95% CI=0.54–2.86). Groups did not differ in the proportion of single fallers (28% vs. 24%; OR=1.24; 95% CI=0.64–2.42; p=0.52) but more subjects in the treatment group had multiple falls (49% vs. 35%; OR=1.83; 95% CI=1.01–3.33; p=0.047); this was no longer significant when adjusted for baseline frailty. Conclusions and Relevance In this group of frail, osteoporotic women, one dose of zoledronic acid improved BMD over 2 years. The clinical importance of nonsignificant

  11. Personality, Cortisol, and Cognition in Non-demented Elderly Subjects: Results from a Population-Based Study

    Science.gov (United States)

    Ouanes, Sami; Castelao, Enrique; von Gunten, Armin; Vidal, Pedro M.; Preisig, Martin; Popp, Julius

    2017-01-01

    Certain personality traits, in particular higher neuroticism, have been associated, on one hand, with elevated cortisol levels, and on the other hand, with poorer cognitive performance. At the same time, several studies highlighted the association between high cortisol and poor cognitive functioning. Here, we hypothesized that increased cortisol may be associated with poorer cognition and with certain personality traits (mainly high neuroticism), and that personality might explain the association between cortisol and cognition. A cross-sectional analysis was conducted using data from Colaus/PsyColaus, a population-based study involving residents of Lausanne, Switzerland. Salivary cortisol samples (upon waking, 30 min after waking, at 11 am and at 8 pm) along with cognitive and personality measures were obtained from 643 non-demented participants aged at least 65. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI). We examined the links between the cortisol Area under the Curve (AUC), the Clinical Dementia Rating Sum of Boxes (CDRSOB) and the NEO-FFI scores. No association was found between personality traits and the CDRSOB or the MMSE score, controlling for age, sex, depression, education and BMI. However, the executive functioning domain z-score was negatively associated with agreeableness (p = 0.005; slope = -0.107 [-0.181; -0.033]) and openness (p = 0.029; slope = -0.081 [-0.154; -0.008]) after controlling for age, sex, depression, education and BMI. The CDRSOB score was positively associated with the cortisol AUC after controlling for age, sex, BMI, education and depression, (p = 0.003; slope = 0.686 [0.240; 1.333]). This association remained significant after controlling for personality traits and for the interaction between personality traits and the cortisol AUC (p = 0.006; slope = 0.792 [0.233; 1.352]. High agreeableness and openness might be associated with poorer executive performance in later life. Increased cortisol may be

  12. Personality, Cortisol, and Cognition in Non-demented Elderly Subjects: Results from a Population-Based Study.

    Science.gov (United States)

    Ouanes, Sami; Castelao, Enrique; von Gunten, Armin; Vidal, Pedro M; Preisig, Martin; Popp, Julius

    2017-01-01

    Certain personality traits, in particular higher neuroticism, have been associated, on one hand, with elevated cortisol levels, and on the other hand, with poorer cognitive performance. At the same time, several studies highlighted the association between high cortisol and poor cognitive functioning. Here, we hypothesized that increased cortisol may be associated with poorer cognition and with certain personality traits (mainly high neuroticism), and that personality might explain the association between cortisol and cognition. A cross-sectional analysis was conducted using data from Colaus/PsyColaus, a population-based study involving residents of Lausanne, Switzerland. Salivary cortisol samples (upon waking, 30 min after waking, at 11 am and at 8 pm) along with cognitive and personality measures were obtained from 643 non-demented participants aged at least 65. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI). We examined the links between the cortisol Area under the Curve (AUC), the Clinical Dementia Rating Sum of Boxes (CDRSOB) and the NEO-FFI scores. No association was found between personality traits and the CDRSOB or the MMSE score, controlling for age, sex, depression, education and BMI. However, the executive functioning domain z-score was negatively associated with agreeableness (p = 0.005; slope = -0.107 [-0.181; -0.033]) and openness (p = 0.029; slope = -0.081 [-0.154; -0.008]) after controlling for age, sex, depression, education and BMI. The CDRSOB score was positively associated with the cortisol AUC after controlling for age, sex, BMI, education and depression, (p = 0.003; slope = 0.686 [0.240; 1.333]). This association remained significant after controlling for personality traits and for the interaction between personality traits and the cortisol AUC (p = 0.006; slope = 0.792 [0.233; 1.352]. High agreeableness and openness might be associated with poorer executive performance in later life. Increased cortisol may be

  13. Population Ageing and Socially Assistive Robots for Elderly Persons: The Importance of Sociodemographic Factors for User Acceptance

    Directory of Open Access Journals (Sweden)

    Priska Flandorfer

    2012-01-01

    Full Text Available Taking care of older adults is among the major challenges currently faced by ageing populations. Researchers, designers, and engineers have proposed socially assistive robots as one way of helping elderly people stay in their homes longer. In a systematic literature review, this paper wants to investigate if and how evaluations of the acceptance of socially assistive robots by older people take into account sociodemographic factors. The results indicate that this only holds true for a few studies. Research that incorporates age, gender, education, and so forth; clearly shows that these key factors have a significant impact. However, the relations are complex and experience with technology mitigates the influence of sociodemographic factors on acceptance. Assistive devices should be adaptable to individual needs to be able to consider all these factors.

  14. 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.

  15. Change over time in brain computed tomographic and magnetic resonance imaging findings in healthy elderly persons. A 10 year prospective study

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    Kasahara, Hiroo [Jikei Univ., Tokyo (Japan). School of Medicine

    1998-09-01

    Early detection, treatment and prevention of dementia have become increasingly important as the population ages. I have performed a follow-up study of changes in the brains of healthy elderly persons with computed tomography (CT) and magnetic resonance imaging (MRI) since 1982. One hundred thirty-three healthy elderly volunteers were first examined in 1982 with CT or MRI, electroencephalography, the Benton Visual Retention Test (BVRT), blood pressure measurement, and interview. Subsequent examinations were done in 1986, 1989, and 1992. On CT, microinfarctions were found in 15.0% of subjects in 1982 and in 13.0% in 1986, and periventricular lucency (PVL) was found in 6.0% and 8.3%. The most frequent findings were vascular changes, which were observed in six persons (5.6%), followed by PVL, which was found in four persons (3.7%). Thus, vascular changes became more pronounced during the follow-up period. Lesions with high signal intensity on T{sub 2}-weighted images (T{sub 2}HSI) were found in 69.5% of subjects and increased in prevalence with age in the 1989 study. Such T{sub 2}HSI lesions were found most frequently in the basal ganglia (61.9%), followed by the thalamus (39.0%), parietal lobe (37.0%), temporal lobe (12.7%), and the pons (8.5%). Of these lesions, lacunar infarctions showed low signal intensity on T{sub 1}-weighted images and were found in 24.6% of subjects; their prevalence also increased with age. Results of BVRT were closely correlated with T{sub 2}HSI lesions, suggesting that T{sub 2}HSIs lesions may affect cognitive function. By 1992, 10 years after the start of the study, 34 (25.6%) of subjects had died and 19 (14.3%) had become demented. Subjects were divided into surviving and dead groups and dementia and non-dementia groups. Findings on CT and BVRT in this study have provided clear clinical indices of death and dementia, especially maximal width of third ventricule in impairment of the diagnosis of dementia. (author)

  16. Autonomy among physically frail older people in nursing home settings

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    -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...... methods and equipment. Participants in each nursing home were divided by lot into either a control group or an intervention group. The control groups received their usual care and treatment. DISCUSSION: This study is designed to assess the status of perceived autonomy at baseline and to provide......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...

  17. 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

    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......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...

  18. [Mutual adaptation of elderly patients with schizophrenia and mentally healthy persons in a family (socio-psychological analysis)].

    Science.gov (United States)

    Rakha'lskiĭ, Iu E; Dru'z, V F

    1989-01-01

    Clinical and psychosocial examinations of 70 families of senile schizophrenic patients and 40 families of healthy persons showed that in the patients' and controls' families, the identical events were caused by the subjects' age itself: lower status and adaptation of senile persons, rationalistic attitude of the relatives toward them, conflicts, disintegrated families, dysharmonic relations. In line with the schizophrenic process, the patients have less frequently higher status, enjoy more care of siblings, more rationalistic attitude of the relatives, higher conflict rate, larger variety of familial cooperation disorders and adaptations.

  19. 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

  20. A Simple Disease-Guided Approach to Personalize ACC/AHA-Recommended Statin Allocation in Elderly People

    DEFF Research Database (Denmark)

    Mortensen, Martin Bødtker; Fuster, Valentin; Muntendam, Pieter;

    2016-01-01

    -based statin therapy due to age alone. OBJECTIVES: This study sought to personalize ACC/AHA risk-based statin eligibility using noninvasive assessment of subclinical atherosclerosis. METHODS: In 5,805 BioImage participants without known ASCVD at baseline, those with ≥7.5% 10-year ASCVD risk were down...

  1. Older age relates to worsening of fine motor skills: A population based study of middle-aged and elderly persons

    NARCIS (Netherlands)

    Y.Y. Hoogendam (Jory); F. van der Lijn (Fedde); M.W. Vernooij (Meike); A. Hofman (Albert); W.J. Niessen (Wiro); A. van der Lugt (Aad); M.A. Ikram (Arfan); J.N. van der Geest (Jos)

    2014-01-01

    textabstractIntroduction: In a population-based study of 1,912 community-dwelling persons of 45 years and older we investigated the relation between age and fine motor skills using the Archimedes spiral drawing test. Also, we studied the effect of brain volume on fine motor skills. Methods: Particip

  2. Disagreement between subjective and actigraphic measures of sleep duration in a population-based study of elderly persons

    NARCIS (Netherlands)

    J.F. van den Berg (Julia); F.J.A. van Rooij (Frank); H. Vos; J.H.M. Tulen (Joke); A. Hofman (Albert); H.M. Miedema (Henk); A.K. Neven (Arie); H.W. Tiemeier (Henning)

    2008-01-01

    textabstractSleep 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, act

  3. 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

  4. 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.

  5. Reporting elder mistreatment.

    Science.gov (United States)

    Capezuti, E; Brush, B L; Lawson, W T

    1997-07-01

    Elder mistreatment, defined as the abuse and neglect of older persons, includes physical, psychological, and sexual abuse, caregiver and self-neglect, and financial exploitation. Fifty states and the District of Columbia have passed legislation to establish adult protective service (APS) programs. State APS statutes authorize APS agencies to investigate cases of elder mistreatment. Some status fund services to alleviate the abusive or neglectful situation. This article analyzes the critical aspects of state-specific APS legislation affecting nursing practice with older adults and the nurse's role in reporting cases of elder mistreatment.

  6. Change of outlook on elderly persons with dementia: a study of trainees during a year of special education.

    Science.gov (United States)

    Skog, M; Grafström, M; Negussie, B; Winblad, B

    1999-08-01

    In 1996 the Silvia Home Foundation started a non-governmental education programme with an integrated day-care unit devoted to patients with dementia: Working chairwoman of the foundation is HM Queen Silvia of Sweden. This study aims to describe the trainees' changed outlook on elderly people with dementia during a year of special education. Data were collected by interviews, informal discussions and participant observations during the lessons. The investigation focused on two questions: the trainees' outlook on the patients and their outlook on the work with the patients. At the beginning of their education, the trainees looked at the patients from a staff's perspective. During their education, this was gradually toned down and they changed to a disease perspective, and eventually to a human dignity perspective. After initially seeing dementia patients as a homogeneous group, the trainees went on to see them as unique human beings. Their outlook on their work also changed, from being task-oriented to a more humanitarian approach.

  7. Theoretical perspectives concerning positive aspects of caring for elderly persons with dementia: stress/adaptation and existentialism.

    Science.gov (United States)

    Farran, C J

    1997-04-01

    Research concerning caregivers of persons with dementia has predominantly been guided by a stress/adaptation paradigm. This paradigm, however, does not fully address the issue of how caregivers manage to do so well under difficult circumstances. Existentialism offers an alternate theoretical view for exploring this issue. This article compares and contrasts these two paradigms-their key elements, strengths, and limitations, and areas of convergence and divergence. It identifies implications for future theory development, research, and clinical practice.

  8. [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.

  9. 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

  10. 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.

  11. 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

  12. [Prevalence of frailty and associated factors in community-dwelling elderly in Belo Horizonte, Minas Gerais State, Brazil: data from the FIBRA study].

    Science.gov (United States)

    Vieira, Renata Alvarenga; Guerra, Ricardo Oliveira; Giacomin, Karla Cristina; Vasconcelos, Karina Simone de Souza; Andrade, Amanda Cristina de Souza; Pereira, Leani Souza Máximo; Dias, João Marcos Domingues; Dias, Rosângela Corrêa

    2013-08-01

    The prevalence of frailty varies greatly and has received insufficient attention in developing countries. This study aimed to identify the prevalence of frailty and associated factors among the elderly in Belo Horizonte, Minas Gerais State, Brazil. Clinical, functional, and socio-demographic factors were analyzed. An ordinal regression model was used to verify conditions associated with frailty and to determine odds ratios ( α= 0.05). Prevalence rates were 46.3% for pre-frailty was 8.7% for weakness. Pre-frail and frail elderly, respectively, showed higher and increasing odds ratios for dependency in instrumental activities of daily living; restrictions in advanced activities of daily living; use of walking aids; comorbidities; falls; depressive symptoms; lower self-efficacy in preventing falls; hospitalization; and advanced age. The study identified a high percentage of frail states associated with higher odds of adverse health conditions, especially related to disability.

  13. 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.

  14. 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

  15. Mortalidad por tumores malignos más frecuentes en el adulto mayor Mortality due to more frequent malignant tumors in elderly person

    Directory of Open Access Journals (Sweden)

    Pablo Cruz González

    2011-03-01

    Full Text Available Introducción: actualmente, las neoplasias malignas constituyen un grupo de enfermedades de gran importancia en la población anciana. Con la edad aumenta la incidencia de la mayoría de los tumores. En Cuba el 65 % de las personas que fallecen por cáncer son mayores de 60 años. Objetivos: caracterizar el comportamiento de la mortalidad por los tumores malignos más frecuentes en el adulto mayor del municipio Plaza de la Revolución durante el quinquenio 2004-2008. Métodos: estudio descriptivo en el que se tomaron todos los fallecidos por esta causa, y que tuvieran residencia en el municipio a partir de las bases de datos de mortalidad de la Dirección Nacional de Estadísticas. Se tuvieron en cuenta las variables: localización anatómica, sexo y edad. Resultados: la localización en próstata ocupó el primer lugar como causa de muerte, con una tasa de 254,1 por 100 000 hab, seguido por el pulmón (189,6. En hombres fueron más frecuentes próstata (254,1 y pulmón (234,8, y en mujeres pulmón (116,5 y mama (112,1. Según la edad, el grupo de 75 años y más fue el más afectado en ambos sexos. Conclusiones: los datos de este estudio confirman un importante crecimiento de la mortalidad en las principales localizaciones, lo que, junto al progresivo envejecimiento de la población, determinará un crecimiento del número anual de casos diagnosticados que generará, a su vez, un aumento de demanda de distintos servicios relacionados con la atención de los pacientes oncológicos en la tercera edad.Introduction: nowadays, the malignant neoplasias are a diseases group very significant in elderly persons. With advanced age increases the incidence of most tumors. In Cuba the 65 % of deceased persons due to cancer is aged over 65. Objectives: to characterize the behavior of mortality due to malignant tumors more frequent in elderly persons from the "Plaza de la Revolución" municipality during the five-year period 2004-2008. Methods: a descriptive

  16. 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

  17. 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.

  18. Children's Attitudes toward the Elderly

    Science.gov (United States)

    Jantz, Richard K.; And Others

    1977-01-01

    A study measured children's attitudes toward and knowledge of older people in American society. Findings indicate that children have little general knowledge of the elderly and very complex, mixed attitudes toward older persons. Ways are suggested in which schools can inculcate positive attitudes toward all people, including the elderly.…

  19. The effects of technological advances on outcomes for elderly persons with exudative age-related macular degeneration.

    Science.gov (United States)

    Sloan, Frank A; Hanrahan, Brian W

    2014-04-01

    IMPORTANCE Exudative age-related macular degeneration (ARMD) is the major cause of blindness among US elderly. Developing effective therapies for this disease has been difficult. OBJECTIVES To assess the effects of introducing new therapies for treating exudative ARMD on vision of the affected population and other outcomes among Medicare beneficiaries newly diagnosed as having ARMD. DESIGN The study used data from a 5% sample of Medicare claims and enrollment data with a combination of a regression discontinuity design and propensity score matching to assess the effects on the introduction or receipt of new technologies on study outcomes during a 2-year follow-up period. SETTING AND PARTICIPANTS The analysis was based on longitudinal data for the United States, January 1, 1994, to December 31, 2011, for Medicare beneficiaries with fee-for-service coverage. The sample was limited to beneficiaries 68 years or older newly diagnosed as having exudative ARMD as indicated by beneficiaries having no claims with this diagnosis in a 3-year look-back period. EXPOSURES The comparisons with vision outcomes were after vs before the introduction of photodynamic therapy and anti-vascular endothelial growth factor (VEGF) therapy. The comparisons for depression and long-term care facility admission were between beneficiaries newly diagnosed as having exudative ARMD who received photodynamic therapy or anti-VEGF therapy compared with beneficiaries having the diagnosis who received no therapy for this disease. MAIN OUTCOMES AND MEASURES Onset of decrease in vision, vision loss or blindness, depression, and admission to a long-term care facility. RESULTS Among beneficiaries newly diagnosed as having exudative ARMD, the introduction of anti-VEGF therapy reduced vision loss by 41% (95% CI, 52%-68%) and onset of severe vision loss and blindness by 46% (95% CI, 47%-63%). Such beneficiaries who received anti-VEGF therapy and were not admitted to a long-term care facility during the look

  20. Attribution, the Attractiveness Stereotype, and the Elderly.

    Science.gov (United States)

    Johnson, Douglas F.; Pittenger, John B.

    1984-01-01

    Tests the applicability of the physical attractiveness stereotype to perceptions of the elderly. In the first study, college-age and elderly observers rated the attractiveness of faces of elderly people. In the second study, subjects rated faces at three levels of attractiveness on personality, success in life experiences, and occupational…

  1. Attribution, the Attractiveness Stereotype, and the Elderly.

    Science.gov (United States)

    Johnson, Douglas F.; Pittenger, John B.

    1984-01-01

    Tests the applicability of the physical attractiveness stereotype to perceptions of the elderly. In the first study, college-age and elderly observers rated the attractiveness of faces of elderly people. In the second study, subjects rated faces at three levels of attractiveness on personality, success in life experiences, and occupational…

  2. Two Principles of good elderly care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene; Eskelinen, Leena; Boll Hansen, Eigil

    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...

  3. When and why frail elderly people give up independent living : The Netherlands as an example

    NARCIS (Netherlands)

    Steverink, Nardi

    2001-01-01

    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 t

  4. When and why frail elderly people give up independent living : The Netherlands as an example

    NARCIS (Netherlands)

    Steverink, Nardi

    2001-01-01

    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 t

  5. Residential and Community Provisions for the Frail Elderly in Germany: Current Issues and Their History.

    Science.gov (United States)

    Dieck, Margret

    1980-01-01

    The position of the "home for the aged" in the total social support network of West Germany is controversial. Senior citizen housing provides a more favorable atmosphere for older adults. Old age homes will have to offer better conditions and more independence. (JAC)

  6. Guardianship of Frail Elders: Student-Supported Process for Legislative Change

    Science.gov (United States)

    Ellor, James W.; Harris, Helen Wilson; Myers, Dennis R.; Russell, Inez

    2009-01-01

    Legislative change, ethical dilemmas, and client management issues were all faced by social work students in a recent effort to impact guardianship in the State of Texas. Since the mid-1990s, Texas had been without a statewide system to provide guardianship services. In 2004 a group of social work students, law students, faculty, guardianship…

  7. Opening the Black Box of Clinical Collaboration in Integrated Care Models for Frail, Elderly Patients

    Science.gov (United States)

    de Stampa, Matthieu; Vedel, Isabelle; Bergman, Howard; Novella, Jean-Luc; Lechowski, Laurent; Ankri, Joel; Lapointe, Liette

    2013-01-01

    Purpose: The purpose of the study was to understand better the clinical collaboration process among primary care physicians (PCPs), case managers (CMs), and geriatricians in integrated models of care. Methods: We conducted a qualitative study with semistructured interviews. A purposive sample of 35 PCPs, 7 CMs, and 4 geriatricians was selected in…

  8. 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

  9. Treatment of colorectal cancer in the elderly

    Institute of Scientific and Technical Information of China (English)

    Monica; Millan; Sandra; Merino; Aleidis; Caro; Francesc; Feliu; Jordi; Escuder; Tani; Francesch

    2015-01-01

    Colorectal cancer has a high incidence, and approxi-mately 60% of colorectal cancer patients are older than 70, with this incidence likely increasing in the near future. Elderly patients(> 70-75 years of age) are a very heterogeneous group, ranging from the very fit to the very frail. Traditionally, these patients have often been under-treated and recruited less frequently to clinical trials than younger patients, and thus are underrepresented in publications about cancer treatment. Recent studies suggest that fit elderly patients can be treated in the same way as their younger counterparts, but the treatment of frail patients with comorbidities is still a matter of controversy. Many factors should be taken into account, including fitness for treatment, the wishes of the patient and family, and quality of life. This review will focus on the existing evidence for surgical, oncologic, and palliative treatment in patients over 70 years old with colorectal cancer. Careful patient assessment is necessary in order to individualize treatment approach, and this should rely on a multidisciplinary process. More well-designed controlled trials are needed in this patient population.

  10. Method and System for Human Action Detections with Acceleration Sensors for the Proposed Rescue System for Disabled and Elderly Persons Who Need a Help in Evacuation from Disaster Area

    Directory of Open Access Journals (Sweden)

    Kohei Arai

    2014-01-01

    Full Text Available Method and system for human action detections with acceleration sensors for the proposed rescue system for disabled and elderly persons who need a help in evacuation from disaster areas is proposed. Not only vital signs, blood pressure, heart beat pulse rate, body temperature, bless and consciousness, but also, the location and attitude of the persons have to be monitored for the proposed rescue system. The attitude can be measured with acceleration sensors. In particular, it is better to discriminate the attitudes, sitting, standing up, and lying down. Also, action speed has to be detected. Experimental results show that these attitude monitoring can be done with acceleration sensors.

  11. The Program of All-Inclusive Care for the Elderly (PACE): an innovative long-term care model in the United States.

    Science.gov (United States)

    Mui, A C

    2001-01-01

    This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.

  12. The mortality of elder mistreatment.

    Science.gov (United States)

    Lachs, M S; Williams, C S; O'Brien, S; Pillemer, K A; Charlson, M E

    1998-08-05

    Although elder mistreatment is suspected to be life threatening in some instances, little is known about the survival of elderly persons who have been mistreated. To estimate the independent contribution of reported elder abuse and neglect to all-cause mortality in an observational cohort of community-dwelling older adults. Prospective cohort study with at least 9 years of follow-up. The New Haven Established Population for Epidemiologic Studies in the Elderly cohort, which included 2812 community-dwelling adults who were older than 65 years in 1982, a subset of whom were referred to protective services for the elderly. All-cause mortality among (1) elderly persons for whom protective services were used for corroborated elder mistreatment (elder abuse, neglect, and/or exploitation), or (2) elderly persons for whom protective services were used for self-neglect. In the first 9 years after cohort inception, 176 cohort members were seen by elderly protective services for verified allegations; 10 (5.7%) of these were for abuse, 30 (17.0%) for neglect, 8 (4.5%) for exploitation, and 128 (72.7%) for self-neglect. At the end of a 13-year follow-up period from cohort inception, cohort members seen for elder mistreatment at any time during the follow-up had poorer survival (9%) than either those seen for self-neglect (17%) or other noninvestigated cohort members (40%) (Pself-neglect (odds ratio, 1.7; 95% confidence interval, 1.2-2.5), when compared with other members of the cohort. Reported and corroborated elder mistreatment and self-neglect are associated with shorter survival after adjusting for other factors associated with increased mortality in older adults.

  13. 社区老年患者失眠自我管理模式研究%Study on self-management model for elderly persons with insomnia

    Institute of Scientific and Technical Information of China (English)

    段永珂; 白琴; 郭红雨; 徐吉祥; 张艳春

    2011-01-01

    目的 改变老年失眠患者的认知,探讨失眠自我管理模式,提高睡眠质量,减少药物滥用.方法 以某市94例社区老年失眠患者为研究对象,采用单双数法单数为试验组,双数为对照组,各47例,以匹斯堡睡眠质量指教(PSQI)为评价工具,试验组进行认知行为指导,自我穴位按摩,自我药物管理递进式干预,对照组维持其原有生活状态和治疗措施,不施加干预.结果 干预结束后试验组PSQI各因子及总分差异均有统计学意义(P<0.05),两组比较除入睡时间外,差异均有统计学意义(P<0.01).试验组有服用催眠药物史者27例中,有26例(96.2%)患者通过非药物自我管理不同程度地减少了药物的使用.其中13例(48.1%)完全停药.结论 实施自我管理模式对社区老年失眠患者睡眠质量管理是可行、经济、安全有效.%Objective To explore the self-management model for elderly persons with insomnia,so as to change their erroneous cognition,improve sleep quality and decrease medication abuse. Methods Ninety-four elderly patients with insomnia in community were recruited and divided into two groups by means of random number table. The patients in the experimental group received progressive intervention including cognitive behavioral therapy,self-acupoint massage and self-medicine management. All the patients were investigated with Pittsburgh Sleep Quality Index(PSQI) before and after the intervention.Results The total score and factor scores of PSQI were significantly decreased after the intervention(P<0.05) in the experimental group. Except the factor score of latent period,there were significant differences on the total score and other factor scores of PSQI between the two groups after the intervention(P<0.01). Among the patients in the experimental group,26 cases(96.2%) reduced the dose of medicine in different extent through non-pharmacological self-management,of which 13 cases(48.1%) completely withdrew from

  14. 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.

  15. 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.

  16. 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.

  17. 49 CFR Appendix A to Part 609 - Elderly and Handicapped

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Elderly and Handicapped A Appendix A to Part 609..., DEPARTMENT OF TRANSPORTATION TRANSPORTATION FOR ELDERLY AND HANDICAPPED PERSONS Pt. 609, App. A Appendix A to Part 609—Elderly and Handicapped The definitions of the term elderly and handicapped as applied...

  18. Lower nutritional status and higher food insufficiency in frail older US adults.

    Science.gov (United States)

    Smit, Ellen; Winters-Stone, Kerrie M; Loprinzi, Paul D; Tang, Alice M; Crespo, Carlos J

    2013-07-14

    Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (n 4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as 'sometimes' or 'often' not having enough food to eat. Analyses were adjusted for sex, race, age, smoking, education, income, BMI, other co-morbid conditions and complex survey design. Prevalence of frailty was highest among people who were obese (20·8 %), followed by overweight (18·4 %), normal weight (16·1 %) and lowest among people who were underweight (13·8 %). Independent of BMI, daily energy intake was lowest in people who were frail, followed by pre-frail and highest in people who were not frail (6648 (se 130), 6966 (se 79) and 7280 (se 84) kJ, respectively, Padults than not frail adults. Research is needed on targeted interventions to improve nutritional status and food insufficiency among frail older adults, while not necessarily increasing BMI.

  19. Nutrition in the elderly.

    Science.gov (United States)

    Pirlich, M; Lochs, H

    2001-12-01

    Malnutrition is more common in elderly persons than in younger adults. Ageing itself, however, neither leads to malabsorption nor to malnutrition with the exception of a higher frequency of atrophic gastritis in older persons. Malnutrition in elderly people is therefore a consequence of somatic, psychic or social problems. Typical causes are chewing or swallowing disorders, cardiac insufficiency, depression, social deprivation and loneliness. Undernutrition is associated with a worse prognosis and is an independent risk factor for morbidity and mortality. Awareness of this problem is therefore important. For the evaluation of nutritional status, it must be remembered that most normal values are derived from younger adults and may not necessarily be suitable for elderly persons. Suitable tools for evaluating the nutritional status of elderly persons are e.g. the body mass index, weight loss within the last 6 months, the Mini Nutritional Assessment (MNA) or the Subjective Global Assessment (SGA). An improvement in the nutritional status can be achieved by simple methods such as the preparation of an adequate diet, hand feeding, additional sip feeding or enteral nutrition.

  20. Hardiness among Elderly Women.

    Science.gov (United States)

    Wagnild, Gail; Young, Heather

    Hardiness has been defined as a mediator in life stress and, within the health/illness context, has been conceptualized as a personality characteristic. This study used a descriptive exploratory design to examine the concept of hardiness among elderly women. The Stress, Appraisal, and Coping model developed by Lazarus and Folkman (1986) was the…