Sport for Older Persons.

Science.gov (United States)

Council of Europe, Strasbourg (France).

The following papers were prepared for a seminar on sport for older people: (1) "Gerontological Aspects of Physical Exercise" (Eino Heikkinen); (2) "Sporting Activities in the Individual Life from the View of Older Persons" (Henning Allmer); (3) "Reasons Why Decision-Makers Should Urge Old People to Practise Physical and Sporting Activities"…

Sociocultural variability in the Latino population: Age patterns and differences in morbidity among older US adults

Directory of Open Access Journals (Sweden)

Catherine Garcia

2018-05-01

Full Text Available Background: The US Latino population is rapidly aging and becoming increasingly diverse with respect to nativity and national origin. Increased longevity along with medical advancements in treatment have resulted in a higher number of older Latinos living with morbidity. Therefore, there is a need to understand variability in Latino health among older adults. Objective: This paper documents mid- and late-life health differences in morbidity by race/ethnicity, nativity, and country of origin among adults aged 50 and older. Methods: We use data from the 2000-2015 National Health Interview Survey to calculate age- and gender-specific proportions based on reports of five morbidity measures: hypertension, heart disease, stroke, cancer, and diabetes among non-Latino Whites and seven Latino subgroups. Results: The foreign-born from Mexico, Cuba, and Central/South America, regardless of gender, exhibit an immigrant advantage for heart disease and cancer in comparison to non-Latino Whites across all age categories. Conversely, island-born Puerto Ricans are generally characterized with higher levels of morbidity. Similarly, US-born Puerto Ricans and Mexicans exhibit morbidity patterns indicative of their minority status. Latinos, regardless of gender, were more likely to report diabetes than non-Latino Whites. Hypertension and stroke have significant variability in age patterns among US- and foreign-born Latinos. Conclusions: Recognizing the importance of within-Latino heterogeneity in health is imperative if researchers are to implement social services and health policies aimed at ameliorating the risk of disease. Contribution: Considering intersectional ethnic, nativity, and country-of-origin characteristics among older Latinos is important to better understand the underlying causes of racial/ethnic disparities in morbidity across the life course.

Donor Smoking and Older Age Increases Morbidity and Mortality After Lung Transplantation

DEFF Research Database (Denmark)

Schultz, H H; Møller, C H; Zemtsovski, M

2017-01-01

survival as well as CLAD-free survival was significantly lower with donors ≥55 years. CONCLUSIONS: Donor smoking history and older donor age impact lung function, mortality, and CLAD-free survival after transplantation. Because of a shortage of organs, extended donor criteria may be considered while taking......BACKGROUND: The lack of lung transplant donors has necessitated the use of donors with a smoking history and donors of older age. We have evaluated the effects of donor smoking history and age on recipient morbidity and mortality with baseline values of pulmonary function and survival free...... of chronic lung allograft dysfunction (CLAD) as morbidity variables. METHODS: This is a retrospective analysis of 588 consecutive lung transplant recipients and their corresponding 454 donors. Donors were divided into three groups: group 1 included smokers, group 2 nonsmokers, and group 3 had unknown smoking...

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

DEFF Research Database (Denmark)

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

2016-01-01

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

Morbidity and Mortality in 7,684 Women According to Personal Hair Dye Use

DEFF Research Database (Denmark)

Vedel-Krogh, Signe; Nielsen, Sune F; Schnohr, Peter

2016-01-01

BACKGROUND: Permanent hair dye contains aromatic amines which are carcinogenic, and can cause allergic skin reactions. In the long term personal use of hair dye might therefore influence both morbidity and mortality. OBJECTIVES: We tested the hypothesis that personal use of hair dye in women...... is associated with increased morbidity and mortality in the general population. METHODS: We included 7,684 women from the Copenhagen City Heart Study with information on the use of personal hair dye. We assessed the risk of cancer, skin diseases, other morbidities, and mortality during a median follow-up of 27...... years (range 0-37). RESULTS: The multivariable adjusted hazard ratio for malignant melanoma in women with versus without personal use of hair dye was 2.07 (95% confidence interval 1.25-3.42). There was no increased risk of other cancer types. For other skin diseases and other major causes of morbidity...

Pain in cognitively impaired older persons.

Science.gov (United States)

Parmelee, P A

1996-08-01

To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.

Personality disorders in older adults : Emerging research issues

NARCIS (Netherlands)

van Alphen, S.P.J.; van Dijk, S.D.M.; Videler, A.C.; Rossi, G.; Dierckx, E.; Bouckaert, F.; Oude Voshaar, R.C.

2015-01-01

Empirical research focusing on personality disorders (PDs) among older adults is mainly limited to studies on psychometric properties of age-specific personality tests, the age neutrality of specific items/scales, and validation of personality inventories for older adults. We identified only two

Personality disorders in older adults : emerging research issues

NARCIS (Netherlands)

van Alphen, S. P. J.; van Dijk, S. D. M.; Videler, A. C.; Rossi, G.; Dierckx, E.; Bouckaert, F.; Oude Voshaar, R. C.

Empirical research focusing on personality disorders (PDs) among older adults is mainly limited to studies on psychometric properties of age-specific personality tests, the age neutrality of specific items/scales, and validation of personality inventories for older adults. We identified only two

Falls and Fall-Prevention in Older Persons: Geriatrics Meets Spaceflight!

Science.gov (United States)

Goswami, Nandu

2017-01-01

This paper provides a general overview of key physiological consequences of microgravity experienced during spaceflight and of important parallels and connections to the physiology of aging. Microgravity during spaceflight influences cardiovascular function, cerebral autoregulation, musculoskeletal, and sensorimotor system performance. A great deal of research has been carried out to understand these influences and to provide countermeasures to reduce the observed negative consequences of microgravity on physiological function. Such research can inform and be informed by research related to physiological changes and the deterioration of physiological function due to aging. For example, head-down bedrest is used as a model to study effects of spaceflight deconditioning due to reduced gravity. As hospitalized older persons spend up to 80% of their time in bed, the deconditioning effects of bedrest confinement on physiological functions and parallels with spaceflight deconditioning can be exploited to understand and combat both variations of deconditioning. Deconditioning due to bed confinement in older persons can contribute to a downward spiral of increasing frailty, orthostatic intolerance, falls, and fall-related injury. As astronauts in space spend substantial amounts of time carrying out exercise training to counteract the microgravity-induced deconditioning and to counteract orthostatic intolerance on return to Earth, it is logical to suggest some of these interventions for bed-confined older persons. Synthesizing knowledge regarding deconditioning due to reduced gravitational stress in space and deconditioning during bed confinement allows for a more comprehensive approach that can incorporate aspects such as (mal-) nutrition, muscle strength and function, cardiovascular (de-) conditioning, and cardio-postural interactions. The impact of such integration can provide new insights and lead to methods of value for both space medicine and geriatrics (Geriatrics

Study of morbidity in persons subjected to combined effect of low dose irradiation and alcohol

International Nuclear Information System (INIS)

Mashneva, N.I.; Zakharov, A.A.

1990-01-01

Materials related to study of morbidity in persons from one of the controled areas subjected to combined effect of low dose ionizing radiation and alcohol are presented. The group under control included persons living in the same area but not misusing alcohol. The morbidity analysis for the period of two years before the accident showed that the number of morbidity cases and days characterized by incapacity for work among 100 working persons was 1.2 and 1.35 times higher as compared to persons not misusing alcohol. Two years after the accident these values constitute 1.6 and 1.75 correspondingly. It is established on the basis of the dispensary examnations, that taking into account other equal conditions the number of morbidity cases related to cardiovasular deseases among the persons misusing alcohol increased (11 % against 6.8 % bycontrol). The number of other chronic morbidity cases does not differ from control values. 7 refs.; 2 tabs

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

Science.gov (United States)

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

2016-01-01

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

Older Persons at Risk of Hospital Readmission

DEFF Research Database (Denmark)

Pedersen, Mona Kyndi

Hospital readmission is common and considered an adverse health outcome in older persons. Acute readmission of recently discharged patients puts additional pressure on clinical resources within health care services and support. Despite the frequency of readmissions, affecting health and wellbeing...... of older persons, there is still a relatively incomplete understanding of the broader array of factors pertaining to hospital readmission. The current evidence on risk factors for hospital readmission is not adequate to identify person at risk of readmission in a heterogeneous population of older persons....... Few studies have explored patients’ experiences of circumstances and incidents leading to readmission. This thesis uses a mixed methods approach and combines quantitative as well as qualitative data to explore and identify risk factors and predictors of hospital readmission. Use of health care...

Coping and personality in older patients with bipolar disorder.

Science.gov (United States)

Schouws, Sigfried N T M; Paans, Nadine P G; Comijs, Hannie C; Dols, Annemiek; Stek, Max L

2015-09-15

Little is known about coping styles and personality traits in older bipolar patients. Adult bipolar patients show a passive coping style and higher neuroticism scores compared to the general population. Our aim is to investigate personality traits and coping in older bipolar patients and the relationship between coping and personality. 75 Older patients (age > 60) with bipolar I or II disorder in a euthymic mood completed the Utrecht Coping List and the NEO Personality Inventory FFI and were compared to normative data. Older bipolar patients show more passive coping styles compared to healthy elderly. Their personality traits are predominated by openness, in contrast conscientiousness and altruism are relatively sparse. Neuroticism was related to passive coping styles, whereas conscientiousness was related to an active coping style. Older bipolar patients have more passive coping styles. Their personality is characterized by openness and relatively low conscientiousness and altruism. Our sample represents a survival cohort; this may explain the differences in personality traits between older patients in this study and in adult bipolar patients in other studies. The association between coping styles and personality traits is comparable to reports of younger adult patients with bipolar disorder. Longitudinal studies are warranted to explore if coping and personality change with ageing in bipolar patients and to determine which coping style is most effective in preventing mood episodes. Copyright © 2015 Elsevier B.V. All rights reserved.

Achieving Integrated Care for Older People: Shuffling the Deckchairs or Making the System Watertight For the Future?

Science.gov (United States)

Harvey, Gill; Dollard, Joanne; Marshall, Amy; Mittinty, Manasi Murthy

2018-01-01

Integrated care has been recognised as a key initiative to resolve the issues surrounding care for older people living with multi-morbidity. Multiple strategies and policies have been implemented to increase coordination of care globally however, evidence of effectiveness remains mixed. The reasons for this are complex and multifactorial, yet many strategies deal with parts of the problem rather than taking a whole systems view with the older person clearly at the centre. This approach of fixing parts of the system may be akin to shuffling the deckchairs on the Titanic, rather than dealing with the fundamental reasons why the ship is sinking. Attempts to make the ship more watertight need to be firmly centred on the older person, pay close attention to implementation and embrace approaches that promote collaborative working between all the stakeholders involved. PMID:29626395

[Should subclinical hypothyroidism in older persons be treated?

NARCIS (Netherlands)

Elzen, W.P. den; Smit, J.W.A.; Mooijaart, S.P.; Gussekloo, J.

2012-01-01

Subclinical hypothyroidism is a common finding in older persons. Clinical guidelines are inconsistent in providing recommendations for the treatment of subclinical hypothyroidism, especially in older persons. To date, there is no high-quality evidence from randomized controlled trials about the

Active Ageing Level of Older Persons: Regional Comparison in Thailand.

Science.gov (United States)

Haque, Md Nuruzzaman

2016-01-01

Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male older persons in Thailand. Results revealed that active ageing level of Thai older persons is not high (mean AAIs for female and male older persons are 0.64 and 0.61, resp., and those are significantly different (p active ageing level. Implementation of an Integrated Active Ageing Package (IAAP), containing policies for older persons to improve their health and economic security, to promote participation in social groups and longer working lives, and to arrange learning programs, would be helpful for increasing older persons' active ageing level in Thailand.

Perspectives on use of personal alarms by older fallers

Directory of Open Access Journals (Sweden)

Kylie Johnston

2010-08-01

Full Text Available Kylie Johnston1, Karen Grimmer-Somers1, Michele Sutherland21International Centre for Allied Health Evidence, University of South Australia, Adelaide; 2Falls Prevention Unit, Department of Health, Government of South Australia, Adelaide, AustraliaBackground: Personal alarms are proposed as a reliable mechanism for older people to obtain assistance after falling. However, little is known about how older people feel about owning and using personal alarms.Aim: This paper reports on experiences of independently living older people, who have recently fallen, regarding alarm use and their independence.Method: Volunteers older than 65 years who had sustained a fall in the previous six months were sought via community invitations. Semistructured telephone interviews were conducted to gain information about their fall and their perspectives on personal alarm use. Interviews were content-analyzed to identify key concepts and themes.Results: Thirty-one interviews were conducted. Twenty callers owned personal alarms. Four subgroups of older fallers were identified; the first group used personal alarms effectively and were advocates for their benefits, the second group owned an alarm but did not use it effectively, the third group did not own alarms mostly because of cost, although were receptive to an alarm should one be provided, and the fourth group did not have an alarm and would not use it even if it was provided.Discussion: Personal alarms produce positive experiences when used effectively by the right people. The cost of personal alarms prohibits some older fallers from being effective alarm users. However, other elderly fallers remain unwilling to consider alarm use even if one was provided. In view of their cost, personal alarms should be targeted to people who will benefit most. ­Alternative strategies should be considered when alarms are unlikely to be used appropriately.Keywords: personal alarm devices, falls, older people, patient perspective

[DSM-5 classification of personality disorders in older persons

NARCIS (Netherlands)

Alphen, S.P. van; Rossi, G.; Dierckx, E.; Oude Voshaar, R.C.

2014-01-01

BACKGROUND: Although it is generally agreed that personality disorders are an important topic in old-age psychiatry, DSM-5 has paid relatively little attention to older persons affected with this severe mental disorder. AIM: To look closely and carefully at several aspects of the way in which DSM-5

PSYCHIATRIC CO - MORBIDITY IN PERSONS WITH HANSEN’S DISEASE

Directory of Open Access Journals (Sweden)

Anita

2015-05-01

Full Text Available OBJECTIVE: To estimate prevalence of psychiatric co - morbidity and its effect on quality of life in persons with Hansen’s disease. METHOD: The study was conducted on around 80 persons above 18 year age with Hansen’s disease in out - patient department dermatology and i n leprosy home. Participants were diagnosed cases of Hansen’s disease, selected randomly and were evaluated with socio demographic questionnaire, Duke’s general health questionnaire, DSM - 5 self rated level 1 cross cutting symptom measure – adult and WHO - QO L - BREF. The period of data collection was from October 2014 to March 2015. RESULTS: The assessment showed that prevalence of at least one psychiatric co morbidity was 83.75% (67/80 patients and of these 67 patients 18(26.86% have one diagnosis, 26(38.80% have two diagnoses and 23(34.32% have 3 or more psychiatric diagnoses. Among all depression was most prevalent (28.35% mental disorder; followed by anxiety disorder (23.88%. Quality of life was significantly impaired in almost all persons with Hansen’ s disease. CONCLUSION: Persons with Hansen’s disease have significantly high prevalence of mental disorders which have much impact on their quality of life which were under diagnosed and thus remained untreated

Trajectories of physical and mental health among persons with morbid obesity and persons with COPD: a longitudinal comparative study

Directory of Open Access Journals (Sweden)

Bonsaksen T

2016-04-01

Full Text Available Tore Bonsaksen,1 May Solveig Fagermoen,2 Anners Lerdal2,3 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, 2Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, 3Department for Patient Safety and Development, Lovisenberg Diakonale Hospital, Oslo, NorwayBackground: Morbid obesity and chronic obstructive pulmonary disease (COPD are prevalent diseases associated with impaired health-related quality of life (HRQoL. Research generally indicates that persons with morbid obesity increase their HRQoL following intervention, whereas evidence of increases in HRQoL in persons with COPD is mixed. Examining the patterns of change over time instead of merely examining whether HRQoL changes will add to the knowledge in this field.Methods: A sample of persons with morbid obesity and persons with COPD was recruited from learning and mastery courses and rehabilitation centers in Norway. The data were collected by self-report questionnaires at the start of patient education and at four subsequent time points during the 1-year follow-up. HRQoL was measured with the Short Form 12, version 2, and repeated measures analysis of variance was employed in the statistical analysis.Results: Participants with morbid obesity linearly increased their physical HRQoL during the 1-year follow-up, whereas participants with COPD showed no change. None of the groups changed their mental HRQoL during follow-up. In all subdomains of HRQoL, the participants with morbid obesity showed favorable, linearly increasing trajectories across the follow-up period. Among the participants with COPD, no change patterns occurred in the subdomains of HRQoL, except for a fluctuating pattern in the mental health domain. Age, sex, and work status did not influence the trajectories of HRQoL in any of the domains.Conclusion: A more favorable trajectory

Program Evaluation of Group-based Cognitive Behavioral Therapy for Insomnia: a Focus on Treatment Adherence and Outcomes in Older Adults with Co-morbidities.

Science.gov (United States)

Ludwin, Brian M; Bamonti, Patricia; Mulligan, Elizabeth A

2017-11-21

To describe a program evaluation of the interrelationship of adherence and treatment outcomes in a sample of veteran older adults with co-morbidities who participated in group-based cognitive behavioral therapy for insomnia. Retrospective data extraction was performed for 14 older adults. Adherence measures and sleep outcomes were measured with sleep diaries and Insomnia Severity Index. Demographic and clinical information was extracted through chart review. Adherence with prescribed time in bed, daily sleep diaries, and maintaining consistent time out of bed and time in bed was generally high. There were moderate, though not significant, improvements in consistency of time in bed and time out of bed over time. Adherence was not significantly associated with sleep outcomes despite improvements in most sleep outcomes. The non-significant relationship between sleep outcomes and adherence may reflect the moderating influence of co-morbidities or may suggest a threshold effect beyond which stricter adherence has a limited impact on outcomes. Development of multi-method adherence measures across all treatment components will be important to understand the influence of adherence on treatment outcomes as monitoring adherence to time in bed and time out of bed had limited utility for understanding treatment outcomes in our sample.

Falls and Fall-Prevention in Older Persons: Geriatrics Meets Spaceflight!

Directory of Open Access Journals (Sweden)

Nandu Goswami

2017-10-01

Full Text Available This paper provides a general overview of key physiological consequences of microgravity experienced during spaceflight and of important parallels and connections to the physiology of aging. Microgravity during spaceflight influences cardiovascular function, cerebral autoregulation, musculoskeletal, and sensorimotor system performance. A great deal of research has been carried out to understand these influences and to provide countermeasures to reduce the observed negative consequences of microgravity on physiological function. Such research can inform and be informed by research related to physiological changes and the deterioration of physiological function due to aging. For example, head-down bedrest is used as a model to study effects of spaceflight deconditioning due to reduced gravity. As hospitalized older persons spend up to 80% of their time in bed, the deconditioning effects of bedrest confinement on physiological functions and parallels with spaceflight deconditioning can be exploited to understand and combat both variations of deconditioning. Deconditioning due to bed confinement in older persons can contribute to a downward spiral of increasing frailty, orthostatic intolerance, falls, and fall-related injury. As astronauts in space spend substantial amounts of time carrying out exercise training to counteract the microgravity-induced deconditioning and to counteract orthostatic intolerance on return to Earth, it is logical to suggest some of these interventions for bed-confined older persons. Synthesizing knowledge regarding deconditioning due to reduced gravitational stress in space and deconditioning during bed confinement allows for a more comprehensive approach that can incorporate aspects such as (mal- nutrition, muscle strength and function, cardiovascular (de- conditioning, and cardio-postural interactions. The impact of such integration can provide new insights and lead to methods of value for both space medicine and

Guidelines to facilitate self-care among older persons in South Africa

Directory of Open Access Journals (Sweden)

Tinda Rabie

2015-10-01

Full Text Available Background: The number of older persons is growing at an alarming rate, yet the South African healthcare sector is not giving this issue the required attention. Moreover, the healthcare sector serves four-fifths of the country's population and primary healthcare (PHC facilities are overcrowded, and thus professional nurses are prevented from providing sufficient self-care health education to older persons. Aim: To develop guidelines for the three role players — the public health sector, professional nurse and older person — to facilitate self-care among older persons in South Africa. Design: Quantitative, descriptive, explorative and contextual research design. Methods: A literature review followed by a self-care assessment of a sample of older persons using the Appraisal of Self-care Agency (ASA-A and Exercise of Self-care Agency (ESCA questionnaires which led to the identification of conclusions and self-care deficits. Results: Based on Menon's psychological health empowerment model, and from the conclusions and self-care deficits, nine self-care guidelines were developed for the public health sector, professional nurses and older persons. Conclusion: This is the first systematic development of guidelines to facilitate self-care among older persons in South Africa. Implications for practice: The implementation of the self-care guidelines by the public health sector, professional nurses and older persons will improve the healthcare of older persons at home which will in turn improve their quality of life, reduce unintentional self-neglect, as well as assist in alleviating overcrowding in clinics because unnecessary visits to the clinic will drop.

Rethinking Worklife Options for Older Persons.

Science.gov (United States)

Habib, Jack, Ed.; Nusberg, Charlotte, Ed.

This volume contains 19 papers that were presented at a conference addressing critical issues related to employment options for older persons. They are arranged in four sections that cover early retirement policies and their implications; older workers of Asia and the Pacific; the impact of technological change on the employment prospects of older…

Multi-morbidity, dependency, and frailty singly or in combination have different impact on health outcomes.

Science.gov (United States)

Woo, Jean; Leung, Jason

2014-04-01

Multi-morbidity, dependency, and frailty were studied simultaneously in a community-living cohort of 4,000 men and women aged 65 years and over to examine the independent and combined effects on four health outcomes (mortality, decline in physical function, depression, and polypharmacy). The influence of socioeconomic status on these relationships is also examined. Mortality data was documented after a mean follow-up period of 9 years, while other health outcomes were documented after 4 years of follow-up. Fifteen percent of the cohort did not have any of these syndromes. Of the remaining participants, nearly one third had multi-morbidity and frailty (pre-frail and frail), while all three syndromes were present in 11 %. All syndromes as well as socioeconomic status were significantly associated with all health outcomes. Mortality was only increased for age, being male, frailty status, and combinations of syndromes that included frailty. Both multi-morbidity and frailtymale was protective. Only a combination of all three syndromes, and age per se, increased the risk of depressive symptoms at 4 years while being male conferred reduced risk. Multi-morbidity, but not frailty status or dependency, and all syndrome combinations that included multi-morbidity were associated with use of ≥ four medications. Decline in homeostatic function with age may thus be quantified and taken into account in prediction of various health outcomes, with a view to prevention, management, formulation of guidelines, service planning, and the conduct of randomized controlled trials of interventions or treatment.

Failure to Thrive in Older Persons: A Concept Derived.

Science.gov (United States)

Braun, Judith Venglarik; And Others

1988-01-01

Discusses how the concept of failure to thrive can be borrowed from pediatrics and redefined for use in caring for older persons, especially institutionalized older persons. Examines issues of undernutrition, declining physical and cognitive functioning, and depression. (Author/ABL)

Osteoporosis in older persons: current pharmacotherapy and future directions.

Science.gov (United States)

Duque, Gustavo

2013-10-01

Osteopororic fractures are highly prevalent in older persons having catastrophic consequences in their quality of life and increasing disability and mortality in this population. The mechanisms of osteoporosis in older persons are unique in terms of cellular changes and response to osteoporosis treatment. Therefore, specifically targeted treatments are required in this particular population. This paper provides an overview on the particular mechanisms of osteoporosis in older persons and the current and future therapeutic strategies to improve bone mass and prevent fractures in this population. Osteoporosis in older persons (especially in the old-old) has a unique pathophysiology that predisposes them to fractures thus having catastrophic consequences. Identification of patients at risk followed by therapies targeted to their cellular changes is pivotal to close the care gap observed in osteoporosis, predominantly in the older population. The treatment of osteoporosis has evolved from daily to yearly dosing thus facilitating compliance and effectiveness. It is expected that future biologically targeted treatments will have a similar separate dosing regime with better anti-fracture efficacy and lower incidence of side effects.

Impact of deleting 5 DSM-IV personality disorders on prevalence, comorbidity, and the association between personality disorder pathology and psychosocial morbidity.

Science.gov (United States)

Zimmerman, Mark; Chelminski, Iwona; Young, Diane; Dalrymple, Kristy; Martinez, Jennifer

2012-02-01

A high rate of comorbidity among the personality disorders has been consistently identified as a problem. To address the problem of excessive comorbidity, the DSM-5 Personality and Personality Disorders Work Group recommended reducing the number of specific personality disorder diagnoses from 10 to 5 by eliminating paranoid, schizoid, histrionic, narcissistic, and dependent personality disorders. No study has examined the impact of this change. The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project examined the impact of eliminating these 5 personality disorders on the prevalence of personality disorders in a large sample of psychiatric outpatients presenting for treatment, comorbidity among the personality disorders, and association with psychosocial morbidity. From September 1997 to June 2008, 2,150 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. More than one-quarter of the patients were diagnosed with one of the 10 DSM-IV personality disorders (28.6%, n = 614). When 5 personality disorders were excluded from consideration, then 25.8% (n = 555) were diagnosed with at least 1 of the 5 personality disorders proposed for retention in DSM-5, and the comorbidity rate dropped from 29.8% to 21.3%. Compared to patients without a personality disorder, the patients with either a retained or an excluded personality disorder had greater psychosocial morbidity. There was little difference in psychosocial morbidity between patients with a retained and an excluded personality disorder. The Personality and Personality Disorders Work Group's desired goal of reducing comorbidity would be achieved by deleting 5 personality disorders, although comorbidity would not be eliminated. The reduction of comorbidity could come with a cost of false-negative diagnoses

'Balancing risk' after fall-induced hip fracture: the older person's need for information.

Science.gov (United States)

McMillan, Laura; Booth, Joanne; Currie, Kay; Howe, Tracey

2014-12-01

Hip fracture is a significant cause of morbidity and mortality in older people. Healthcare professionals have a role to identify and respond to challenges and concerns that older people face as they strive to manage risk of future falls and rebuild confidence and independence after discharge. This study aimed to explore the postdischarge concerns of older people after fall-induced hip fracture. Glaser's approach to the grounded theory method guided qualitative interviews conducted with 19 older people in their own homes up to 3 months post discharge, in two health authority areas. A theory of 'taking control' was generated. 'Balancing risk' emerged as a key strategy that older people employed to help them to take control after discharge home. Older people attempted to control or 'balance' their risk of future falls and dependence by implementing two further strategies: 'protective guarding' and 'following orders'. The instinctive strategy of protective guarding and the learned strategy of following orders were implemented simultaneously and were characterised by older people aiming to pace their progress and balance risk safely and appropriately. To apply these strategies, older people required information from healthcare professionals. In circumstances where older people did not receive or did not understand the information provided, they were left 'grasping to understand' and were more likely to miscalculate risk. This leads to damaged confidence and in some cases further falls. The concept of balancing risk aims to help healthcare professionals understand the older person's perspective of hip fracture and to recognise the efforts that people make to guard against further injury and dependence in the early postdischarge period. © 2013 Blackwell Publishing Ltd.

Drugs and the older person

African Journals Online (AJOL)

2007-09-14

Sep 14, 2007 ... Sebastiana Kalula is Head of Geriatric Medicine and Acting Director of The Albertina and Walter .... performance of cognitive and physical .... Older persons may need multiple drug therapy for an increased number of chronic.

Delusional patterns and its pre-morbid personality linkages in ...

African Journals Online (AJOL)

DSM IVTR, psychological tests: MMPI, SCL-90R and clinical observations were used for the diagnosis of the patients according to the centre policy. Two recording scales designed by the researchers were used to assign the participants to different types of delusions and pre-morbid personalities. The study design was a ...

Active Ageing Level of Older Persons: Regional Comparison in Thailand

Directory of Open Access Journals (Sweden)

Md. Nuruzzaman Haque

2016-01-01

Full Text Available Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1 has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male older persons in Thailand. Results revealed that active ageing level of Thai older persons is not high (mean AAIs for female and male older persons are 0.64 and 0.61, resp., and those are significantly different (p<0.001. Mean AAI in Central region is lower than North, Northeast, and South regions but there is no significant difference in the latter three regions of Thailand. Special emphasis should be given to Central region and policy should be undertaken for increasing active ageing level. Implementation of an Integrated Active Ageing Package (IAAP, containing policies for older persons to improve their health and economic security, to promote participation in social groups and longer working lives, and to arrange learning programs, would be helpful for increasing older persons’ active ageing level in Thailand.

Associations between life conditions and multi-morbidity in marginalized populations: the case of Palestinian refugees.

Science.gov (United States)

Habib, Rima R; Hojeij, Safa; Elzein, Kareem; Chaaban, Jad; Seyfert, Karin

2014-10-01

Evidence suggests that higher multi-morbidity rates among people with low socioeconomic status produces and maintains poverty. Our research explores the relationship between socioeconomic deprivation and multi-morbidity among Palestinian refugees in Lebanon, a marginalized and impoverished population. A representative sample of Palestinian refugees in Lebanon was surveyed, interviewing 2501 respondents (97% response rate). Multi-morbidity was measured by mental health, chronic and acute illnesses and disability. Multinomial logistic regression models assessed the association between indicators of poverty and multi-morbidities. Findings showed that 14% of respondents never went to school, 41% of households reported water leakage and 10% suffered from severe food insecurity. Participants with an elementary education or less and those completing intermediate school were more than twice as likely to report two health problems than those with secondary education or more (OR: 2.60, CI: 1.73-3.91; OR: 2.47, CI: 1.62-3.77, respectively). Those living in households with water leakage were nearly twice as likely to have three or more health reports (OR = 1.88, CI = 1.45-2.44); this pattern was more pronounced for severely food insecure households (OR = 3.41, CI = 1.83-6.35). We identified a positive gradient between socioeconomic status and multi-morbidity within a refugee population. These findings reflect inequalities produced by the health and social systems in Lebanon, a problem expected to worsen following the massive influx of refugees from Syria. Ending legal discrimination and funding infrastructural, housing and health service improvements may counteract the effects of deprivation. Addressing this problem requires providing a decent livelihood for refugees in Lebanon. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

Discriminability of personality profiles in isolated and Co-morbid marijuana and nicotine users.

Science.gov (United States)

Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L; Filbey, Francesca M

2016-04-30

Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Health services needs of older persons: emerging findings from Tarakan City, East Kalimantan

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Rina K. Kusumaratna

2011-12-01

Full Text Available As older persons are steadily increasing in number and there are no specialized comprehensive healthcare services for older persons in Indonesia, including East Kalimantan, the aim of the present study was to determine the extent of the problems facing healthcare staff and officials in Tarakan City, East Kalimantan, in providing comprehensive healthcare services attuned to the needs of older persons.This study was a qualitative interview-based survey with focus group discussions, involving heads and healthcare officials of seven puskesmas in Tarakan City, East Kalimantan district, with the addition of a number of district health planning officials. The results revealed a difference between daily hospital referral rate of older persons by puskesmas staff and actual daily hospital admission rate for the referrals. None of the consulted healthcare staff had any speciality education in geriatrics or older persons health. The older persons most frequently presented to the hospital with hypertension, diabetes, and myocardial insufficiency. On the other hand, at the health centers the presenting conditions were hypertension, gastroenteritis, rheumatism, sleep disorders, and upper respiratory tract infections. Improved access to healthcare for older persons should be achieved by improving knowledge and skills of human resources, including communication skills, and of supporting healthcare service infrastructure at puskesmas, specifically oriented towards the needs of and designed for use by older persons, such as ramps for wheelchairs, and handrails in corridors. Local governments should strengthen the appropriate service delivery to older persons, and provide support for the maintenance, sustainability and strengthening of community-based care for older persons.

Health service needs of older persons: emerging findings from Tarakan City, East Kalimantan

Directory of Open Access Journals (Sweden)

Rina K. Kusumaratna

2016-02-01

Full Text Available As older persons are steadily increasing in number and there are no specialized comprehensive healthcare services for older persons in Indonesia, including East Kalimantan, the aim of the present study was to determine the extent of the problems facing healthcare staff and officials in Tarakan City, East Kalimantan, in providing comprehensive healthcare services attuned to the needs of older persons.This study was a qualitative interview-based survey with focus group discussions, involving heads and healthcare officials of seven puskesmas in Tarakan City, East Kalimantan district, with the addition of a number of district health planning officials. The results revealed a difference between daily hospital referral rate of older persons by puskesmas staff and actual daily hospital admission rate for the referrals. None of the consulted healthcare staff had any speciality education in geriatrics or older persons health. The older persons most frequently presented to the hospital with hypertension, diabetes, and myocardial insufficiency. On the other hand, at the health centers the presenting conditions were hypertension, gastroenteritis, rheumatism, sleep disorders, and upper respiratory tract infections. Improved access to healthcare for older persons should be achieved by improving knowledge and skills of human resources, including communication skills, and of supporting healthcare service infrastructure at puskesmas, specifically oriented towards the needs of and designed for use by older persons, such as ramps for wheelchairs, and handrails in corridors. Local governments should strengthen the appropriate service delivery to older persons, and provide support for the maintenance, sustainability and strengthening of community-based care for older persons.

Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.

Science.gov (United States)

Janssen, Ian; Heymsfield, Steven B; Ross, Robert

2002-05-01

morbidity and mortality in older persons.

The effect of different public health interventions on longevity, morbidity, and years of healthy life

Directory of Open Access Journals (Sweden)

Cai Liming

2007-04-01

Full Text Available Abstract Background Choosing cost-effective strategies for improving the health of the public is difficult because the relative effects of different types of interventions are not well understood. The benefits of one-shot interventions may be different from the benefits of interventions that permanently change the probability of getting sick, recovering, or dying. Here, we compare the benefits of such types of public health interventions. Methods We used multi-state life table methods to estimate the impact of five types of interventions on mortality, morbidity (years of life in fair or poor health, and years of healthy life (years in excellent, very good, or good health. Results A one-shot intervention that makes all the sick persons healthy at baseline would increase life expectancy by 3 months and increase years of healthy life by 6 months, in a cohort beginning at age 65. An equivalent amount of improvement can be obtained from an intervention that either decreases the probability of getting sick each year by 12%, increases the probability of a sick person recovering by 16%, decreases the probability that a sick person dies by 15%, or decreases the probability that a healthy person dies by 14%. Interventions aimed at keeping persons healthy increased longevity and years of healthy life, while decreasing morbidity and medical expenditures. Interventions focused on preventing mortality had a greater effect on longevity, but had higher future morbidity and medical expenditures. Results differed for older and younger cohorts and depended on the value to society of an additional year of sick life. Conclusion Interventions that promote health and prevent disease performed well, but other types of intervention were sometimes better. The value to society of interventions that increase longevity but also increase morbidity needs further research. More comprehensive screening and treatment of new Medicare enrollees might improve their health and

Cardiometabolic risk in a population of older adults with multiple co-morbidities in rural south africa: the HAALSI (Health and Aging in Africa: longitudinal studies of INDEPTH communities) study.

Science.gov (United States)

Gaziano, Thomas A; Abrahams-Gessel, Shafika; Gomez-Olive, F Xavier; Wade, Alisha; Crowther, Nigel J; Alam, Sartaj; Manne-Goehler, Jennifer; Kabudula, Chodziwadziwa W; Wagner, Ryan; Rohr, Julia; Montana, Livia; Kahn, Kathleen; Bärnighausen, Till W; Berkman, Lisa F; Tollman, Stephen

2017-02-17

A consequence of the widespread uptake of anti-retroviral therapy (ART) is that the older South African population will experience an increase in life expectancy, increasing their risk for cardiometabolic diseases (CMD), and its risk factors. The long-term interactions between HIV infection, treatment, and CMD remain to be elucidated in the African population. The HAALSI cohort was established to investigate the impact of these interactions on CMD morbidity and mortality among middle-aged and older adults. We recruited randomly selected adults aged 40 or older residing in the rural Agincourt sub-district in Mpumalanga Province. In-person interviews were conducted to collect baseline household and socioeconomic data, self-reported health, anthropometric measures, blood pressure, high-sensitivity C-reactive protein (hsCRP), HbA1c, HIV-status, and point-of-care glucose and lipid levels. Five thousand fifty nine persons (46.4% male) were enrolled with a mean age of 61.7 ± 13.06 years. Waist-to-hip ratio was high for men and women (0.92 ± 0.08 vs. 0.89 ± 0.08), with 70% of women and 44% of men being overweight or obese. Blood pressure was similar for men and women with a combined hypertension prevalence of 58.4% and statistically significant increases were observed with increasing age. High total cholesterol prevalence in women was twice that observed for men (8.5 vs. 4.1%). The prevalence of self-reported CMD conditions was higher among women, except for myocardial infarction, and women had a statistically significantly higher prevalence of angina (10.82 vs. 6.97%) using Rose Criteria. The HIV - persons were significantly more likely to have hypertension, diabetes, or be overweight or obese than HIV + persons. Approximately 56% of the cohort had at least 2 measured or self-reported clinical co-morbidities, with HIV + persons having a consistently lower prevalence of co-morbidities compared to those without HIV. Absolute 10-year risk cardiovascular risk

Determinants of thoughts of death or suicide in depressed older persons

NARCIS (Netherlands)

Bogers, Ista C. H. M.; Zuidersma, Marij; Boshuisen, Marjolein L.; Comijs, Hannie C.; Voshaar, Richard C. Oude

Background: In depressed persons, thoughts of death and suicide are assumed to represent different degrees of a construct: suicidality. However, this can be questioned in older persons facing physical and social losses. Thoughts of death in depressed older persons are hardly examined in the absence

Testimony on Physical Fitness for Older Persons.

Science.gov (United States)

President's Council on Physical Fitness and Sports, Washington, DC.

Collected here are fourteen statements on the beneficial effects of physical fitness programs for older persons presented at hearings before the Subcommittee on Aging of the Committee on Labor and Public Welfare, U.S. Senate. Areas discussed include: What research tells us regarding the contribution of exercise to the health of older people;…

Exploring the health status of older persons in Sub-Saharan Africa.

Science.gov (United States)

Audain, Keiron; Carr, Michelle; Dikmen, Derya; Zotor, Francis; Ellahi, Basma

2017-11-01

Sub-Saharan Africa (SSA) has traditionally had a low life expectancy due to the onslaught of the HIV epidemic, high levels of chronic diseases, injuries, conflict and undernutrition. Therefore, research into public health concerns of older persons has largely been overlooked. With a growing population, the roll-out of antiretroviral treatment, and the effects of globalisation, SSA is experiencing an increase in the number of people over 50 years of age as well as an increase in the prevalence of non-communicable diseases (NCD). The aim of this review is to highlight available research on the health status of older persons in SSA, and to identify the current gaps that warrant further investigation. A literature search was conducted across multiple databases to identify studies in SSA on older persons (aged 50 years and older) related to health indicators including nutritional status, NCD and HIV burden. While it was concluded that older persons are at an increased risk of poor health, it was also determined that significant gaps exist in this particular area of research; namely nutrient deficiency prevalence. Resources should be directed towards identifying the health concerns of older persons and developing appropriate interventions.

STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation.

LENUS (Irish Health Repository)

Gallagher, P

2012-02-03

OBJECTIVE: Older people experience more concurrent illnesses, are prescribed more medications and suffer more adverse drug events than younger people. Many drugs predispose older people to adverse events such as falls and cognitive impairment, thus increasing morbidity and health resource utilization. At the same time, older people are often denied potentially beneficial, clinically indicated medications without a valid reason. We aimed to validate a new screening tool of older persons\\' prescriptions incorporating criteria for potentially inappropriate drugs called STOPP (Screening Tool of Older Persons\\' Prescriptions) and criteria for potentially appropriate, indicated drugs called START (Screening Tool to Alert doctors to Right, i.e. appropriate, indicated Treatment). METHODS: A Delphi consensus technique was used to establish the content validity of STOPP\\/START. An 18-member expert panel from academic centers in Ireland and the United Kingdom completed two rounds of the Delphi process by mail survey. Inter-rater reliability was assessed by determining the kappa-statistic for measure of agreement on 100 data-sets. RESULTS: STOPP is comprised of 65 clinically significant criteria for potentially inappropriate prescribing in older people. Each criterion is accompanied by a concise explanation as to why the prescribing practice is potentially inappropriate. START consists of 22 evidence-based prescribing indicators for commonly encountered diseases in older people. Inter-rater reliability is favorable with a kappa-coefficient of 0.75 for STOPP and 0.68 for START. CONCLUSION: STOPP\\/START is a valid, reliable and comprehensive screening tool that enables the prescribing physician to appraise an older patient\\'s prescription drugs in the context of his\\/her concurrent diagnoses.

Morbidity pattern and personal hygiene in children among private primary school in urban area: are the trends changing?

Science.gov (United States)

Mhaske, Mayavati S; Khismatrao, Deepak S; Kevin, Fernandez; Pandve, Harshal T; Kundap, Ritesh P

2013-07-01

School health is an important intervention as a great deal of research tells us that schools can have a major effect on children's health, by teaching them about health and promoting healthy behaviors. The aim of this study is to determine common health problems and assess personal hygiene status among primary school children. A cross-sectional study was conducted in academic years 2009-2010 and 2010-2011, with three health check-up camps organized in private primary school of Pune city. A total of 450 students were assessed for health problems and composite score of personal hygiene status was calculated ranging from 0 to 5 by examination of hairs, nails, skin and clothes. Proportions calculated with application of Chi-square test and Pearson co-efficient applied to observe the relation between two quantitative variables. Out of 450 students examined, 56.2% were boys and 43.8% were girls with age ranging from 5 to 10 years. The major morbidities observed were dental caries (65.1%), upper respiratory tract infections (38.2%), ear wax (29.9%) and myopia (10.0%). Mean hygiene score was significantly higher in girls (4.32) than boys (3.95) and poor hygiene observed in older boys. Increasing myopia and poor dental hygiene denotes a changing morbidity pattern in private primary school of the urban area. The hygiene status of the girls is significantly better than boys.

Older persons' lived experiences of depression and self-management.

Science.gov (United States)

Holm, Anne Lise; Lyberg, Anne; Lassenius, Erna; Severinsson, Elisabeth; Berggren, Ingela

2013-10-01

Mental ill-health, such as depression in the elderly, is a complex issue that is influenced by the life-world perspective of older persons. Their self-management ability should be strengthened based on an understanding of their situation, perspectives, and vulnerability. The aim of this study was to explore and increase understanding of old persons' lived experiences of depression and self-management using an interpretative explorative design. Understanding was developed by means of hermeneutic interpretation. One theme, Relationships and Togetherness, and four subthemes, A Sense of Carrying a Shoulder Bag, Walking on Eggshells, Holding the Reins, and Estrangement--a Loss of Togetherness, emerged. A collaborative approach can be important for empowering older persons through self-development and management. Although the findings of the present study cannot be considered conclusive or definitive, they nevertheless contribute new knowledge of older persons' lived experiences of depression in everyday life.

Labour Force Participation Rates of Older Persons: An International Comparison.

Science.gov (United States)

Clark, Robert L.; Anker, Richard

1990-01-01

Using data from 151 countries, labor force participation of older men and women was analyzed and related to economic, demographic, and policy variables. Reduced participation rates are related to increased income levels, structural changes, social security programs, and, for men, the ratio of older persons to persons of standard working age. (SK)

The role of co-morbid personality pathology in predicting self-reported aggression in patients with schizophrenia

DEFF Research Database (Denmark)

Bo, Sune; Abu-Akel, Ahmad; Kongerslev, Mickey

2013-01-01

BACKGROUND: Personality pathology affects behavioral patterns in patients with schizophrenia notwithstanding psychotic symptomatology. An investigation of the role of co-morbid personality pathology in the occurrence of aggression in schizophrenia is explored using both categorical and dimensional...... approaches to personality pathology. METHODS: In a cross-sectional study we evaluate, in 97 patients diagnosed with schizophrenia, the effect of personality pathology on the occurrence of aggression in schizophrenia using both a categorical approach, as described in DSM-IV-TR Axis II, and a dimensional...... approach, as operationalized in the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). We also employ mediation analyses to explore the extent to which dimensions within the DAPP mediate the relationship between co-morbid personality disorders and aggression. RESULTS...

Psychotherapeutic treatment levels of personality disorders in older adults

OpenAIRE

Videler, Arjan; Cornelis, Christina; Rossi, G.; van Royen, R.J.J.; Rosowsky, E.; van Alphen, S.P.J.

2015-01-01

Treatment of personality disorders (PDs) in older adults is a highly underexplored topic. In this article clinical applicability of the findings from a recent Delphi study regarding treatment aspects of PDs in older adults is explored. This concerns the relevance of three psychotherapeutic treatment levels for PDs in later life: (a) personality-changing treatment, (b) adaptation-enhancing treatment, and (c) supportive-structuring treatment. By means of three cases concerning the three levels,...

Factors associated with self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease: a cross-sectional study.

Science.gov (United States)

Bonsaksen, Tore; Fagermoen, May Solveig; Lerdal, Anners

2015-01-01

Living with chronic illnesses can be stressful and may negatively impact persons' self-esteem. Personal factors, like self-efficacy and illness perceptions, and also factors related to the environment, activity, and participation may be associated with self-esteem in chronic illness populations. This cross-sectional comparative study explored sociodemographic variables, work, physical activity, illness perceptions, and general self-efficacy in relation to self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease (COPD). The study had a cross-sectional design. A total of 223 eligible participants were recruited from patient education courses, and data were collected at baseline. Self-esteem was measured with The Rosenberg self-esteem scale; the general self-efficacy scale was used to measure self-efficacy, and brief illness perception questionnaire was also used. This is an instrument assessing cognitions about the illness and emotional responses towards it. Multivariate linear regression was used in the statistical analyses. In obese participants (n = 134), higher self-esteem was associated with lower emotional response, a shorter timeline, and higher general self-efficacy. In COPD participants (n = 89), higher self-esteem was associated with higher general self-efficacy. The independent variables accounted for 42.9% (morbid obesity) and 49.4% (COPD) of the self-esteem variance. In participants in both illness groups, higher self-efficacy was associated with increased self-esteem. A shorter timeline and lower emotional response to illness was related to higher self-esteem only for the obese participants. The results indicate that believing in one's capacity to cope with everyday challenges is important for self-esteem in persons with morbid obesity and in persons with COPD, whereas illness perceptions related to the duration of illness and the coping with emotions also is important for self-esteem in persons with morbid

Wound Healing in Older Adults.

Science.gov (United States)

Gould, Lisa J; Fulton, Ana Tuya

2016-02-01

Impaired wound healing in the elderly represents a major clinical problem that is growing as our population ages. Wound healing is affected by age and by co-morbid conditions, particularly diabetes and obesity. This is particularly important in Rhode Island as the state has a very high percentage of vulnerable older adults. A multi- disciplinary approach that incorporates the skills of a comprehensive wound center with specialized nursing, geriatric medicine and palliative care will facilitate rapid wound healing, reduce costs and improve outcomes for our older adults that suffer from 'problem wounds'.

Personality disorder traits, risk factors, and suicide ideation among older adults.

Science.gov (United States)

Jahn, Danielle R; Poindexter, Erin K; Cukrowicz, Kelly C

2015-11-01

Personality disorder traits are relatively prevalent among older adults, and can be associated with complex and chronic difficulties, including suicide risk. However, there is a lack of research regarding personality disorders and suicide ideation in older adults. Depressive symptoms and hopelessness may be important to the relation between personality disorders and suicide risk. Additionally, variables from the interpersonal theory of suicide, perceived burdensomeness and thwarted belongingness, may be critical risk factors for suicide in this population. We hypothesized that perceived burdensomeness and thwarted belongingness, theory-based variables, would act as parallel mediators of the relation between personality disorder traits and suicide ideation, whereas depressive symptoms and hopelessness would not. The hypothesis was tested in a sample of 143 older adults recruited from a primary care setting. Participants completed self-report questionnaires of personality traits, suicide ideation, depressive symptoms, hopelessness, perceived burdensomeness, and thwarted belongingness. Findings from a non-parametric bootstrapping procedure indicated that perceived burdensomeness, thwarted belongingness, and depressive symptoms mediated the relation between total personality disorder traits and suicide ideation. Hopelessness did not act as a mediator. These findings indicate that perceived burdensomeness, thwarted belongingness, and depressive symptoms are likely important risk factors for suicide ideation among older adults. Clinicians should be aware of these issues when assessing and treating suicide risk among older adults.

Cardiometabolic risk in a population of older adults with multiple co-morbidities in rural south africa: the HAALSI (Health and Aging in Africa: longitudinal studies of INDEPTH communities study

Directory of Open Access Journals (Sweden)

Thomas A. Gaziano

2017-02-01

Full Text Available Abstract Background A consequence of the widespread uptake of anti-retroviral therapy (ART is that the older South African population will experience an increase in life expectancy, increasing their risk for cardiometabolic diseases (CMD, and its risk factors. The long-term interactions between HIV infection, treatment, and CMD remain to be elucidated in the African population. The HAALSI cohort was established to investigate the impact of these interactions on CMD morbidity and mortality among middle-aged and older adults. Methods We recruited randomly selected adults aged 40 or older residing in the rural Agincourt sub-district in Mpumalanga Province. In-person interviews were conducted to collect baseline household and socioeconomic data, self-reported health, anthropometric measures, blood pressure, high-sensitivity C-reactive protein (hsCRP, HbA1c, HIV-status, and point-of-care glucose and lipid levels. Results Five thousand fifty nine persons (46.4% male were enrolled with a mean age of 61.7 ± 13.06 years. Waist-to-hip ratio was high for men and women (0.92 ± 0.08 vs. 0.89 ± 0.08, with 70% of women and 44% of men being overweight or obese. Blood pressure was similar for men and women with a combined hypertension prevalence of 58.4% and statistically significant increases were observed with increasing age. High total cholesterol prevalence in women was twice that observed for men (8.5 vs. 4.1%. The prevalence of self-reported CMD conditions was higher among women, except for myocardial infarction, and women had a statistically significantly higher prevalence of angina (10.82 vs. 6.97% using Rose Criteria. The HIV− persons were significantly more likely to have hypertension, diabetes, or be overweight or obese than HIV+ persons. Approximately 56% of the cohort had at least 2 measured or self-reported clinical co-morbidities, with HIV+ persons having a consistently lower prevalence of co-morbidities compared to those without

Decreased chronic morbidity but elevated HIV associated cytokine levels in HIV-infected older adults receiving HIV treatment: benefit of enhanced access to care?

Directory of Open Access Journals (Sweden)

Portia C Mutevedzi

Full Text Available The association of HIV with chronic morbidity and inflammatory markers (cytokines in older adults (50+years is potentially relevant for clinical care, but data from African populations is scarce.To examine levels of chronic morbidity by HIV and ART status in older adults (50+years and subsequent associations with selected pro-inflammatory cytokines and body mass index.Ordinary, ordered and generalized ordered logistic regression techniques were employed to compare chronic morbidity (heart disease (angina, arthritis, stroke, hypertension, asthma and diabetes and cytokines (Interleukins-1 and -6, C-Reactive Protein and Tumor Necrosis Factor-alpha by HIV and ART status on a cross-sectional random sample of 422 older adults nested within a defined rural South African population based demographic surveillance.Using a composite measure of all morbidities, controlling for age, gender, BMI, smoking and wealth quintile, HIV-infected individuals on ART had 51% decreased odds (95% CI:0.26-0.92 of current morbidity compared to HIV-uninfected. In adjusted regression, compared to HIV-uninfected, the proportional odds (aPOR of having elevated inflammation markers of IL6 (>1.56 pg/mL was nearly doubled in HIV-infected individuals on (aPOR 1.84; 95%CI: 1.05-3.21 and not on (aPOR 1.94; 95%CI: 1.11-3.41 ART. Compared to HIV-uninfected, HIV-infected individuals on ART had >twice partial proportional odds (apPOR=2.30;p=0.004 of having non-clinically significant raised hsCRP levels(>1 ug/mL; ART-naïve HIV-infected individuals had >double apPOR of having hsCRP levels indicative of increased heart disease risk(>3.9 ug/mL;p=0.008.Although HIV status was associated with increased inflammatory markers, our results highlight reduced morbidity in those receiving ART and underscore the need of pro-actively extending these services to HIV-uninfected older adults, beyond mere provision at fixed clinics. Providing health services through regular community chronic disease

Impact on participation and autonomy: test of validity and reliability for older persons

Directory of Open Access Journals (Sweden)

Isabelle Ottenvall Hammar

2014-10-01

Full Text Available In research and healthcare it is important to measure older persons’ self-determination in order to improve their possibilities to decide for themselves in daily life. The questionnaire Impact on Participation and Autonomy (IPA assesses self-determination, but is not constructed for older persons. The aim of this study was to examine the validity and reliability of the IPA-S questionnaire for persons aged 70 years and older. The study was performed in two steps; first a validity test of the Swedish version of the questionnaire, IPA-S, followed by a reliability test-retest of an adjusted version. The validity was tested with focus groups and individual interviews on persons aged 77-88 years, and the reliability on persons aged 70-99 years. The validity test result showed that IPA-S is valid for older persons but it was too extensive and the phrasing of the items needed adjustments. The reliability test-retest on the adjusted questionnaire, IPA-Older persons (IPA-O, showed that 15 of 22 items had high agreement. IPA-O can be used to measure older persons’ self-determination in their care and rehabilitation.

Ageing and mental health resources for older persons in the African ...

African Journals Online (AJOL)

To better understand the organisation of care for older persons, data are being collected to reduce the imbalance between 'disease information\\' and 'resource information\\' – information that addresses older persons\\' needs in terms of mental health care. This review presents some results from the continent. Mental health ...

Measuring personality functioning in older adults: construct validity of the Severity Indices of Personality Functioning - Short Form (SIPP-SF).

Science.gov (United States)

Rossi, Gina; Debast, Inge; van Alphen, S P J

2017-07-01

The dimensional personality disorders model in the Diagnostic and Statistical Manual (DSM)-5 section III conceptually differentiates impaired personality functioning (criterion A) from the presence of pathological traits (criterion B). This study is the first to specifically address the measurement of criterion A in older adults. Moreover, the convergent/divergent validity of criterion A and criterion B will be compared in younger and older age groups. The Severity Indices of Personality Functioning - Short Form (SIPP-SF) was administered in older (N = 171) and younger adults (N = 210). The factorial structure was analyzed with exploratory structural equation modeling. Differences in convergent/divergent validity between personality functioning (SIPP-SF) and pathological traits (Personality Inventory for DSM-5; Dimensional Assessment of Personality Pathology-Basic Questionnaire) were examined across age groups. Identity Integration, Relational Capacities, Responsibility, Self-Control, and Social Concordance were corroborated as higher order domains. Although the SIPP-SF domains measured unique variation, some high correlations with pathological traits referred to overlapping constructs. Moreover, in older adults, personality functioning was more strongly related to Psychoticism, Disinhibition, Antagonism and Dissocial Behavior compared to younger adults. The SIPP-SF construct validity was demonstrated in terms of a structure of five higher order domains of personality functioning. The instrument is promising as a possible measure of impaired personality functioning in older adults. As such, it is a useful clinical tool to follow up effects of therapy on levels of personality functioning. Moreover, traits were associated with different degrees of personality functioning across age groups.

Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)--a realist synthesis.

Science.gov (United States)

Maidment, Ian; Booth, Andrew; Mullan, Judy; McKeown, Jane; Bailey, Sylvia; Wong, Geoffrey

2017-07-03

Medication-related adverse events have been estimated to be responsible for 5700 deaths and cost the UK £750 million annually. This burden falls disproportionately on older people. Outcomes from interventions to optimise medication management are caused by multiple context-sensitive mechanisms. The MEdication Management in Older people: REalist Approaches BAsed on Literature and Evaluation (MEMORABLE) project uses realist synthesis to understand how, why, for whom and in what context interventions, to improve medication management in older people on complex medication regimes residing in the community, work. This realist synthesis uses secondary data and primary data from interviews to develop the programme theory. A realist logic of analysis will synthesise data both within and across the two data sources to inform the design of a complex intervention(s) to help improve medication management in older people. 1. Literature review The review (using realist synthesis) contains five stages to develop an initial programme theory to understand why processes are more or less successful and under which situations: focussing of the research question; developing the initial programme theory; developing the search strategy; selection and appraisal based on relevance and rigour; and data analysis/synthesis to develop and refine the programme theory and context, intervention and mechanism configurations. 2. Realist interviews Realist interviews will explore and refine our understanding of the programme theory developed from the realist synthesis. Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff will be interviewed. 3. Developing framework for the intervention(s) Data from the realist synthesis and interviews will be used to refine the programme theory for the intervention(s) to identify: the mechanisms that need to be 'triggered', and the contexts related to these

[Polypharmacy viewed not only through the prism of multi-morbidity, but also as an independent geriatric syndrome].

Science.gov (United States)

Weber, Pavel; Meluzínová, Hana; Prudius, Dana; Bielaková, Katarína

Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. The authors highlight the medication used in the anticipated positive and potential negative potential. While physicians often must make difficult trade-offs between the guidelines on one hand and complicated multi-morbidity, on the other hand, while trying to avoid polypharmacy ( 5 drugs), especially excessive polypharmacy ( 10 drugs). Multimorbid elderly patients who are treated in accordance with guidelines typically use large amounts of medicaments. This polypharmacy increases the risk of adverse drug reactions and drug interactions. The authors point out the pitfalls of performance of large clinical studies and EBM on one side and the daily clinical practice at the risk of their indiscriminate application, albeit with good intentions to improve the health of seniors.Key words: evidence based medicine - geriatrisation of medicine - multi-morbidity - old age - polypharmacy - prescription - randomized clinical trials.

The development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): a large-scale data sharing initiative.

Science.gov (United States)

Lutomski, Jennifer E; Baars, Maria A E; Schalk, Bianca W M; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

2013-01-01

In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons' health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) which would be integrated into all funded research protocols. In this context, we describe TOPICS data sharing initiative (www.topics-mds.eu). A working group drafted TOPICS-MDS prototype, which was subsequently approved by a multidisciplinary panel. Using instruments validated for older populations, information was collected on demographics, morbidity, quality of life, functional limitations, mental health, social functioning and health service utilisation. For informal caregivers, information was collected on demographics, hours of informal care and quality of life (including subjective care-related burden). Between 2010 and 2013, a total of 41 research projects contributed data to TOPICS-MDS, resulting in preliminary data available for 32,310 older persons and 3,940 informal caregivers. The majority of studies sampled were from primary care settings and inclusion criteria differed across studies. TOPICS-MDS is a public data repository which contains essential data to better understand health challenges experienced by older persons and informal caregivers. Such findings are relevant for countries where increasing health-related expenditure has necessitated the evaluation of contemporary health care delivery. Although open sharing of data can be difficult to achieve in practice, proactively addressing issues of data protection, conflicting data analysis requests and funding limitations during TOPICS-MDS developmental phase has fostered a data sharing culture. To date, TOPICS-MDS has been successfully incorporated into 41 research projects, thus supporting the feasibility of constructing a large (>30,000 observations

Attitudes toward older adults: A matter of cultural values or personal values?

Science.gov (United States)

Zhang, Xin; Xing, Cai; Guan, Yanjun; Song, Xuan; Melloy, Robert; Wang, Fei; Jin, Xiaoyu

2016-02-01

The current research aimed to address the inconsistent findings regarding cultural differences in attitudes toward older adults by differentiating the effects of personal and cultural values. In Study 1, we used data from the sixth wave of the World Values Survey to examine attitudes toward older adults across cultures, and how different personal values (i.e., communal vs. agentic) and cultural values (i.e., individualism) predicted these attitudes. The results of hierarchical linear modeling analyses showed that after controlling for potential covariates, personal communal values positively correlated with positive attitudes toward older adults; however, cultural individualistic values did not. To further examine the causal effects of personal values (vs. cultural values), we conducted an experimental study and confirmed that priming personal values rather than cultural values had significant effects on ageism attitudes. The present studies help to reconcile conflicting results on cultural differences in attitudes toward older adults. (c) 2016 APA, all rights reserved).

Association of personal hygiene with common morbidities among upper primary school children in rural Odisha.

Science.gov (United States)

Paul, Kalyan Kumar; Panigrahi, Sandeep Kumar; Soodi Reddy, Arun Kiran; Sahu, Trilochan

2017-01-01

In India, children of upper primary school receive less attention from health-care providers. The majority of their health problems are preventable through hygienic practices. The aim of this study was to find out the association of personal hygiene with common morbidities among upper primary school children. A cross-sectional study conducted in a rural upper primary school of Odisha. A semi-structured schedule based on the Global School Health Survey Questionnaire and necessary instruments for clinical examination were used. Data were entered in Microsoft Excel 2007 and analyzed by SPSS version 20 software. Of 90 participants, 58 (64.4%) were girls. The mean age was 11.8 (±1.01) years. The mean body mass index of females was significantly higher than males (16.95 vs. 14.72; P = 0.001). More than 90% of children maintained good personal hygiene such as clean tongue, clean hair, handwashing, and using footwear. The most common morbidities found were dental caries (38.9%), history of worms in stool and lethargy (20%). A mean score of 6.14 ± 0.11 (out of 8) was seen for personal hygiene and not associated with any particular morbidity or gender. Brushing daily was significantly associated with reduced dental caries (χ 2 = 8.7; P personal hygiene. School health services should also focus on upper primary school children for improvement of personal hygiene.

Psychotherapeutic treatment levels of personality disorders in older adults

NARCIS (Netherlands)

Videler, Arjan; Cornelis, Christina; Rossi, G.; van Royen, R.J.J.; Rosowsky, E.; van Alphen, S.P.J.

2015-01-01

Treatment of personality disorders (PDs) in older adults is a highly underexplored topic. In this article clinical applicability of the findings from a recent Delphi study regarding treatment aspects of PDs in older adults is explored. This concerns the relevance of three psychotherapeutic treatment

Social relations and the self-esteem of older persons.

Science.gov (United States)

Lee, G R; Shehan, C L

1989-12-01

This study employs survey data from a sample of persons 55 years of age and older to examine the antecedents of self-esteem. Hypotheses are derived from a theoretical orientation that hinges on the ability of the individual to terminate relations that might be productive of negative reflected appraisals. Consistent with hypotheses, friendship interaction is positively related to self-esteem, whereas kinship interaction is not. Marital satisfaction also affects self-esteem positively; among men, this effect is stronger for the retired than for the employed. Finally, never-married and nonemployed older women have lower self-esteem than other women have. Implications are drawn regarding the importance and role of self-esteem in theories of psychological well-being among older persons.

Guidelines to facilitate self-care among older persons in South Africa

Directory of Open Access Journals (Sweden)

Tinda Rabie

2015-06-01

Implications for practice: The implementation of the self-care guidelines by the public health sector, professional nurses and older persons will improve the healthcare of older persons at home which will in turn improve their quality of life, reduce unintentional self-neglect, as well as assist in alleviating overcrowding in clinics because unnecessary visits to the clinic will drop.

Older persons' existential loneliness, as interpreted by their significant others - an interview study.

Science.gov (United States)

Larsson, Helena; Rämgård, Margareta; Bolmsjö, Ingrid

2017-07-10

In order to better understand people in demanding medical situations, an awareness of existential concerns is important. Studies performed over the last twenty years conclude that when dying and death come closer, as in the case with older people who are stricken by infirmity and diseases, existential concerns will come to the fore. However, studies concerning experiences of existential loneliness (EL) are sparse and, in addition, there is no clear definition of EL. EL is described as a complex phenomenon and referred to as a condition of life, an experience, and a process of inner growth. Listening to someone who knows the older person well, as significant others often do, may be one way of learning more about EL. This study is part of a larger research project on EL, the LONE study, where EL is explored through interviews with frail older people, their significant others and health care professionals. The aim of this study was to explore frail older (>75) persons' EL, as interpreted by their significant others. The study is qualitative and based on eighteen narrative interviews with nineteen significant others of older persons. The data was analysed using Hsieh and Shannon's conventional content analysis. According to the interpretation of significant others, the older persons experience EL (1) when they are increasingly limited in body and space, (2) when they are in a process of disconnecting, and (3) when they are disconnected from the outside world. The result can be understood as if the frail older person is in a process of letting go of life. This process involves the body, in that the older person is increasingly limited in his/her physical abilities. The older person's long-term relationships are gradually lost, and finally the process entails the older person's increasingly withdrawing into him- or herself and turning off the outside world. The result of this study is consistent with previous research that has shown that EL is a complex phenomenon, but

Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: comparative study.

Science.gov (United States)

Zimmerman, Mark; Ellison, William; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

2015-10-01

The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. The patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years. The level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder. © The Royal College of Psychiatrists 2015.

Salivary function and glycemic control in older persons with diabetes.

Science.gov (United States)

Chavez, E M; Taylor, G W; Borrell, L N; Ship, J A

2000-03-01

There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study's purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population. Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated (age range, 54-90 years). Diabetic status was determined by a glycosylated hemoglobin (HbA(1c)) test and a 2-hour glucose tolerance test. Poor glycemic control was defined as HbA(1c) >9%. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire. Persons with poorly controlled diabetes had lower (P =.01) stimulated parotid flow rates than persons with well-controlled diabetes and nondiabetic control subjects. There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.

Subjective dysphagia in older care home residents: a cross-sectional, multi-centre point prevalence measurement

NARCIS (Netherlands)

Maarel-Wierink, C.D. van der; Meijers, J.M.M.; Visschere, L.M. De; Baat, C. de; Halfens, R.J.; Schols, J.M.

2014-01-01

BACKGROUND: Dysphagia has been found to be strongly associated with aspiration pneumonia in frail older people. Aspiration pneumonia is causing high hospitalization rates, morbidity, and often death. Better insight in the prevalence of (subjective) dysphagia in frail older people may improve its

Older people, personal hygiene, and skin care.

Science.gov (United States)

Cowdell, Fiona

2011-01-01

Skin health is essential for well being in older people. Personal hygiene is fundamental to skin health, but a lack of evidence exists about effective practices. An evidence base, disseminated through nursing education and patient health promotion, must be developed.

Personality and attitudes as predictors of risky driving among older drivers.

Science.gov (United States)

Lucidi, Fabio; Mallia, Luca; Lazuras, Lambros; Violani, Cristiano

2014-11-01

Although there are several studies on the effects of personality and attitudes on risky driving among young drivers, related research in older drivers is scarce. The present study assessed a model of personality-attitudes-risky driving in a large sample of active older drivers. A cross-sectional design was used, and structured and anonymous questionnaires were completed by 485 older Italian drivers (Mean age=68.1, SD=6.2, 61.2% males). The measures included personality traits, attitudes toward traffic safety, risky driving (errors, lapses, and traffic violations), and self-reported crash involvement and number of issued traffic tickets in the last 12 months. Structural equation modeling showed that personality traits predicted both directly and indirectly traffic violations, errors, and lapses. More positive attitudes toward traffic safety negatively predicted risky driving. In turn, risky driving was positively related to self-reported crash involvement and higher number of issued traffic tickets. Our findings suggest that theoretical models developed to account for risky driving of younger drivers may also apply in the older drivers, and accordingly be used to inform safe driving interventions for this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

Antisocial Personality Disorder in Older Adults: A Critical Review.

Science.gov (United States)

Holzer, Katherine J; Vaughn, Michael G

2017-11-01

Antisocial personality disorder (ASPD) has enormous negative impacts on the affected individuals, their loved ones, and society. This burden is intensified by the social and functional changes related to age. The lower prevalence of ASPD in older adults compared to younger adults is well-documented. This discrepancy, often attributed solely to antisocial "burnout," contributes to the lack of attention given to this disorder in older adults and may signify difficulty measuring ASPD in this population. These measurement issues likely stem from problems with the validity of the diagnostic criteria for older adults which may not effectively capture changes that occur with age. This review focuses on the current literature surrounding the validity of ASPD criteria with older adults and relevant concepts, including the connection between criminality and ASPD. Issues with screening tools and the measurement of ASPD caused by problems with the criteria are also discussed. Finally, recommendations for improvement, including use of dimensional models of personality disorders, a potential geriatric subclassification of criteria, and modification of the existing criteria are presented with clinical implications and suggestions for future research.

Locus of control and coping strategies in older persons with and without depression.

Science.gov (United States)

Bjørkløf, Guro Hanevold; Engedal, Knut; Selbæk, Geir; Maia, Deborah Bezerra; Coutinho, Evandro Silvia Freire; Helvik, Anne-Sofie

2016-08-01

To compare locus of control and coping strategies in older persons with and without depression. This cross-sectional study included 144 depressed in-patients from seven psychogeriatric hospital units, and 106 community-dwelling older persons without depression. All participants were 60 years and older. Locus of control was assessed by a 17-items self-report questionnaire with six response categories. Coping strategies were assessed by a 26-items self-report questionnaire with five response categories. For analytical purposes, age (controlling for demographics, health, and social variables, the depressed in-patients showed a higher external locus of control orientation and a less frequent use of problem-focused coping strategies compared with the non-depressed group. No differences in use of emotion-focused strategies were found between the two groups. Compared with the non-depressed old persons, the depressed hospitalized older persons were characterized by perceptions of less personal control, and less use of problem-focused strategies, what also might have brought positive alterations into their situation.

Methods of comprehensive geriatric assessment of older patients with rectal cancer

Directory of Open Access Journals (Sweden)

S. S. Gordeev

2017-01-01

Full Text Available The article presents a literature review on application of modern risk predictors of complications and morbidity necessary for selection of oncologically justified treatment methods for older patients with rectal cancer taking into account advancement of the disease and concomitant pathology. Use of modern scales, calculators, and questionnaires for evaluation of functional and physical status of this complex patient category by a multidisciplinary team allows to personalize therapy approach, minimize complications and morbidity after specific treatment. Application of the developed algorithms of assessment of older patients creates satisfactory conditions for their treatment based on oncological adequacy, functionality, and safety.  

Discriminability of Personality Profiles in Isolated and Co-Morbid Marijuana and Nicotine Users

OpenAIRE

Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L.; Filbey, Francesca M

2016-01-01

Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co-morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively fo...

Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults.

Science.gov (United States)

Wuthrich, V M; Rapee, R M; Kangas, M; Perini, S

2016-03-01

Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults. A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale. Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder. Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.

Shifting between self-governing and being governed: a qualitative study of older persons' self-determination.

Science.gov (United States)

Ottenvall Hammar, Isabelle; Dahlin-Ivanoff, Synneve; Wilhelmson, Katarina; Eklund, Kajsa

2014-11-28

Older persons' right to exercise self-determination in daily life is supported by several laws. Research shows that older persons' self-determination is not fully respected within the healthcare sector. In order to enable and enhance older persons' self-determination, extensive knowledge of older persons' self-determination is needed. The aim of this study was to explore experiences of self-determination when developing dependence in daily activities among community-dwelling persons 80 years and older. Qualitative interviews were performed in accordance with a grounded theory method, with 11 persons aged 84-95 years who were beginning to develop dependence in daily activities. The data analysis revealed the core category, "Self-determination - shifting between self-governing and being governed". The core category comprised three categories: "Struggling against the aging body", "Decision-making is relational", and "Guarding one's own independence". Self-determination in daily activities was related to a shifting, which was two-fold, and varied between self-governing and being governed by the aging body, or by others. The findings imply a need to adopt a person-centered approach where the older persons' own preferences and needs are in focus, in order to enhance their possibilities to exercise self-determination.

Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo.

Science.gov (United States)

Toci, Ervin; Burazeri, Genc; Jerliu, Naim; Sørensen, Kristine; Ramadani, Naser; Hysa, Bajram; Brand, Helmut

2015-09-01

The aim was to describe health literacy among the older population of Kosovo, an Albanian speaking post-war country in the Western Balkans, in the context of self-perceived health status and self-reported chronic morbidity. A cross-sectional study was conducted in Kosovo in 2011 including 1753 individuals aged ≥ 65 years (886 men, 867 women; mean age 73.4 ± 6.3 years; response rate: 77%). Participants were asked to assess, on a scale from 1 to 5, their level of difficulty with regard to access, understanding, appraisal and application of health information. Sub-scale scores and an overall health literacy score were calculated for each participant. Information on self-perceived health status, presence and number of chronic diseases and socioeconomic characteristics was also collected. Mean values of the overall health literacy score and all sub-scale scores (access, understanding, appraisal and application) were lower among older people who reported a poorer health status or at least one chronic condition compared with individuals who perceived their health status as good or had no chronic conditions (p association between health literacy levels and self-perceived health and chronic morbidity in this post-war European population. The putative link with chronic morbidity and lower adherence to health services is hard to establish through this cross-sectional study. Prospective population-based studies should be conducted in Kosovo and other transitional settings to replicate these findings and properly address the causal relationship between health literacy and health status. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sleep duration, nap habits, and mortality in older persons.

Science.gov (United States)

Cohen-Mansfield, Jiska; Perach, Rotem

2012-07-01

To examine the effect of nighttime sleep duration on mortality and the effect modification of daytime napping on the relationship between nighttime sleep duration and mortality in older persons. Prospective survey with 20-yr mortality follow-up. The Cross-Sectional and Longitudinal Aging Study, a multidimensional assessment of a stratified random sample of the older Jewish population in Israel conducted between 1989-1992. There were 1,166 self-respondent, community-dwelling participants age 75-94 yr (mean, 83.40, standard deviation, 5.30). Nighttime sleep duration, napping, functioning (activities of daily living, instrumental activities of daily living, Orientation Memory Concentration Test), health, and mortality. Duration of nighttime sleep of more than 9 hr was significantly related to increased mortality in comparison with sleeping 7-9 hr (hazard ratio [HR] = 1.31, P habits, and mortality in older persons. SLEEP 2012;35(7):1003-1009.

Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India.

Science.gov (United States)

Ajay, Shweta; Kasthuri, Arvind; Kiran, Pretesh; Malhotra, Rahul

In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India. All impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden. A total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β=6.6; 95% CI: 2.1-11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β=13.9; CI: 2.5-25.4). Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Balance Training with Wii Fit Plus for Community-Dwelling Persons 60 Years and Older.

Science.gov (United States)

Roopchand-Martin, Sharmella; McLean, Roshé; Gordon, Carron; Nelson, Gail

2015-06-01

This study sought to determine the effect of 6 weeks of training, using activities from the Nintendo(®) (Kyoto, Japan) "Wii™ Fit Plus" disc, on balance in community-dwelling Jamaicans 60 years and older. A single group pretest/posttest design was used. Thirty-three subjects enrolled and 28 completed the study. Participants completed 30-minute training sessions on the Nintendo "Wii Fit" twice per week for 6 weeks. Activities used included "Obstacle Course," "Penguin Slide," "Soccer Heading," "River Bubble," "Snow Board," "Tilt Table," "Skate Board," and "Yoga Single Tree Pose." Balance was assessed with the Berg Balance Scale, the Multi Directional Reach Test, the Star Excursion Balance Test and the Modified Clinical Test for Sensory Integration in Balance. There was significant improvement in the mean Berg Balance Scale score (P=0.004), Star Excursion Balance Test score (SEBT) (PBalance. Balance games on the Nintendo "Wii Fit Plus" disc can be used as a tool for balance training in community-dwelling persons 60 years of age and older.

Factors associated with increasing functional decline in multimorbid independently living older people

NARCIS (Netherlands)

Laan, W.; Bleijenberg, N.; Drubbel, I.; Numans, M.E.; De Wit, N.J.; Schuurmans, M.J.

2013-01-01

Objectives With increasing age the levels of activities of daily living (ADL) deteriorate. In this study we aimed to investigate which demographic characteristics and disorders are associated with ADL disabilities in multi-morbid older people. Study design We performed a cross-sectional study with

Personality, suicidal ideation, and reasons for living among older adults.

Science.gov (United States)

Segal, Daniel L; Marty, Meghan A; Meyer, William J; Coolidge, Frederick L

2012-03-01

This study examined associations between diverse types of personality disorder (PD) features, personality traits, suicidal ideation, and protective factors against suicide among community-dwelling older adults. Participants (N = 109, M age = 71.4 years, 61% female) completed the Coolidge Axis II Inventory, NEO Five-Factor Inventory, Geriatric Suicide Ideation Scale, and Reasons for Living Inventory. PD features had positive correlations with suicidal ideation and mixed relationships with aspects of reasons for living. Personality traits had negative correlations with suicidal ideation, with the exception of neuroticism, which had a positive relationship, and were mostly unrelated to reasons for living. In regression analyses, borderline and histrionic were the only PD features that contributed significant variance in suicidal ideation, whereas neuroticism was the only personality trait that contributed significant variance in suicidal ideation. No individual PD features or personality traits contributed significant variance in reasons for living. The findings highlight the complexity of risk and protective factors for suicide and suggest that a thorough assessment of suicidal potential among older adults should include attention to their underlying personality traits.

Communicative challenges in the home care of older persons: a qualitative exploration.

NARCIS (Netherlands)

Sundler, A.J.; Eide, H.; Dulmen, S. van; Holmström, I.K.

2016-01-01

Aim To explore communicative challenges in encounters between nurse assistants and older persons during home care visits. Background The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home

Older persons' experiences of a home-based exercise program with behavioral change support.

Science.gov (United States)

Arkkukangas, Marina; Sundler, Annelie J; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

2017-12-01

It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore

NARCIS (Netherlands)

Deurenberg-Yap, M.; Chew, S.K.; Lin, V.F.; Tan, B.Y.; Staveren, van W.A.; Deurenberg, P.

2001-01-01

Paper Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore M Deurenberg-Yap1, S K Chew2, V F P Lin1, B Y Tan2, W A van Staveren3 and P Deurenberg3,4 1Research and Information Management, Health Promotion Board, Singapore 2Department of Epidemiology and Disease

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

DEFF Research Database (Denmark)

Kollerup, Mette Geil; Angel, Sanne

2015-01-01

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

Attitudes towards personal genomics among older Swiss adults: An exploratory study

Directory of Open Access Journals (Sweden)

Laura Mählmann

2016-03-01

Conclusion: This study indicates a relatively positive overall attitude towards personal genomic testing among older Swiss adults, a group not typically represented in surveys about personal genomics. Genomic data of older adults can be highly relevant to late life health and maintenance of quality of life. In addition they can be an invaluable source for better understanding of longevity, health and disease. Understanding the attitudes of this population towards genomic analyses, although important, remains under-examined.

Adult antisocial syndrome co-morbid with borderline personality disorder is associated with severe conduct disorder, substance dependence and violent antisociality.

Science.gov (United States)

Freestone, Mark; Howard, Rick; Coid, Jeremy W; Ullrich, Simone

2013-01-01

This study tested the hypothesis that syndromal adult antisocial behaviour (AABS) co-morbid with borderline personality disorder (BPD) is a syndrome that emerges from severe conduct disorder (CD) in childhood and adolescence and is strongly associated, in adulthood, with both violence and substance dependence. In a sample of 8 580 community-resident adults screened for the presence of personality disorders, the following predictions arising from this hypothesis were tested: first, that those with AABS co-morbid with BPD would, in comparison with those showing AABS or BPD only, show a high level of antisocial outcomes, including violence; second, that adjusting for co-morbid alcohol dependence would attenuate group differences in many of the antisocial outcomes, and violence in particular; and third, that the AABS/BPD group would show both a high prevalence and a high severity of CD, and that adjusting for co-morbid CD would attenuate any association found between AABS/BPD co-morbidity and violence. Results confirmed these predictions, suggesting that AABS/BPD co-morbidity mediates the relationship between childhood CD and a predisposition to adult violence. The triad of AABS/BPD co-morbidity, alcohol dependence and severe CD is likely associated with the risk of criminal recidivism in offenders with personality disorder following release into the community. Copyright © 2012 John Wiley & Sons, Ltd.

Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

Science.gov (United States)

French, L R M; Turner, K M; Dawson, S; Moran, P

2017-05-01

It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Association of cognition with temporal discounting in community based older persons

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Boyle Patricia A

2012-08-01

Full Text Available Abstract Background The objective of this study was to test the hypothesis that cognitive function is negatively associated with temporal discounting in old age. Methods Participants were 388 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging in the Chicago metropolitan area. Temporal discounting was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Cognition was measured using a detailed battery including 19 tests. The association between cognition and temporal discounting was examined via mixed models adjusted for age, sex, education, income, and the number of chronic medical conditions. Results Descriptive data revealed a consistent pattern whereby older persons with lower cognitive function were more likely to discount greater but delayed rewards compared to those with higher cognitive function. Further, in a mixed effect model adjusted for age, sex, education, income, and chronic medical conditions, global cognitive function was negatively associated with temporal discounting (estimate = −0.45, SE = 0.18, p = 0.015, such that a person with lower cognition exhibited greater discounting. Finally, in subsequent models examining domain specific associations, perceptual speed and visuospatial abilities were associated with temporal discounting, but episodic memory, semantic memory and working memory were not. Conclusion Among older persons without dementia, a lower level of cognitive function is associated with greater temporal discounting. These findings have implications regarding the ability of older persons to make decisions that involve delayed rewards but maximize well-being.

Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center.

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Jacob, Christian P; Romanos, Jasmin; Dempfle, Astrid; Heine, Monika; Windemuth-Kieselbach, Christine; Kruse, Anja; Reif, Andreas; Walitza, Susanne; Romanos, Marcel; Strobel, Alexander; Brocke, Burkhard; Schäfer, Helmut; Schmidtke, Armin; Böning, Jobst; Lesch, Klaus-Peter

2007-09-01

The prevalence and consequences of co-morbid axis-I and axis-II disorders as well as personality traits were examined in a large cohort of adult attention-deficit/hyperactivity disorder (AADHD) at a tertiary referral center. In- and outpatients referred for diagnostic assessment of AADHD were screened. 372 affected probands were examined by means of the Structured Clinical Interview of DSM-IV axis-I/II disorders, the Revised NEO Personality Inventory (NEO-PI-R), and the Tridimensional Personality Questionnaire (TPQ). Lifetime co-morbidity with mood disorders was 57.3%, with anxiety disorders 27.2%, and with substance use disorders 45.0%. The histrionic personality disorder (35.2%) was the most frequent personality disorder. AADHD patients exhibited significantly altered scores on most of the NEO-PI-R and TPQ personality dimensions. The extent of substance abuse and dependence, as well as the presence of antisocial personality disorder alone or the cumulative number of other specific personality disorders was associated with lower psychosocial status (pdisorders was remarkably prevalent. In AADHD co-morbid mood, anxiety, and personality disorders as well as substance abuse/dependence is likely to be predictive of poor outcome.

Association of personal hygiene with common morbidities among upper primary school children in rural Odisha

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Kalyan Kumar Paul

2017-01-01

Full Text Available Context: In India, children of upper primary school receive less attention from health-care providers. The majority of their health problems are preventable through hygienic practices. Aims: The aim of this study was to find out the association of personal hygiene with common morbidities among upper primary school children. Settings and Design: A cross-sectional study conducted in a rural upper primary school of Odisha. Subjects and Methods: A semi-structured schedule based on the Global School Health Survey Questionnaire and necessary instruments for clinical examination were used. Statistical Analysis Used: Data were entered in Microsoft Excel 2007 and analyzed by SPSS version 20 software. Results: Of 90 participants, 58 (64.4% were girls. The mean age was 11.8 (±1.01 years. The mean body mass index of females was significantly higher than males (16.95 vs. 14.72; P = 0.001. More than 90% of children maintained good personal hygiene such as clean tongue, clean hair, handwashing, and using footwear. The most common morbidities found were dental caries (38.9%, history of worms in stool and lethargy (20%. A mean score of 6.14 ± 0.11 (out of 8 was seen for personal hygiene and not associated with any particular morbidity or gender. Brushing daily was significantly associated with reduced dental caries (χ2 = 8.7; P < 0.005 and foul-smelling breath (χ2 = 4.93; P < 0.05. Fungal infections were significantly less in children who bathed daily (χ2 = 28.7; <0.005 and wore clean clothes (χ2 = 5.06; P < 0.05. Conclusion: Dental caries, foul-smelling breath, and fungal infections were significantly associated with poor personal hygiene. School health services should also focus on upper primary school children for improvement of personal hygiene.

Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people.

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McCormack, Brendan; Dewing, Jan; Breslin, Liz; Coyne-Nevin, Ann; Kennedy, Kate; Manning, Mary; Peelo-Kilroe, Lorna; Tobin, Catherine; Slater, Paul

2010-06-01

To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. © 2010 Blackwell Publishing Ltd.

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

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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.

Relationship of personal hygiene with nutrition and morbidity profile: A study among primary school children in South Kolkata

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Deb Soumya

2010-01-01

Full Text Available Background: Majority of the health problems affecting school children are preventable by promotion of hygienic practices through proper health education by the teachers, who are the first contacts. Objectives: The study was undertaken to find out the status of nutrition and personal hygiene among primary school children and their association with their varied morbidity profiles. Materials and Methods: A descriptive, observational, cross-sectional study was conducted in a primary school situated in the largest slum of Kolkata. Results: The participants included 103 boys and 81 girls, with a mean age of 6.2 years. The mean personal hygiene score of the girls (4.15 ± 0.98 was significantly higher than that of boys (3.2 ± 1.4 [P<0.05]. Most of the boys (54.37% and girls (74.07% were normally nourished as per the CDC growth chart. Over 70% of the children were suffering from one or more morbidities, the most common morbidity in both the sexes being pallor, followed by worm infestation. Personal hygiene scores were significantly higher (P<0.05 among those children who were normally nourished as well as those who did not suffer from any morbidity in the last 15 days. Conclusions: Care should be taken to improve the pitiable state of personal hygiene and poor sanitary practices of these school children through coordinated and concerted health education measures by teachers as well as parents.

Altered vision destabilizes gait in older persons.

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Helbostad, Jorunn L; Vereijken, Beatrix; Hesseberg, Karin; Sletvold, Olav

2009-08-01

This study assessed the effects of dim light and four experimentally induced changes in vision on gait speed and footfall and trunk parameters in older persons walking on level ground. Using a quasi-experimental design, gait characteristics were assessed in full light, dim light, and in dim light combined with manipulations resulting in reduced depth vision, double vision, blurred vision, and tunnel vision, respectively. A convenience sample of 24 home-dwelling older women and men (mean age 78.5 years, SD 3.4) with normal vision for their age and able to walk at least 10 m without assistance participated. Outcome measures were gait speed and spatial and temporal parameters of footfall and trunk acceleration, derived from an electronic gait mat and accelerometers. Dim light alone had no effect. Vision manipulations combined with dim light had effect on most footfall parameters but few trunk parameters. The largest effects were found regarding double and tunnel vision. Men increased and women decreased gait speed following manipulations (p=0.017), with gender differences also in stride velocity variability (p=0.017) and inter-stride medio-lateral trunk acceleration variability (p=0.014). Gender effects were related to differences in body height and physical functioning. Results indicate that visual problems lead to a more cautious and unstable gait pattern even under relatively simple conditions. This points to the importance of assessing vision in older persons and correcting visual impairments where possible.

Exploring resilience in nurses caring for older persons

African Journals Online (AJOL)

Petronella Benadé

Methodology: An explorative, descriptive qualitative research design was ... This challenging behaviour of the older persons is stressful to ... and involvement from management in facilities may cause ... Studies regarding the resilience of professional nurses in .... After the data had been analysed, a thorough literature con-.

Women and stroke patients are more at risk for fall- related injury among older persons

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Sulistyowati Tuminah Darjoko

2016-05-01

Women and stroke sufferers were at higher risk of fall-related injury among older persons. Prevention of fall-related injury should be done by older persons through periodic control of their health condition.

Improving the care of older persons in Australian prisons using the Policy Delphi method.

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Patterson, Karen; Newman, Claire; Doona, Katherine

2016-09-01

There are currently no internationally recognised and approved processes relating to the care of older persons with dementia in prison. This research aimed to develop tools and procedures related to managing the care of, including the identification and assessment of, older persons with dementia who are imprisoned in New South Wales, Australia. A modified approach to the Policy Delphi method, using both surveys and facilitated discussion groups, enabled experts to come together to discuss improving the quality of care provision for older persons with dementia in prison and achieve research aims. © The Author(s) 2014.

Developing person-centred practice in hip fracture care for older people.

Science.gov (United States)

Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine

2016-12-14

To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

Is there a U-shaped association between physical activity and falling in older persons?

NARCIS (Netherlands)

Peeters, G.M.E.E.; van Schoor, N.M.; Pluijm, S.M.; Deeg, D.J.H.; Lips, P.T.A.M.

2010-01-01

Summary: This study tests whether the relationship between physical activity and (recurrent) falling is U-shaped. Among 1,337 community-dwelling older persons, no evidence for a nonlinear association was found. If all older persons increase their physical activity level with 100 units, 4% may be

Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

NARCIS (Netherlands)

Reeve, J.; Blakeman, T.; Freeman, G.K.; Green, L.A.; James, P.A.; Lucassen, P.L.; Martin, C.M.; Sturmberg, J.P.; Weel, C. van

2013-01-01

BACKGROUND: A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet

Evidence-Based Approaches to Remedy and Also to Prevent Abuse of Community-Dwelling Older Persons

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Donna M. Wilson

2011-01-01

Full Text Available Elder abuse is a global issue, with an estimated 4–10% of older persons in Canada abused each year. Although Canadian legislation has been created to prevent and punish the abuse of older persons living in nursing homes and other care facilities, community-dwelling older persons are at greater risk of abuse. This paper highlights the importance of evidence-based actions targeted at three determinants of health: (a personal health practices and coping skills, (b social support networks, and (c social environments. Two research studies are profiled as case studies that illustrate the ready possibility and value of two specific types of actions on community-based older-person abuse. This paper argues for the immediate and widespread adoption of these evidence-based measures and for additional empirical evidence to guide the correction of underreporting of abuse, raise awareness of its serious nature, and increase options to not only stop it but ultimately prevent it.

Communication between nurses and family caregivers of hospitalised older persons: a literature review.

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Bélanger, Louise; Bourbonnais, Anne; Bernier, Roxanne; Benoit, Monique

2017-03-01

To review the literature concerning the feelings, thoughts and behaviours of nurses and family caregivers of hospitalised older persons when they communicate with one another. Communication between nurses and family caregivers of hospitalised older persons is not always optimal. Improving the frequency and quality of this communication might be a way to make the most of available human capital in order to better care for hospitalised older people. A literature review was carried out of qualitative, quantitative and mixed-design studies relating to communication between nurses and family caregivers. Findings were analysed thematically. Family caregiver thoughts, feelings and behaviours relative to nurse control and authority, nurse recognition of their contribution, information received from and shared with nurses and care satisfaction could influence communication with nurses. Nurse thoughts regarding usefulness of family caregivers as care partners and their lack of availability to meet family caregiver demands could influence communication with family caregivers. The thoughts, feelings and behaviours of family caregivers and nurses that might create positive or negative circular patterns of communication are evidenced. Further research is required to gain a more comprehensive understanding of the phenomenon. Nurses must be trained in how to communicate with family caregivers in order to form a partnership geared to preventing complications in hospitalised older persons. Results could be used to inform policy regarding the care of hospitalised older persons. © 2016 John Wiley & Sons Ltd.

Proactive Personality and Training Motivation among Older Workers: A Mediational Model of Goal Orientation

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Setti, Ilaria; Dordoni, Paola; Piccoli, Beatrice; Bellotto, Massimo; Argentero, Piergiorgio

2015-01-01

Purpose: This paper aims at examining the relationship between proactive personality and training motivation among older workers (aged over 55 years) in a context characterized by the growing ageing of the global population. First, the authors hypothesized that proactive personality predicts the motivation to learn among older workers and that…

Schema therapy for personality disorders in older adults : A multiple-baseline study

NARCIS (Netherlands)

Videler, A.C.; van Alphen, S.P.J.; Van Royen, R.J.J.; van der Feltz-Cornelis, C.M.; Rossi, G.; Arntz, A.

2018-01-01

No studies have been conducted yet into the effectiveness of treatment of personality disorders in later life. This study is a first test of the effectiveness of schema therapy for personality disorders in older adults. Multiple-baseline design with eight cluster C personality disorder patients,

Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

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Poot, Antonius J; den Elzen, Wendy P J; Blom, Jeanet W; Gussekloo, Jacobijn

2014-01-01

Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP) and practice. This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons) study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social). For 2664 randomly chosen respondents (median age 82 years; 68% female) information was collected on level of satisfaction (satisfied, neutral, dissatisfied) with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (ppatient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to investigate the causal associations between care organization, patient characteristics, indicators of quality, and patient perceptions.

Factors associated with self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease: A cross-sectional study

OpenAIRE

Bonsaksen, Tore; Fagermoen, May Solveig; Lerdal, Anners

2014-01-01

Living with chronic illnesses can be stressful and may negatively impact persons’ self-esteem. Personal factors, like self-efficacy and illness perceptions, and also factors related to the environment, activity, and participation may be associated with self-esteem in chronic illness populations. This cross-sectional comparative study explored sociodemographic variables, work, physical activity, illness perceptions, and general self-efficacy in relation to self-esteem in persons with morbid ob...

The "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) randomized controlled trial: design and methods.

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Landi, Francesco; Cesari, Matteo; Calvani, Riccardo; Cherubini, Antonio; Di Bari, Mauro; Bejuit, Raphael; Mshid, Jerome; Andrieu, Sandrine; Sinclair, Alan J; Sieber, Cornel C; Vellas, Bruno; Topinkova, Eva; Strandberg, Timo; Rodriguez-Manas, Leocadio; Lattanzio, Fabrizia; Pahor, Marco; Roubenoff, Ronenn; Cruz-Jentoft, Alfonso J; Bernabei, Roberto; Marzetti, Emanuele

2017-02-01

The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed at comparing the efficacy of a MCI, based on long-term structured physical activity, nutritional counseling/dietary intervention, and an information and communication technology intervention, versus a healthy aging lifestyle education program designed to prevent mobility disability in 1500 older persons with physical frailty and sarcopenia who will be followed for up to 36 months. The primary outcome of the SPRINTT trial is mobility disability, operationalized as the inability to walk for 400 m within 15 min, without sitting, help of another person, or the use of a walker. Secondary outcomes include changes in muscle mass and strength, persistent mobility disability, falls and injurious falls, disability in activities of daily living, nutritional status, cognition, mood, the use of healthcare resources, cost-effectiveness analysis, quality of life, and mortality rate. SPRINTT results are expected to promote significant advancements in the management of frail older persons at high risk

Family and social aspects associated with depression among older persons in a Chinese context.

Science.gov (United States)

Zeng, Wen; North, Nicola; Kent, Bridie

2013-12-01

This study aims to explore the factors associated with depression among older persons in Macau, in relation to family and social aspects. Depression among community-dwelling older persons in Macau has been shown to be present at high rates. In Chinese culture, depression leads to social stigmatisation, suggesting a need to better understand depression as a sociocultural phenomenon. A mixed methods study was undertaken to identify the key influences on depression among Chinese older persons in Macau. Quantitative (standardised tests) and qualitative (collection of narratives) data were collected from 31 purposively selected participants, all community-dwelling older persons with depression. Depression was common among the participants. The paper reports on the family and social aspects, one of the findings of the study. Informants readily described their thoughts and judgements of themselves in graphic language. As they explored their life stories, family and social aspects emerged as significant influences that associated with depression. In a society and culture that relies on and values filial support, experiences of being widowed, having poor family support and weak social networks appeared to compound and exacerbate depression. These findings highlight that filial support, valued in Chinese culture, is seriously strained by the realities of contemporary society. Yet current government policies rely on and confirm the role of family support. Findings from this study suggest a need for such policies to be reviewed to address the realities of family and social support. The findings have several implications for clinical practice. Firstly, the cultural context of Chinese older persons should be considered and emphasised in nursing practice. Secondly, the root of depression among Chinese older persons is seen to lie in their social, family, cultural and day-to-day living issues. © 2012 Blackwell Publishing Ltd.

Interdisciplinary Team Collaboration during Discharge of Depressed Older Persons: A Norwegian Qualitative Implementation Study

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Anne Lise Holm

2013-01-01

Full Text Available In order to deliver effective care, it is necessary to organise interdisciplinary activities for older persons who suffer from depressive disorders. This paper evaluated the interdisciplinary team members’ perceptions of cooperation in the discharge planning of depressed older persons based on the Chronic Care Model (CCM. A qualitative implementation design was used, data were collected by means of multistage focus groups, and a thematic analysis was performed. Three themes emerged: lack of effective team leadership in the community, the need to change the delivery system, and enhancing self-management support for depressed older persons as well as the participation of their families. It was concluded that nurse managers must find ways of supporting the depressed older persons by better structuring the care, increasing cooperation with organisational leadership, and creating an environment characterised by trust and mutual respect. Distrust can have serious implications for discharge planning collaboration. The development of a common vision of transparency in the organization is important as is a policy of change among leadership and in clinical practice.

Healthy ageing in Isan-Thai culture--A phenomenographic study based on older persons' lived experiences.

Science.gov (United States)

Manasatchakun, Pornpun; Chotiga, Pleumjit; Roxberg, Åsa; Asp, Margareta

2016-01-01

Healthy ageing is a concept that concerns older persons' quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons' experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons' qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: "being independent in dependence," "being at peace," and "being a valuable person." This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people.

The role of patient personality in the identification of depression in older primary care patients.

Science.gov (United States)

McCray, Laura W; Bogner, Hillary R; Sammel, Mary D; Gallo, Joseph J

2007-11-01

Our aim was to evaluate whether personality factors significantly contribute to the identification of depression in older primary care patients, even after controlling for depressive symptoms. We examined the association between personality factors and the identification of depression among 318 older adults who participated in the Spectrum study. High neuroticism (unadjusted Odds Ratio (OR) 2.36, 95% Confidence Interval (CI) [1.42, 3.93]) and low extraversion (adjusted OR 2.24, CI [1.26, 4.00]) were associated with physician identification of depression. Persons with high conscientiousness were less likely to be identified as depressed by the doctor (adjusted OR 0.45, CI [0.22, 0.91]). Personality factors influence the identification of depression among older persons in primary care over and above the relationship of depressive symptoms with physician identification. Knowledge of personality may influence the diagnosis and treatment of depression in primary care. Copyright 2007 John Wiley & Sons, Ltd.

Understanding views on everyday use of personal health information: Insights from community dwelling older adults.

Science.gov (United States)

Hartzler, A L; Osterhage, K; Demiris, G; Phelan, E A; Thielke, S M; Turner, A M

2018-09-01

Older adults apply various strategies to pursue healthy aging, but we know little about their views and use of personal health information to accomplish those ends. As a first step in formulating the role of personal health information management (PHIM) in healthy aging, we explored the perspectives of older adults on health and health information used in their everyday lives through four focus groups with 25 community-dwelling adults aged 60 and over. We found that the concept of wellness-the holistic and multidimensional nature of health and wellbeing-plays prominently in how older adults think about health and health information. Participants expressed wellness from a position of personal strength, rather than health-related deficits, by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement. Although these themes involve personal health information, existing PHIM systems that focus on disease management are generally not designed to support wellness activities. Substantial opportunity exists to fill this wellness support gap with innovative health information technology designed for older adults. Findings carry implications for the design of PHIM tools that support healthy aging and methods for engaging older adults as co-producers of this critical support.

Reconciling concepts of space and person-centred care of the older person with cognitive impairment in the acute care setting.

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Rushton, Carole; Edvardsson, David

2017-07-01

Although a large body of literature exists propounding the importance of space in aged care and care of the older person with dementia, there is, however, only limited exploration of the 'acute care space' as a particular type of space with archetypal constraints that maybe unfavourable to older people with cognitive impairment and nurses wanting to provide care that is person-centred. In this article, we explore concepts of space and examine the implications of these for the delivery of care to older people who are cognitively impaired. Our exploration is grounded in theorisations of space offered by key geographers and phenomenologists, but also draws on how space has been constructed within the nursing literature that refers specifically to acute care. We argue that space, once created, can be created and that nursing has a significant role to play in the process of its recreation in the pursuit of care that is person-centred. We conclude by introducing an alternative logic of space aimed at promoting the creation of more salutogenic spaces that invokes a sense of sanctuary, safeness, and inclusion, all of which are essential if the care provided to the older person with cognitive impairment is apposite to their needs. The concept of 'person-centred space' helps to crystallize the relationship between space and person-centred care and implies more intentional manipulation of space that is more conducive to caring and healing. Significantly, it marks a return to Nightingale's wisdom, that is, to put the person in the best possible conditions for nature to act upon them. © 2016 John Wiley & Sons Ltd.

Physical fitness related to age and physical activity in older persons

NARCIS (Netherlands)

van Heuvelen, M.J.G.; Kempen, G.I.J.M.; Ormel, J.; Rispens, P

Objective: This study investigated physical fitness as a function of age and leisure time physical activity (LTPA) in a community-based sample of 624 persons aged 57 yr and older. Methods: LTPA during the last 12 months was assessed through personal interviews. A wide range of physical fitness

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

OpenAIRE

Teh, Jane Kimm Lii; Tey, Nai Peng; Ng, Sor Tho

2014-01-01

This study investigates factors affecting older persons' state of loneliness in multiethnic Malaysia using data from the 2004 Malaysian Population and Family Survey, the first nationally representative sample in Malaysia. The study sample was extracted to include Malays, Chinese, Indians and other Indigenous groups aged 60 and above, and who had children (n = 1791). Cross tabulations and ordinal logistic regression methods were used in the analysis. Among the ethnic groups, older Malays were ...

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

Science.gov (United States)

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

2017-11-02

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

Perspectives of health and self-care among older persons-To be implemented in an interactive information and communication technology-platform.

Science.gov (United States)

Göransson, Carina; Wengström, Yvonne; Ziegert, Kristina; Langius-Eklöf, Ann; Eriksson, Irene; Kihlgren, Annica; Blomberg, Karin

2017-12-01

To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves. The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals. Descriptive qualitative design. This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis. Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons. The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research. Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing. © 2017 John Wiley & Sons Ltd.

[Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru].

Science.gov (United States)

Moquillaza-Risco, Marlene; León, Elsa; Dongo, Mario; Munayco, César V

2015-10-01

Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program "Vida Digna" and the probability of functional dependency by age, and stratified by gender and cognitive impairment. MATERIALS ANDE METHODS: We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time of enrollment in the program. We did a descriptive analysis of the socio-demographic variables and we also determined the frequency of health conditions. Furthermore, we determined the probability of functional dependency by age, and stratified by gender and cognitive impairment through a logistic regression model. The older homeless persons at the time of enrollment in the program were mostly single men, with a primary education or no education. The study subjects had a high frequency of chronic and mental diseases. 50% of them had certain level of functional impairment and roughly 70% had a certain level of cognitive impairment. The probability of functional dependency increased by age, and it was higher in women than in men. This probability increased according to the level of cognitive impairment. This study shows that older homeless persons are a vulnerable population not only because they live outdoors but also because they a have also for the high prevalence of chronic and mental diseases. These diseases prevent the homeless persons from living by themselves special care to overcome their situations.

Chronic diseases among older people and co-resident psychological morbidity: a 10/66 Dementia Research Group population-based survey.

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Honyashiki, Mina; Ferri, Cleusa P; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Llibre-Rodrigues, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Prince, Martin J

2011-11-01

This is the first study to investigate the associations between chronic health conditions of older people and their impact on co-resident psychological morbidity using population-based samples in low and middle income countries (LAMICs). Single-phase cross-sectional catchment area surveys were undertaken in urban sites in Cuba, Dominican Republic and Venezuela, and in rural and urban catchment areas in Mexico, Peru, India and China. All residents aged 65 years and over were interviewed with a co-resident key informant. Exposures were structured clinical diagnoses (10/66 and DSM-IV dementia and ICD-10 depression), self-reported diagnosis (stroke) and physical impairments. Mediating variables were dependence and disability (WHODAS 2.0), and the outcome was co-resident psychological morbidity assessed using SRQ-20. Poisson regression analysis was used to estimate the prevalence ratios (PRs) for the associations between health conditions and psychological morbidity in each site, and meta-analysis was used to pool the estimates. 11,988 pairs comprising a participant and a co-resident informant were included in the analysis. After meta-analysis, independent effects were noted for depression (PR2.11; 95% CI 1.82-2.45), dementia (PR 1.98; 95% CI 1.72-2.28), stroke (PR 1.42; 95% CI 1.17-1.71) and physical impairments (PR 1.17; 95% CI 1.13-1.21). The effects were partly mediated through disability and dependence. The mean population attributable fraction of total chronic conditions was 30.1%. The prevalence of co-resident psychological morbidity is higher among co-residents of older people with chronic conditions. This effect was prominent for, but not confined to, depression and dementia. Attention needs to be directed to chronic conditions.

Personality and psychological distress among older adult, long-term cancer survivors.

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Deimling, Gary T; Albitz, Casey; Monnin, Kara; Renzhofer Pappada, Holly T; Nalepa, Elizabeth; Boehm, Melinda Laroco; Mitchell, Claire

2017-01-01

This research examines a model of how personality (Five-Factor Model) is related to adjustment to cancer in later life in terms of the presence of continuing cancer-related worry and depression among older adult, long-term cancer survivors. Data from an NCI-funded study with 275 older adult (age 60+), long-term (5+ years) survivors of breast, prostate, and colorectal cancer were examined. Regression analyses identified neuroticism as the strongest predictor of cancer-related worry along with continuing cancer-related symptoms. For depression, three personality dimensions (neuroticism, conscientiousness, and agreeableness) were significant predictors. Findings suggest the importance of considering the central role that survivors' personality characteristics play in understanding cancer-related worries and depression. Understanding these dispositional characteristics is key for social workers and health-care practitioners in counseling survivors experiencing these common mental health effects.

Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties.

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Wilberforce, Mark; Challis, David; Davies, Linda; Kelly, Michael P; Roberts, Chris; Loynes, Nik

2016-03-07

Person-centredness is promoted as a central feature of the long-term care of older adults. Measures are needed to assist researchers, service planners and regulators in assessing this feature of quality. However, no systematic review exists to identify potential instruments and to provide a critical appraisal of their measurement properties. A systematic review of measures of person-centredness was undertaken. Inclusion criteria restricted references to multi-item instruments designed for older adult services, or otherwise with measurement properties tested in an older adult population. A two-stage critical appraisal was conducted. First, the methodological quality of included references was assessed using the COSMIN toolkit. Second, seven measurement properties were rated using widely-recognised thresholds of acceptability. These results were then synthesised to provide an overall appraisal of the strength of evidence for each measurement property for each instrument. Eleven measures tested in 22 references were included. Six instruments were designed principally for use in long-stay residential facilities, and four were for ambulatory hospital or clinic-based services. Only one measure was designed mainly for completion by users of home care services. No measure could be assessed across all seven measurement properties. Despite some instruments having promising measurement properties, this was consistently undermined by the poor methodological quality underpinning them. Testing of hypotheses to support construct validity was of particularly low quality, whilst measurement error was rarely assessed. Two measures were identified as having been the subject of the most rigorous testing. The review is unable to unequivocally recommend any measures of person-centredness for use in older adult care. Researchers are advised to improve methodological rigour when testing instruments. Efforts may be best focused on testing a narrower range of measurement properties but to a

Personal Meaning Orientations and Psychosocial Adaptation in Older Adults

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Gary T. Reker

2011-04-01

Full Text Available This study examined how different patterns of sources of meaning in life impact the psychosocial adaptation of older adults. A total of 120 (62 women and 58 men community-residing older adults completed self-report measures of sources of meaning in life, physical health, life satisfaction, depression, personality, existential regrets, attitudes toward aging, and attitudes toward life. Cluster analysis of sources of meaning revealed four distinct meaning orientations: self-transcendent (n = 32, collectivistic (n = 24, individualistic (n = 34, and self-preoccupied (n = 30. MANCOVA analysis of the four groups, controlling for age, marital status, education, and financial satisfaction, revealed a strong multivariate main effect for meaning orientation. No statistically significant gender and Gender × Meaning orientation interaction effects were found. Older adults, who derive meaning from self-transcendent sources, are more extraverted, open to experience, agreeable, and conscientious; perceive greater purpose and coherence in life; feel more in control in directing their lives; express a stronger desire to get more out of life; and are less depressed compared with those who derive meaning through pursuing self-serving interests without any real commitment to personal, interpersonal, or societal development. The implications of the findings for positive aging are discussed.

Art, music, story: The evaluation of a person-centred arts in health programme in an acute care older persons' unit.

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Ford, Karen; Tesch, Leigh; Dawborn, Jacqueline; Courtney-Pratt, Helen

2018-06-01

To evaluate the impact of an arts in health programme delivered by a specialised artist within an acute older person's unit. Acute hospitals must meet the increasingly complex needs of older people who experience multiple comorbidities, often including cognitive impairment, either directly related to their admission or longer term conditions, including dementia. A focus on physical illness, efficiency and tasks within an acute care environment can all divert attention from the psychosocial well-being of patients. This focus also decreases capacity for person-centred approaches that acknowledge and value the older person, their life story, relationships and the care context. The importance of arts for health and wellness, including responsiveness to individual need, is well established: however, there is little evidence about its effectiveness for older people in acute hospital settings. We report on a collaborative arts in health programme on an acute medical ward for older people. The qualitative study used collaborative enquiry underpinned by a constructivist approach to evaluate an arts programme that involved participatory art-making activities, customised music, song and illustration work, and enlivening the unit environment. Data sources included observation of art activities, semi-structured interviews with patients and family members, and focus groups with staff. Data were transcribed and thematically analysed using a line by line approach. The programme had positive impacts for the environment, patients, families and staff. The environment exhibited changes as a result of programme outputs; patients and families were engaged and enjoyed activities that aided recovery from illness; and staff also enjoyed activities and importantly learnt new ways of working with patients. An acute care arts in health programme is a carefully nuanced programme where the skills of the arts health worker are critical to success. Utilising such skill, continued focus on person

Socio-demographics characteristics and health conditions of older homeless persons of Lima, Peru

OpenAIRE

Moquillaza-Risco, Marlene; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; León, Elsa; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; Dongo, Mario; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.; Munayco, César V.; Programa Nacional Vida Digna (PNVD), Ministerio de la Mujer y Poblaciones Vulnerables. Lima, Perú.

2015-01-01

Objectives. Determine the socio-demographics characteristics and health conditions of older homeless persons at the time of enrollment into the National Program “Vida Digna” and the probability of functional dependency by age, and stratified by gender and cognitive impairment. Materials ande methods. We performed a cross sectional study, reviewing all registration forms of the program in order to identify socio-demographic variables and health conditions of older homeless persons at the time ...

Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

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Antonius J Poot

Full Text Available BACKGROUND: Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP and practice. METHODS AND FINDINGS: This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social. For 2664 randomly chosen respondents (median age 82 years; 68% female information was collected on level of satisfaction (satisfied, neutral, dissatisfied with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (p<0.001. Per additional health domain with problems, the risk of being dissatisfied increased 1.7 times (95% CI 1.4-2.14; p<0.001. This was independent of age, gender, and demographic and clinical parameters (adjusted OR 1.4, 95% CI 1.1-1.8; p = 0.021. CONCLUSION: In older persons, dissatisfaction with general practice is strongly correlated with rising complexity of health problems, independent of age, demographic and clinical parameters. It remains unclear whether complexity of health problems is a patient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to

Bi-dimension decomposed hidden Markov models for multi-person activity recognition

Institute of Scientific and Technical Information of China (English)

Wei-dong ZHANG; Feng CHEN; Wen-li XU

2009-01-01

We present a novel model for recognizing long-term complex activities involving multiple persons. The proposed model, named 'decomposed hidden Markov model' (DHMM), combines spatial decomposition and hierarchical abstraction to capture multi-modal, long-term dependent and multi-scale characteristics of activities. Decomposition in space and time offers conceptual advantages of compaction and clarity, and greatly reduces the size of state space as well as the number of parameters.DHMMs are efficient even when the number of persons is variable. We also introduce an efficient approximation algorithm for inference and parameter estimation. Experiments on multi-person activities and multi-modal individual activities demonstrate that DHMMs are more efficient and reliable than familiar models, such as coupled HMMs, hierarchical HMMs, and multi-observation HMMs.

[Personality disorders and psychiatric morbidity in adolescent anorexia nervosa. Results of a prospective 10 year catamnesis].

Science.gov (United States)

Müller, B; Herpertz, S; Heussen, N; Neudörfl, A; Wewetzer, C; Remschmidt, H; Herpertz-Dahlmann, B

2000-05-01

The aim of the current prospective study was to examine at regular intervals the course of the eating disorder symptoms and the psychiatric (co-) morbidity including personality disorders among juvenile patients who fulfilled the DSM-III-R criteria for anorexia nervosa. Ten years after release from hospital all 39 patients (100%), as well as a control group parallelized for age, gender and occupational status were personally followed-up. Symptoms of eating disorders were documented by means of the Standardized Interview for Anorexia and Bulimia nervosa (SIAB, Fichter et al., 1991), the Composite International Diagnostic Interview (WHO, 1990) was applied to diagnose psychiatric (co-) morbidity, and the Structured Clinical Interview (SKID-II, Spitzer et al., 1993) to assess personality disorders. Compared to the control group, at the time of follow-up a significantly greater number of patients were suffering from a psychiatric disorder, primarily an anxiety disorder, an affective disorder or from drug, respectively alcohol abuse. Personality disorders, chiefly anxious-avoidant types on the DSM-III-R were diagnosed among almost one-fourth of the patients. Our findings indicate that anorexia nervosa is not a developmental disorder limited to puberty but a disorder associated both cross-sectionally as well as longitudinally with other psychiatric disorders.

The big five personality factors as predictors of driving status in older adults.

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Gadbois, Emily A; Dugan, Elizabeth

2015-02-01

Although factors including cognitive and health status have been associated with driving cessation in older adults, the role of psychosocial variables is not well studied. Previous research on young adult drivers has suggested that personality may be related to driving behavior, but this study is among the first to explore the relationship between driving status and the Big Five Model of personality for older adults. Data are from the Health and Retirement Study (2008 wave, n = 4,028). Descriptive, bivariate, and multiple logistic regression analyses were conducted. Neuroticism (β = -0.4511, p Personality adds a unique contribution to the prediction of late-life driving status. © The Author(s) 2014.

Exploring opportunities for healthy aging among older persons with a history of homelessness in Toronto, Canada.

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Waldbrook, Natalie

2015-03-01

Within the areas of literature on both population aging and health and homelessness, little attention has been given to the opportunities and barriers to healthy aging among older persons with a history of homelessness. Set in the context of inner-city Toronto, Canada, this article reports on the findings from qualitative interviews with 29 formerly homeless older persons. The findings illustrate participants' experiences of positive health change since moving into a stable housing environment and the aspects of housing they perceive to have improved their health and wellbeing. The qualitative findings also draw attention to the ongoing barriers to healthy aging that can be experienced among older persons with a history of homelessness. Overall, this study draws on the lived experiences of formerly homeless older persons to offer a better understanding of the long-term effects of homelessness on health, wellbeing, and aging. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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Roulet Schwab, Delphine; Wangmo, Tenzin

2017-09-01

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

Types of phone usage: Age differences between younger and older persons

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Simona-Nicoleta Vulpe

2017-12-01

Full Text Available I Even if more and more people use mobile phones, the gap between younger and older age groups persists and its importance is timely and widened given the present ageing and digital inequality phenomena. How wide is the difference on types of phone usage between different age groups? For answering this research question, we employ binary logistic regressions on several types of phone usage keeping into account age and controlling for region, education, income and whether respondents use a feature phone or a smartphone. The analysed data come from the Spring Change Assessment Survey 2010 provided by the Pew Research Center and it is representative for the United States of America. Our results show that, net of the all the variables included in the model, older persons are less likely than younger persons to use such phone functions, but the strength of association is low. Education and income are relevant for these functions. Using a smartphone in comparison with using a feature phone is important in all the situations included, as well as income. Considering models only for older persons, over 65 years of age, college and income are less relevant. Using a smartphone is more likely than using a feature phone to encourage all types of phone usage, independently of age.

Job Crafting: Older Workers’ Mechanism for Maintaining Person-Job Fit

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Wong, Carol M.; Tetrick, Lois E.

2017-01-01

Aging at work is a dynamic process. As individuals age, their motives, abilities and values change as suggested by life-span development theories (Lang and Carstensen, 2002; Kanfer and Ackerman, 2004). Their growth and extrinsic motives weaken while intrinsic motives increase (Kooij et al., 2011), which may result in workers investing their resources in different areas accordingly. However, there is significant individual variability in aging trajectories (Hedge et al., 2006). In addition, the changing nature of work, the evolving job demands, as well as the available opportunities at work may no longer be suitable for older workers, increasing the likelihood of person-job misfit. The potential misfit may, in turn, impact how older workers perceive themselves on the job, which leads to conflicting work identities. With the traditional job redesign approach being a top-down process, it is often difficult for organizations to take individual needs and skills into consideration and tailor jobs for every employee (Berg et al., 2010). Therefore, job crafting, being an individualized process initiated by employees themselves, can be a particularly valuable mechanism for older workers to realign and enhance their demands-abilities and needs-supplies fit. Through job crafting, employees can exert personal agency and make changes to the task, social and cognitive aspects of their jobs with the goal of improving their work experience (Wrzesniewski and Dutton, 2001). Building on the Life Span Theory of Control (Heckhausen and Schulz, 1995), we posit that job crafting, particularly cognitive crafting, will be of increasing value as employees age. Through reframing how they think of their job and choosing to emphasize job features that are personally meaningful, older workers can optimize their resources to proactively redesign their jobs and maintain congruent, positive work identities. PMID:28943859

Job Crafting: Older Workers’ Mechanism for Maintaining Person-Job Fit

Directory of Open Access Journals (Sweden)

Carol M. Wong

2017-09-01

Full Text Available Aging at work is a dynamic process. As individuals age, their motives, abilities and values change as suggested by life-span development theories (Lang and Carstensen, 2002; Kanfer and Ackerman, 2004. Their growth and extrinsic motives weaken while intrinsic motives increase (Kooij et al., 2011, which may result in workers investing their resources in different areas accordingly. However, there is significant individual variability in aging trajectories (Hedge et al., 2006. In addition, the changing nature of work, the evolving job demands, as well as the available opportunities at work may no longer be suitable for older workers, increasing the likelihood of person-job misfit. The potential misfit may, in turn, impact how older workers perceive themselves on the job, which leads to conflicting work identities. With the traditional job redesign approach being a top-down process, it is often difficult for organizations to take individual needs and skills into consideration and tailor jobs for every employee (Berg et al., 2010. Therefore, job crafting, being an individualized process initiated by employees themselves, can be a particularly valuable mechanism for older workers to realign and enhance their demands-abilities and needs-supplies fit. Through job crafting, employees can exert personal agency and make changes to the task, social and cognitive aspects of their jobs with the goal of improving their work experience (Wrzesniewski and Dutton, 2001. Building on the Life Span Theory of Control (Heckhausen and Schulz, 1995, we posit that job crafting, particularly cognitive crafting, will be of increasing value as employees age. Through reframing how they think of their job and choosing to emphasize job features that are personally meaningful, older workers can optimize their resources to proactively redesign their jobs and maintain congruent, positive work identities.

MULTI - multifunctional interface of the IBM XT and AT type personal computers

International Nuclear Information System (INIS)

Gross, T.; Kalavski, D.; Rubin, D.; Tulaev, A.B.; Tumanov, A.V.

1988-01-01

MULTI multifunctional interface which enables to solve problems of personal computer connestion with physical equipment without application of intermediate buses is described. Parallel 32-digit bidirectional 1/10 register and buffered bus of personal computer represent MULTI base. Ways of MULTI application are described

Risk Aversion is Associated with Decision Making among Community-Based Older Persons.

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Boyle, Patricia A; Yu, Lei; Buchman, Aron S; Bennett, David A

2012-01-01

Risk aversion is associated with many important decisions among younger and middle aged persons, but the association of risk aversion with decision making has not been well studied among older persons who face some of the most significant decisions of their lives. Using data from 606 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the association of risk aversion with decision making. Risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15) versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $20 to $300 with the gain amounts varied randomly over questions. Decision making was measured using a 12 item version of the Decision Making Competence Assessment Tool. In a linear regression model adjusted for age, sex, education, and income, greater risk aversion was associated with poorer decision making [estimate = -1.03, standard error (SE) = 0.35, p = 0.003]. Subsequent analyses showed that the association of risk aversion with decision making persisted after adjustment for global cognitive function as well as executive and non-executive cognitive abilities. Similar to findings from studies of younger persons, risk aversion is associated with poorer decision making among older persons who face a myriad of complex and influential decisions.

COLLAGE 360: A Model of Person-Centered Care To Promote Health Among Older Adults.

Science.gov (United States)

Howard, Elizabeth P; Schreiber, Robert; Morris, John N; Russotto, Aline; Flashner-Fineman, Susan

2016-01-01

Health care leaders and providers have introduced the assumption the typical elder, even in the presence of complex, chronic disease and prevailing illness, is capable of assuming greater personal responsibility for their health care, with a shift from provider-centered to a person-centered model of care. For older adults who often and repeatedly face challenges managing and maintaining their health status, guidance and support is needed. In this study, COLLAGE 360 , a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness, care coordination and self-management of health care was implemented in one continuing care retirement community. Following completion of two assessment tools via directed conversation with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive effects in the areas of mood, loneliness, social interaction, health status, and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult's medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person-centered, health promotion approach needed among this population.

Subjective Age and Health Perceptions of Older Persons: Maintaining the Youthful Bias in Sickness and in Health.

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Staats, Sara; And Others

1993-01-01

Self-reports of 250 persons over age 50 confirmed increasing bias toward reporting more youthful age as one ages. Optimistic perceptions of health were maintained in older subjects. Results from two subsets of sample (n=48) indicated that youthful and optimistic bias occurred both in older persons with poorer/failing health and in persons in…

Obsessive–compulsive disorder: subclassification based on co-morbidity

Science.gov (United States)

Nestadt, G.; Di, C. Z.; Riddle, M. A.; Grados, M. A.; Greenberg, B. D.; Fyer, A. J.; McCracken, J. T.; Rauch, S. L.; Murphy, D. L.; Rasmussen, S. A.; Cullen, B.; Pinto, A.; Knowles, J. A.; Piacentini, J.; Pauls, D. L.; Bienvenu, O. J.; Wang, Y.; Liang, K. Y.; Samuels, J. F.; Roche, K. Bandeen

2011-01-01

Background Obsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes. Method Seven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated. Results Two and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness. Conclusions OCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors. PMID:19046474

How older persons structure information in the decision to seek medical care

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Peter J. Veazie

2014-10-01

Full Text Available Typical models of the decision to seek care consider information as a single conceptual object. This paper presents an alternative that allows multiple objects. For older persons seeking care, results support this alternative. Older decision-makers that segregate information into multiple conceptual objects assessed separately are characterized by socio-demographic (younger age, racial category, non-Hispanic, higher education, higher income, and not married, health status (better general health for men and worse general health for women, fewer known illnesses, and neuropsychological (less memory loss for men, trouble concentrating and trouble making decisions for men factors. Results of this study support the conclusion that older persons are more likely to integrate information, and individuals with identifiable characteristics are more likely to do so than others. The theory tested in this study implies a potential explanation for misutilization of care (either over or under-utilization.

Do Reincarnation Beliefs Protect Older Adult Chinese Buddhists against Personal Death Anxiety?

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Hui, Victoria Ka-Ying; Coleman, Peter G.

2012-01-01

The aim of this exploratory survey study was to develop and validate a Buddhist reincarnation beliefs scale and explore the relation between Buddhist reincarnation beliefs and personal death anxiety in 141 older adult Hong Kong Chinese Buddhists. Buddhist reincarnation beliefs were unrelated to personal death anxiety. This suggests that not all…

[Vitamins and nutritional supplements in older persons: How to diagnose and when to substitute?].

Science.gov (United States)

Polivka, D; von Arnim, C A F

2015-11-01

Despite an excellent food supply in Germany, a large percentage of older persons living at home or institutionalized older persons suffer from or are at risk for malnutrition. The purpose of this article is to highlight the association between nutrient deficiencies and age-related diseases and give rational recommendations for substitution. Both malnutrition and low levels of specific nutrients are associated with cognitive and functional impairment, dementia, and depression in older persons. Most prevalent are deficiencies in vitamin B1, vitamin B12, and vitamin D. Serum levels are often misleading and show false negative results in vitamin B1 and B12 deficiencies; therefore, determination of erythrocyte transketolase activity (ETKA) and the thiamine pyrophosphate (TPP) effect for vitamin B1 and of methylmalonic acid and holotranscobalamine for vitamin B12 is recommended. Prophylactic supplementation with vitamins is not supported by prospective trials; however, positive data from observational studies support a Mediterranean diet combined with intake of vitamins, antioxidants, and unsaturated fatty acids. Older persons should be regularly screened for malnutrition and the threshold for determination of vitamin B1, B12, and vitamin D should be low. Vitamin substitution should be reserved for proven deficits. There is now data regarding cognition from prospective trials on effects of a healthy diet combined with other life-style factors like physical and cognitive activity.

Research on Multi - Person Parallel Modeling Method Based on Integrated Model Persistent Storage

Science.gov (United States)

Qu, MingCheng; Wu, XiangHu; Tao, YongChao; Liu, Ying

2018-03-01

This paper mainly studies the multi-person parallel modeling method based on the integrated model persistence storage. The integrated model refers to a set of MDDT modeling graphics system, which can carry out multi-angle, multi-level and multi-stage description of aerospace general embedded software. Persistent storage refers to converting the data model in memory into a storage model and converting the storage model into a data model in memory, where the data model refers to the object model and the storage model is a binary stream. And multi-person parallel modeling refers to the need for multi-person collaboration, the role of separation, and even real-time remote synchronization modeling.

PSYCHIATRIC MORBIDITY PATTERN OF THE FIRST-DEGREE RELATIVES OF SCHIZOPHRENICS: CROSS-SECTIONAL STUDY

Directory of Open Access Journals (Sweden)

Alexander Gnana Durai

2015-11-01

Full Text Available : CONTEXT: Family, Twin and Adoption studies show the inheritance patterns of schizophrenia. The findings from these studies provide support to the claim that familial clustering of schizophrenia is a combined expression of genetic and environmental factors. AIMS: Following the line of previous research, this study attempts to find out any difference in the psychiatric morbidity pattern among the first-degree relatives of familial and sporadic schizophrenics. SETTINGS AND DESIGN: We conducted a cross-sectional survey among a convenience sample of 100 first-degree relatives (age between 18 to 55 years of familial (n=22 and sporadic (n=29 schizophrenics from psychiatric outpatient clinic, of a Government Hospital, India. The schizophrenics satisfied the DSM-IV criteria and all the first degree relatives interviewed never had any psychiatric consultation before or were abusing alcohol or other substances or having any organic pathology. METHODS AND MATERIAL: Informed consent from the patients and relatives was obtained. Survey questionnaires were administered and no personal identifying information was collected. Middle Sex Hospital Questionnaire (MHQ, Eysenck's Personality Questionnaire (EPQ, Multi-Phasic Personality Questionnaire (MPQ and Screening Test for Co-Morbid Personality Disorders (STCPD were administered to the participants.

Sensory functioning and personality development among older adults.

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Stephan, Yannick; Sutin, Angelina R; Bosselut, Grégoire; Terracciano, Antonio

2017-03-01

Deficits in sensory functioning, such as poor vision and hearing, take a significant toll on quality of life. Little is known, however, about their relation with personality development across adulthood. This study examined whether baseline and change in vision and hearing were associated with personality change over a 4-year period. Participants (N = 7,471; Mage = 66.89; 59% women) were drawn from the Health and Retirement Study. They provided data on vision, hearing, and personality both at baseline and 4 years later. Poor vision and hearing at baseline and declines in vision and hearing over time were independently related to steeper declines in extraversion, agreeableness, openness, and conscientiousness, and less decline in neuroticism, controlling for demographic factors, disease burden, and depressive symptoms. Sensory functioning was generally a stronger predictor of personality change than disease burden or depressive symptoms. Consistent with evidence that poor and worsening sensory functions compromise individuals' interactions with the social and physical environment, this study found deficits in hearing and vision were also associated with maladaptive personality trajectories in older adults. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Patterns and expenditures of multi-morbidity in an insured working population in the United States: insights for a sustainable health care system and building healthier lives.

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Greene, Robert; Dasso, Edwin; Ho, Sam; Frank, Jerry; Scandrett, Graeme; Genaidy, Ash

2013-12-01

The U.S. health care system is currently heading toward unsustainable health care expenditures and increased dissatisfaction with health outcomes. The objective of this population-based study is to uncover practical insights regarding patients with 1 or more chronic illnesses. A cross-sectional investigation was designed to gather data from health records drawn from diverse US geographic markets. A database of 9.74 million fully-insured, working individuals was used, together with members in the same households. Among nearly 3.43 million patients with claims, 2.22 million had chronic conditions. About 24.3% had 1 chronic condition and 40.4% had multi-morbidity. Health care expenditures for chronic conditions accounted for 92% of all costs (52% for chronic costs and 40% for nonchronic costs). Psychiatry, orthopedics-rheumatology, endocrinology, and cardiology areas accounted for two thirds of these chronic condition costs; nonchronic condition costs were dominated by otolaryngology, gastroenterology, dermatology, orthopedics-rheumatology conditions, and preventive services. About 50.1% of all households had 2 or more members with chronic conditions. In summary, multi-morbidity is prevalent not only among those older than age 65 years but also in younger and working individuals, and commonly occurs among several members of a household. The authors suggest that the disease-focused model of medicine should change to a more holistic illness-wellness model, emphasizing not only the physical but also the mental and social elements that can influence individual health. In that way the chronic care model could be broadened in context and content to improve the health of patients and households.

Differential impact of personality traits on distracted driving behaviors in teens and older adults.

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Parr, Morgan N; Ross, Lesley A; McManus, Benjamin; Bishop, Haley J; Wittig, Shannon M O; Stavrinos, Despina

2016-07-01

To determine the impact of personality on distracted driving behaviors. Participants included 120 drivers (48 teens, 72 older adults) who completed the 45-item Big Five Personality questionnaire assessing self-reported personality factors and the Questionnaire Assessing Distracted Driving (QUADD) assessing the frequency of distracted driving behaviors. Associations for all five personality traits with each outcome (e.g., number of times texting on the phone, talking on the phone, and interacting with the phone while driving) were analyzed separately for teens and older adults using negative binomial or Poisson regressions that controlled for age, gender and education. In teens, higher levels of openness and conscientiousness were predictive of greater reported texting frequency and interacting with a phone while driving, while lower levels of agreeableness was predictive of fewer reported instances of texting and interacting with a phone while driving. In older adults, greater extraversion was predictive of greater reported talking on and interacting with a phone while driving. Other personality factors were not significantly associated with distracted driving behaviors. Personality traits may be important predictors of distracted driving behaviors, though specific traits associated with distracted driving may vary across age groups. The relationship between personality and distracted driving behaviors provides a unique opportunity to target drivers who are more likely to engage in distracted driving behavior, thereby increasing the effectiveness of educational campaigns and improving driving safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical characteristics of older psychiatric inpatients with borderline personality disorder.

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Trappler, B; Backfield, J

2001-01-01

This case study investigation considers typical and potentially unique characteristics of older (> 50 years) Borderline Personality Disorder (BPD) patients and describes their impact on an inpatient psychiatric unit encompassing a therapeutic milieu setting and multidisciplinary treatment teams. The somatization of symptoms, in particular, and the associated therapeutic, medical, and psychopharmacological interventions, result in prolonged and elaborate treatments that undermine clinical and personal boundaries, clash with managed care directives, and engender frustrating and elusive transferential and countertransferential reactions. Moreover, the guilt-inducing nature of somatization and physical frailty in older individuals, combined with the well-documented ability of BPD patients, regardless of age, to incite stormy and 'split' relationships, are linked characteristics that may describe a diagnostic subtype of BPD. Rather than suggesting a diminution of psychopathology as BPD patients age, the results of this investigation indicate that their persistent difficulties may only be altering in content and in pathological adaptation to changing needs.

Caregivers of older persons with multiple sclerosis: determinants of health-related quality of life.

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Buhse, Marijean; Della Ratta, Carol; Galiczewski, Janet; Eckardt, Patricia

2015-04-01

This study was conducted to determine which factors (clinical and demographic) are associated with mental and physical health-related quality of life (HRQOL) for caregivers of older persons with multiple sclerosis (MS). The Andersen's Healthcare Utilization Model guided this study. Knowledge of identified predictors of HRQOL may prompt nurses who care for persons with MS to address these issues and provide supportive care. A cross-sectional descriptive design was used to examine the relationship between patient with MS and caregiver clinical and demographic factors with caregiver physical and mental HRQOL. Patients with MS aged 60 years or older and their caregivers from four MS centers on Long Island, New York, self-selected into this study (n = 102). A caregiver survey was administered that collected demographic information and included validated questionnaires measuring HRQOL, caregiver burden, and caregiver perception of risk for neuropsychological impairment of patients with MS. Patient surveys collected demographic information and validated questionnaires measuring cognition, depression, and disability. Multivariate linear regression was used to examine patient and caregiver variables to explain caregiver physical and mental HRQOL. The caregivers in this study were older (mean age = 61 years) with existing comorbidities. We found that caregiver mental HRQOL was negatively associated with patient depression and, surprisingly, positively associated with caregiver burden and caregiver comorbidity of heart disease. Caregiver physical HRQOL was negatively associated with caregiver comorbidities of arthritis and diabetes and lower household income. The challenges older caregivers face when caring for older persons with MS have been shown to affect their mental and physical QOL. Nurses who care for older patients with MS will increasingly rely on older caregivers to provide patient-centered interventions. This descriptive study, based on the Anderson theoretical

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

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Foss, Christina

2011-07-01

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

Meaning in life of older persons : An integrative literature review

NARCIS (Netherlands)

MSc S.H.A. Hupkens; Anja Machielse; Dr. M.J.B.M. Goumans; P. Derkx

2016-01-01

The aim of this integrative review for nurses is to synthesize knowledge from scholarly literature to provide insight into how older persons find meaning in life, what are influencing circumstances, and what are their sources of meaning. The review serves as a starting point for including meaning in

Assisting Older Persons With Adjusting to Hearing Aids.

Science.gov (United States)

Lane, Kari R; Clark, M Kathleen

2016-02-01

This intervention study tested the feasibility and initial effect of Hearing Aid Reintroduction (HEAR) to assist persons aged 70 to 85 years adjust to hearing aids. Following this 30-day intervention, hearing aid use increased between 1 and 8 hr per day with 50% of participants able to wear them for at least 4 hr. Hearing aid satisfaction improved from not satisfied to satisfied overall. The study demonstrated that HEAR is feasible and could improve hearing aid use of a substantial number of older persons who had previously failed to adjust to their hearing aids and had given up. However, further testing among a larger and more diverse population is needed to better understand the effectiveness and sustainability of the intervention. © The Author(s) 2014.

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

Science.gov (United States)

Teh, Jane Kimm Lii; Tey, Nai Peng; Ng, Sor Tho

2014-01-01

This study investigates factors affecting older persons' state of loneliness in multiethnic Malaysia using data from the 2004 Malaysian Population and Family Survey, the first nationally representative sample in Malaysia. The study sample was extracted to include Malays, Chinese, Indians and other Indigenous groups aged 60 and above, and who had children (n = 1791). Cross tabulations and ordinal logistic regression methods were used in the analysis. Among the ethnic groups, older Malays were more likely than their Chinese and Indian counterparts to experience loneliness. Loneliness was found to be associated with age, marital status, education level, sources of income, health status, and physical limitations. Among older people, feelings of loneliness were inversely related with coresidence with adult children and participation in religious activities. Sociodemographic changes have eroded the traditional family support system for the elderly, while social security remains inadequate. This study shows the important role of family in alleviating loneliness among older people. Hence the need to promote and facilitate coresidence, as well as participation in religious activities, and a healthy lifestyle as a priority strategy is in line with the objectives of the National Policy for the Older People. PMID:25383374

Family support and loneliness among older persons in multiethnic Malaysia.

Science.gov (United States)

Teh, Jane Kimm Lii; Tey, Nai Peng; Ng, Sor Tho

2014-01-01

This study investigates factors affecting older persons' state of loneliness in multiethnic Malaysia using data from the 2004 Malaysian Population and Family Survey, the first nationally representative sample in Malaysia. The study sample was extracted to include Malays, Chinese, Indians and other Indigenous groups aged 60 and above, and who had children (n = 1791). Cross tabulations and ordinal logistic regression methods were used in the analysis. Among the ethnic groups, older Malays were more likely than their Chinese and Indian counterparts to experience loneliness. Loneliness was found to be associated with age, marital status, education level, sources of income, health status, and physical limitations. Among older people, feelings of loneliness were inversely related with coresidence with adult children and participation in religious activities. Sociodemographic changes have eroded the traditional family support system for the elderly, while social security remains inadequate. This study shows the important role of family in alleviating loneliness among older people. Hence the need to promote and facilitate coresidence, as well as participation in religious activities, and a healthy lifestyle as a priority strategy is in line with the objectives of the National Policy for the Older People.

Kinesiophobia, Pain, Muscle Functions, and Functional Performances among Older Persons with Low Back Pain

Directory of Open Access Journals (Sweden)

Nor Azizah Ishak

2017-01-01

Full Text Available Objectives. This study aims (1 to determine the association between kinesiophobia and pain, muscle functions, and functional performances and (2 to determine whether kinesiophobia predicts pain, muscle functions, and functional performance among older persons with low back pain (LBP. Methods. This is a correlational study, involving 63 institutionalized older persons (age = 70.98±7.90 years diagnosed with LBP. Anthropometric characteristics (BMI and functional performances (lower limb function, balance and mobility, and hand grip strength were measured. Muscle strength (abdominal and back muscle strength was assessed using the Baseline® Mechanical Push/Pull Dynamometer, while muscle control (transverse abdominus and multifidus was measured by using the Pressure Biofeedback Unit. The pain intensity and the level of kinesiophobia were measured using Numerical Rating Scale and Tampa Scale of Kinesiophobia, respectively. Data were analyzed using Pearson’s correlation coefficients and multivariate linear regressions. Results. No significant correlations were found between kinesiophobia and pain and muscle functions (all p>0.05. Kinesiophobia was significantly correlated with mobility and balance (p=0.038, r=0.263. Regressions analysis showed that kinesiophobia was a significant predictor of mobility and balance (p=0.038. Conclusion. We can conclude that kinesiophobia predicted mobility and balance in older persons with LBP. Kinesiophobia should be continuously assessed in clinical settings to recognize the obstacles that may affect patient’s compliance towards a rehabilitation program in older persons with LBP.

Significance of white-coat hypertension in older persons with isolated systolic hypertension

DEFF Research Database (Denmark)

Franklin, Stanley S; Thijs, Lutgarde; Hansen, Tine W

2012-01-01

The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who ...... had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (=90 mm Hg) or by daytime ABP (=85 mm Hg), a history of cardiovascular disease, and persons...

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.

NARCIS (Netherlands)

Hafskjold, L.; Sundler, A.J.; Holmström, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.

2015-01-01

Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol

NARCIS (Netherlands)

Hafskjold, L.; Sundler, A.J.; Holmstrom, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.

2015-01-01

INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

Nonkin in older adults’ personal networks: more important among later cohorts?

NARCIS (Netherlands)

Suanet, B.; van Tilburg, T.G.; Broese Van Groenou, M.I.

2013-01-01

Objectives. Research on age-related changes in personal networks has found compelling evidence for socioemotional selectivity theory and exchange theory holding that older adults experience a decline in less emotionally close nonkin relations as they age. However, recent societal developments are

When Contact Is Not Enough: Affecting First Year Medical Students' Image towards Older Persons.

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Sasmita Kusumastuti

Full Text Available Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude.To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image.Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives and the Attitudes toward Old People (AOP; 34 positions questionnaires.Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC in the academic year 2012-2013 participated.Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores.Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01. The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01 and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001. Exploratory principal component analysis showed particularly low scores on 'comportment' and 'pleasurable interaction' whereas the scores on 'personality traits' and 'habitual behaviour' significantly deteriorated (both p < 0.001. These patterns were irrespective of the student's gender and previous contact experience.Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

Which Types of Activities Are Associated With Risk of Recurrent Falling in Older Persons?

NARCIS (Netherlands)

Peeters, G.M.E.E.; Verweij, L.M.; van Schoor, N.M.; Pijnappels, M.A.G.M.; Pluijm, S.M.F.; Visser, M.; Lips, P.

2010-01-01

Background.This study explored the associations between various types of activities, their underlying physical components, and recurrent falling in community-dwelling older persons.Methods.This study included 1,329 community-dwelling persons (≥65 years) of the Longitudinal Aging Study Amsterdam

From Right place--Wrong person, to Right place--Right person: dignified care for older people.

Science.gov (United States)

Tadd, Win; Hillman, Alex; Calnan, Michael; Calnan, Sian; Read, Simon; Bayer, Antony

2012-04-01

To examine: older people's and their relatives' views of dignified care; health care practitioners' behaviours and practices in relation to dignified care; the occupational, organizational and cultural factors that impact on care; and develop evidence-based recommendations for dignified care. An ethnography of four acute trusts in England and Wales involving semi-structured interviews with recently discharged older people (n = 40), their relatives (n = 25), frontline staff (n = 79) and Trust managers (n = 32), complemented by 617 hours of non-participant observation in 16 wards in NHS trusts. 'Right Place - Wrong Person' refers to the staffs' belief that acute wards are not the 'right place' for older people. Wards were poorly-designed, confusing and inaccessible for older people; older people were bored through lack of communal spaces and activities and they expressed concern about the close proximity of patients of the opposite sex; staff were demoralised and ill-equipped with skills and knowledge to care for older people, and organizational priorities caused patients to be frequently moved within the system. In none of the wards studied was care either totally dignified or totally undignified. Variations occurred from ward to ward, in the same ward when different staff were on-duty and at different times of the day. The failure to provide dignified care is often a result of systemic and organizational factors rather than a failure of individual staff and it is these that must be addressed if dignified care is to be ensured.

The Impact of Visual Disability on the Quality of Life of Older Persons in Rural Northeast Thailand

Science.gov (United States)

La Grow, Steven; Sudnongbua, Supaporn; Boddy, Julie

2011-01-01

A high rate of self-reported visual disability was found among a sample of persons aged 60 and older in the course of a study that assessed the impact of feelings of abandonment among older persons in a remote rural area in northeast Thailand (Sudnongbua, La Grow, & Boddy, 2010). This study assessed the impact of self-reported visual…

Development and Validation of Multi-Dimensional Personality ...

African Journals Online (AJOL)

This study was carried out to establish the scientific processes for the development and validation of Multi-dimensional Personality Inventory (MPI). The process of development and validation occurred in three phases with five components of Agreeableness, Conscientiousness, Emotional stability, Extroversion, and ...

MULTI-PERSON DECISION FOR SUSTAINABLE DESIGN ON IBS FLOOR SYSTEM SELECTION

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Christiono Utomo

2013-05-01

Full Text Available Selecting a design solution (choice problem is one of the natures of design decision. If the problem is more complex and involves multi participants, decision aid is necessary. This paper discusses the nature of group judgment and negotiation on multi-criteria decision-making methodologies. It presents a conceptual model of negotiation support in a multi-person decision on building floor system selection. Decision technique (AHP was applied for decision process in a satisfying options and game theory for coalition formation. An n-person cooperative game is represented by a set of all players. The proposed coalition formation model enables each agent to select individually or coalition. It improves the value of building system decision. It further emphasizes the importance of performance evaluation in the design process and value-based decision. The support model can be extended to an automated negotiation and in different building system selection with proper  modification. Keywords: Multi-person, design decision, IBS, floor system selection.

Conceptions of Healthy Aging Held by Relatives of Older Persons in Isan-Thai Culture: A Phenomenographic Study.

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Manasatchakun, Pornpun; Roxberg, Åsa; Asp, Margareta

2018-01-01

In Thailand, family nurses are expected to provide support for older persons and their family members to promote healthy aging. Family bonds are strong, and relatives are expected to take care of their older family members. However, there is limited research on how older persons' family members perceive healthy aging. This study aimed to describe the conceptions of healthy aging held by the children and grandchildren of older persons in northeast Thailand. In a phenomenographic study, 14 interviews were performed to qualitatively analyze different conceptions of healthy aging. Four descriptive categories emerged: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. The conceptions of healthy aging entail both autonomy and interdependence. The relative's perspective needs to be considered when policies relating to healthy aging are implemented in the community and when family nurses provide support to families to promote healthy aging.

Perspectives on Adolescent Sexual Relations With Older Persons: A Systematic Review of the Literature.

Science.gov (United States)

Tener, Dafna

2018-01-01

Relations between minors under the age of consent and older persons are legally prohibited in many countries. However, the nature of these relationships, their impact on the lives of minors involved, and how they should be dealt by law enforcement and welfare systems are highly controversial. The differences between the way these relations are perceived by the minors involved and the public are also unclear. This literature review examines them as perceived by youths or young adults who had experienced sexual relations with a person at least 2 years older during their adolescence as well as by students and other adult members of the public. A systematic search of 977 studies initially identified as relevant yielded 16 studies that fit the inclusion criteria. Most (13) research samples were located in the United States, and the remainder were in the United Kingdom (2) and Australia (1). All were published in English. Four main themes emerged from the analysis of these studies: adolescent motives for sexual relations with older persons (two studies); characteristics of sexual relations between adolescents and older persons (6); contextual factors affecting the way such relations are perceived, including the partners' ages and genders (11); and perspectives on the legal framing of such relations (6). The studies' findings are discussed and implications for future research, policy, and practice are suggested, highlighting the complexity and ambiguity of the phenomenon and calling on intervention programs to focus on strengthening the family unit and social network of these youth and for policies to address teen sexuality as defined both normatively and legally.

Oral health matters for the nutritional status of older persons-A population-based study.

Science.gov (United States)

Lindmark, Ulrika; Jansson, Henrik; Lannering, Christina; Johansson, Linda

2018-03-01

To explore the association between oral health and nutritional status in the context of daily care for older people. Oral problems often increase with age and affect a person's ability to chew and swallow. They might also influence the ability to maintain a satisfactory nutritional status. Oral health awareness is therefore of great importance in nursing care for older people. A retrospective cross-sectional study. Data from the Swedish quality register, Senior Alert, were used, including structured assessments of both oral and nutritional status using the Revised Oral Assessment Guide-Jönköping and the Mini Nutritional Assessment. In total, 1,156 persons (mean age: 82.8 ± 7.9) had both oral and nutritional assessments registered by the nursing staff in daily care. Approximately 29% of participants had moderate oral health problems. Another 12% had severe problems. Over 60% of the persons were considered at risk of malnutrition or were malnourished. There was a weak correlation between poor nutritional status and poor oral health, and approximately one-third of the persons who were at risk or malnourished had simultaneous oral problems. A multivariate logistic regression revealed that when problems involving voice and swallowing were present, there was also a greater possibility of being assessed as at risk of malnourishment or being malnourished. There is a relationship between oral health problems and nutritional status, indicating the importance of evaluating oral health status in older persons with nutritional problems. Nursing staff involved in care for older people should be aware of the importance of including regular oral health check-ups in their work. There is also a need for nursing staff members and oral health professionals to exchange knowledge. © 2017 John Wiley & Sons Ltd.

Low Energy Trauma in Older Persons: Where to Next?

Science.gov (United States)

Chehade, Mellick; Gill, Tiffany K; Visvanathan, Renuka

2015-01-01

The global population is increasing rapidly with older persons accounting for the greatest proportion. Associated with this rise is an increased rate of injury, including polytrauma, for which low energy falls has become the main cause. The resultant growing impact on trauma resources represents a major burden to the health system. Frailty, with its related issues of cognitive dysfunction and sarcopenia, is emerging as the unifying concept that relates both to the initial event and subsequent outcomes. Strategies to better assess and manage frailty are key to both preventing injury and improving trauma outcomes in the older population and research that links measures of frailty to trauma outcomes will be critical to informing future directions and health policy. The introduction of "Geriatric Emergency Departments" and the development of "Fracture Units" for frail older people will facilitate increased involvement of Geriatricians in trauma care and aid in the education of other health disciplines in the core principles of geriatric assessment and management. Collectively these should lead to improved care and outcomes for both survivors and those requiring end of life decisions and palliation.

Physical Functioning in Older Persons With Somatoform Disorders : A Pilot Study

NARCIS (Netherlands)

Benraad, Carolien E. M.; Hilderink, Peter H.; van Driel, Dorine T. J. W.; Disselhorst, Luc G.; Lubberink, Brechtje; van Wolferen, Loes; Rikkert, Marcel G. M. Olde; Voshaar, Richard C. Oude

Objectives: The primary objective of this study was to systematically examine the physical functioning of older persons with somatoform disorders, as this has never been carried out before. Second, we wanted to test our hypothesis that higher somatic disease burden in patients with somatoform

Personal factors associated with health-related quality of life in persons with morbid obesity on treatment waiting lists in Norway.

Science.gov (United States)

Lerdal, Anners; Andenæs, Randi; Bjørnsborg, Eva; Bonsaksen, Tore; Borge, Lisbet; Christiansen, Bjørg; Eide, Hilde; Hvinden, Kari; Fagermoen, May Solveig

2011-10-01

To explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population. A cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style. Respondents scored lower on all the HRQoL sub-domains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores. Personal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons.

Pain Catastrophizing in Borderline Morbidly Obese and Morbidly Obese Individuals with Osteoarthritic Knee Pain

Directory of Open Access Journals (Sweden)

Tamara J Somers

2008-01-01

Full Text Available OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m2 or greater OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m2 and 34 kg/m2. Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients.

Personality and Lung Function in Older Adults.

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Terracciano, Antonio; Stephan, Yannick; Luchetti, Martina; Gonzalez-Rothi, Ricardo; Sutin, Angelina R

2017-10-01

Lung disease is a leading cause of disability and death among older adults. We examine whether personality traits are associated with lung function and shortness of breath (dyspnea) in a national cohort with and without chronic obstructive pulmonary disease (COPD). Participants (N = 12,670) from the Health and Retirement Study were tested for peak expiratory flow (PEF) and completed measures of personality, health behaviors, and a medical history. High neuroticism and low extraversion, openness, agreeableness, and conscientiousness were associated with lower PEF, and higher likelihood of COPD and dyspnea. Conscientiousness had the strongest and most consistent associations, including lower risk of PEF less than 80% of the predicted value (OR = 0.67; 0.62-0.73) and dyspnea (OR = 0.52; 0.47-0.57). Although attenuated, the associations remained significant when accounting for smoking, physical activity, and chronic diseases including cardiovascular and psychiatric disorders. The associations between personality and PEF or dyspnea were similar among those with or without COPD, suggesting that psychological links to lung function are not disease dependent. In longitudinal analyses, high neuroticism (β = -0.019) and low conscientiousness (β = 0.027) predicted steeper declines in PEF. A vulnerable personality profile is common among individuals with limited lung function and COPD, predicts shortness of breath and worsening lung function. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Multidimensional measures validated for home health needs of older persons: A systematic review.

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de Rossi Figueiredo, Daniela; Paes, Lucilene Gama; Warmling, Alessandra Martins; Erdmann, Alacoque Lorenzini; de Mello, Ana Lúcia Schaefer Ferreira

2018-01-01

To conduct a systematic review of the literature on valid and reliable multidimensional instruments to assess home health needs of older persons. Systematic review. Electronic databases, PubMed/Medline, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online and the Latin American and Caribbean Health Sciences Information. All English, Portuguese and Spanish literature which included studies of reliability and validity of instruments that assessed at least two dimensions: physical, psychological, social support and functional independence, self-rated health behaviors and contextual environment and if such instruments proposed interventions after evaluation and/or monitoring changes over a period of time. Older persons aged 60 years or older. Of the 2397 studies identified, 32 were considered eligible. Two-thirds of the instruments proposed the physical, psychological, social support and functional independence dimensions. Inter-observer and intra-observer reliability and internal consistency values were 0.7 or above. More than two-thirds of the studies included validity (n=26) and more than one validity was tested in 15% (n=4) of these. Only 7% (n=2) proposed interventions after evaluation and/or monitoring changes over a period of time. Although the multidimensional assessment was performed, and the reliability values of the reviewed studies were satisfactory, different validity tests were not present in several studies. A gap at the instrument conception was observed related to interventions after evaluation and/or monitoring changes over a period of time. Further studies with this purpose are necessary for home health needs of the older persons. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health-Related Behavior Mediates the Association Between Personality and Memory Performance in Older Adults.

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Allen, Mark S; Laborde, Sylvain; Walter, Emma E

2017-03-01

This prospective study explored the potential mediating role of health-related behavior (alcohol involvement, diet, television viewing, and physical activity) in the association between personality and change in memory performance over 2 years. A nationally representative sample of 8,376 U.K. participants aged 55 years and older (4,572 women, 3,804 men) completed self-report measures of personality and health-related behavior in 2010, and completed a memory performance task in 2010 and 2012. After removing variance associated with potential confounding variables, neuroticism and agreeableness had negative associations, and openness and conscientiousness positive associations with change in memory performance. There were no moderation effects by age, sex, education level, or ethnicity. Multiple mediator models demonstrated that physical activity, television viewing, and alcohol intake mediated associations between personality and change in memory performance. These findings provide evidence that the association between personality and memory performance in older adults can be explained, in part, through health-related behavior.

Participatory design facilitates Person Centred Nursing in service improvement with older people: a secondary directed content analysis.

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Wolstenholme, Daniel; Ross, Helen; Cobb, Mark; Bowen, Simon

2017-05-01

To explore, using the example of a project working with older people in an outpatient setting in a large UK NHS Teaching hospital, how the constructs of Person Centred Nursing are reflected in interviews from participants in a Co-design led service improvement project. Person Centred Care and Person Centred Nursing are recognised terms in healthcare. Co-design (sometimes called participatory design) is an approach that seeks to involve all stakeholders in a creative process to deliver the best result, be this a product, technology or in this case a service. Co-design practice shares some of the underpinning philosophy of Person Centred Nursing and potentially has methods to aid in Person Centred Nursing implementation. The research design was a qualitative secondary Directed analysis. Seven interview transcripts from nurses and older people who had participated in a Co-design led improvement project in a large teaching hospital were transcribed and analysed. Two researchers analysed the transcripts for codes derived from McCormack & McCance's Person Centred Nursing Framework. The four most expressed codes were as follows: from the pre-requisites: knowing self; from care processes, engagement, working with patient's beliefs and values and shared Decision-making; and from Expected outcomes, involvement in care. This study describes the Co-design theory and practice that the participants responded to in the interviews and look at how the co-design activity facilitated elements of the Person Centred Nursing framework. This study adds to the rich literature about using emancipatory and transformational approaches to Person Centred Nursing development, and is the first study exploring explicitly the potential contribution of Co-design to this area. Methods from Co-design allow older people to contribute as equals in a practice development project, co-design methods can facilitate nursing staff to engage meaningfully with older participants and develop a shared

Personality and medication non-adherence among older adults enrolled in a six-year trial

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Jerant, Anthony; Chapman, Benjamin; Duberstein, Paul; Robbins, John; Franks, Peter

2011-01-01

Objectives Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non-adherence is unclear. We investigated the relationship between five-factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non-adherence among older participants during a six-year randomized placebo-controlled trial (RCT). Design Observational cohort data from 771 subjects aged ≥72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT of Ginkgo biloba for prevention of dementia. Methods Random effects logistic regression analyses examined effects of NEO Five-Factor Inventory scores on medication non-adherence, determined via pill counts every 6 months (median follow-up 6.1 years) and defined as taking personality factor associated with non-adherence: a 1 SD increase was associated with a 3.8% increase in the probability of non-adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non-adherence: a 1 SD decrease in mental status exam score was associated with a 3.0% increase in the probability of non-adherence (95% CI [0.2, 5.9]). Conclusions Neuroticism was associated with medication non-adherence over 6 years of follow-up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older adults at risk for medication non-adherence. PMID:21226789

[Multiple chronic conditions and morbidity burden: challenges and considerations for an organizational strategy].

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Balicer, Ran; Bitterman, Haim; Shadmi, Efrat

2012-07-01

Technological advances combined with the aging of the population bring about an increasingly growing number of patients with chronic conditions and multi-morbidity. Multi-morbidity, the co-occurrence of chronic and/or non-chronic conditions in an individual, is the norm among elderly patients, and is becoming increasingly common among younger adults. The Israeli health system, like other systems worldwide, is faced with the challenges posed by the increase in complex multi-morbidity, in an era of growing fiscal constraints, a situation that can induce financial and organizational crises. To effectively cope with such circumstances, a paradigm shift is needed. Health systems need to focus on overall morbidity burden and multi-morbidity (rather than the prevailing one disease at a time approach) and on better care integration. The Israeli health system entails many of the essential elements for addressing the challenges of integrated care, including universal health coverage and advanced health information technology systems. Yet, like other health systems, there is a need for care management support mechanisms that are more effectively tailored to meet the needs of the highly multimorbid patients. This review outlines the organizational approach required to better align care for the main customers of health care in the 21st century: patients with multi-morbidity. We focus on four domains: assessment of morbidity burden according to measures that account for the interaction and synergism amongst conditions; integration across the care continuum; enhancement of primary care and self-management support approaches; and provision of uniquely tailored care management solutions for the highest risk multi-morbid patients.

TREATMENT OF CANCER IN THE OLDER AGED PERSON

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Lodovico Balducci

2010-05-01

Full Text Available

 Cancer is a disease of aging .  Currently 50% of all malignancies occur in individuals 65 and over and by the year 2030 older individuals will account for 70% of all neoplasms.

 With the aging of the population the management of cancer in the older person with chemotherapy is beoming increasingly common. This treatment may be  safe and effective if some appropriate measures are taken, including, an assessment of the physiologic age of each patient, modification of doses according to the renal function, use of meyelopoietic growth factors prophylactically in presence of moderately toxic chemotherapy, and provision of an adequate caregiver. Cure, prolongation of survival, and symptom palliation are universal goals of medical treatment.   Prolongation of active life expectancy  should be added to the treatment goal of the older aged person .

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

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De Almeida Mello Johanna

2012-08-01

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

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

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

2012-08-06

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

Conscious knowledge influences decision-making differently in substance abusers with and without co-morbid antisocial personality disorder.

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Mellentin, Angelina I; Skøt, Lotte; Teasdale, Thomas W; Habekost, Thomas

2013-08-01

Decision-making impairment, as measured by the Iowa Gambling Task (IGT), is a consistent finding among individuals with substance use disorder (SUD). We studied how this impairment is influenced by co-morbid antisocial personality disorder (ASPD) and conscious knowledge of the task. Three groups were investigated: SUD individuals without co-morbid ASPD (n = 30), SUD individuals with co-morbid ASPD (n = 16), and healthy controls (n = 17). Both SUD and SUD+ASPD participants had poor overall IGT performance. A block-by-block analysis revealed that SUD participants exhibited slow but steady improvement across the IGT, whereas SUD+ASPD participants exhibited initial normal improvement, but dropped off during the last 40 trials. Conscious knowledge of the task was significantly correlated to performance for controls and SUD participants, but not for SUD+ASPD participants. Our findings suggest that decision-making proceeds differently in SUD and SUD+ASPD individuals due to differences in acquisition and application of conscious knowledge. © 2013 The Scandinavian Psychological Associations.

Statin Use and Self-Reported Hindering Muscle Complaints in Older Persons: A Population Based Study.

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Milly A van der Ploeg

Full Text Available Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease. Although serious adverse events are rare, many statin users report mild muscle pain and/or muscle weakness. It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population.The present research was performed within the Integrated Systematic Care for Older Persons (ISCOPE study in the Netherlands (Netherlands trial register, NTR1946. All registered adults aged ≥ 75 years from 59 participating practices (n = 12,066 were targeted. Information about the medical history and statin use at baseline and after 9 months was available for 4355 participants from the Electronic Patient Records of the general practitioners. In the screening questionnaire at baseline we asked participants: 'At the moment, which health complaints limit you the most in your day-to-day life?' Answers indicating muscle or musculoskeletal complaints were coded as such. No specific questions about muscle complaints were asked.The participants had a median age of 80.3 (IQR 77.6-84.4 years, 60.8% were female and 28.5% had a history of CVD. At baseline 29% used a statin. At follow-up, no difference was found in the prevalence of self-reported hindering muscle complaints in statin users compared to non-statin users (3.3% vs. 2.5%, OR 1.39, 95% CI 0.94-2.05; P = 0.98. Discontinuation of statin use during follow-up was independent of self-reported hindering muscle complaints.Based on the present findings, prevalent statin use in this community-dwelling older population is not associated with self-reported hindering muscle complaints; however, the results might be different for incident users.

Statin Use and Self-Reported Hindering Muscle Complaints in Older Persons: A Population Based Study.

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van der Ploeg, Milly A; Poortvliet, Rosalinde K E; van Blijswijk, Sophie C E; den Elzen, Wendy P J; van Peet, Petra G; de Ruijter, Wouter; Blom, Jeanet W; Gussekloo, Jacobijn

2016-01-01

Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease. Although serious adverse events are rare, many statin users report mild muscle pain and/or muscle weakness. It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population. The present research was performed within the Integrated Systematic Care for Older Persons (ISCOPE) study in the Netherlands (Netherlands trial register, NTR1946). All registered adults aged ≥ 75 years from 59 participating practices (n = 12,066) were targeted. Information about the medical history and statin use at baseline and after 9 months was available for 4355 participants from the Electronic Patient Records of the general practitioners. In the screening questionnaire at baseline we asked participants: 'At the moment, which health complaints limit you the most in your day-to-day life?' Answers indicating muscle or musculoskeletal complaints were coded as such. No specific questions about muscle complaints were asked. The participants had a median age of 80.3 (IQR 77.6-84.4) years, 60.8% were female and 28.5% had a history of CVD. At baseline 29% used a statin. At follow-up, no difference was found in the prevalence of self-reported hindering muscle complaints in statin users compared to non-statin users (3.3% vs. 2.5%, OR 1.39, 95% CI 0.94-2.05; P = 0.98). Discontinuation of statin use during follow-up was independent of self-reported hindering muscle complaints. Based on the present findings, prevalent statin use in this community-dwelling older population is not associated with self-reported hindering muscle complaints; however, the results might be different for incident users.

Nonkin in older adults' personal networks: more important among later cohorts?

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Suanet, Bianca; van Tilburg, Theo G; Broese van Groenou, Marjolein I

2013-07-01

Research on age-related changes in personal networks has found compelling evidence for socioemotional selectivity theory and exchange theory holding that older adults experience a decline in less emotionally close nonkin relations as they age. However, recent societal developments are likely to have increased the salience of nonkin relations. We hypothesize that age-related decline in the proportion of nonkin in personal networks has been delayed or is slower in late birth cohorts of older adults compared with earlier cohorts. Seven observations by the Longitudinal Aging Study Amsterdam covering a time span of 17 years since 1992 were analyzed using multilevel regression analysis. The sample had 12,949 person-year observations from 3,516 respondents born between 1908 and 1937. Age-related decline in the proportion of nonkin is absent for cohorts born after 1922 and large for cohorts born in 1922 and before. Mediating variables for health and other resources did not explain cohort differences in age-related change. The salience of nonkin relationships is likely to have increased due to societal changes, resulting in absence or delay of decline in later cohorts. The findings raise the need for a reevaluation of old age and the creation of new theoretical perspectives.

Ageing out of place: The meaning of home among hispanic older persons living in the United States.

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Curtin, Alicia; Martins, Diane C; Gillsjö, Catharina; Schwartz-Barcott, Donna

2017-09-01

To explore the meaning of home among older Hispanic immigrants who are "aging out of place." Emerging evidence supports the concept of older persons ageing in place. Nurse researchers have demonstrated that older person who age in place have better physical, psychological and cognitive outcomes. Less, however, is known about older persons who are "aging out of place," meaning out of their country of origin. With the growth of home health care, there is a need to understand the older immigrants' meaning of home when ageing out of their country of origin. An inductive, qualitative descriptive research design was used. Seventeen Hispanic participants, ranging in age from 65 to 83 years were interviewed using a semi-structured interview protocol. Two major finding of the study focused on participants' descriptions of home in their country of origin and in the USA. The majority of participants described their home in their native country as the community, countryside or town (pueblo) and in the U.S.A. as family. The level of social isolation and loneliness among participants was evident. Older Hispanic immigrants who are "aging out of place" integrate their past experiences of sense of place in their native country with their present experiences of home in the USA. The need to understand the role of the community and the family in the provision of nursing care in the home may be more important than the physical structure or setting in which it is delivered. Further intra- and cross-national studies are needed to provide a framework for understanding the issues of ageing and immigration globally. Gerontological nurses need to recognise the complexity of family relationships for older Hispanic persons who are ageing out of place of origin and their risk of depression, social isolation, and loneliness. © 2017 John Wiley & Sons Ltd.

Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature.

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de São José, José; Barros, Rosanna; Samitca, Sanda; Teixeira, Ana

2016-01-01

The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research. © 2015 John Wiley & Sons Ltd.

Morbidity pattern and health-seeking behavior of aged population residing in Shimla hills of north India: A cross-sectional study

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Deepak Sharma

2013-01-01

Full Text Available Background: Population aging is a global phenomenon. In India, the size of the elderly population is growing fast. Many older adults have multiple medical conditions. Understanding elderly health problems and health-seeking behavior is prerequisite for proving comprehensive geriatric care to them. Objectives: To assess the morbidity pattern and study the health-seeking behavior of the elderly people of Shimla district in Himachal Pradesh. Materials and Methods: A total of 400 elderly people aged 60 years and above were selected from urban and rural areas of Shimla hills in North India by simple random sampling. Statistical software Epi info software version 3.2 was used for analyzing data. Descriptive statistics were used to describe sociodemographic and morbidity variables. Results: The most common morbidity identified among them were musculoskeletal problems (55.0% followed by hypertension (40.5%. Two third were seeking treatment for their health problems. Among older persons not seeking treatment for their medical condition, most considered these morbidities as an age-related phenomenon. Many perceived that the health services were too far. Conclusion: The high morbidity load among elderly in the present study stresses for efforts to provide better health care to them and thus ensure that they remain active members of our society. Residence emerged out to be most significant determinant of healthcare-seeking behavior. Policy makers must focus on rural elderly and their beliefs which prevent them from seeking healthcare.

Co-morbid disorders in Tourette syndrome

DEFF Research Database (Denmark)

Debes, Nanette Marinette Monique

2013-01-01

in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co......-morbid disorders, like rage, anxiety, and conduct disorders. The symptoms of a co-morbid disorder might appear prior to the time that tics reach clinical attention. The TS phenotype probably changes during the course of the disease. The exact aetiology of the co-occurrence of co-morbid disorders and TS...

Multi-person tracking with overlapping cameras in complex, dynamic environments

NARCIS (Netherlands)

Liem, M.; Gavrila, D.M.

2009-01-01

This paper presents a multi-camera system to track multiple persons in complex, dynamic environments. Position measurements are obtained by carving out the space defined by foreground regions in the overlapping camera views and projecting these onto blobs on the ground plane. Person appearance is

Bus use and older people: a literature review applying the Person-Environment-Occupation model in macro practice.

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Broome, Kieran; McKenna, Kryss; Fleming, Jennifer; Worrall, Linda

2009-03-01

The same reasons that prompt older people to give up driving can also result in difficulties with accessing public transport. Difficulties using public transport can limit older people's participation in society, thereby impacting negatively on their health. Focusing on public buses, this review explicates the link between bus usability and the health of older people and frames existing evidence on bus usability issues. The Person-Environment-Occupation (PEO) model offers a framework by which bus usability can be assessed. A combination of person-centred, environmental, and occupation-related factors, including bus design, service provision and performance, information, and the attitudes of staff and the community, impact on older people's ability to catch buses. More systematic research needs to take place in order to develop a comprehensive understanding of bus usability. Occupational therapy has a key role to play in conceptualizing, implementing, and evaluating improvements in bus usability for older people.

The anxiety disorders and suicidal ideation: accounting for co-morbidity via underlying personality traits.

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Naragon-Gainey, K; Watson, D

2011-07-01

The anxiety disorders are robust correlates/predictors of suicidal ideation, but it is unclear whether (a) the anxiety disorders are specifically associated with suicidal ideation or (b) the association is due to co-morbidity with depression and other disorders. One means of modeling co-morbidity is through the personality traits neuroticism/negative emotionality (N/NE) and extraversion/positive emotionality (E/PE), which account for substantial shared variance among the internalizing disorders. The current study examines the association between the internalizing disorders and suicidal ideation, after controlling for co-morbidity via N/NE and E/PE. The sample consisted of 327 psychiatric out-patients. Multiple self-report and interview measures were collected for internalizing disorders [depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), social anxiety, panic and specific phobia] and suicidal ideation, as well as self-report measures for N/NE and E/PE. A model was hypothesized in which each disorder and suicidal ideation was regressed on N/NE, and depression and social anxiety were regressed on E/PE. Structural equation modeling (SEM) was used to examine the unique association of suicidality with each disorder, beyond shared variance with N/NE and E/PE. The hypothesized model was an acceptable fit to the data. Although zero-order analyses indicated that suicidal ideation was moderately to strongly correlated with all of the disorders, only depression and PTSD remained significantly associated with suicidal ideation in the SEM analyses. In a latent variable model that accounts for measurement error and a broad source of co-morbidity, only depression and PTSD were uniquely associated with suicidal ideation; panic, GAD, social anxiety and specific phobia were not.

Life space and mental health: a study of older community-dwelling persons in Australia.

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Byles, Julie E; Leigh, Lucy; Vo, Kha; Forder, Peta; Curryer, Cassie

2015-01-01

The ability of older people to mobilise within and outside their community is dependent on a number of factors. This study explored the relationship between spatial mobility and psychological health among older adults living in Australia. The survey sample consisted of 260 community-dwelling men and women aged 75-80 years, who returned a postal survey measuring spatial mobility (using the Life Space Questionnaire) and psychological health (using the SF36 Health Related Quality of Life Profile). From the Life Space Questionnaire, participants were given a life-space score and multinomial regression was used to explore the potential effect of mental health on life-space score. The study found a significant association between mental health and life space. However, gender, physical functioning, and ability to drive were most strongly associated with the extent of life space and spatial mobility. Compared to men, older women are more likely to experience less spatial mobility and restricted life space, and hence are more vulnerable to social isolation. Mental health and life space were associated for the older people in this study. These findings have important implications for health policy and highlight the need to support older persons to maintain independence and social networks, and to successfully age in place within their community. This study also highlights the utility of the Life Space Questionnaire in terms of identifying older persons at risk of poorer mental health.

The clinical identification of peripheral neuropathy among older persons.

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Richardson, James K

2002-11-01

To identify simple clinical rules for the detection of a diffuse peripheral neuropathy among older outpatients. Observational, blinded, controlled study. A tertiary-care electrodiagnostic laboratory and biomechanics laboratory. One hundred research subjects, 68 with electrodiagnostic evidence of peripheral neuropathy, between the ages of 50 and 80 years. Not applicable. One examiner, unaware of the results of electrodiagnostic testing, evaluated Achilles' and patellar reflexes, Romberg testing, semiquantified vibration, and position sense at the toe and ankle in all subjects, and unipedal stance time and the Michigan Diabetes Neuropathy Score in a subset of subjects. Significant group differences were present in all clinical measures tested. Three signs, Achilles' reflex (absent despite facilitation), vibration (128Hz tuning fork perceived for <10s), and position sense (<8/10 1-cm trials) at the toe, were the best predictors of peripheral neuropathy on both univariate and logistic regression (pseudo R(2)=.744) analyses. The presence of 2 or 3 signs versus 0 or 1 sign identified peripheral neuropathy with sensitivity, specificity, and positive and negative predictive values of 94.1%, 84.4%, 92.8%, and 87.1%, respectively. Values were similar among subgroups of subjects with and without diabetes mellitus. When other clinicians applied the technique to 12 more subjects, excellent interrater reliability regarding the presence of peripheral neuropathy (kappa=.833) and good to excellent interrater reliability for each sign (kappa range,.667-1.00) were shown. Among older persons, the presence of 2 or 3 of the 3 clinical signs strongly suggested electrodiagnostic evidence of a peripheral neuropathy, regardless of etiology. Age-related decline in peripheral nerve function need not be a barrier to the clinical recognition of a diffuse peripheral neuropathy among older persons. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of

An exploratory study of the personal health records adoption model in the older adult with chronic illness

Directory of Open Access Journals (Sweden)

Melanie D Logue

2013-05-01

Full Text Available Background Despite international efforts moving toward integrated care using health information technologies and the potential of electronic PHRs to help us better coordinate patient-centered care, PHR adoption in the United States remains low among patients who have been offered free access to them from private-sector companies. If older adult stand to benefit from the use of PHRs for its usefulness in self-managing chronic illness, why have they not been more readily adopted? Since the chronically ill older adult has unique circumstances that impact their decision to participate in self-directed care, a theoretical framework to help understand factors that influence the adoption of PHRs is important. Here we describe the results of an exploratory study that provided an initial test of such a framework.Methods The study used a descriptive survey methodology with 38 older adults. The survey questionnaire asked about the personal barriers and facilitators associated with personal health record adoption and included items measuring each of the PHRAM’s four interacting factors (environmental factors, personal factors, technology factors, and self-management, and the resulting behavioural outcome.Results Younger seniors had a more positive attitude toward computers, knew what health resources were available on the internet, agreed that they had the resources in place to use PHRs, and would be more influenced by a family member than a healthcare provider to use them. Conversely, older seniors reported less confidence in their ability to use Internet-based PHRs and did not perceive that they had the resources in place to use them.Conclusions The results of this study indicated that personal, environmental, technology, chronic illness, and behavioral factors operated concurrently as personal barriers and/or facilitators to the adoption of PHRs among the older adult with chronic illness. These factors cannot be isolated because the person commonly

Reliability and Validity of Five Mental Health Scales in Older Persons.

Science.gov (United States)

Himmelfarb, Samuel; Murrell, Stanley A.

1983-01-01

Assessed five scales as mental health measures for older persons (N=318). The internal consistency reliabilities for the anxiety, depression, and well-being scales were moderately high to high, but the reliabilities for the affect balance scale suggest some caution. Cutting points for the well-being and depression scales are suggested. (Author/JAC)

Trends in fall-related hospital admissions in older persons in the Netherlands

NARCIS (Netherlands)

K.A. Hartholt (Klaas); N. van der Velde (Nathalie); C.W.N. Looman (Caspar); E.M.M. van Lieshout (Esther); M.J.M. Panneman (Martien); E.F. van Beeck (Ed); P. Patka (Peter); T.J.M. van der Cammen (Tischa)

2010-01-01

textabstractBackground: Fall-related injuries, hospitalizations, and mortality among older persons represent a major public health problem. Owing to aging societies worldwide, a major impact on fall-related health care demand can be expected. We determined time trends in numbers and incidence of

The impact of work-related and personal resources on older workers' fatigue, work enjoyment and retirement intentions over time.

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Stynen, Dave; Jansen, Nicole W H; Kant, IJmert

2017-12-01

This study aims to examine the impact of work-related and personal resources on older workers' retirement intentions by studying the pathways (fatigue and work enjoyment) from resources to retirement intentions, the buffering role of resources for psychological job demands, in a cross-sectional and longitudinal timeframe. Longitudinal results on a subsample of full-time, older workers (n = 1642) from the Maastricht Cohort Study suggest that over four years of follow-up personal resources like personal mastery and perceived health related to less (prolonged) fatigue and more work enjoyment. Personal mastery also related to later retirement intentions. A work-related resource like decision authority related to less prolonged fatigue. (Prolonged) fatigue related to earlier retirement intentions, suggesting that fatigue may be a pathway to early retirement. Finally, little evidence was found for effect modification by resources. This prospective study indicates that work-related and personal resources may be useful for prolonging working careers. Practitioner Summary: To date, the impact of work-related and personal resources on older workers' retirement intentions is rarely studied. As this prospective study shows that resources may impact older workers' (prolonged) fatigue, work enjoyment and retirement intentions, the monitoring and fostering of resources is of importance for prolonging their working careers.

Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: A case study.

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Hadziabdic, Emina; Hjelm, Katarina

2018-04-01

The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden. A descriptive qualitative study. A descriptive case study based on a review of 14 public documents and individual interviews with two experts in the area, analysed with qualitative content analysis. This study found that shared language, preservation of customs and habits and collaboration between the representatives of the municipality, Finnish-speaking migrant associations and staff at the nursing home influenced the development of the culturally specific nursing home for older Finnish-speaking people intended to avoid loneliness, isolation and misunderstandings among older Finnish-speaking. Collaboration between healthcare service for older persons and minority people resulted in an optimal culturally specific nursing home, simultaneously encountering the majority culture. Nursing and healthcare services need to be aware of positive effects of collaboration with stakeholders to achieve optimal culturally specific nursing homes.

Maternal morbid obesity and obstetric outcomes.

LENUS (Irish Health Repository)

Farah, Nadine

2012-02-01

OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

Adiposity predicts cognitive decline in older persons with diabetes: a 2-year follow-up.

Directory of Open Access Journals (Sweden)

Angela Marie Abbatecola

Full Text Available BACKGROUND: The mechanisms related to cognitive impairment in older persons with Type 2 diabetes (DM remains unclear. We tested if adiposity parameters and body fat distribution could predict cognitive decline in older persons with DM vs. normal glucose tolerance (NGT. METHODOLOGY: 693 older persons with no dementia were enrolled: 253 with DM in good metabolic control; 440 with NGT (age range:65-85 years. Longitudinal study comparing DM and NGT individuals according to the association of baseline adiposity parameters (body mass index (BMI, waist-hip-ratio (WHR, waist circumference (WC and total body fat mass to cognitive change (Mini Mental State Examination (MMSE, a composite score of executive and attention functioning (CCS over time. FINDINGS: At baseline, in DM participants, MMSE correlated with WHR (beta = -0.240; p = 0.043, WC (beta = -0.264; p = 0.041 while CCS correlated with WHR (beta = -0.238; p = 0.041, WC (beta = -0.326; p = 0.013 after adjusting for confounders. In NGT subjects, no significant correlations were found among any adiposity parameters and MMSE, while CCS was associated with WHR (beta = -0.194; p = 0.036 and WC (beta = -0.210; p = 0.024. Participants with DM in the 3(rd tertile of total fat mass showed the greatest decline in cognitive performance compared to those in 1(st tertile (tests for trend: MMSE(p = 0.007, CCS(p = 0.003. Logistic regression models showed that 3(rd vs. 1(st tertile of total fat mass, WHR, and WC predicted an almost two-fold decline in cognitive function in DM subjects at 2(nd yr (OR 1.68, 95%IC 1.08-3.52. CONCLUSIONS: Total fat mass and central adiposity predict an increased risk for cognitive decline in older person with DM.

Cognitive decline impairs financial and health literacy among community-based older persons without dementia.

Science.gov (United States)

Boyle, Patricia A; Yu, Lei; Wilson, Robert S; Segawa, Eisuke; Buchman, Aron S; Bennett, David A

2013-09-01

Literacy is an important determinant of health and well-being across the life span but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: (a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory); and (b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. Six-hundred and forty-five community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those used in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n = 447) persons with repeated cognitive assessments available for up to 14 years, regression

Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study.

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Koh, Mervyn Yong Hwang; Chong, Poh Heng; Neo, Patricia Soek Hui; Ong, Yew Jin; Yong, Woon Chai; Ong, Wah Ying; Shen, Mira Li Juan; Hum, Allyn Yin Mei

2015-07-01

The prevalence of burnout, psychological morbidity and the use of coping mechanisms among palliative care practitioners in Singapore have not been studied. We aimed to study the prevalence of burnout and psychological morbidity among palliative care practitioners in Singapore and its associations with demographic and workplace factors as well as the use of coping mechanisms. This was a multi-centre, cross-sectional study of all the palliative care providers within the public healthcare sector in Singapore. The study was conducted in hospital palliative care services, home hospice and inpatient hospices in Singapore. The participants were doctors, nurses and social workers. The prevalence of burnout among respondents in our study was 91 of 273 (33.3%) and psychological morbidity was 77 (28.2%). Working >60 h per week was significantly associated with burnout (odds ratio: 9.02, 95% confidence interval: 2.3-35.8, p = 0.002) and psychological morbidity (odds ratio: 7.21, 95% confidence interval: 1.8-28.8, p = 0.005). Home hospice care practitioners (41.5%) were more at risk of developing psychological morbidity compared to hospital-based palliative care (17.5%) or hospice inpatient care (26.0%) (p = 0.007). Coping mechanisms like physical well-being, clinical variety, setting boundaries, transcendental (meditation and quiet reflection), passion for one's work, realistic expectations, remembering patients and organisational activities were associated with less burnout. Our results reveal that burnout and psychological morbidity are significant in the palliative care community and demonstrate a need to look at managing long working hours and promoting the use of coping mechanisms to reduce burnout and psychological morbidity. © The Author(s) 2015.

Aging perceptions and self-efficacy mediate the association between personality traits and depressive symptoms in older adults.

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O'Shea, D M; Dotson, V M; Fieo, R A

2017-12-01

Personality traits have been shown to be predictors of depressive symptoms in late life. Thus, we examined whether other more modifiable sources of individual differences such as self-efficacy and self-perceptions of aging would mediate the association between personality traits and depressive symptoms in older adults. Data were obtained from 3,507 older adult participants who took part in the 2012 Health and Retirement Study. The "Big Five" personality traits, self-efficacy, aging perceptions, and depressive symptoms were assessed. Mediation analyses tested the hypothesis that self-efficacy and aging perceptions would mediate the relationship between personality traits and depressive symptoms. All five personality traits were significant predictors of depressive symptoms. Neuroticism was positively associated with depressive symptoms and had the greatest effect compared with the other personality traits. There was a significant indirect effect of neuroticism, extraversion, and conscientiousness on depressive symptoms (including both mediators). The mediating effect of aging perceptions on the relationship between neuroticism and depressive symptoms was the strongest compared with self-efficacy, accounting for approximately 80% of the total indirect effect. Our results provide support for interventions aimed at improving self-perceptions related to efficacy and aging in order to reduce depressive symptoms in older adults. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Conscious knowledge influences decision making differently in substance use disorder adults with or without co-morbid antisocial personality disorder

DEFF Research Database (Denmark)

Mellentin, Angelina; Skot, Lotte; Teasdale, Thomas William

2013-01-01

Decision-making impairment, as measured by the Iowa Gambling Task (IGT), is a consistent finding among individuals with substance use disorder (SUD). We studied how this impairment is influenced by co-morbid antisocial personality disorder (ASPD) and conscious knowledge of the task. Three groups...

Big Five personality and depression diagnosis, severity and age of onset in older adults.

Science.gov (United States)

Koorevaar, A M L; Comijs, H C; Dhondt, A D F; van Marwijk, H W J; van der Mast, R C; Naarding, P; Oude Voshaar, R C; Stek, M L

2013-10-01

Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, ppersonality measures. This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset. © 2013 Elsevier B.V. All rights reserved.

Identifying Risk Factors for the Prediction of Hospital Readmission among Older Persons with Cardiovascular Disease.

Science.gov (United States)

Middleton, Renee Annette

Older persons (55 years and older) with cardiovascular disease are at increased risk for hospital readmission when compared to other subgroups of our population. This issue presents an economic problem, a concern for the quality and type of care provided, and an urgent need to implement innovative strategies designed to reduce the rising cost of…

Trends in fall-related hospital admissions in older persons in the Netherlands

NARCIS (Netherlands)

Hartholt, Klaas A.; van der Velde, Nathalie; Looman, Caspar W. N.; van Lieshout, Esther M. M.; Panneman, Martien J. M.; van Beeck, Ed F.; Patka, Peter; van der Cammen, Tischa J. M.

2010-01-01

Fall-related injuries, hospitalizations, and mortality among older persons represent a major public health problem. Owing to aging societies worldwide, a major impact on fall-related health care demand can be expected. We determined time trends in numbers and incidence of fall-related hospital

Validation of the FFM PD count technique for screening personality pathology in later middle-aged and older adults.

Science.gov (United States)

Van den Broeck, Joke; Rossi, Gina; De Clercq, Barbara; Dierckx, Eva; Bastiaansen, Leen

2013-01-01

Research on the applicability of the five factor model (FFM) to capture personality pathology coincided with the development of a FFM personality disorder (PD) count technique, which has been validated in adolescent, young, and middle-aged samples. This study extends the literature by validating this technique in an older sample. Five alternative FFM PD counts based upon the Revised NEO Personality Inventory (NEO PI-R) are computed and evaluated in terms of both convergent and divergent validity with the Assessment of DSM-IV Personality Disorders Questionnaire (shortly ADP-IV; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders - Fourth edition). For the best working count for each PD normative data are presented, from which cut-off scores are derived. The validity of these cut-offs and their usefulness as a screening tool is tested against both a categorical (i.e., the DSM-IV - Text Revision), and a dimensional (i.e., the Dimensional Assessment of Personality Pathology; DAPP) measure of personality pathology. All but the Antisocial and Obsessive-Compulsive counts exhibited adequate convergent and divergent validity, supporting the use of this method in older adults. Using the ADP-IV and the DAPP - Short Form as validation criteria, results corroborate the use of the FFM PD count technique to screen for PDs in older adults, in particular for the Paranoid, Borderline, Histrionic, Avoidant, and Dependent PDs. Given the age-neutrality of the NEO PI-R and the considerable lack of valid personality assessment tools, current findings appear to be promising for the assessment of pathology in older adults.

Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people's perceptions.

Science.gov (United States)

Price, Kay; Grimmer, Karen; Foot, Jan

2017-12-01

Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens. Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach. Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA. Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require. What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people's health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging. What does this paper add

Augmented Reality: Sustaining Autonomous Way-Finding in the Community for Older Persons with Cognitive Impairment.

Science.gov (United States)

Sejunaite, K; Lanza, C; Ganders, S; Iljaitsch, A; Riepe, M W

2017-01-01

Impairment of autonomous way-finding subsequent to a multitude of neurodegenerative and other diseases impedes independence of older persons and their everyday activities. It was the goal to use augmented reality to aid autonomous way-finding in a community setting. A spatial map and directional information were shown via head-up display to guide patients from the start zone on the hospital campus to a bakery in the nearby community. Hospital campus and nearby community. Patients with mild cognitive impairment (age 63 to 89). A head-up display was used to help patients find their way. Time needed to reach goal and number of assists needed. With use of augmented reality device, patients preceded along the correct path in 113 out of 120 intersections. Intermittent reassurance was needed for most patients. Patients affirmed willingness to use such an augmented reality device in everyday life if needed or even pay for it. Augmented reality guided navigation is a promising means to sustain autonomous way-finding as a prerequisite for autonomy of older persons in everyday activities. Thus, this study lays ground for a field trial in the community using assistive technology for older persons with cognitive impairment.

Health throughout the lifespan: The phenomenon of the inner child reflected in events during childhood experienced by older persons.

Science.gov (United States)

Sjöblom, Margareta; Öhrling, Kerstin; Prellwitz, Maria; Kostenius, Catrine

2016-01-01

The aim of this study was to describe and gain more knowledge of the phenomenon of the inner child, reflected in events during childhood experienced by older persons. Thirteen older persons aged 70 to 91 years old were interviewed. A hermeneutical phenomenological analysis of the data revealed two main themes: the inner child becomes visible and the inner child's presence through life. The participants' narratives showed that their understanding of the experiences included both positive and negative feelings, as well as ways to be creative, in which the inner child became visible. The participants' experiences indicated that the inner child was present throughout the lifespan, was found in challenges that occurred in life, and could turn something bad into something good. However, the presence of the inner child could also be a source for development throughout life and could interfere with the person. The findings from this study point to older persons' need to be recognized, acknowledged, and understood as a unique person living his or her own life. In addition, dimensions of well-being such as feeling safe, loved, supported, and creating space for fantasy and possibilities can be compared to the physical, mental, social, and existential dimensions of well-being found in WHO surveys and definitions of health. This calls for a holistic approach when caring for older persons.

Personalized Multi-Student Improvement Based on Bayesian Cybernetics

Science.gov (United States)

Kaburlasos, Vassilis G.; Marinagi, Catherine C.; Tsoukalas, Vassilis Th.

2008-01-01

This work presents innovative cybernetics (feedback) techniques based on Bayesian statistics for drawing questions from an Item Bank towards personalized multi-student improvement. A novel software tool, namely "Module for Adaptive Assessment of Students" (or, "MAAS" for short), implements the proposed (feedback) techniques. In conclusion, a pilot…

Re-offending in forensic patients released from secure care: the role of antisocial/borderline personality disorder co-morbidity, substance dependence and severe childhood conduct disorder.

Science.gov (United States)

Howard, Rick; McCarthy, Lucy; Huband, Nick; Duggan, Conor

2013-07-01

Research suggests that a particular externalising phenotype, manifested in a developmental trajectory from severe childhood conduct disorder through early-onset substance abuse to adult antisocial/borderline personality disorder co-morbidity, may increase risk of antisocial behaviour in general and criminal recidivism in particular. This study aims to test the hypothesis that antisocial/borderline co-morbidity together with the triad of substance dependence, severe conduct disorder and borderline pathology would result in an increased risk of criminal recidivism. Fifty-three men who had been assessed and treated in a secure hospital unit were followed up after they had returned to the community. They were assessed for severity of the following: (i) antisocial personality disorder; (ii) borderline personality disorder; (iii) drug/alcohol dependence; and (iv) high Psychopathy Checklist Revised scores (factors 1 and 2). Patients with antisocial/borderline co-morbidity took significantly less time to re-offend compared with those without such co-morbidity. Both Psychopathy Checklist Revised factor 2 and the tripartite risk measure significantly predicted time to re-offence; the former largely accounted for the predictive accuracy of the latter. Risk of criminal recidivism can be adequately assessed without recourse to the pejorative term 'psychopath'. It is sufficient to assess the presence of the three elements of our risk measure: borderline and antisocial personality disorders in the context of drug/alcohol dependence and severe childhood conduct disorder. Practical implications of the study are as follows. (i) Sound assessment of personality, inclusive of a detailed history of childhood conduct disorder as well as adolescent and adult substance misuse, yields good enough information about risk of recidivism without recourse to the pejorative concept of 'psychopathy'. (ii) Given the high risk of alcohol-related violence in individuals with antisocial/borderline co-morbidity

Effects of between-person differences and within-person changes in symptoms of anxiety and depression on older age cognitive performance.

Science.gov (United States)

Laukka, E J; Dykiert, D; Allerhand, M; Starr, J M; Deary, I J

2018-06-01

Anxiety and depression are both important correlates of cognitive function. However, longitudinal studies investigating how they covary with cognition within the same individual are scarce. We aimed to simultaneously estimate associations of between-person differences and within-person variability in anxiety and depression with cognitive performance in a sample of non-demented older people. Participants in the Lothian Birth Cohort 1921 study, a population-based narrow-age sample (mean age at wave 1 = 79 years, n = 535), were examined on five occasions across 13 years. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS) and cognitive performance was assessed with tests of reasoning, logical memory, and letter fluency. Data were analyzed using two-level linear mixed-effects models with within-person centering. Divergent patterns were observed for anxiety and depression. For anxiety, between-person differences were more influential; people who scored higher on HADS anxiety relative to other same-aged individuals demonstrated poorer cognitive performance on average. For depression, on the other hand, time-varying within-person differences were more important; scoring higher than usual on HADS depression was associated with poorer cognitive performance relative to the average level for that participant. Adjusting for gender, childhood mental ability, emotional stability, and disease burden attenuated these associations. The results from this study highlight the importance of addressing both between- and within-person effects of negative mood and suggest that anxiety and depression affect cognitive function in different ways. The current findings have implications for assessment and treatment of older age cognitive deficits.

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

Directory of Open Access Journals (Sweden)

Surekha Kishore

2015-06-01

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

Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.

Science.gov (United States)

Gross, Cary P; Fried, Terri R; Tinetti, Mary E; Ross, Joseph S; Genao, Inginia; Hossain, Sabina; Wolf, Elizabeth; Lewis, Carmen L

2015-03-01

To understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screening. We conducted interviews with adults >65 years old with at least two chronic conditions who were taking ≥five medications daily. Patients were first asked how age and multimorbidity influence their cancer screening decisions. After showing them an educational prompt that explained the relationship between life expectancy and the benefits of cancer screening, respondents were then asked about screening in the context of specific health scenarios. Using grounded theory, three independent readers coded responses for salient themes. Sample size was determined by thematic saturation. Most respondents (26 of 28) initially indicated that their overall health or medical conditions do not influence their cancer screening decisions. After viewing the educational prompt, respondents described two broad approaches to cancer screening in the setting of increasing age or multi-morbidity. The first was a "benefits versus harms" approach in which participants weighed direct health benefits (e.g. reducing cancer incidence or mortality) and harms (e.g. complications or inconvenience). The second was a heuristic approach. Some heuristics favored screening, such as a persistent belief in unspecified benefits from screening, value of knowledge about cancer status, and not wanting to "give up", whereas other heuristics discouraged screening, such as fatalism or a reluctance to learn about their cancer status. When considering cancer screening, some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

Health throughout the lifespan: The phenomenon of the inner child reflected in events during childhood experienced by older persons

Directory of Open Access Journals (Sweden)

Margareta Sjöblom

2016-06-01

Full Text Available The aim of this study was to describe and gain more knowledge of the phenomenon of the inner child, reflected in events during childhood experienced by older persons. Thirteen older persons aged 70 to 91 years old were interviewed. A hermeneutical phenomenological analysis of the data revealed two main themes: the inner child becomes visible and the inner child's presence through life. The participants’ narratives showed that their understanding of the experiences included both positive and negative feelings, as well as ways to be creative, in which the inner child became visible. The participants’ experiences indicated that the inner child was present throughout the lifespan, was found in challenges that occurred in life, and could turn something bad into something good. However, the presence of the inner child could also be a source for development throughout life and could interfere with the person. The findings from this study point to older persons’ need to be recognized, acknowledged, and understood as a unique person living his or her own life. In addition, dimensions of well-being such as feeling safe, loved, supported, and creating space for fantasy and possibilities can be compared to the physical, mental, social, and existential dimensions of well-being found in WHO surveys and definitions of health. This calls for a holistic approach when caring for older persons.

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.

Science.gov (United States)

Hafskjold, Linda; Sundler, Annelie J; Holmström, Inger K; Sundling, Vibeke; van Dulmen, Sandra; Eide, Hilde

2015-04-15

This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people

Big Five personality characteristics are associated with depression subtypes and symptom dimensions of depression in older adults.

Science.gov (United States)

Koorevaar, A M L; Hegeman, J M; Lamers, F; Dhondt, A D F; van der Mast, R C; Stek, M L; Comijs, H C

2017-12-01

This study examined the associations of personality characteristics with both subtypes and symptom dimensions of depression in older adults. Three hundred and seventy-eight depressed older adults participated in the Netherlands Study of Depression in Older Persons. Personality characteristics were assessed by the NEO-Five Factor Inventory. Subtypes and symptom dimensions of depression were determined using the Composite International Diagnostic Interview and the Inventory of Depressive Symptomatology (IDS). Multinomial logistic regression analyses were performed to examine the associations between personality and atypical, melancholic, and unspecified subtypes of major depression. Linear regression analyses examined the associations between personality and the IDS mood, somatic, and motivation symptom dimensions. The analyses were adjusted for confounders and additionally adjusted for depression severity. Neuroticism, Extraversion, Conscientiousness, and Agreeableness were associated with specified (atypical or melancholic) major depression compared with unspecified major depression in the bivariate analyses but lost their significance after adjustments for functional limitations and severity of depression. Neuroticism was positively associated with the IDS mood and motivation symptom dimensions, also in the adjusted models. Further, Extraversion and Agreeableness were negatively associated with the IDS mood symptom dimension, and Extraversion and Conscientiousness were negatively associated with the IDS motivation symptom dimension. None was associated with the IDS somatic symptom dimension. This study demonstrated the association of personality characteristics with mood and motivational symptoms of late-life depression. The lacking ability of personality to differentiate between melancholic and atypical depression seems to be largely explained by severity of depressive symptoms. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Conceptions of Healthy Aging Held by Relatives of Older Persons in Isan-Thai Culture: A Phenomenographic Study

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Pornpun Manasatchakun

2018-01-01

Full Text Available In Thailand, family nurses are expected to provide support for older persons and their family members to promote healthy aging. Family bonds are strong, and relatives are expected to take care of their older family members. However, there is limited research on how older persons’ family members perceive healthy aging. This study aimed to describe the conceptions of healthy aging held by the children and grandchildren of older persons in northeast Thailand. In a phenomenographic study, 14 interviews were performed to qualitatively analyze different conceptions of healthy aging. Four descriptive categories emerged: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. The conceptions of healthy aging entail both autonomy and interdependence. The relative’s perspective needs to be considered when policies relating to healthy aging are implemented in the community and when family nurses provide support to families to promote healthy aging.

A critical appraisal of nutritional intervention studies in malnourished, community dwelling older persons

NARCIS (Netherlands)

van Schueren, M.A.E.; Wijnhoven, H A H; Kruizenga, H M; Visser, M

2016-01-01

BACKGROUND & AIMS: With the rapidly increasing number of malnourished older persons in the community, this review aims to summarize the effects of nutritional intervention studies for this target group. METHODS: Based on 2 previous reviews (2009, 2011) an update of the literature was performed.

Muscle Functions and Functional Performance among Older Persons with and without Low Back Pain

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Nor Azizah Ishak

2016-01-01

Full Text Available This study aims to compare muscle functions and functional performances between older persons with and without low back pain (LBP and to determine the association between muscle functions and functional performances. This is a cross-sectional study, involving 95 older persons (age = 70.27±7.26 years. Anthropometric characteristics, muscle functions, and functional performances were measured. Data were analyzed using ANOVA, Pearson’s correlation, and multiple linear regression. The functional performances showed no significant differences (females LBP versus non-LBP, males LBP versus non-LBP (p<0.05. For muscle functions, significant differences were found (females LBP versus non-LBP for abdominal muscle strength (p=0.006 and back muscle strength (p=0.07. In the LBP group, significant correlations were found between back and abdominal muscle strength and hand grip strength (r=0.377 and r=0.396, resp., multifidus control and lower limb function (r=0.363 in females, and back muscle strength and lower limb function (r=0.393 in males (all p<0.05. Regression analysis showed that abdominal and back muscle strengths were significant predictors of hand grip strength (p=0.041 and p=0.049, resp., and multifidus control was a significant predictor of lower limb function in females (p=0.047. This study demonstrates that older women with LBP exhibit poorer muscle functions compared to older women without LBP.

The emergency telephone conversation in the context of the older person in suicidal crisis: a qualitative study.

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Deuter, Kate; Procter, Nicholas; Rogers, John

2013-01-01

Suicide in older people is a significant public health issue with a predicted future increase. Contemporary research directs considerable attention toward physical, mental, and social risk factors that contribute to suicidality in older people; still, little is understood about the fundamental meanings that older people in suicidal crisis attribute to these factors. The aim of this qualitative study was to describe, analyze, and compare counselors' and older peoples' perceptions of the suicidal crisis during an emergency telephone conversation. Data collection consisted of individual interviews with telephone counselors (N = 7) working within an emergency mental health triage service, and listening to telephone calls (N = 14) received by the service responding to people aged 65 years and over in suicidal crisis. Triangulation of the two data sets resulted in the emergence of three key themes. We found (1) congruence in the way risk factors were perceived by counselors and communicated during telephone conversations, (2) dissension between counselors' perceptions of end-of-life issues and older people's feelings of ambivalence about wanting to die and not knowing what to do and (3) the need for working side-by-side with the older person, exploring acute changes and immediate capacity for change. An explicit focus on risk factors alone may preclude counselors from gaining a deeper understanding of suicidal crisis in an older person's life. This research has begun to capture and illuminate how telephone counselors can deliver effective crisis intervention as older people struggle and make meaning through their suffering.

A Multi-Peer Assessment Platform for Programming Language Learning: Considering Group Non-Consensus and Personal Radicalness

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Wang, Yanqing; Liang, Yaowen; Liu, Luning; Liu, Ying

2016-01-01

Multi-peer assessment has often been used by teachers to reduce personal bias and make the assessment more reliable. This study reviews the design and development of multi-peer assessment systems that detect and solve two common issues in such systems: non-consensus among group members and personal radicalness in some assessments. A multi-peer…

The personal active aging strategies of older adults in Europe: a systematic review of qualitative evidence.

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Klugar, Miloslav; Čáp, Juraj; Klugarová, Jitka; Marečková, Jana; Roberson, Donald N; Kelnarová, Zuzana

2016-05-01

There is a consensus that the aging population is beginning to impact on many facets of our life. They have more medical problems and the potential to "drain" the focus of the medical community, as well as national budgets with their accompanying medical bills. Personal strategies related to active aging will help us to better understand and identify how older adults in Europe prepare themselves for the natural process of aging and what are their personal approaches to active aging. The objective of this review was to synthesize the best available evidence regarding the older adult's perspective on the personal strategies related to active aging among older adults in Europe. This review considered studies that included older adults (age over 55 years) who live in Europe. This review considered studies that investigated older adults' perspectives on (any) personal strategies related to active aging. Europe (considering "some similarity" in health care systems and retirement policies). This review considered any qualitative designs. A three-step search strategy was used to identify published and unpublished studies. The extensive search process was conducted in October 2014 and considered published and unpublished studies from the inception of databases until October 2014. Studies published in any language which had an abstract in English, Czech and Slovak languages were considered for inclusion in this review. Studies were appraised for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the papers included in the review by two independent reviewers using the standardized JBI-QARI data extraction tool. Data synthesis was performed using the meta-aggregation approach of meta-synthesis recommended by the Joanna Briggs Institute. Fourteen studies were included in this systematic review. From these 14 studies, 42 findings were extracted; findings were

Variations in older persons' descriptions of the burden of loneliness.

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Hauge, Solveig; Kirkevold, Marit

2012-09-01

Research indicates that approximately one-third of older people over the age of 65 years report loneliness, with even higher rates among those aged over 85. Loneliness is associated with a variety of health issues, such as depression, anxiety, physical impairment and social isolation. The purpose of this paper is to describe the characteristics of the burden of loneliness, and investigate the variability in how it is described by older. In-depth interviews were conducted with 12 older people in autumn 2006 and spring 2007 in Norway. Participants aged from 70 to 97 years were recruited from a variety of backgrounds, and varied in health status and social status. The findings reported in this paper are based on hermeneutic analyses of the interviews. Our findings indicate that some of the participants experienced loneliness that they felt able to manage. They experienced a fluctuating loneliness that was linked to feeling valuable and having power and energy. However, another group described experiences of agonising loneliness. They felt a present and extensive loneliness, together with feeling less valuable and lacking in power and initiative. They seemed trapped in their loneliness, and unable to overcome their situation themselves. Our findings indicate that the burden of loneliness is experienced differently. For some older persons, the experience of loneliness is so severe that they urgently need help to manage their situation. 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Somatic chronic diseases and 6-year change in cognitive functioning among older persons

NARCIS (Netherlands)

Comijs, H.; Kriegsman, D.M.W.; Dik, M.G.; Deeg, D.J.H.; Jonker, C.; Stalman, W.A.B.

2009-01-01

The influence of seven highly prevalent somatic chronic diseases on changes in cognitive functioning is investigated in older persons in a prospective design covering a 6-year follow-up period. The data were collected as part of the Longitudinal Aging Study Amsterdam (LASA). The associations between

Exploration of the Raven APM-National Adult Reading Test discrepancy as a measure of intellectual decline in older persons.

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van den Berg, Esther; Nys, Gudrun M S; Brands, Augustina M A; Ruis, Carla; van Zandvoort, Martine J E; Kessels, Roy P C

2013-01-01

Previous studies have shown that the discrepancy between performance on "fluid" and "crystallized" intelligence measures may serve as an indicator for intellectual decline. The validity of this procedure in older persons is unknown. The present study developed a multiple regression equation, to predict the Raven Advanced Progressive Matrices (APM) score from the National Adult Reading Test (NART) score and demographic variables in a large sample of healthy older persons (n = 270). The discrepancy between the predicted and observed Raven APM scores was transformed into a percentile distribution as an indicator of intellectual decline, which can be used in clinical practice. The validity of the procedure was further examined by comparing the proportion of persons with a significant decline (at the -1 and -1.65 SD level) between two older patient samples (87 patients with cerebral stroke and 387 patients with diabetes mellitus) by means of χ(2) tests. There was a significantly higher rate of intellectual decline at the -1 SD ("below average") and -1.65 SD ("impaired") cutoff levels for patients with stroke compared with patients with diabetes (stroke, 34% and 14%; diabetes, 16% and 5%, p Raven APM-NART discrepancy may be a useful measure of intellectual decline in older persons.

Predictors of older adults' personal and community mobility: using a comprehensive theoretical mobility framework.

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Umstattd Meyer, M Renée; Janke, Megan C; Beaujean, A Alexander

2014-06-01

Forty-six percent of older adults report limitations in their mobility, and maintaining mobility is considered an important factor in keeping adults independent and active in later life. This study tests a comprehensive theoretical framework of mobility (Webber, S. C., Porter, M. M., & Menec, V. H. [2010]. Mobility in older adults: A comprehensive framework. The Gerontologist, 50[4], 443-450. doi:10.1093/geront/gnq013) identifying multiple determinants that additively influence mobility (financial, psychosocial, environmental, physical, and cognitive), as well as cross-cutting influences of gender, culture, and biography. Structural equation modeling was used to examine several models of mobility using data from 6,112 respondents in the Health and Retirement Study (mean age: 74.74, 85% white, 41% male, 57% married). The original measurement model fit the data well. When both personal and community mobility were simultaneously predicted, only the physical, cognitive, psychosocial, and environmental determinants were retained in the independent models. Age and marital status also predicted personal and community mobility. Although most of these relationships were in the expected direction, interestingly when both forms of mobility were included in the model, poorer cognitive ability was associated with greater personal mobility in the final model. Results indicate the importance of accounting for and examining comprehensive models of mobility. The factors affecting older adults' mobility are complex, and these relationships need to be explored in more depth to ensure the maintenance of individuals' independence and quality of life.

Multi-patch matching for person re-identification

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Labidi, Hocine; Luo, Sen-Lin; Boubekeur, Mohamed B.; Benlefki, Tarek

2015-08-01

Recognizing a target object across non-overlapping distributed cameras is known in the computer vision community as the problem of person re-identification. In this paper, a multi-patch matching method for person reidentification is presented. Starting from the assumption that: the appearance (clothes) of a person does not change during the time of passing in different cameras field of view , which means the regions with the same color in target image will be identical while crossing cameras. First, we extract distinctive features in the training procedure, where each image target is devised into small patches, the SIFT features and LAB color histograms are computed for each patch. Then we use the KNN approach to detect group of patches with high similarity in the target image and then we use a bi-directional weighted group matching mechanism for the re-identification. Experiments on a challenging VIPeR dataset show that the performances of the proposed method outperform several baselines and state of the art approaches.

Personality and Cognitive Decline in Older Adults: Data From a Longitudinal Sample and Meta-Analysis

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Terracciano, Antonio; Stephan, Yannick; Sutin, Angelina R.

2016-01-01

Objectives: Personality traits are associated with risk of dementia; less is known about their association with the trajectory of cognitive functioning. This research examines the association between the 5 major dimensions of personality and cognitive function and decline in older adulthood and includes a meta-analysis of published studies. Method: Personality traits, objective and subjective memory, and cognitive status were collected in a large national sample (N = 13,987) with a 4-year follow-up period. For each trait, the meta-analysis pooled results from up to 5 prospective studies to examine personality and change in global cognition. Results: Higher Neuroticism was associated with worse performance on all cognitive measures and greater decline in memory, whereas higher Conscientiousness and Openness were associated with better memory performance concurrently and less decline over time. All traits were associated with subjective memory. Higher Conscientiousness and lower Extraversion were associated with better cognitive status and less decline. Although modest, these associations were generally larger than that of hypertension, diabetes, history of psychological treatment, obesity, smoking, and physical inactivity. The meta-analysis supported the association between Neuroticism and Conscientiousness and cognitive decline. Discussion: Personality is associated with cognitive decline in older adults, with effects comparable to established clinical and lifestyle risk factors. PMID:25583598

Effect evaluation of a multifactor community intervention to reduce falls among older persons

NARCIS (Netherlands)

Wijlhuizen, G.J.; Bois, P. du; Dommelen, P. van; Hopman-Rock, M.

2007-01-01

The objective of the study was to evaluate the effectiveness of a multifactor and multimethod community intervention programme to reduce falls among older persons by at least 20%. In a pre-test-post test design, self-reported falls were registered for 10 months in the intervention community and two

m2-ABKS: Attribute-Based Multi-Keyword Search over Encrypted Personal Health Records in Multi-Owner Setting.

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Miao, Yinbin; Ma, Jianfeng; Liu, Ximeng; Wei, Fushan; Liu, Zhiquan; Wang, Xu An

2016-11-01

Online personal health record (PHR) is more inclined to shift data storage and search operations to cloud server so as to enjoy the elastic resources and lessen computational burden in cloud storage. As multiple patients' data is always stored in the cloud server simultaneously, it is a challenge to guarantee the confidentiality of PHR data and allow data users to search encrypted data in an efficient and privacy-preserving way. To this end, we design a secure cryptographic primitive called as attribute-based multi-keyword search over encrypted personal health records in multi-owner setting to support both fine-grained access control and multi-keyword search via Ciphertext-Policy Attribute-Based Encryption. Formal security analysis proves our scheme is selectively secure against chosen-keyword attack. As a further contribution, we conduct empirical experiments over real-world dataset to show its feasibility and practicality in a broad range of actual scenarios without incurring additional computational burden.

The effects of multi-domain versus single-domain cognitive training in non-demented older people: a randomized controlled trial

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Cheng Yan

2012-03-01

Full Text Available Abstract Background Whether healthy older people can benefit from cognitive training (CogTr remains controversial. This study explored the benefits of CogTr in community dwelling, healthy, older adults and compared the effects of single-domain with multi-domain CogTr interventions. Methods A randomized, controlled, 3-month trial of CogTr with double-blind assessments at baseline and immediate, 6-month and 12-month follow-up after training completion was conducted. A total of 270 healthy Chinese older people, 65 to 75 years old, were recruited from the Ganquan-area community in Shanghai. Participants were randomly assigned to three groups: multi-domain CogTr, single-domain CogTr, and a wait-list control group. Twenty-four sessions of CogTr were administrated to the intervention groups over a three-month period. Six months later, three booster training sessions were offered to 60% of the initial training participants. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Form A, the Color Word Stroop test (CWST, the Visual Reasoning test and the Trail Making test (TMT were used to assess cognitive function. Results Multi-domain CogTr produced statistically significant training effects on RBANS, visual reasoning, and immediate and delayed memory, while single-domain CogTr showed training effects on RBANS, visual reasoning, word interference, and visuospatial/constructional score (all P Conclusions Cognitive training can improve memory, visual reasoning, visuospatial construction, attention and neuropsychological status in community-living older people and can help maintain their functioning over time. Multi-domain CogTr enhanced memory proficiency, while single-domain CogTr augmented visuospatial/constructional and attention abilities. Multi-domain CogTr had more advantages in training effect maintenance. Clinical Trial Registration Chinese Clinical Trial Registry. Registration number: ChiCTR-TRC-09000732.

Validation of a Modified Life-Space Assessment in Multimorbid Older Persons With Cognitive Impairment.

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Ullrich, Phoebe; Werner, Christian; Bongartz, Martin; Kiss, Rainer; Bauer, Jürgen; Hauer, Klaus

2018-01-31

To investigate the validity, reliability, sensitivity to change, and feasibility of a modified University of Alabama at Birmingham Study of Aging Life-Space Assessment (UAB-LSA) in older persons with cognitive impairment (CI). The UAB-LSA was modified for use in persons with CI Life-Space Assessment for Persons with Cognitive Impairment (LSA-CI). Measurement properties of the LSA-CI were investigated using data of 118 multimorbid older participants with CI [mean age (SD): 82.3 (6.0) years, mean Mini-Mental State Examination score: 23.3 (2.4) points] from a randomized controlled trial (RCT) to improve motor performance and physical activity. Construct validity was asessed by Spearman's rank (rs) and point-biseral correlations (rpb) with age, gender, motor, and cognitive status, psychosocial factors, and sensor-derived (outdoor) physical activity variables. Test-retest reliability was analyzed using intra-class correlation coefficients (ICCs). Sensitivity to change was determined by standardized response means (SRMs) calculated for the RCT intervention group. The LSA-CI demonstrated moderate to high construct validity, with significant correlations of the LSA-CI scores with (outdoor) physical activity (rs = .23-.63), motor status (rs = .27-.56), fear of falling-related psychosocial variables (rs = |.24-.44|), and demographic characteristics (rpb = |.27-.32|). Test-retest reliability was good to excellent (ICC = .65-.91). Sensitivity to change was excellent for the LSA-CI composite score (SRM = .80) and small to moderate for the LSA-CI subscores (SRM = .35-.60). A completion rate of 100% and a mean completion time of 4.1 min) documented good feasibility. The LSA-CI represents a valid, reliable, sensitive, and feasible interview-based life-space assessment tool in multimorbid older persons with CI. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dental caries, periodontal disease, and cardiac arrhythmias in community-dwelling older persons aged 80 and older: is there a link?

DEFF Research Database (Denmark)

Holm-Pedersen, Poul; Avlund, Kirsten; Morse, Douglas E

2005-01-01

lesions had 2.8 times higher odds (95% confidence interval=1.1-7.0) of arrhythmia than persons without active coronal caries, but there was no greater risk for persons with three or more coronal caries lesions. There was no association between periodontal disease and arrhythmia. CONCLUSION: The findings......OBJECTIVES: To examine whether caries or periodontitis is associated with cardiac arrhythmias in community-dwelling people aged 80 and older. SETTING: Urban, community-based population in Stockholm, Sweden. DESIGN: Cross-sectional. PARTICIPANTS: Eligible persons were identified through...... by a physician or the Stockholm Inpatient Register. Active root caries, active coronal caries, and periodontitis were assessed using previously defined National Institute of Dental and Craniofacial Research diagnostic criteria. RESULTS: The primary finding of the multivariate logistic regression analysis...

Associations of Older Taiwanese Adults' Personal Attributes and Perceptions of the Neighborhood Environment Concerning Walking for Recreation and Transportation.

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Liao, Yung; Huang, Pin-Hsuan; Hsiang, Chih-Yu; Huang, Jing-Huei; Hsueh, Ming-Chun; Park, Jong-Hwan

2017-12-18

This study examines the cross-sectional associations between personal and perceived neighborhood environment attributes regarding walking for recreation and transportation among older Taiwanese adults. Data related to personal factors, perceived environmental factors, and time spent engaging in transportation-related and recreational walking were obtained from 1032 older adults aged 65 years and above. The data were analyzed by carrying out an adjusted binary logistic regression. After adjusting for potential confounders, two commonly perceived environmental factors, the presence of sidewalks (PS) and the presence of a destination (PD), were positively associated with 150 min of walking for recreation. Different personal and perceived environmental factors were associated with walking for recreation and transportation. These findings suggest that policy-makers and physical activity intervention designers should develop both common and individual environmental strategies in order to improve and increase awareness of the neighborhood environment to promote recreational and transportation walking behaviors among older adults.

Patient, resident, or person: Recognition and the continuity of self in long-term care for older people.

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Pirhonen, Jari; Pietilä, Ilkka

2015-12-01

Becoming a resident in a long-term care facility challenges older people's continuity of self in two major ways. Firstly, as they leave behind their previous home, neighborhood, and often their social surroundings, older people have to change their life-long lifestyles, causing fears of the loss of one's self. Secondly, modern-day care facilities have some features of 'total' institutions that produce patient-like role expectations and thus challenge older people's selves. Our ethnographic study in a geriatric hospital and a sheltered home in Finland aims to find out what features of daily life either support or challenge older people's continuity of self. A philosophical reading of the concept of recognition is used to explore how various daily practices and interactions support recognizing people as persons in long-term care. Categories of institution-centered and person-centered features are described to illustrate multiple ways in which people are recognized and misrecognized. The discussion highlights some ways in which long-term care providers could use the results of the study. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparative dynamic analysis of morbidity in various age groups in Russian Federation

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Vera A. Pogodina

2016-09-01

Conclusion ― Rate of healthcare visits in Russian Federation was higher for children aged 0-14 years and population older than 18 years. Morbidity increase rate was higher in children aged 0-14 years and women older than 55 years and men older than 60 years. Structural differences in disease groups were detected, which may be taken into account when planning preventive measures according to population age.

Cognitive function is associated with risk aversion in community-based older persons

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Buchman Aron S

2011-09-01

Full Text Available Abstract Background Emerging data from younger and middle-aged persons suggest that cognitive ability is negatively associated with risk aversion, but this association has not been studied among older persons who are at high risk of experiencing loss of cognitive function. Methods Using data from 369 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the correlates of risk aversion and tested the hypothesis that cognition is negatively associated with risk aversion. Global cognition and five specific cognitive abilities were measured via detailed cognitive testing, and risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15 versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $21.79 to $151.19 with the gain amounts varied randomly over questions. We first examined the bivariate associations of age, education, sex, income and cognition with risk aversion. Next, we examined the associations between cognition and risk aversion via mixed models adjusted for age, sex, education, and income. Finally, we conducted sensitivity analyses to ensure that our results were not driven by persons with preclinical cognitive impairment. Results In bivariate analyses, sex, education, income and global cognition were associated with risk aversion. However, in a mixed effect model, only sex (estimate = -1.49, standard error (SE = 0.39, p i.e., semantic memory, episodic memory, working memory, and perceptual speed; performance on visuospatial abilities was not. Conclusion A lower level of cognitive ability and female sex are associated with greater risk aversion in advanced age.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

Science.gov (United States)

Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.

2015-01-01

Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores dementia; with 29% in public hospitals. Prevalence varied between hospitals (P dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638

Associations of Older Taiwanese Adults’ Personal Attributes and Perceptions of the Neighborhood Environment Concerning Walking for Recreation and Transportation

Directory of Open Access Journals (Sweden)

Yung Liao

2017-12-01

Full Text Available This study examines the cross-sectional associations between personal and perceived neighborhood environment attributes regarding walking for recreation and transportation among older Taiwanese adults. Data related to personal factors, perceived environmental factors, and time spent engaging in transportation-related and recreational walking were obtained from 1032 older adults aged 65 years and above. The data were analyzed by carrying out an adjusted binary logistic regression. After adjusting for potential confounders, two commonly perceived environmental factors, the presence of sidewalks (PS and the presence of a destination (PD, were positively associated with 150 min of walking for recreation. Different personal and perceived environmental factors were associated with walking for recreation and transportation. These findings suggest that policy-makers and physical activity intervention designers should develop both common and individual environmental strategies in order to improve and increase awareness of the neighborhood environment to promote recreational and transportation walking behaviors among older adults.

Associations of Older Taiwanese Adults’ Personal Attributes and Perceptions of the Neighborhood Environment Concerning Walking for Recreation and Transportation

Science.gov (United States)

Huang, Pin-Hsuan; Hsiang, Chih-Yu; Huang, Jing-Huei; Park, Jong-Hwan

2017-01-01

This study examines the cross-sectional associations between personal and perceived neighborhood environment attributes regarding walking for recreation and transportation among older Taiwanese adults. Data related to personal factors, perceived environmental factors, and time spent engaging in transportation-related and recreational walking were obtained from 1032 older adults aged 65 years and above. The data were analyzed by carrying out an adjusted binary logistic regression. After adjusting for potential confounders, two commonly perceived environmental factors, the presence of sidewalks (PS) and the presence of a destination (PD), were positively associated with 150 min of walking for recreation. Different personal and perceived environmental factors were associated with walking for recreation and transportation. These findings suggest that policy-makers and physical activity intervention designers should develop both common and individual environmental strategies in order to improve and increase awareness of the neighborhood environment to promote recreational and transportation walking behaviors among older adults. PMID:29258241

Predictors of mortality and short-term physical and cognitive dependence in critically ill persons 75 years and older: a prospective cohort study.

Science.gov (United States)

Daubin, Cédric; Chevalier, Stéphanie; Séguin, Amélie; Gaillard, Cathy; Valette, Xavier; Prévost, Fabrice; Terzi, Nicolas; Ramakers, Michel; Parienti, Jean-Jacques; du Cheyron, Damien; Charbonneau, Pierre

2011-05-16

The purpose of this study was to identify predictors of 3-month mortality in critically ill older persons under medical care and to assess the clinical impact of an ICU stay on physical and cognitive dependence and subjective health status in survivors. We conducted a prospective observational cohort study including all older persons 75 years and older consecutively admitted into ICU during a one-year period, except those admitted after cardiac arrest, All patients were followed for 3 months or until death. Comorbidities were assessed using the Charlson index and physical dependence was evaluated using the Katz index of Activity of Daily Living (ADL). Cognitive dependence was determined by a score based on the individual components of the Lawton index of Daily Living and subjective health status was evaluated using the Nottingham Health Profile (NHP) score. One hundred patients were included in the analysis. The mean age was 79.3 ± 3.4 years. The median Charlson index was 6 [IQR, 4 to 7] and the mean ADL and cognitive scores were 5.4 ± 1.1 and 1.2 ± 1.4, respectively, corresponding to a population with a high level of comorbidities but low physical and cognitive dependence. Mortality was 61/100 (61%) at 3 months. In multivariate analysis only comorbidities assessed by the Charlson index [Adjusted Odds Ratio, 1.6; 95% CI, 1.2-2.2; p physical (p = 0.04), and cognitive (p = 0.62) dependence in survivors had changed very little at 3 months. In addition, the mean NHP score was 213.1 ± 132.8 at 3 months, suggesting an acceptable perception of their quality of life. In a selected population of non surgical patients 75 years and older, admission into the ICU is associated with a 3-month survival rate of 38% with little impact on physical and cognitive dependence and subjective health status. Nevertheless, a high comorbidity level (ie, Charlson index), multi-organ failure, and the need for extra-renal support at the early phase of intensive care could be considered as

Orthostatic Intolerance in Older Persons: Etiology and Countermeasures

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Nandu Goswami

2017-11-01

and falls-related injuries in older persons.

Methodological challenges in a study on falls in an older population of Cape Town, South Africa.

Science.gov (United States)

Kalula, Sebastiana Z; Ferreira, Monica; Swingler, George H; Badri, Motasim; Sayer, Avan A

2017-09-01

Falls are a major cause of disability, morbidity and mortality in older persons, but have been under researched in developing countries. To describe challenges encountered in a community-based study on falls in a multi-ethnic population aged ≥65 years in a low-income setting. The study was conducted in four stages: A pilot study (n=105) to establish a sample size for the survey. An equipment validation study (n=118) to use for fall risk determination. A cross-sectional baseline (n=837) and a 12-month follow-up survey (n=632) to establish prevalence and risk factors for falls. Prevalence rate of 26.4% (95% CI 23.5-29.5%) and risk factors for recurrent falls: previous falls, self-reported poor mobility and dizziness were established. Adaptations to the gold standard prospective fall research study design were employed: 1) to gain access to the study population in three selected suburbs, 2) to perform assessments in a non-standardised setting, 3) to address subjects' poverty and low literacy levels, and high attrition of subjects and field workers. Studies on falls in the older population of low- to middle-income countries have methodological challenges. Adaptive strategies used in the Cape Town study and the research experience reported may be instructive for investigators planning similar studies in such settings.

Cognitive function is associated with risk aversion in community-based older persons.

Science.gov (United States)

Boyle, Patricia A; Yu, Lei; Buchman, Aron S; Laibson, David I; Bennett, David A

2011-09-11

Emerging data from younger and middle-aged persons suggest that cognitive ability is negatively associated with risk aversion, but this association has not been studied among older persons who are at high risk of experiencing loss of cognitive function. Using data from 369 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the correlates of risk aversion and tested the hypothesis that cognition is negatively associated with risk aversion. Global cognition and five specific cognitive abilities were measured via detailed cognitive testing, and risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15) versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $21.79 to $151.19 with the gain amounts varied randomly over questions. We first examined the bivariate associations of age, education, sex, income and cognition with risk aversion. Next, we examined the associations between cognition and risk aversion via mixed models adjusted for age, sex, education, and income. Finally, we conducted sensitivity analyses to ensure that our results were not driven by persons with preclinical cognitive impairment. In bivariate analyses, sex, education, income and global cognition were associated with risk aversion. However, in a mixed effect model, only sex (estimate = -1.49, standard error (SE) = 0.39, p risk aversion. Thus, a lower level of global cognitive function and female sex were associated with greater risk aversion. Moreover, performance on four out of the five cognitive domains was negatively related to risk aversion (i.e., semantic memory, episodic memory, working memory, and perceptual speed); performance on visuospatial abilities was not. A lower level of cognitive ability and female sex are associated with greater

Explaining excess morbidity amongst homeless shelter users

DEFF Research Database (Denmark)

Benjaminsen, Lars; Birkelund, Jesper Fels

2018-01-01

AIMS: This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. METHODS: Data set...... includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk...... of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. RESULTS: The excess morbidity associated with shelter use is substantially lower than in studies that did not include...

Reconciling conceptualizations of relationships and person-centred care for older people with cognitive impairment in acute care settings.

Science.gov (United States)

Rushton, Carole; Edvardsson, David

2018-04-01

Relationships are central to enacting person-centred care of the older person with cognitive impairment. A fuller understanding of relationships and the role they play facilitating wellness and preserving personhood is critical if we are to unleash the productive potential of nursing research and person-centred care. In this article, we target the acute care setting because much of the work about relationships and older people with cognitive impairment has tended to focus on relationships in long-term care. The acute care setting is characterized by archetypal constraints which differentiate it from long-term care, in terms of acuity and haste, task-orientated work patterns and influence from "the rule of medicine," all of which can privilege particular types of relating. In this article, we drew on existing conceptualizations of relationships from theory and practice by tapping in to the intellectual resources provided by nurse researchers, the philosophy of Martin Buber and ANT scholars. This involved recounting two examples of dyadic and networked relationships which were re-interpreted using two complementary theoretical approaches to provide deeper and more comprehensive conceptualizations of these relationships. By re-presenting key tenets from the work of key scholars on the topic relationships, we hope to hasten socialization of these ideas into nursing into the acute care setting. First, by enabling nurses to reflect on how they might work toward cultivating relationships that are more salutogenic and consistent with the preservation of personhood. Second, by stimulating two distinct but related lines of research enquiry which focus on dyadic and networked relationships with the older person with cognitive impairment in the acute care setting. We also hope to reconcile the schism that has emerged in the literature between preferred approaches to care of the older person with cognitive impairment, that is person-centred care versus relationship-centred care

Licit prescription drug use in a Swedish population according to age, gender and socioeconomic status after adjusting for level of multi-morbidity

DEFF Research Database (Denmark)

Thorell, Kristine; Skoog, Jessica; Zielinski, Andrzej

2012-01-01

There is a great variability in licit prescription drug use in the population and among patients. Factors other than purely medical ones have proven to be of importance for the prescribing of licit drugs. For example, individuals with a high age, female gender and low socioeconomic status are more...... and socioeconomic status after adjustment for multi-morbidity level....

Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review.

Science.gov (United States)

Goisser, Sabine; Kemmler, Wolfgang; Porzel, Simone; Volkert, Dorothee; Sieber, Cornel Christian; Bollheimer, Leo Cornelius; Freiberger, Ellen

2015-01-01

One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity.

Between-person and within-person associations among processing speed, attention switching, and working memory in younger and older adults.

Science.gov (United States)

Stawski, Robert S; Sliwinski, Martin J; Hofer, Scott M

2013-01-01

BACKGROUND/STUDY CONTEXT: Theories of cognitive aging predict associations among processes that transpire within individuals, but are often tested by examining between-person relationships. The authors provide an empirical demonstration of how associations among measures of processing speed, attention switching, and working memory are different when considered between persons versus within persons over time. A sample of 108 older adults (M (age) = 80.8, range = 66-95) and 68 younger adults (M (age) = 20.2, range = 18-24) completed measures of processing speed, attention switching, and working memory on six occasions over a 14-day period. Multilevel modeling was used to examine processing speed and attention switching performance as predictors of working memory performance simultaneously across days (within-person) and across individuals (between-person). The findings indicates that simple comparison and response speed predicted working memory better than attention switching between persons, whereas attention switching predicted working memory better than simple comparison and response speed within persons over time. Furthermore, the authors did not observe strong evidence of age differences in these associations either within or between persons. The findings of the current study suggest that processing speed is important for understanding between-person and age-related differences in working memory, whereas attention switching is more important for understanding within-person variation in working memory. The authors conclude that theories of cognitive aging should be evaluated by analysis of within-person processes, not exclusively age-related individual differences.

Personal and other factors affecting acceptance of smartphone technology by older Chinese adults.

Science.gov (United States)

Ma, Qi; Chan, Alan H S; Chen, Ke

2016-05-01

It has been well documented that in the 21st century, there will be relatively more older people around the world than in the past. Also, it seems that technology will expand in this era at an unprecedented rate. Therefore, it is of critical importance to understand the factors that influence the acceptance of technology by older people. The positive impact that the use of mobile applications can have for older people was confirmed by a previous study (Plaza et al., 2011). The study reported here aimed to explore and confirm, for older adults in China, the key influential factors of smartphone acceptance, and to describe the personal circumstances of Chinese older adults who use smartphone. A structured questionnaire and face to face individual interviews were used with 120 Chinese older adults (over 55). Structural Equation Modeling was used to confirm a proposed smartphone acceptance model based on Technology Acceptance Model (TAM), and the Unified Theory of Acceptance and Use of Technology (UTAUT). The results showed that those who were younger, with higher education, non-widowed, with better economic condition related to salary or family support were more likely to use smartphone. Also, cost was found to be a critical factor influencing behavior intention. Self-satisfaction and facilitating conditions were proved to be important factors influencing perceived usefulness and perceived ease of use. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The impact of older person's frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.

Science.gov (United States)

Oldenkamp, Marloes; Hagedoorn, Mariët; Wittek, Rafael; Stolk, Ronald; Smidt, Nynke

2017-10-01

To examine the impact of changes in an older person's frailty on the care-related quality of life of their informal caregiver. Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health). Care-related quality of life was measured with the Care-Related Quality of Life instrument (CarerQoL-7D), containing two positive (fulfilment, perceived support) and five negative dimensions (relational problems, mental health problems, physical health problems, financial problems, problems combining informal care with daily activities). 660 older person/caregiver couples were included. Older persons were on average 79 (SD 6.9) years of age, and 61% was female. Caregivers were on average 65 (SD 12.6) years of age, and 68% was female. Results of the multivariable linear and logistic regression analyses showed that an increase in older person's frailty over time was related to a lower total care-related quality of life of the caregiver, and to more mental and physical health problems, and problems with combining informal care with daily activities at follow-up. A change in the older person's psychological well-being was most important for the caregiver's care-related quality of life, compared to the other health domains. Health professionals observing decreasing psychological well-being of an older person and increasing hours of informal care provision should be aware of the considerable problems this may bring to their informal caregiver, and should tailor interventions to support informal caregivers according to their specific needs and problems.

A Personal Context-Aware Multi-Device Coaching Service that Supports a Healthy Lifestyle

NARCIS (Netherlands)

op den Akker, Hendrikus J.A.; Klaassen, Randy; Lavrysen, Tine; Geleijnse, Gijs; van Halteren, Aart; Schwietert, Henk; van der Hout, Marloes

2011-01-01

This paper describes work in progress in the European Artemis project Smarcos. Smarcos focuses on interusability of multi-device embedded and networked services. The work presented here is devoted to the development of context-aware personal coaching service systems that give users personalized

Suicide Risk Factors Among Older Adults: Exploring Thwarted Belongingness and Perceived Burdensomeness in Relation to Personality and Self-Esteem.

Science.gov (United States)

Eades, Allison; Segal, Daniel L; Coolidge, Frederick L

2018-01-01

The objective of this study was to explore the role of personality and self-esteem in later life within two established risk factors for suicidal ideation (SI)-Thwarted Belongingness (TB) and Perceived Burdensomeness (PB). The data about personality (i.e., Five Factor Model [FFM] and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Personality Disorders [PD]), self-esteem, TB, PB, and SI were collected from 102 community-dwelling older adults and analyzed using bivariate and multivariate techniques. All FFM domains and most PD traits were significantly correlated with SI, TB, and PB. Furthermore, FFM and PD traits explained a significant and meaningful amount of variance of SI, TB, and PB. Self-esteem demonstrated strong negative relationships with SI, TB, and PB. Personality features and self-esteem are important associated features for SI, TB, and PB. Clinicians should consider this information when assessing and evaluating for suicidal risk among older adults. The findings also highlight the need to consider personality traits in developing prevention strategies.

The role of gender in the association between personality and task priority in older adults' dual-tasking while walking.

Science.gov (United States)

Agmon, Maayan; Armon, Galit; Denesh, Shani; Doumas, Mihalis

2018-01-02

Falls are a major problem for older adults. Many falls occur when a person's attention is divided between two tasks, such as a dual task (DT) involving walking. Most recently, the role of personality in walking performance was addressed; however, its association with DT performance remains to be determined. This cross-sectional study of 73 older, community-dwelling adults explores the association between personality and DT walking and the role of gender in this relationship. Personality was evaluated using the five-factor model. Single-task (ST) and DT assessment of walking-cognitive DT performance comprised a 1-min walking task and an arithmetic task performed separately (ST) and concurrently (DT). Dual-task costs (DTCs), reflecting the proportional difference between ST and DT performance, were also calculated. Gender plays a role in the relationship between personality and DT. Extraversion was negatively associated with DTC-motor for men (ΔR 2  = 0.06, p fall prevention.

Stroke-attributable death among older persons during the great recession.

Science.gov (United States)

Falconi, April; Gemmill, Alison; Karasek, Deborah; Goodman, Julia; Anderson, Beth; Lee, Murray; Bellows, Benjamin; Catalano, Ralph

2016-05-01

Epidemiological evidence indicates an elevated risk for stroke among stressed persons, in general, and among individuals who have lost their job, in particular. We, therefore, tested the hypothesis that stroke accounted for a larger fraction of deaths during the Great Recession than expected from other deaths and from trends, cycles, and other forms of autocorrelation. Based on vital statistics death data from California spanning 132 months from January 2000 through December 2010, we found support for the hypothesis. These findings appear attributable to non-Hispanic white men, who experienced a 5% increase in their monthly odds of stroke-attributable death. Total mortality in this group, however, did not increase. Findings suggest that 879 deaths among older white men shifted from other causes to stroke during the 36 months following the start of the Great Recession. We infer the Great Recession may have affected social, biologic, and behavioral risk factors that altered the life histories of older white men in ways that shifted mortality risk toward stroke. Copyright © 2015 Elsevier B.V. All rights reserved.

Response to "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study"

NARCIS (Netherlands)

de Jongh, A.; ten Broeke, E.

2014-01-01

Last November, the European Journal of Psychotraumatology published an interesting paper entitled "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study". This article

The impact of occupational therapy and lifestyle interventions on older persons' health, well-being, and occupational adaptation.

Science.gov (United States)

Johansson, Ann; Björklund, Anita

2016-01-01

The aim of this study was to investigate whether a four-month occupational based health-promoting programme for older persons living in community dwellings could maintain/improve their general health and well-being. Further, the aim was to explore whether the programme facilitated the older persons' occupational adaptation. The study had a quasi-experimental design, with a non-equivalent control group combined with semi-structured interviews. The intervention group comprised 22 participants, and the control group 18. Outcomes were measured using the Short Form 36, Life Satisfaction Index-Z and Meaningful Activity Participation Assessment. Content analysis, based on concepts from the Model of Occupational Adaptation, was used to analyse the interviews. The intervention group showed statistically significant improvements in general health variables such as vitality and mental health, and positive trends for psychological well-being. There were no statistically significant differences between the intervention group and the control group, but the groups were not fully matched. The qualitative analysis based on Occupational Adaptation pointed out social aspects as a compliment to the overall results. Participating in meaningful, challenging activities in different environments stimulates the occupational adaptation process; this is something occupational therapists could use to empower older persons to find their optimal occupational lives.

A Look at Person- and Family-Centered Care Among Older Adults: Results from a National Survey [corrected].

Science.gov (United States)

Wolff, Jennifer L; Boyd, Cynthia M

2015-10-01

Person-centered and family-centered care represents the pinnacle of health care quality, but delivering it is challenging, as is assessing whether it has occurred. Prior studies portray older adults as passive in health decisions and burdened by care-but emphasize age-based differences or focus on vulnerable subgroups. We aimed to examine domains of person-centered and family-centered care among older adults and whether the social context in which older adults manage their health relates to preferences for participating in health decisions and experiences with care. This was an observational study of a nationally representative survey of adults aged 65+ years, conducted in concert with the 2012 National Health and Aging Trends Study (n = 2040). Approach to managing health (self-manage, co-manage, delegate); preferences for making health care decisions with: (1) doctors, (2) family/close friends; and experiences with care pertaining to treatment burden were measured. Approximately two-thirds of older adults self-manage (69.4 %) and one-third co-manage (19.6 %) or delegate (11.0 %) health care activities. The majority prefer an independent or shared role when making health decisions with doctors (84.7 %) and family/close friends (95.9 %). Nearly four in ten older adults (37.9 %) experience treatment burden-that managing health care activities are sometimes or often hard for either them or their family/close friends, that health care activities get delayed or don't get done, or that they are cumulatively too much to do. Relative to older adults who self-manage, those who delegate health care activities are more likely to prefer to share or leave health decisions to doctors (aOR = 1.79 (95 % CI, 1.37-2.33) and family/close friends (aOR = 3.12 (95 % CI, 2.23-4.36), and are more likely to experience treatment burden (aOR = 2.37 (95 % CI, 1.61-3.47). Attaining person-centered and family-centered care will require strategies that respect diverse decision

Do personal conditions and circumstances surrounding partner loss explain loneliness in newly bereaved older adults?

NARCIS (Netherlands)

van Baarsen, B.; Smit, J.H; Snijders, T.A.B.; Knipscheer, K.P.M.

This longitudinal study aims to explain loneliness in newly bereaved older adults, taking into account personal and circumstantial conditions surrounding the partner's death. A distinction is made between emotional and social loneliness. Data were gathered both before and after partner loss. Results

Do personal conditions and circumstances surrounding partner loss explain loneliness in newly bereaved older adults?

NARCIS (Netherlands)

van Baarsen, B.; Smit, J.H.; Snijders, T.A.B.; Knipscheer, C.P.M.

1999-01-01

This longitudinal study aims to explain loneliness in newly bereaved older adults, taking into account personal and circumstantial conditions surrounding the partner's death. A distinction is made between emotional and social loneliness. Data were gathered both before and after partner loss. Results

Emotional expressivity in older and younger adults' descriptions of personal memories.

Science.gov (United States)

Schryer, Emily; Ross, Michael; St Jacques, Peggy; Levine, Brian; Fernandes, Myra

2012-01-01

BACKGROUND/STUDY CONTEXT: According to the socioemotional selectivity theory (SST; Mather & Carstensen, 2003, Psychological Sciences, 14, 409-415), aging is associated with greater motivation to regulate emotions. The authors propose that the language people use to describe personal memories provides an index of age differences in emotional self-regulation. In the present article, the authors reanalyzed three previously published studies in which older (aged 60-88) and younger (aged 17-33) participants described emotional and neutral memories from their recent and distant pasts. The authors analyzed the language of the memories using Pennebaker, Booth, and Francis's (2007) Linguistic Inquiry Word Count program (Austin, TX: LIWC Inc.), which calculates the percentage of positive and negative emotion words. In Studies 1 and 2, older adults used more positive emotion words than did younger adults to describe their autobiographical memories from the recent past, particularly when these were of a neutral valence. In Study 3, older adults used more positive emotion words when describing more recent memories (from the past 5 years) but not when describing distant childhood or adolescent memories. The authors suggest that these age differences in emotional expressivity support SST, and represent an as-yet unreported age difference that may stem from differences in motivation to regulate emotion.

Elder abuse and its medical outcomes in older Chinese people with cognitive and physical impairments.

Science.gov (United States)

Fang, Boye; Yan, Elsie; Chan, Ko Ling; Ip, Partick

2018-05-04

Elder abuse poses a major public health threat considering the ongoing rapid aging of the global population. This study investigates the association between elder abuse by family caregivers and medical outcomes among older Chinese patients with cognitive and physical impairments in the People's Republic of China. Using cross-sectional design, 1002 older patients (aged 55 y and older) and their family caregivers were recruited from 3 grade A hospitals in Guangdong Province. The major independent variable is caregiver-reported elder abuse, while outcome variables include cardiovascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, peptic ulcer, digestive disorder, chronic hepatic disease, chronic renal disease, metabolic disease, acute inflammation, joint disease, tumor, and general injury. The prevalence of these medical conditions among patients who were abused and those who were not were compared using descriptive analyses and chi-square tests, and logistic regression was used to establish the relevant independent associations. A total of 429 (42.8%) older persons have experienced physical or psychological abuse over the past 12 months. After adjusting for potential confounders, abused older persons were more susceptible to cardiovascular disease, chronic obstructive pulmonary disease, peptic ulcer, digestive disorder, metabolic disease, acute inflammation, tumor, and injuries. Elder abuse is associated with various major medical morbidities. Interdisciplinary cooperation is necessary to identify and reduce the adverse physiological consequences in victims. Copyright © 2018 John Wiley & Sons, Ltd.

Prevalence of psychiatric and physical morbidity in an urban geriatric population

OpenAIRE

Seby, K.; Chaudhury, Suprakash; Chakraborty, Rudraprosad

2011-01-01

Background: With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. Aims: To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Settings and Design: Cross-sectional, epidemiological study. Materials...

[Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness].

Science.gov (United States)

Park, Chorong; Song, Misoon; Cho, Belong; Lim, Jaeyoung; Song, Wook; Chang, Heekyung; Park, Yeon-Hwan

2015-04-01

The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

Striking a balance between in-person care and the use of eHealth to support the older rural population with chronic pain

Directory of Open Access Journals (Sweden)

Anne Roberts

2015-09-01

Full Text Available New and existing information communication technologies (ICT are playing an increasingly important role in the delivery of health and social care services. eHealth1 has the potential to supplement in-person home visits for older, rural adults with chronic pain. The Technology to support Older Adults' Personal and Social Interaction project—TOPS—examines interactions between older people and their health/social care providers and considers how eHealth could play a part in enhancing the life experiences of older people with chronic pain, who live in remote/rural areas. This paper reports findings from the TOPS study, drawing upon observations of health/social care home visits to chronic pain patients and interviews with patients and health/social care providers in rural Scotland. Patients and care professionals believe in-person care promotes the general well-being of older people with pain. However, our findings show that the potential recipients of eHealth are open to the use of such technologies and that although they cannot be expected to replace existing models of care, eHealth may provide opportunities to sustain and enhance these interactions.

Presenteeism, stress resilience, and physical activity in older manual workers: a person-centred analysis.

Science.gov (United States)

Thogersen-Ntoumani, Cecilie; Black, Julie; Lindwall, Magnus; Whittaker, Anna; Balanos, George M

2017-12-01

This study used a person-centred approach to explore typologies of older manual workers based on presenteeism, stress resilience, and physical activity. Older manual workers ( n  = 217; 69.1% male; age range 50-77; M age = 57.11 years; SD = 5.62) from a range of UK-based organisations, representing different manual job roles, took part in the study. A cross-sectional survey design was used. Based on the three input variables: presenteeism, stress resilience and physical activity, four distinct profiles were identified on using Latent Profile Analysis. One group ('High sport/exercise and well-functioning'; 5.50%) engaged in high levels of sport/exercise and exhibited low levels of stress resilience and all types of presenteeism. Another profile ('Physically burdened'; 9.70%) reported high levels of work and leisure-time physical activity, low stress resilience, as well as high levels of presenteeism due to physical and time demands. A 'Moderately active and functioning' group (46.50%) exhibited moderate levels on all variables. Finally, the fourth profile ('Moderately active with high presenteeism'; 38.20%) reported engaging in moderate levels of physical activity and had relatively high levels of stress resilience, yet also high levels of presenteeism. The profiles differed on work affect and health perceptions largely in the expected directions. There were no differences between the profiles in socio-demographics. These results highlight complex within-person interactions between presenteeism, stress resilience, and physical activity in older manual workers. The identification of profiles of older manual workers who are at risk of poor health and functioning may inform targeted interventions to help retain them in the workforce for longer.

Risk and protective factors of different functional trajectories in older persons : Are these the same?

NARCIS (Netherlands)

Kempen, G.I.; Ranchor, A.V.; van Sonderen, E.; van Jaarsveld, C.H.; Sanderman, R.

We examined whether risk and protective factors of different functional trajectories were the same in 1,765 Dutch older persons. We assessed disability in 1993 and reassessed it in 2001. For 2001 as compared with 1993, we distinguished three trajectory groups: substantially poorer, somewhat poorer,

National indicators for quality of drug therapy in older persons: the Swedish experience from the first 10 years.

Science.gov (United States)

Fastbom, Johan; Johnell, Kristina

2015-03-01

Inappropriate drug use is an important health problem in elderly persons. Beginning with the Beers' criteria in the early 1990s, explicit criteria have been extensively used to measure and improve quality of drug use in older people. This article describes the Swedish indicators for quality of drug therapy in the elderly, introduced in 2004 and updated in 2010. These indicators were designed to be applied to people aged 75 years and over, regardless of residence and other characteristics. The indicators are divided into drug specific, covering choice, indication and dosage of drugs, polypharmacy, drug-drug interactions (DDIs), drug use in decreased renal function and in some symptoms; and diagnosis specific, covering the rational, irrational and hazardous drug use in common disorders in elderly people. During the 10 years since introduction, the Swedish indicators have several applications. They form the basis for recommendations for drug therapy in older people, are implemented in prescribing supports and drug utilisation reviews, are used in national benchmarking of the quality of Swedish healthcare and have contributed to initiatives from pensioner organisations. The indicators have also been used in several pharmacoepidemiological studies. Since 2005, there have been signs of improvement of the quality of drug prescribing to elderly persons in Sweden. For example, the prescribing of drugs that should be avoided in older persons decreased by 36 % between 2006 and 2012 in persons aged 80 years and older. Similarly, drug combinations that may cause DDIs decreased by 26 % and antipsychotics by 41 %. The indicators have likely contributed to this.

Music induces different cardiac autonomic arousal effects in young and older persons.

Science.gov (United States)

Hilz, Max J; Stadler, Peter; Gryc, Thomas; Nath, Juliane; Habib-Romstoeck, Leila; Stemper, Brigitte; Buechner, Susanne; Wong, Samuel; Koehn, Julia

2014-07-01

Autonomic arousal-responses to emotional stimuli change with age. Age-dependent autonomic responses to music-onset are undetermined. To determine whether cardiovascular-autonomic responses to "relaxing" or "aggressive" music differ between young and older healthy listeners. In ten young (22.8±1.7 years) and 10 older volunteers (61.7±7.7 years), we monitored respiration (RESP), RR-intervals (RRI), and systolic and diastolic blood pressure (BPsys, BPdia) during silence and 180second presentations of two "relaxing" and two "aggressive" classical-music excerpts. Between both groups, we compared RESP, RRI, BPs, spectral-powers of mainly sympathetic low-frequency (LF: 0.04-0.15Hz) and parasympathetic high-frequency (HF: 0.15-0.5Hz) RRI-oscillations, RRI-LF/HF-ratios, RRI-total-powers (TP-RRI), and BP-LF-powers during 30s of silence, 30s of music-onset, and the remaining 150s of music presentation (analysis-of-variance and post-hoc analysis; significance: pmusic-onset, "relaxing" music decreased RRI in older and increased BPsys in younger participants, while "aggressive" music decreased RRI and increased BPsys, LF-RRI, LF/HF-ratios, and TP-RRI in older, but increased BPsys and RESP and decreased HF-RRI and TP-RRI in younger participants. Signals did not differ between groups during the last 150s of music presentation. During silence, autonomic modulation was lower - but showed sympathetic predominance - in older than younger persons. Responses to music-onset, particularly "aggressive" music, reflect more of an arousal- than an emotional-response to music valence, with age-specific shifts of sympathetic-parasympathetic balance mediated by parasympathetic withdrawal in younger and by sympathetic activation in older participants. Copyright © 2014 Elsevier B.V. All rights reserved.

The smart house for older persons and persons with physical disabilities: structure, technology arrangements, and perspectives.

Science.gov (United States)

Stefanov, Dimitar H; Bien, Zeungnam; Bang, Won-Chul

2004-06-01

Smart houses are considered a good alternative for the independent life of older persons and persons with disabilities. Numerous intelligent devices, embedded into the home environment, can provide the resident with both movement assistance and 24-h health monitoring. Modern home-installed systems tend to be not only physically versatile in functionality but also emotionally human-friendly, i.e., they may be able to perform their functions without disturbing the user and without causing him/her any pain, inconvenience, or movement restriction, instead possibly providing him/her with comfort and pleasure. Through an extensive survey, this paper analyzes the building blocks of smart houses, with particular attention paid to the health monitoring subsystem as an important component, by addressing the basic requirements of various sensors implemented from both research and clinical perspectives. The paper will then discuss some important issues of the future development of an intelligent residential space with a human-friendly health monitoring functional system.

Second Career Opportunities for Older Persons.

Science.gov (United States)

Institute of Lifetime Learning, Washington, DC.

This pamphlet describes some of the employment opportunities available to older adults and discusses procedures for obtaining the training for, and actually beginning, a second career. Covered in the individual sections of the brochure are the following topics: characteristics and attitudes of older workers, long-range planning, employment…

Social relations and loneliness among older patients consulting their general practitioner

DEFF Research Database (Denmark)

Due, Tina Drud; Sandholdt, Håkon; Waldorff, Frans Boch

2017-01-01

INTRODUCTION: Social relations are important for people and affect their quality of life, morbidity and mortality. This holds true especially for older persons. General practitioners (GPs) are in a unique position to address social relations and loneliness; however, no GP population-based studies...... have assessed older patients' social relations and loneliness. The aim of this study was to analyse the social relations and loneliness of patients aged 65 years and above consulting their GP. METHODS: This survey counted the participation of 12 general practices in the Capital Region of Denmark....... During a three-week period, the practices invited their patients to fill out a questionnaire on health, social relations and loneliness. RESULTS: Of 767 eligible patients, 474 were included and 461 answered one or more items about social participation or loneliness. A total of 36.2% had a high, 45.5% had...

Social relations and loneliness among older patients consulting their general practitioner

DEFF Research Database (Denmark)

Due, Tina Drud; Sandholdt, Håkon; Waldorff, Frans Boch

2017-01-01

Introduction: Social relations are important for people and affect their quality of life, morbidity and mortality. This holds true especially for older persons. General practitioners (GPs) are in a unique position to address social relations and loneliness; however, no GP population-based studies...... have assessed older patients’ social relations and loneliness. The aim of this study was to analyse the social relations and loneliness of patients aged 65 years and above consulting their GP. Methods: This survey counted the participation of 12 general practices in the Capital Region of Denmark....... During a three-week period, the practices invited their patients to fill out a questionnaire on health, social relations and loneliness. 
 Results: Of 767 eligible patients, 474 were included and 461 answered one or more items about social participation or loneliness. A total of 36.2% had a high, 45...

The nursing staff's opinion of falls among older persons with dementia. a cross-sectional study

Directory of Open Access Journals (Sweden)

Slaasletten Randi

2011-06-01

Full Text Available Abstract The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs and enrolled nurses (ENs and staff with ≤5 and >5 years of employment in the care units in question. Background Falls are common among older people and persons with dementia constitute an additional risk group. Methods The study had a cross-sectional design and included nursing staff (n = 63, response rate 66% working in four special care units for older persons with dementia. Data collection was conducted with a questionnaire consisting of 64 questions. Results The respondents reported that the individuals' mental and physical impairment constitute the most frequent causes of falls. The findings also revealed a lack of, or uncertainty about, routines of documentation and reporting fall-risk and fall-preventing interventions. Respondents who had been employed in the care units more than five years reported to a higher degree that colours and material on floors caused falls. RNs considered the residents' autonomy and freedom of movement as a cause of falls to a significantly higher degree than ENs. RNs also reported a significantly longer time than ENs before fall incidents were discovered, and they used conversation and closeness as fall-preventing interventions to a significantly higher degree than ENs. Conclusions Individual factors were the most common causes to falls according to the nursing staff. RNs used closeness and dialog as interventions to a significantly higher degree to prevent falls than ENs. Caring of for older people with dementia consisted of a comprehensive on-going assessment by the nursing staff to balance the residents' autonomy-versus-control to minimise fall

The development of the Older Person's Nurse Fellowship: Education concept to delivery.

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Naughton, Corina; Hayes, Nicky; Zahran, Zainab; Norton, Christine; Lee, Geraldine; Fitzpatrick, Joanne M; Crawford, Mary; Tee, Stephen

2016-09-01

Preparing the nursing workforce to meet the challenges of an ageing population is a priority for many countries. The development of an Older Person's Nurse Fellowship (OPNF) programme for senior clinical nurses is an important innovation. This article describes the philosophical development, delivery and early evaluation of the OPNF. In 2014, Health Education England funded 24 senior clinical nurses to participate in the OPNF. The Fellowship was designed to build clinical leadership and innovation capability and develop a network of nurses to influence local and national strategy for older people's care. The Fellows selected were drawn from mental health (n=4), community/primary care (n=9) and acute care (n=11). The twelve month programme consisted of two Masters-level modules, delivered through study days and e-learning. The first cohort (n=12) commenced the course in November 2014 with a module designed to enhance clinical knowledge and skills. Evaluation data were collected from the first cohort using anonymous surveys (n=11) and focus group interviews (n=9). Descriptive statistics are presented for the quantitative data and common themes are described in the qualitative data. The overall satisfaction with the clinical module was high with a median score of 18/20 (range 17-20). Topics such as comprehensive geriatric assessment, frailty, pharmacology and cognitive assessment were regarded as highly relevant and most likely to result in a change to clinical practice. In the focus group interviews students discussed their learning experience in terms of: module specificity, peer-to-peer learning and using the OPNF as leverage for change. The OPNF is a timely innovation and a positive commitment to developing an academic pathway for senior nurses. It marks an important step in the future development of the older person's nursing workforce. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review

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Goisser, Sabine; Kemmler, Wolfgang; Porzel, Simone; Volkert, Dorothee; Sieber, Cornel Christian; Bollheimer, Leo Cornelius; Freiberger, Ellen

2015-01-01

One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity. PMID:26346071

A cross-validation Delphi method approach to the diagnosis and treatment of personality disorders in older adults.

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Rosowsky, Erlene; Young, Alexander S; Malloy, Mary C; van Alphen, S P J; Ellison, James M

2018-03-01

The Delphi method is a consensus-building technique using expert opinion to formulate a shared framework for understanding a topic with limited empirical support. This cross-validation study replicates one completed in the Netherlands and Belgium, and explores US experts' views on the diagnosis and treatment of older adults with personality disorders (PD). Twenty-one geriatric PD experts participated in a Delphi survey addressing diagnosis and treatment of older adults with PD. The European survey was translated and administered electronically. First-round consensus was reached for 16 out of 18 items relevant to diagnosis and specific mental health programs for personality disorders in older adults. Experts agreed on the usefulness of establishing criteria for specific types of treatments. The majority of psychologists did not initially agree on the usefulness of pharmacotherapy. Expert consensus was reached following two subsequent rounds after clarification addressing medication use. Study results suggest consensus among regarding psychosocial treatments. Limited acceptance amongst US psychologists about the suitability of pharmacotherapy for late-life PDs contrasted with the views expressed by experts surveyed in Netherlands and Belgium studies.

Visual risk factors for falls in older people.

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Lord, Stephen R

2006-09-01

Poor vision reduces postural stability and significantly increases the risk of falls and fractures in older people. Most studies have found that poor visual acuity increases the risk of falls. However, studies that have included multiple visual measures have found that reduced contrast sensitivity and depth perception are the most important visual risk factors for falls. Multifocal glasses may add to this risk because their near-vision lenses impair distance contrast sensitivity and depth perception in the lower visual field. This reduces the ability of an older person to detect environmental hazards. There is now evidence that maximising vision through cataract surgery is an effective strategy for preventing falls. Further randomised controlled trials are required to determine whether individual strategies (such as restriction of use of multifocal glasses) or multi-strategy visual improvement interventions can significantly reduce falls in older people. Public health initiatives are required to raise awareness in older people and their carers of the importance of regular eye examinations and use of appropriate prescription glasses.

Systemic lupus erythematosus presenting as morbid jealousy.

Science.gov (United States)

Ravindran, A.; Carney, M. W.; Denman, A. M.

1980-01-01

A patient fulfilling the diagnostic criteria for systemic lupus erythematosus and presenting with morbid jealousy is described. There was evidence of cerebral lupus. Her physical and mental symptoms responded to a combination of chlorpromazine and steroids. The morbid mental process was probably caused by her physical condition while the content of her disordered thought and behaviour was determined by her introverted premorbid personality, religiosity, unhappy childhood experiences and frustrated desire for children. PMID:7413541

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

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

2016-08-03

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

The third person in the room: The needs of care partners of older people in home care services-A systematic review from a person-centred perspective.

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Anker-Hansen, Camilla; Skovdahl, Kirsti; McCormack, Brendan; Tønnessen, Siri

2018-04-01

To identify and synthesise the needs of care partners of older people living at home with assistance from home care services. "Ageing in place" is a promoted concept where care partners and home care services play significant roles. Identifying the needs of care partners and finding systematic ways of meeting them can help care partners to cope with their role. This study is based on the PRISMA reporting guidelines. The systematic review of qualitative and quantitative studies was guided by the Joanna Briggs Institute methodology. In total, 16 studies were included in the review, eleven qualitative and five quantitative. Three main categories were revealed in the analysis: the need for quality interaction, the need for a shared approach to care and the need to feel empowered. Care partners of older people have several, continuously unmet needs. A person-centred perspective can contribute new understandings of how to meet these needs. A knowledge gap has been identified regarding the needs of care partners of older people with mental health problems. There is a need to develop a tool for systematic collaboration between home care services and care partners, so that the identified needs can be met in a more thorough, systematic and person-centred way. The carers in home care services need competence to identify and meet the needs of care partners. The implementation of person-centred values in home care services can contribute to meet the needs of care partners to a greater extent than today. Future research on the needs of care partners of older people with mental health problems needs to be undertaken. © 2017 John Wiley & Sons Ltd.

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

LENUS (Irish Health Repository)

2018-01-25

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

Relationship of personal hygiene with nutrition and morbidity profile: a study among primary school children in South kolkata.

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Deb, Soumya; Dutta, Sinjita; Dasgupta, Aparajita; Misra, Raghunath

2010-04-01

Majority of the health problems affecting school children are preventable by promotion of hygienic practices through proper health education by the teachers, who are the first contacts. The study was undertaken to find out the status of nutrition and personal hygiene among primary school children and their association with their varied morbidity profiles. A descriptive, observational, cross-sectional study was conducted in a primary school situated in the largest slum of Kolkata. The participants included 103 boys and 81 girls, with a mean age of 6.2 years. The mean personal hygiene score of the girls (4.15 ± 0.98) was significantly higher than that of boys (3.2 ± 1.4) [PPersonal hygiene scores were significantly higher (Ppersonal hygiene and poor sanitary practices of these school children through coordinated and concerted health education measures by teachers as well as parents.

Age-Related Differences in the Effect of Psychological Distress on Mortality: Type D Personality in Younger versus Older Patients with Cardiac Arrhythmias

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Johan Denollet

2013-01-01

Full Text Available Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14 was used to assess general psychological distress in 455 younger (≤70 y,. Cardiac resynchronization therapy (CRT, but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34 and 2.26 (95% CI 1.16–4.41 for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

Becoming an Older Volunteer: A Grounded Theory Study

Science.gov (United States)

Witucki Brown, Janet; Chen, Shu-li; Mefford, Linda; Brown, Allie; Callen, Bonnie; McArthur, Polly

2011-01-01

This Grounded Theory study describes the process by which older persons “become” volunteers. Forty interviews of older persons who volunteered for Habitat for Humanity were subjected to secondary content analysis to uncover the process of “becoming” a volunteer. “Helping out” (core category) for older volunteers occurs within the context of “continuity”, “commitment” and “connection” which provide motivation for volunteering. When a need arises, older volunteers “help out” physically and financially as health and resources permit. Benefits described as “blessings” of volunteering become motivators for future volunteering. Findings suggest that older volunteering is a developmental process and learned behavior which should be fostered in older persons by personally inviting them to volunteer. Intergenerational volunteering projects will allow older persons to pass on knowledge and skills and provide positive role modeling for younger volunteers. PMID:21994824

Becoming an Older Volunteer: A Grounded Theory Study

Directory of Open Access Journals (Sweden)

Janet Witucki Brown

2011-01-01

Full Text Available This Grounded Theory study describes the process by which older persons “become” volunteers. Forty interviews of older persons who volunteered for Habitat for Humanity were subjected to secondary content analysis to uncover the process of “becoming” a volunteer. “Helping out” (core category for older volunteers occurs within the context of “continuity”, “commitment” and “connection” which provide motivation for volunteering. When a need arises, older volunteers “help out” physically and financially as health and resources permit. Benefits described as “blessings” of volunteering become motivators for future volunteering. Findings suggest that older volunteering is a developmental process and learned behavior which should be fostered in older persons by personally inviting them to volunteer. Intergenerational volunteering projects will allow older persons to pass on knowledge and skills and provide positive role modeling for younger volunteers.

Older, wiser, and happier? Comparing older adults' and college students' self-defining memories.

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Singer, Jefferson; Rexhaj, Blerim; Baddeley, Jenna

2007-11-01

The present study compared self-defining memories in adults 50 years of age and older to the self-defining memories of college students. Findings are largely congruent with previous memory and ageing research, but shed additional light on how personal memories are employed to achieve a sense of identity and continuity in older adults. Older adults' self-defining memories, compared to those of younger adults, were more positive in emotional tone, more summarised and less detailed, and more likely to contain integrative meaning. The implications of these findings for assessing normative personal memory in older adults are discussed along with more general observations about narrative identity in older adulthood.

Complaints in long-term care facilities for older persons: why residents do not give 'free advice'.

NARCIS (Netherlands)

Bomhoff, M.; Friele, R.

2017-01-01

In health care policies, the right to complain is presented as a key patient right. Complaints are also seen as a potential vehicle for quality improvement. However, in long-term care facilities for older persons in the Netherlands, relatively few complaints are registered. An explorative

Complaints in long-term care facilities for older persons : Why residents do not give 'free advice'

NARCIS (Netherlands)

Bomhoff, Manja; Friele, R.D.

2017-01-01

In health care policies, the right to complain is presented as a key patient right. Complaints are also seen as a potential vehicle for quality improvement. However, in long-term care facilities for older persons in the Netherlands, relatively few complaints are registered. An explorative

Anxiety symptoms in 74+ community-dwelling elderly: associations with physical morbidity, depression and alcohol consumption.

Directory of Open Access Journals (Sweden)

Martina Forlani

Full Text Available OBJECTIVE: Anxiety among community-dwelling older adults has not been studied sufficiently. The aims of this cross-sectional population-based study were to estimate the point prevalence of clinically relevant anxiety symptoms and to describe their socio-demographic and clinical features, with particular focus on the association with somatic illnesses. METHODS: Three-hundred-sixty-six non-demented older adults (mean age 83.7±6.2, range 74-99 years from the Faenza Project (Northern Italy were assessed using the Cambridge Mental Disorders of the Elderly Examination-Revised (CAMDEX-R and the Geriatric Anxiety Inventory short form (GAI-sf. Multi-adjusted regression analyses were used to estimate Odds Ratio (OR and 95% Confidence Intervals (95% CI. RESULTS: Clinically relevant anxiety symptoms occurred in one out of five participants (point prevalence 21.0% and were significantly associated with depression (OR 5.6 per rank; 95% CI: 3.1-10.1, physical morbidity (OR 3.5 per illness; 95% CI: 1.0-11.9 and female gender (OR 2.8; 95% CI: 1.4-5.5. Further, there were significant associations with a consumption of alcohol exceeding 1 alcoholic unit/day. CONCLUSIONS: Anxiety symptoms are very common in older subjects, especially when medically ill. Depression and alcohol consumption often co-occur with late-life anxiety symptoms, thus requiring special attention in daily clinical practice.

Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons.

Science.gov (United States)

Benjumea, Angela-María; Curcio, Carmen-Lucía; Duque, Gustavo; Gómez, Fernando

2018-02-15

The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown. This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic. This is a cross-sectional study in Manizales, Andes Mountains, Colombia. A cohort of 534 subjects (mean age = 74, 75% female) Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP) including an index of skeletal mass, muscle strength, and gait speed. Dynapenia was defined as a handgrip force ≤ 30 kg for men and ≤ 20 kg for women. Dynapenia and sarcopenia were present in 84.6% and 71.2% respectively. Both were more prevalent in older subjects and women than men. While sarcopenia was associated with body mass index and hypertension, dynapenia was associated with hypothyroidism and visual impairment. After controlling for all covariates, sarcopenia was associated with low IADL and mobility disability. Sarcopenia was associated with mobility, ADL and IADL disability. Dynapenia was not associated with disability in this high - risk population. Systematic assessment of sarcopenia should be implemented in falls and fractures clinics to identify sarcopenia and develop interventions to prevent functional decline among elderly individuals.

Morphing the feature-based multi-blocks of normative/healthy vertebral geometries to scoliosis vertebral geometries: development of personalized finite element models.

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Hadagali, Prasannaah; Peters, James R; Balasubramanian, Sriram

2018-03-12

Personalized Finite Element (FE) models and hexahedral elements are preferred for biomechanical investigations. Feature-based multi-block methods are used to develop anatomically accurate personalized FE models with hexahedral mesh. It is tedious to manually construct multi-blocks for large number of geometries on an individual basis to develop personalized FE models. Mesh-morphing method mitigates the aforementioned tediousness in meshing personalized geometries every time, but leads to element warping and loss of geometrical data. Such issues increase in magnitude when normative spine FE model is morphed to scoliosis-affected spinal geometry. The only way to bypass the issue of hex-mesh distortion or loss of geometry as a result of morphing is to rely on manually constructing the multi-blocks for scoliosis-affected spine geometry of each individual, which is time intensive. A method to semi-automate the construction of multi-blocks on the geometry of scoliosis vertebrae from the existing multi-blocks of normative vertebrae is demonstrated in this paper. High-quality hexahedral elements were generated on the scoliosis vertebrae from the morphed multi-blocks of normative vertebrae. Time taken was 3 months to construct the multi-blocks for normative spine and less than a day for scoliosis. Efforts taken to construct multi-blocks on personalized scoliosis spinal geometries are significantly reduced by morphing existing multi-blocks.

Preventing Falls in Older Persons.

Science.gov (United States)

Moncada, Lainie Van Voast; Mire, L Glen

2017-08-15

The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling older adults who are at increased risk of falls. Although the U.S. Preventive Services Task Force and American Academy of Family Physicians do not recommend routine multifactorial intervention to prevent falls in all community-dwelling older adults, they state that it may be appropriate in individual cases. The Centers for Disease Control and Prevention developed an algorithm to aid in the implementation of the American Geriatrics Society/British Geriatrics Society guideline. The algorithm suggests assessment and multifactorial intervention for those who have had two or more falls or one fall-related injury. Multifactorial interventions should include exercise, particularly balance, strength, and gait training; vitamin D supplementation with or without calcium; management of medications, especially psychoactive medications; home environment modification; and management of postural hypotension, vision problems, foot problems, and footwear. These interventions effectively decrease falls in the community, hospital, and nursing home settings. Fall prevention is reimbursed as part of the Medicare Annual Wellness Visit.

Effects of a Behavioral Program on Exercise Adherence and Exercise Self-Efficacy in Community-Dwelling Older Persons

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Azizan, Azliyana; Kuan, Chua Siew

2013-01-01

Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P exercising alone on increasing exercise adherence and level of self-efficacy in older persons. PMID:24489539

Towards enhanced emotional interactions with older persons: findings from a nursing intervention in home health care.

NARCIS (Netherlands)

Veenvliet, C.; Eide, H.; Lange, M.A. de; Dulmen, S. van

2016-01-01

Background. Living at home with a physical condition that requires assistance places high emotional burden on older persons that needs to be attended to by nurses. However, nurses in home health care have previously been found to communicate primarily in an instrumental way. This increases the risk

The Moderating Effect of Personality Type on the Relationship between Leisure Activity and Executive Control in Older Adults

Science.gov (United States)

Hill, Nikki L.; Lin, Feng Vankee; Parisi, Jeanine M.; Kolanowski, Ann

2016-01-01

We examined the moderating effect of personality on the association between leisure activities and executive control in healthy community-dwelling older adults. We found two distinct personality typologies: individuals with a Resilient personality were characterized by emotional stability and self-confidence; whereas, those who resembled an Overcontrolled personality tended to be introverted, but also low on neuroticism. Resilient individuals were more likely than Overcontrolled individuals to demonstrate higher executive function and attention as a result of participation in mental activities. These results suggest that personality might be important to include in studies that test the efficacy of activity interventions for improving cognition. PMID:27087715

Alcohol use, depression, and life satisfaction among older persons in Jamaica.

Science.gov (United States)

Gibson, Roger C; Waldron, Norman K; Abel, Wendel D; Eldemire-Shearer, Denise; James, Kenneth; Mitchell-Fearon, Kathryn

2017-04-01

We aimed to determine the prevalence of alcohol use among older Jamaicans as well as to explore among this population the relationships between alcohol use and: age, sex, depressive symptoms, and life satisfaction. Although the nature of these relationships among the proposed study population were uncertain, in other settings alcohol use has tended to decline with increasing age, occur more commonly among men than women, and show non-linear relationships with depressive symptoms and life satisfaction. Data gathered by two-stage cluster sampling for a nationally representative health and lifestyle survey of 2,943 community-dwelling older Jamaicans, aged 60 to 103 years, were subjected to secondary analysis using the Student's t-test and χ 2 test as appropriate. Current alcohol use was reported by 21.4% of the participants. It steadily declined with age and was six times more prevalent among men (37.6%) than women (6.2%). These findings were statistically significant as were associations of current alcohol use with comparatively lower levels of depressive symptoms. Current alcohol use was also more prevalent among persons who were either highly satisfied or highly dissatisfied with their lives, compared to others who had levels of life satisfaction between these two extremes. Current alcohol use among older Jamaicans occurs primarily among men, declines with increasing age, and is associated with a relatively low likelihood of depression. It is also associated with very high and very low levels of life satisfaction.

Is Personality Associated with Health Care Use by Older Adults?

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Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

2013-01-01

Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and

Geriatric dermatology: optimising care in frail older adults

NARCIS (Netherlands)

Lubeek, S.F.K.

2017-01-01

Healthcare providers are expected to be increasingly confronted with the growing population of older adults. In the Netherlands, the frailest and most dependent older adults live in nursing homes. Skin problems are common in this patient population and they can result in a high level of morbidity,

The Debate around the Need for an International Convention on the Rights of Older Persons

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Doron, Israel; Apter, Itai

2010-01-01

In recent years, there has been a growing interest and debate around the question, whether there is a need for an international convention on the rights of older persons. The debate around this question is far from simple or consensual. Although there are strong voices in favor, there are also strong arguments against. Moreover, the mere fact that…

The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care

DEFF Research Database (Denmark)

Krag, Marlene Øhrberg; Hasselbalch, Lotte; Siersma, Volkert Dirk

2016-01-01

Aims/hypothesis: The aim of this study was to assess gender differences in mortality and morbidity during 13 follow-up years after 6 years of structured personal care in patients with type 2 diabetes mellitus. Methods: In the Diabetes Care in General Practice (DCGP) multicentre, cluster......-randomised, controlled trial (ClinicalTrials.gov registration no. NCT01074762), 1,381 patients newly diagnosed with type 2 diabetes were randomised to receive 6 years of either structured personal care or routine care. The intervention included regular follow-up, individualised goal setting and continuing medical...... = 0.005). Conclusions/interpretation: Compared with routine care, structured personal diabetes care reduced all-cause mortality and diabetes-related death in women but not in men. This gender difference was also observed for any diabetes-related outcome and stroke but was not statistically significant...

Mindfulness and eating behaviour styles in morbidly obese males and females

NARCIS (Netherlands)

Ouwens, M.A.; Schiffer, A.A.J.; Visser, L.I.; Raaijmakers, L.J.C.; Nyklicek, I.

2015-01-01

Background: Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions

Associations of recent weight loss with health care costs and utilization among older women.

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John T Schousboe

Full Text Available The association of weight loss with health care costs among older women is uncertain. Our study aim was to examine the association of objectively measured weight change with subsequent total health care (THC costs and other health care utilization among older women. Our study population included 2,083 women (mean age 80.2 years enrolled in the Study of Osteoporotic Fractures and U.S. Medicare Fee for Service. Weight loss and gain were defined, respectively, as ≥5% decrease and ≥5% increase in body weight, and weight maintenance as <5% change in body weight over a period of 4.5 years. THC costs, outpatient costs, hospitalizations, and skilled nursing facility [SNF] utilization were estimated from Medicare claims for 1 year after the period during which weight change was measured. The associations of weight change with THC and outpatient costs were estimated using generalized linear models with gamma variance and log link functions, and with hospitalizations and SNF utilization using logistic models. Adjusted for age and current body mass index (BMI, weight loss compared with weight maintenance was associated with a 35% increase in THC costs ($2148 [95% CI, 745 to 3552], 2014 U.S. dollars, a 15% increase in outpatient costs ($329 [95% C.I. -1 to 660], and odds ratios of 1.42 (95% CI, 1.14 to 1.76 for ≥1 hospital stay and 1.45 (95% CI, 1.03 to 2.03 for ≥1 SNF stay. These associations did not vary by BMI category. After additional adjustment for multi-morbidity and functional status, associations of weight loss with all four outcomes were no longer significant. In conclusion, ≥5% weight loss among older women is not associated with increased THC and outpatient costs, hospitalization, and SNF utilization, irrespective of BMI category after accounting for multi-morbidity and impaired functional status that accompany weight loss.

20 CFR 404.1585 - Trial work period for persons age 55 or older who are blind.

Science.gov (United States)

2010-04-01

... who are blind. 404.1585 Section 404.1585 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... § 404.1585 Trial work period for persons age 55 or older who are blind. If you become eligible for disability benefits even though you were doing substantial gainful activity because you are blind and age 55...

Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative

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Olivier Beauchet

2017-08-01

Full Text Available Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1 to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2 to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities.Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD initiative and the Generation 100 (Gen 100 study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV of gait parameters were used for the analyses.Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls, were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded

Older persons' worries expressed during home care visits: Exploring the content of cues and concerns identified by the Verona coding definitions of emotional sequences.

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Hafskjold, Linda; Eide, Tom; Holmström, Inger K; Sundling, Vibeke; van Dulmen, Sandra; Eide, Hilde

2016-12-01

Little is known about how older persons in home care express their concerns. Emotional cues and concerns can be identified by the Verona coding definitions of emotional sequences (VR-CoDES), but the method gives no insight into what causes the distress and the emotions involved. The aims of this study are to explore (1) older persons' worries and (2) the content of these expressions. An observational exploratory two-step approach was used to investigate audiotaped recordings from 38 Norwegian home care visits with older persons and nurse assistants. First, 206 cues and concerns were identified using VR-CoDES. Second, the content and context of these expressions were analysed inductively. Four main categories emerged: worries about relationships with others, worries about health care-related issues, worries about aging and bodily impairment, and life narratives and value issues, with several subcategories showing the causes of worry and emotions involved. The two-step approach provides an in-depth knowledge of older persons' worries, causes of worries, and their related emotions. The subcategories described in a language close to the experience can be useful in practice development and communication training for students and health care providers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons

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Angela-María Benjumea

2018-02-01

Full Text Available BACKGROUND: The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown. AIM: This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic. METHODS: This is a cross-sectional study in Manizales, Andes Mountains, Colombia.  534 subjects (mean age = 74, 75% female Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP including an index of skeletal mass, muscle strength, and gait speed. Dynapenia was defined as a handgrip force ≤ 30 kg for men and ≤ 20 kg for women. RESULTS: Dynapenia and sarcopenia were present in 84.6% and 71.2% respectively. Both were more prevalent in older subjects and women than men.  While sarcopenia was associated with body mass index and hypertension, dynapenia was associated with hypothyroidism and visual impairment.  After controlling for all covariates, sarcopenia was associated with low IADL and mobility disability. CONCLUSIONS: Sarcopenia was associated with mobility, ADL and IADL disability. Dynapenia was not associated with disability in this high - risk population. Systematic assessment of sarcopenia should be implemented in falls and fractures clinics to identify sarcopenia and develop interventions to prevent functional decline among elderly individuals.

Time does not heal all wounds: older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders.

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Raposo, Sarah M; Mackenzie, Corey S; Henriksen, Christine A; Afifi, Tracie O

2014-11-01

We aimed to examine the prevalence of several types of childhood adversity across adult cohorts, whether age moderates the effect of childhood adversity on mental health, the relationship between childhood adversity and psychopathology among older adults, the dose-response relationship between number of types of childhood adversities and mental disorders in later life, and whether lifetime mental health treatment reduces the odds of psychopathology among older survivors of childhood adversity. In a population-based, cross-sectional study on a nationally representative U.S. sample, we studied 34,653 community-dwelling Americans 20 years and older, including 7,080 adults 65 years and older from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Trained lay interviewers assessed past-year mood and anxiety disorders and lifetime personality disorders. Participants self-reported childhood adversity based on questions from the Adverse Childhood Experiences Study. Childhood adversity was prevalent across five age cohorts. In our adjusted models, age did not moderate the effect of childhood adversity on mental disorders. Older adults who experienced childhood adversity had higher odds of having mood (odds ratio: 1.73; 95% confidence interval: 1.32-2.28), anxiety (odds ratio: 1.48; 95% confidence interval: 1.20-1.83), and personality disorders (odds ratio: 2.11; 95% confidence interval: 1.75-2.54) after adjusting for covariates. An increasing number of types of childhood adversities was associated with higher odds of personality disorders and somewhat higher odds of anxiety disorders. Treatment-seeking was associated with a reduced likelihood of anxiety and, especially, mood disorders in older adult childhood adversity survivors. These results emphasize the importance of preventing childhood adversity and intervening once it occurs to avoid the negative mental health effects that can last into old age. Copyright © 2014 American Association for

The Effectiveness and Safety of Manual Therapy on Pain and Disability in Older Persons With Chronic Low Back Pain: A Systematic Review.

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de Luca, Katie E; Fang, Sheng Hung; Ong, Justin; Shin, Ki-Soo; Woods, Samuel; Tuchin, Peter J

2017-09-01

The aim of this study was to perform a systematic review of the literature of the effectiveness and safety of manual therapy interventions on pain and disability in older persons with chronic low back pain (LBP). A literature search of 4 electronic databases was performed (PubMed, EMBASE, OVID, and CINAHL). Inclusion criteria included randomized controlled trials of manual therapy interventions on older persons who had chronic LBP. Effectiveness was determined by extracting and examining outcomes for pain and disability, with safety determined by the report of adverse events. The PEDro scale was used for quality assessment of eligible studies. The search identified 405 articles, and 38 full-text articles were assessed. Four studies met the inclusion criteria. All trials were of good methodologic quality and had a low risk of bias. The included studies provided moderate evidence supporting the use of manual therapy to reduce pain levels and alleviate disability. A limited number of studies have investigated the effectiveness and safety of manual therapy in the management of older people with chronic LBP. The current evidence to make firm clinical recommendations is limited. Research with appropriately designed trials to investigate the effectiveness and safety of manual therapy interventions in older persons with chronic LBP is required. Copyright © 2017. Published by Elsevier Inc.

Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults.

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Huang, Ivy A; Neuhaus, John M; Chiong, Winston

2016-02-01

Black and Hispanic older Americans are less likely than white older Americans to possess advance directives. Understanding the reasons for this racial and ethnic difference is necessary to identify targets for future interventions to improve advance care planning in these populations. The aim of the study was to evaluate whether racial and ethnic differences in advance directive possession are explained by other demographic factors, religious characteristics, and personal health values. A general population survey was conducted in a nationally representative sample using a web-enabled survey panel of American adults aged 50 and older (n = 2154). In a sample of older Americans, white participants are significantly more likely to possess advance directives (44.0%) than black older Americans (24.0%, p personal health values. These findings support targeted efforts to mitigate racial disparities in access to advance care planning.

Framing the construct of life satisfaction in terms of older adults' personal goals.

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Rapkin, B D; Fischer, K

1992-03-01

Older adults' life satisfaction can be better understood in light of their personal goals. This study of 179 elders examined (a) how goals correlate with satisfaction, (b) whether elders maintain satisfaction by accommodating goals to past losses, and (c) how correlations between satisfaction and key predictors differ among groups with different goals. Satisfaction was related positively to social maintenance and energetic life-style goals and negatively to concerns for improvement, disengagement, stability, and reduced activity. Past losses were correlated with current goals but not with satisfaction, consistent with the notion of accommodation. A cluster analysis identified 5 patterns of goals: high demand, age prescribed, self-focused, socially engaged, and low demand. Correlations between satisfaction and other predictors differed by cluster, suggesting that the determinants of elders' satisfaction depend on personal goals.

Method for Assigning Priority Levels in Acute Care (MAPLe-AC predicts outcomes of acute hospital care of older persons - a cross-national validation

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Ljunggren Gunnar

2011-06-01

Full Text Available Abstract Background Although numerous risk factors for adverse outcomes for older persons after an acute hospital stay have been identified, a decision making tool combining all available information in a clinically meaningful way would be helpful for daily hospital practice. The purpose of this study was to evaluate the ability of the Method for Assigning Priority Levels for Acute Care (MAPLe-AC to predict adverse outcomes in acute care for older people and to assess its usability as a decision making tool for discharge planning. Methods Data from a prospective multicenter study in five Nordic acute care hospitals with information from admission to a one year follow-up of older acute care patients were compared with a prospective study of acute care patients from admission to discharge in eight hospitals in Canada. The interRAI Acute Care assessment instrument (v1.1 was used for data collection. Data were collected during the first 24 hours in hospital, including pre-morbid and admission information, and at day 7 or at discharge, whichever came first. Based on this information a crosswalk was developed from the original MAPLe algorithm for home care settings to acute care (MAPLe-AC. The sample included persons 75 years or older who were admitted to acute internal medical services in one hospital in each of the five Nordic countries (n = 763 or to acute hospital care either internal medical or combined medical-surgical services in eight hospitals in Ontario, Canada (n = 393. The outcome measures considered were discharge to home, discharge to institution or death. Outcomes in a 1-year follow-up in the Nordic hospitals were: living at home, living in an institution or death, and survival. Logistic regression with ROC curves and Cox regression analyses were used in the analyses. Results Low and mild priority levels of MAPLe-AC predicted discharge home and high and very high priority levels predicted adverse outcome at discharge both in the Nordic

A model for morbidity after lung resection in octogenarians.

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Berry, Mark F; Onaitis, Mark W; Tong, Betty C; Harpole, David H; D'Amico, Thomas A

2011-06-01

Age is an important risk factor for morbidity after lung resection. This study was performed to identify specific risk factors for complications after lung resection in octogenarians. A prospective database containing patients aged 80 years or older, who underwent lung resection at a single institution between January 2000 and June 2009, was reviewed. Preoperative, histopathologic, perioperative, and outcome variables were assessed. Morbidity was measured as a patient having any perioperative event as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. A multivariable risk model for morbidity was developed using a panel of established preoperative and operative variables. Survival was calculated using the Kaplan-Meier method. During the study period, 193 patients aged 80 years or older (median age 82 years) underwent lung resection: wedge resection in 77, segmentectomy in 13, lobectomy in 96, bilobectomy in four, and pneumonectomy in three. Resection was accomplished via thoracoscopy in 149 patients (77%). Operative mortality was 3.6% (seven patients) and morbidity was 46% (89 patients). A total of 181 (94%) patients were discharged directly home. Postoperative events included atrial arrhythmia in 38 patients (20%), prolonged air leak in 24 patients (12%), postoperative transfusion in 22 patients (11%), delirium in 16 patients (8%), need for bronchoscopy in 14 patients (7%), and pneumonia in 10 patients (5%). Significant predictors of morbidity by multivariable analysis included resection greater than wedge (odds ratio 2.98, p=0.006), thoracotomy as operative approach (odds ratio 2.6, p=0.03), and % predicted forced expiratory volume in 1s (odds ratio 1.28 for each 10% decrement, p=0.01). Octogenarians can undergo lung resection with low mortality. Extent of resection, use of a thoracotomy, and impaired lung function increase the risk of complications. Careful evaluation is necessary to select the most appropriate approach in

Effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment: the DANTE Study Leiden.

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Moonen, Justine E F; Foster-Dingley, Jessica C; de Ruijter, Wouter; van der Grond, Jeroen; de Craen, Anton J M; van der Mast, Roos C

2016-03-01

the relationship between antihypertensive medication and orthostatic hypotension in older persons remains ambiguous, due to conflicting observational evidence and lack of data of clinical trials. to assess the effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment. a total of 162 participants with orthostatic hypotension were selected from the Discontinuation of Antihypertensive Treatment in Elderly people (DANTE) Study. This randomised clinical trial included community-dwelling participants aged ≥75 years, with mild cognitive impairment, using antihypertensive medication and without serious cardiovascular disease. Participants were randomised to discontinuation or continuation of antihypertensive treatment (ratio 1:1). Orthostatic hypotension was defined as a drop of at least 20 mmHg in systolic blood pressure and/or 10 mmHg in diastolic blood pressure on standing from a seated position. Outcome was the absence of orthostatic hypotension at 4-month follow-up. Relative risks (RR) were calculated by intention-to-treat and per-protocol analyses. at follow-up, according to intention-to-treat analyses, of the 86 persons assigned to discontinuation of antihypertensive medication, 43 (50%) were free from orthostatic hypotension, compared with 29 (38%) of the 76 persons assigned to continuation of medication [RR 1.31 (95% confidence interval (CI) 0.92-1.87); P = 0.13]. Per-protocol analysis showed that recovery from orthostatic hypotension was significantly higher in persons who completely discontinued all antihypertensive medication (61%) compared with the continuation group (38%) [RR 1.60 (95% CI 1.10-2.31); P = 0.01]. in older persons with mild cognitive impairment and orthostatic hypotension receiving antihypertensive medication, discontinuation of antihypertensive medication may increase the probability of recovery from orthostatic hypotension. © The Author 2016. Published by Oxford

Staff awareness of the application of Mental Health and Guardianship Legislation in the care of hospitalised older persons.

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Panesar, Narinder; Valachova, Iveta; Schmidtman, Robert; Chan, Daniel Kam Yin

2018-02-01

The study aimed to survey hospital staff knowledge of the application of the Mental Health Act 2007 (NSW) (MHA) and the Guardianship Act 1987 (NSW) (GA) in the care and treatment of older persons in a teaching hospital in Sydney. Method Over a two-month period in 2017, a survey questionnaire was distributed to staff involved in older persons' care across the hospital. The majority of the hospital staff demonstrated basic theoretical knowledge of both the GA (76%) and of the MHA (84.5%). Fewer (64.5%) appeared to understand the practical application of the MHA in the hypothetical clinical situations. An even lower proportion of staff appeared to understand the application of the GA either to obtain consent for medical treatment or to appoint a guardian through the Guardianship Division of the NSW Civil and Administrative Tribunal (NCAT). Although clinical staff of the hospital displayed fair knowledge and awareness about the application of the MHA and the GA to inpatient care of older adults, further education is necessary, particularly about the application of the GA. The authors suggest similar findings may occur at other New South Wales hospitals, which may raise concern and need for education.

Diagnostic challenges in the older patient

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Killinger Lisa

2012-09-01

Full Text Available Abstract Older patients often present with a long, complex history and a clinical picture that frequently includes co-morbidities. It is essential that health professionals caring for older patients become familiar with common age-related changes, and the specific clinical factors that complicate the diagnostic process. A case-based approach is taken in this article to explore the diagnostic challenges in caring for older patients. Three areas of focus are used: a polypharmacy, b cognitive issues such as delirium, dementia and depression, and c increased odds of pathologies and chronic illnesses.

On the Prototyping of an ICT-Enhanced Toilet System for Assisting Older Persons Living Independently and Safely at Home.

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Panek, Paul; Fazekas, Gabor; Lüftenegger, Theresa; Mayer, Peter; Pilissy, Tamas; Raffaelli, Matteo; Rist, Atilla; Rosenthal, Ramona; Savanovic, Arso; Sobjak, Anna; Sonntag, Franziska; Toth, Andras; Unger, Birgit

2017-01-01

Standard toilets often do not meet the needs of a significant number of older persons and persons with disabilities. The EU funded iToilet project aims at design and development of a new type of ICT enhanced modular toilet system which shall be able to support autonomy, dignity and safety of older persons living at home. Methodologically the project started with gathering user requirements by means of questionnaires, interviews and focus group discussion involving a total of 74 persons, thereof 41 subjects with movement disorders (primary users), 21 caregivers (secondary users) and 12 healthcare managers (tertiary users). Most important wishes were bilateral removable handrails, height and tilt adjustment, emergency detection, simplicity. In parallel to the ongoing technical development participatory design activities have been carried out at user test sites in order to continuously involve users into the design process and to allow quick feedback with regards to early prototype parts. The project currently is working on the finalization of the first prototype ready to enter the lab trial stage in spring 2017. The experiences will be used for redesigning a prototype 2 which is planned to be tested in real life settings early 2018.

Person-Centered Care for Older Adults With Serious Mental Illness and Substance Misuse Within a Program of All-Inclusive Care for the Elderly.

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Cacchione, Pamela Z; Eible, Lisa; Gill, Le'Roi L; Huege, Steven F

2016-05-01

Providing person-centered care (PCC) to older adults with dual diagnosis, co-occurring serious mental illness (SMI), and substance misuse is complex and requires an interprofessional team. Older adults, who qualify for both Medicaid and Medicare (i.e., dual-eligibles) are overrepresented in the population of older adults with SMI and substance misuse. Programs of All-Inclusive Care for the Elderly (PACE) exist to support community living needs of nursing home-eligible older adults and are increasingly in a position to serve older adults with SMI and substance misuse issues. PACE programs provide integrated person-centered mental health care to address the serious medical, social, and emotional complications posed by having SMI and substance misuse disorders. The case study presented illustrates PCC provided to a dual-diagnosis PACE participant, illustrating the impact of recent and past trauma on current psychopathology and substance misuse. Finally, recommendations for addressing PCC of dual diagnosis within the PACE model are provided. [Journal of Gerontological Nursing, 42(5), 11-17.]. Copyright 2016, SLACK Incorporated.

Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension

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Franklin, Stanley S.; Thijs, Lutgarde; Hansen, Tine W.; Li, Yan; Boggia, José; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Torp-Pedersen, Christian; Dolan, Eamon; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Imai, Yutaka; Wang, Jiguang; Ibsen, Hans; O’Brien, Eoin; Staessen, Jan A.

2013-01-01

The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (≥90 mm Hg) or by daytime ABP (≥85 mm Hg), a history of cardiovascular disease, and persons hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP ≥140/hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79–1.53]; P=0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43–2.79]; Phypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, “treated normalized hypertension.” Therefore, one should be cautious in applying the term “white-coat hypertension” to persons receiving antihypertensive treatment. PMID:22252396

Function in context: why American and Trinidadian young and older adults remember the personal past.

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Alea, Nicole; Bluck, Susan; Ali, Sideeka

2015-01-01

Multiple and interacting contextual (culture, life phase) and person-specific predictors (i.e., personality, tendency to think-talk about the past) of the functions of autobiographical memory were examined using the Thinking about Life Experiences Scale. American (N = 174) and Trinidadian (N = 182) young and older adults self-reported how frequently they remembered the personal past to serve self, social and directive functions, how often they thought and talked about their past overall, and completed a measure of trait personality. Independent contextual and person-specific predictors were found for using memory to serve a social-bonding function: Americans, young adults, those higher in extraversion, lower in conscientiousness and individuals who frequently think and talk about the past more often use autobiographical memory for social bonding. Across cultures, younger adults report more frequently using memory to serve all three functions, whereas Trinidadians who think more often about the past compared with those who reflect less often are more likely to use it for self and directive functions. Findings are discussed in terms of the individual's embeddedness in cultural and life phase contexts when remembering.

Symptom distress in older adults following cancer surgery.

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Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

2013-01-01

Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

Should clinical case definitions of influenza in hospitalized older adults include fever?

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Falsey, Ann R; Baran, Andrea; Walsh, Edward E

2015-08-01

Influenza is a major cause of morbidity and mortality in elderly persons. Fever is included in all standard definitions of influenza-like illness (ILI), yet older patients may have diminished febrile response to infection. Therefore, we examined the utility of various thresholds to define fever for case definitions of influenza in persons ≥ 65 years of age. Data from two prospective surveillance studies for respiratory viral infection in adults hospitalized with acute cardiopulmonary illnesses with or without fever were examined. The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded. The diagnosis of influenza was made by a combination of viral culture, reverse-transcription polymerase chain reaction, antigen testing, and serology. A total of 2410 subjects (66% ≥ 65 years of age) were enrolled; 281 had influenza (261 influenza A, 19 influenza B, and one mixed influenza A and B). The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults. Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively. Clinical decision rules using the presence of cough and fever may be helpful when screening for influenza or empiric antiviral treatment when rapid influenza testing is not available; however, lower fever thresholds may be considered for elderly subjects. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence.

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Collamati, Agnese; Martone, Anna Maria; Poscia, Andrea; Brandi, Vincenzo; Celi, Michela; Marzetti, Emanuele; Cherubini, Antonio; Landi, Francesco

2016-02-01

The use of medication with anticholinergic properties is widespread among older subjects. Many drugs of common use such as antispasmodics, bronchodilators, antiarrhythmics, antihistamines, anti-hypertensive drugs, antiparkinson agents, skeletal muscle relaxants, and psychotropic drugs have been demonstrated to have an anticholinergic activity. The most frequent adverse effects are dry mouth, nausea, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment such as confusion, agitation and coma. A growing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment in the elderly population. However, the morbidity and management issues associated with unwanted anticholinergic activity are underestimated and frequently overlooked. Moreover, their possible relation with specific negative outcome in the elderly population is still not firmly established. The aim of the present review was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older persons. We searched PubMed and Cochrane combining the search terms "anticholinergic", "delirium", "cognitive impairment", "falls", "mortality" and "discontinuation". Medicines with anticholinergic properties may increase the risks of functional and cognitive decline, morbidity, institutionalization and mortality in older people. However, such evidences are still not conclusive probably due to possible confounding factors. In particular, more studies are needed to investigate the effects of discontinuation of drug with anticholinergic properties. Overall, minimizing anticholinergic burden should always be encouraged in clinical practice to improve short-term memory, confusion and delirium, quality of life and daily functioning.

Morbidity, Mortality, and Seasonality of Influenza Hospitalizations in Egypt, November 2007-November 2014

Science.gov (United States)

Kandeel, Amr; Labib, Manal; Said, Mayar; El-Refai, Samir; El-Gohari, Amani; Talaat, Maha

2016-01-01

Background Influenza typically comprises a substantial portion of acute respiratory infections, a leading cause of mortality worldwide. However, influenza epidemiology data are lacking in Egypt. We describe seven years of Egypt’s influenza hospitalizations from a multi-site influenza surveillance system. Methods Syndromic case definitions identified individuals with severe acute respiratory infection (SARI) admitted to eight hospitals in Egypt. Standardized demographic and clinical data were collected. Nasopharyngeal and oropharyngeal swabs were tested for influenza using real-time reverse transcription polymerase chain reaction and typed as influenza A or B, and influenza A specimens subtyped. Results From November 2007–November 2014, 2,936/17,441 (17%) SARI cases were influenza-positive. Influenza-positive patients were more likely to be older, female, pregnant, and have chronic condition(s) (all p<0.05). Among them, 53 (2%) died, and death was associated with older age, five or more days from symptom onset to hospitalization, chronic condition(s), and influenza A (all p<0.05). An annual seasonal influenza pattern occurred from July–June. Each season, the proportion of the season’s influenza-positive cases peaked during November–May (19–41%). Conclusions In Egypt, influenza causes considerable morbidity and mortality and influenza SARI hospitalization patterns mirror those of the Northern Hemisphere. Additional assessment of influenza epidemiology in Egypt may better guide disease control activities and vaccine policy. PMID:27607330

Morbidity, Mortality, and Seasonality of Influenza Hospitalizations in Egypt, November 2007-November 2014.

Directory of Open Access Journals (Sweden)

Amr Kandeel

Full Text Available Influenza typically comprises a substantial portion of acute respiratory infections, a leading cause of mortality worldwide. However, influenza epidemiology data are lacking in Egypt. We describe seven years of Egypt's influenza hospitalizations from a multi-site influenza surveillance system.Syndromic case definitions identified individuals with severe acute respiratory infection (SARI admitted to eight hospitals in Egypt. Standardized demographic and clinical data were collected. Nasopharyngeal and oropharyngeal swabs were tested for influenza using real-time reverse transcription polymerase chain reaction and typed as influenza A or B, and influenza A specimens subtyped.From November 2007-November 2014, 2,936/17,441 (17% SARI cases were influenza-positive. Influenza-positive patients were more likely to be older, female, pregnant, and have chronic condition(s (all p<0.05. Among them, 53 (2% died, and death was associated with older age, five or more days from symptom onset to hospitalization, chronic condition(s, and influenza A (all p<0.05. An annual seasonal influenza pattern occurred from July-June. Each season, the proportion of the season's influenza-positive cases peaked during November-May (19-41%.In Egypt, influenza causes considerable morbidity and mortality and influenza SARI hospitalization patterns mirror those of the Northern Hemisphere. Additional assessment of influenza epidemiology in Egypt may better guide disease control activities and vaccine policy.

Prevalence of psychiatric and physical morbidity in an urban geriatric population.

Science.gov (United States)

Seby, K; Chaudhury, Suprakash; Chakraborty, Rudraprosad

2011-04-01

With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Cross-sectional, epidemiological study. All the consenting elderly persons in a municipal ward division (n=202) were enrolled after surveying a total adult population of 7239 people. A door to door survey was undertaken where the participants were interviewed and physically examined. General Health Questionnaire-12, Mini Mental State Examination, CAGE Questionnaire and Geriatric Depression Scale were used in the interview apart from consulting the available documents. Other family members were also interviewed to verify the information. Chi-square test with Yates correction. Psychiatric illnesses were detected in 26.7% while physical illnesses were present in 69.8% of the population surveyed. Predominant psychiatric diagnoses were depressive disorders, dementia, generalized anxiety disorder, alcohol dependence and bipolar disorder. The most common physical illness was visual impairment, followed by cardiovascular disease, rheumatic illnesses, pulmonary illnesses, hearing impairment, genitourinary diseases and neurological disorders. Presence of dementia was associated with increased age, single/widowed/separated status, nuclear family, economic dependence, low education, cardiovascular disorders, rheumatic disorders and neurological disorders. Depression was associated with female sex, single/widowed/separated status, staying in nuclear families, economic dependence on others and co-morbid physical illnesses, specifically cardiovascular disorders and visual impairment. This study presented a higher rate of dementia and old age depression. The interesting

Targeting the underlying causes of undernutrition. Cost-effectiveness of a multifactorial personalized intervention in community-dwelling older adults: A randomized controlled trial.

Science.gov (United States)

van der Pols-Vijlbrief, Rachel; Wijnhoven, Hanneke A H; Bosmans, Judith E; Twisk, Jos W R; Visser, Marjolein

2017-12-01

Undernutrition in old age is associated with increased morbidity, mortality and health care costs. Treatment by caloric supplementation results in weight gain, but compliance is poor in the long run. Few studies targeted underlying causes of undernutrition in community-dwelling older adults. This study aimed to evaluate the cost-effectiveness of a multifactorial personalized intervention focused on eliminating or managing the underlying causes of undernutrition to prevent and reduce undernutrition in comparison with usual care. A randomized controlled trial was performed among 155 community-dwelling older adults receiving home care with or at risk of undernutrition. The intervention included a personalized action plan and 6 months support. The control group received usual care. Body weight, and secondary outcomes were measured in both groups at baseline and 6 months follow-up. Multiple imputation, linear regression and generalized estimating equation analyses were used to analyze intervention effects. In the cost-effectiveness analyses regression models were bootstrapped to estimate statistical uncertainty. This intervention showed no statistically significant effects on body weight, mid-upper arm circumference, grip strength, gait speed and 12-Item Short-Form Health Survey physical component scale as compared to usual care, but there was an effect on the 12-Item Short-Form Health Survey mental component scale (0-100) (β = 8.940, p=0.001). Borderline significant intervention effects were found for both objective and subjective physical function measures, Short Physical Performance Battery (0-12) (β = 0.56, p=0.08) and ADL-Barthel score (0-20) (β = 0.69, p=0.09). Societal costs in the intervention group were statistically non-significantly lower than in the control group (mean difference -274; 95% CI -1111; 782). Cost-effectiveness acceptability curves showed that the probability of cost-effectiveness was 0.72 at a willingness-to-pay of 1000�

Adverse drug reactions in older patients during hospitalisation: are they predictable?

LENUS (Irish Health Repository)

O'Connor, Marie N

2012-11-01

adverse drug reactions (ADRs) are a major cause of morbidity and healthcare utilisation in older people. The GerontoNet ADR risk score aims to identify older people at risk of ADRs during hospitalisation. We aimed to assess the clinical applicability of this score and identify other variables that predict ADRs in hospitalised older people.

An Investigation of the Most Influential Factors Predicting Nursing Students' Knowledge and Attitude toward Older Persons

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Little, Elaine B.

2017-01-01

The aging population with complex health needs is growing. Nursing programs are challenged to educate student nurses competent and willing to meet this specific population's needs. Research on ageism supports the presence of aging bias. Possible negative attitudes towards older persons by nursing students is a concern for nurse educators. Nursing…

Narratives of Self-Neglect: Patterns of Traumatic Personal Experiences and Maladaptive Behaviors in Cognitively Intact Older Adults.

Science.gov (United States)

Lien, Cynthia; Rosen, Tony; Bloemen, Elizabeth M; Abrams, Robert C; Pavlou, Maria; Lachs, Mark S

2016-11-01

To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. Descriptive study involving semistructured interviews and unstructured narratives. A parent study of self-neglect characteristics. Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69). Interviews included a comprehensive psychiatric assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis-I and II Disorders and an unstructured interview that allowed subjects to describe important elements of their life stories. Content analysis was used to identify personal experiences and behavior patterns in each subject's narrative. Four types of traumatic personal experiences (psychologically traumatic loss, separation or abandonment (29%); violent victimization, physical trauma, or sexual abuse (19%); exposure to war or political violence (9%); prolonged mourning (7%)) and five behavior patterns (significant financial instability (23%), severe lifelong mental illness (16%), mistrust of people or paranoia (13%), distrust and avoidance of the medical establishment (13%), substance abuse or dependence (13%)) were identified in the life stories. Patterns of traumatic personal experiences and maladaptive behaviors that self-neglecters frequently report were identified. Experiences, perceptions, and behaviors developed over a lifetime may contribute to elder self-neglect. Further exploration and better understanding of these patterns may identify potential risk factors and areas for future targeted screening, intervention, and prevention. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Have they done what they should? Moral reasoning in the context of translating older persons' everyday problems into eligible needs for home modification services.

Science.gov (United States)

Johansson, Karin

2013-09-01

This study explores how moral reasoning is expressed in matching health care with the problems older persons experience in their everyday life. Narrative data were collected from older persons who had applied for home modification services and from professionals involved in these services in Sweden. A theoretical framework, based on theories on the anthropology of morals, was applied to explore how the participants made conclusions about "what should be done." Moral reasoning was found to be guided by ideologies related to the historical and cultural context of the Swedish welfare state. Different interpretations of how these values should be expressed in specific situations led to different conclusions about what should be done. The study highlights the importance of understanding how values are enacted rather than what values different social agents have in order to understand how health care services can be designed and provided to support older persons' everyday life. © 2013 by the American Anthropological Association.

Sources of stress and psychological morbidity among undergraduate physiotherapy students.

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Walsh, J M; Feeney, C; Hussey, J; Donnellan, C

2010-09-01

Professional education can be a stressful experience for some individuals, and may impact negatively on emotional well-being and academic performance. Psychological morbidity and associated sources of stress have not been investigated extensively in physiotherapy students. This study explored sources of stress, psychological morbidity and possible associations between these variables in undergraduate physiotherapy students. A questionnaire-based survey. The Undergraduate Sources of Stress Questionnaire was used to identify sources of stress, and the General Health Questionnaire-12 (GHQ-12) was used to rate the prevalence of psychological morbidity, using a conservative GHQ threshold of 3 to 4 to determine probable 'cases'. Uni- and multivariate tests of correlation were used to analyse the data. An Irish educational institution. One hundred and twenty-five physiotherapy undergraduate students. More than one-quarter of all students (27%) scored above the GHQ threshold, indicating probable psychological morbidity. This is higher than the level of psychological morbidity reported by the general population. Regression analysis showed that academic (beta=0.31, Pphysiotherapy students, with academic and personal issues being the greatest concern. While personal causes of stress such as stressful events and mood are more difficult to control, manipulation of curricular factors may have positive effects on academic sources of stress. Copyright 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Long-acting intramuscular naltrexone for opioid use disorder: Utilization and association with multi-morbidity nationally in the Veterans Health Administration.

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Kelly, Megan M; Reilly, Erin; Quiñones, Timothy; Desai, Nitigna; Rosenheck, Robert

2018-02-01

Long acting intramuscular (IM) naltrexone is an effective treatment for opioid use disorder (OUD), but rates and correlates of its use have not been studied. National administrative from the Veterans Health Administration (VHA) from Fiscal Year 2012 identified only 16 VHA facilities that prescribed IM naltrexone to 5 or more veterans diagnosed with OUD. Data from these facilities were used to identify sociodemographic, diagnostic, and service use characteristics, including use of psychotropic medication, that were characteristic of veterans who filled prescriptions for IM naltrexone. This was in comparison to users of opiate agonist treatments (methadone or buprenorphine) or veterans with no pharmacologic treatment for OUD. Comparisons were made using both bi-variate analyses and multivariable logistic regression. Only 179 of 16,402 veterans with OUD (1%) at these 16 facilities filled a prescription for IM naltrexone and only 256 of 99,394 (0.26%) nationally. These veterans were characterized by past homelessness, co-morbid alcohol use disorder, multiple psychiatric disorders, and a greater likelihood of psychiatric hospitalization, as well as mental health outpatient and antidepressant medication use. IM naltrexone is rarely used for OUD and is primarily used for patients with multiple co-morbidities, especially alcohol use disorder and serious mental illness. The use of this treatment illustrates many of the principles identified by the emerging focus on multi-morbidity as a critical feature of clinical practice. Copyright © 2017. Published by Elsevier B.V.

Effective communication with older adults.

Science.gov (United States)

Daly, Louise

2017-06-07

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

Alcohol abuse and postoperative morbidity

DEFF Research Database (Denmark)

Tønnesen, Hanne

2003-01-01

Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re......-operation. The personal and economic consequences are tremendous. The incidence of alcohol abusers undergoing surgery was 7% to 49%, according to gender and diagnosis. They have been identified by a self-reported alcohol intake, which implies the possibility of underestimation. Alcohol markers could be used for a more...

Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection.

Science.gov (United States)

Johs, Nikolas A; Wu, Kunling; Tassiopoulos, Katherine; Koletar, Susan L; Kalayjian, Robert C; Ellis, Ronald J; Taiwo, Babafemi; Palella, Frank J; Erlandson, Kristine M

2017-07-01

Older human immunodeficiency virus (HIV)-infected adults may experience higher rates of frailty and disability than the general population. Improved understanding of the prevalence, risk factors, and types of impairment can better inform providers and the healthcare system. HIV-infected participants within the AIDS Clinical Trials Group A5322 HAILO study self-reported disability by the Lawton-Brody Instrumental Activities of Daily Living (IADL) Questionnaire. Frailty was measured by 4-m walk time, grip strength, self-reported weight loss, exhaustion, and low activity. Logistic regression models identified characteristics associated with any IADL impairment. Agreement between IADL impairment and frailty was assessed using the weighted kappa statistic. Of 1015 participants, the median age was 51 years, 15% were aged ≥60 years, 19% were female, 29% black, and 20% Hispanic. At least 1 IADL impairment was reported in 18% of participants, most commonly with housekeeping (48%) and transportation (36%) and least commonly with medication management (5%). In multivariable models, greater disability was significantly associated with neurocognitive impairment, lower education, Medicare/Medicaid insurance (vs private/other coverage), smoking, and low physical activity. Although a greater proportion of frail participants had IADL impairment (52%) compared to non-frail (11%) persons, agreement was poor (weighted kappa disability occurs frequently among middle-aged and older HIV-infected adults on effective antiretroviral therapy. Potentially modifiable risk factors (smoking, physical activity) provide targets for interventions to maintain independent living. Systematic recognition of persons at greater risk for disability can facilitate connection to resources that may help preserve independence. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Experience of emotion in frail older people towards the end of life: A secondary data analysis.

Science.gov (United States)

Findlay, Caitlin; Lloyd, Anna; Finucane, Anne M

2017-12-02

People are living longer, but with increased age comes greater frailty and multi-morbidity. This secondary data analysis examines transcripts from interviews with 11 frail older people and 6 informal carers to explore emotion in relation to frailty and deteriorating health. Anger and frustration were frequently experienced with declining functional ability; sadness occurred with social isolation, loss of autonomy and independence; anxiety was evident when transition to a care home was discussed; and contentment was described when connecting with others. Reluctant acceptance emerged as a coping strategy. Insights gained from analysing emotion may inform communications training courses for community nurses, though further research is required.

Development and psychometric properties of the Maastricht Personal Autonomy Questionnaire (MPAQ) in older adults with a chronic physical illness.

Science.gov (United States)

Mars, Godelief M J; van Eijk, Jacques Th M; Post, Marcel W M; Proot, Ireen M; Mesters, Ilse; Kempen, Gertrudis I J M

2014-08-01

To develop and test the Maastricht Personal Autonomy Questionnaire (MPAQ), an instrument measuring personal autonomy of older adults with a chronic physical illness in accordance with their experience of autonomy. Achievement of personal autonomy is conceptualized as correspondence between the way people's lives are actually arranged and the way people want to arrange their lives. A field test was conducted in three waves (n = 412, n = 125 and n = 244) among a random sample of people older than 59 years with either chronic obstructive pulmonary disease or diabetes mellitus. Construct validity, reproducibility and responsiveness were evaluated. The MPAQ entailing 16 items consists of three scales: degree of (personal) autonomy, working on autonomy and dilemmas. Construct validity was largely supported by confirmatory factor analysis and correlations between the MPAQ and other instruments. Intraclass correlation coefficients ranged from 0.61 to 0.80 and SRDsgroup from 0.10 to 0.13. Mean change was larger (0.54) than was SRDgroup (0.11) in patients who had deteriorated, but smaller in patients who had improved (0.07). The MPAQ has good content and construct validity and moderate reproducibility. Responsiveness is weak, although better for deterioration than for improvement.

Obfuscatable multi-recipient re-encryption for secure privacy-preserving personal health record services.

Science.gov (United States)

Shi, Yang; Fan, Hongfei; Xiong, Guoyue

2015-01-01

With the rapid development of cloud computing techniques, it is attractive for personal health record (PHR) service providers to deploy their PHR applications and store the personal health data in the cloud. However, there could be a serious privacy leakage if the cloud-based system is intruded by attackers, which makes it necessary for the PHR service provider to encrypt all patients' health data on cloud servers. Existing techniques are insufficiently secure under circumstances where advanced threats are considered, or being inefficient when many recipients are involved. Therefore, the objectives of our solution are (1) providing a secure implementation of re-encryption in white-box attack contexts and (2) assuring the efficiency of the implementation even in multi-recipient cases. We designed the multi-recipient re-encryption functionality by randomness-reusing and protecting the implementation by obfuscation. The proposed solution is secure even in white-box attack contexts. Furthermore, a comparison with other related work shows that the computational cost of the proposed solution is lower. The proposed technique can serve as a building block for supporting secure, efficient and privacy-preserving personal health record service systems.

Enhancing Connectedness Through Peer Training for Community-Dwelling Older People: A Person Centred Approach.

Science.gov (United States)

Burmeister, Oliver K; Bernoth, Maree; Dietsch, Elaine; Cleary, Michelle

2016-06-01

Social interaction and connectedness is important to the mental health and wellbeing of older people. The aim of this research study was to facilitate and increase opportunities for social connectedness for older people living in regional areas through the use of technology training. Weekly technology training sessions were conducted at a Seniors Citizen's Club with a peer trainer (an experienced, retired computer teacher) and sessions were attended not only by the six study participants, but also by other club members, with up to 15 club members participating in sessions. Data analysis involved all documents generated by the project, including the individual interviews, researcher observations of training sessions, reports from the peer trainer and weekly diaries maintained by participants. Findings demonstrated that computer training at the Senior Citizens Club helped participants build group cohesion and to form tiered connections with partners, family, and friends with whom they no longer live. When the trainer is seen as a peer, and training is person-centred, older people are more receptive to learning, exploring, and experimenting with technology. Although only six people were involved in the in-depth evaluation part of the study, voluntary training with the trainer in the absence of any funding continues even to this present time. The outcome of this research reinforces the potential for technology facilitated tiered connectivity to enhance the quality of life for older people living in regional and rural Australia.

Dehydration in the Older Adult.

Science.gov (United States)

Miller, Hayley J

2015-09-01

Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause. Traditional markers for dehydration do not take into consideration many of the physiological differences present in older adults. Clinical assessment of dehydration in older adults poses different findings, yet is not always diagnostic. Treatment of dehydration should focus on prevention and early diagnosis before it negatively effects health and gives rise to comorbidities. The current article discusses what has most thoroughly been studied; the best strategies and assessment tools for evaluation, diagnosis, and treatment of dehydration in older adults; and what needs to be researched further. [Journal of Gerontological Nursing, 41(9), 8-13.]. Copyright 2015, SLACK Incorporated.

Within-person variability in response speed as an indicator of cognitive impairment in older adults.

Science.gov (United States)

Strauss, Esther; Bielak, Allison A M; Bunce, David; Hunter, Michael A; Hultsch, David F

2007-11-01

Within-person variability may be an important indicator of central nervous system compromise. In this study, within-person variability in response speed was examined in community-dwelling older adults, ages 64-92 years, using a new framework that takes into account both the extent (single versus multiple domains affected) and nature (amnestic versus non-amnestic) of the cognitive impairment. Those with multiple domains of impairment were more variable than those who showed an isolated area of impairment, regardless of whether memory was one of the domains affected. Further, for those with difficulties in two or more non-memory domains, increased variability was most evident in more cognitively demanding situations, when individuals had to manipulate information held briefly in mind, switch cognitive set or inhibit an automatic response. Finally, group differentiation was better achieved when within-person variability as opposed to mean speed of performance was considered.

Proposal of a service delivery integration index of home care for older persons: application in several European cities.

NARCIS (Netherlands)

Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

2006-01-01

PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

Regular multi-component exercise increases physical fitness and muscle protein anabolism in frail, obese, older adults

OpenAIRE

Villareal, Dennis T.; Smith, Gordon I.; Sinacore, David R.; Shah, Krupa; Mittendorfer, Bettina

2010-01-01

Aging is associated with a decline in strength, endurance, balance, and mobility. Obesity worsens the age-related impairment in physical function and often leads to frailty. The American College of Sports Medicine recommends a multi-component (strength, endurance, flexibility, and balance) exercise program to maintain physical fitness. However, the effect of such an exercise program on physical fitness in frail, obese older adults is not known. We therefore determined the effect of a 3 month-...

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD: A large, nationally representative survey in the Australian population

Directory of Open Access Journals (Sweden)

O'Neil Adrienne

2012-01-01

Full Text Available Abstract Background Co-morbid major depressive disorder (MDD and cardiovascular disease (CVD is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841 to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6. Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9 and CVD only (adj OR:0.8, 95% CI: 0.6-0.9 also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3 compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6. Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population

Science.gov (United States)

2012-01-01

Background Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is

Burnout, psychological morbidity, job stress, and job satisfaction in Chinese neurologists.

Science.gov (United States)

Zhou, Xinyu; Pu, Juncai; Zhong, Xiaoni; Zhu, Dan; Yin, Dinghong; Yang, Lining; Zhang, Yuqing; Fu, Yuying; Wang, Haiyang; Xie, Peng

2017-05-02

To investigate the prevalence of and personal and professional characteristics associated with burnout, psychological morbidity, job stress, and job satisfaction in Chinese neurologists. The China Neurologist Association conducted a national cross-sectional study from September 2014 to March 2015. A questionnaire including the Maslach Burnout Inventory, the 12-item General Health Questionnaire, the Consultants' Mental Health Questionnaire, and questions assessing personal and professional characteristics, career satisfaction, and current doctor-patient relationships was administered. A total of 693 directors of neurology departments and 6,111 neurologists in 30 Chinese provinces returned surveys. Overall, 53.2% of responding neurologists experienced burnout, 37.8% had psychological morbidity, 50.7% had high levels of job stress, 25.7% had low levels of job satisfaction, 76.9% had poor doctor-patient relationships, and 58.1% regretted becoming a doctor. Factors independently associated with burnout were lower income, more hours worked per week, more nights on call per month, working in public hospitals, psychological morbidity, high levels of job stress, low levels of job satisfaction, and poor doctor-patient relationships. Factors independently associated with psychological morbidity included lower income, more nights on call per month, working in enterprise-owned hospitals, burnout, high levels of job stress, and low levels of job satisfaction. Burnout and psychological morbidity are common in Chinese neurologists. Burnout is the single greatest predictor of neurologists' psychological morbidity, high job stress, and low job satisfaction. © 2017 American Academy of Neurology.

Can echocardiographic findings predict falls in older persons?

NARCIS (Netherlands)

N. van der Velde (Nathalie); B.H.Ch. Stricker (Bruno); J.R.T.C. Roelandt (Jos); F.J. ten Cate (Folkert); T.J.M. van der Cammen (Tischa)

2007-01-01

textabstractBackground. The European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers. Method and

Morbidity pattern and health seeking behavior in elderly population of Raipur City, Chhattisgarh, India

Directory of Open Access Journals (Sweden)

Md. Alam Naushad

2016-09-01

Full Text Available Background: Epidemiological transition across globe is considered as the net result of the demographic transition. The shape of the population pyramid is gradually changing from a wide-based and narrow topped form to a barrel-shaped form in recent future (1. Aims & Objectives: 1. To determine morbidity pattern in elderly population, 2. To assess their health care seeking behavior. Material & Methods: Study design- A Community based cross sectional observational study. Study setting - Pt J.N.M. Medical College, Raipur, Chhattisgarh. Study Duration: July 2013 to June 2014. Sampling method: - Multi stage simple random sampling. Sample size: 640. Sample Size were calculated by using statistical formula, n= Z21-α/2 P(1-P/d. Study tool: Pre-designed, Pre-tested Performa. Ethical consideration-Written document from institutional ethical Committee and Informed Consent from subject. Inclusion criteria: 1. All elderly persons in the age group of 60 years and above who were residing in the study area for at least one year, and willing to Participate in study without compulsion. Exclusion Criteria: 1. Those who were not willing to participate in study. Results & Conclusions: Prevalence of morbidity was 95.31%. Morbidity was positively associated with advancement of age and predominant in females (98.92% and those belong to slum (98.43% and lower (98.14% socio-economic status while inversely associated with Physical activity. Out of total morbid population 70.49% had chronic illness. Most common system involvement was Gastro intestinal system (82.62%. Perception about illness was increased with advancement of age. Majority were seeking therapy from private registered practitioner (35.52%.

Can echocardiographic findings predict falls in older persons?

NARCIS (Netherlands)

van der Velde, Nathalie; Stricker, Bruno H. Ch; Roelandt, Jos R. T. C.; ten Cate, Folkert J.; van der Cammen, Tischa J. M.

2007-01-01

BACKGROUND: The European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers. METHOD AND FINDINGS: In

Co-morbidity of personality disorder in schizophrenia among psychiatric outpatients in China: data from epidemiologic survey in a clinical population.

Science.gov (United States)

Wei, YanYan; Zhang, TianHong; Chow, Annabelle; Tang, YingYing; Xu, LiHua; Dai, YunFei; Liu, XiaoHua; Su, Tong; Pan, Xiao; Cui, Yi; Li, ZiQiang; Jiang, KaiDa; Xiao, ZePing; Tang, YunXiang; Wang, JiJun

2016-07-08

The reported rates of personality disorder (PD) in subjects with schizophrenia (SZ) are quite varied across different countries, and less is known about the heterogeneity of PD among subjects with SZ. We examined the co-morbidity of PD among patients who are in the stable phase of SZ. 850 subjects were randomly sampled from patients diagnosed with SZ in psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. Co-morbidity of PDs was assessed through preliminary screening and patients were administered several modules of the SCID-II. Evidence of heterogeneity was evaluated by comparing patients diagnosed with SZ with those who presented with either affective disorder or neurosis (ADN). 204 outpatients (24.0 %) in the stable phase of SZ met criteria for at least one type of DSM-IV PD. There was a higher prevalence of Cluster-A (odd and eccentric PD) and C (anxious and panic PD) PDs in SZ (around 12.0 %). The most prevalent PD was the paranoid subtype (7.65 %). Subjects with SZ were significantly more likely to have schizotypal PD (4.4 % vs. 2.1 %, p = 0.003) and paranoid PD (7.6 % vs. 5.4 %, p = 0.034), but much less likely to have borderline, obsessive-compulsive, depressive, narcissistic and histrionic PD. These findings suggest that DSM-IV PD is common in patients with SZ than in the general population. Patterns of co-morbidity with PDs in SZ are different from ADN.

Relationship between pure-tone audiogram findings and speech perception among older Japanese persons.

Science.gov (United States)

Maeda, Yukihide; Takao, Soshi; Sugaya, Akiko; Kataoka, Yuko; Kariya, Shin; Tanaka, Satomi; Nagayasu, Rie; Nakagawa, Atsuko; Nishizaki, Kazunori

2018-02-01

To clarify how the pure-tone threshold (PTT) on the PTA predicts speech perception (SP) in elderly Japanese persons. Data on PTT and SP were cross-sectionally analyzed in Japanese persons (656 ears in 353 patients, aged ≥65 years). Correlations of SP and average PTT in all tested frequencies were evaluated by Pearson's correlation coefficient and simple linear regression. After adjusting for sex, laterality of ears, and age, the relationship of average and frequency-specific PTT with impaired SP ≤50% was estimated by logistic regression models. SP correlated well (r = -0.699) with the average PTT of all tested frequencies. On the other hand, the correlation between patient age and SP was weak, especially among ≤85-year-old persons (r = -0.092). Linear regression showed that the average PTT corresponding to SP of 50% was 76.4 dB nHL. Odds ratios for impaired SP were highest for PTT at 2000 Hz. Odds ratios were higher for middle (500, 1000, 2000 Hz) and high frequencies (4000, 8000 Hz) than low frequencies (125, 250 Hz). The PTT on the pure-tone audiogram (PTA) is a good predictor of SP by speech audiometry among older persons, which could provide clinically important information for hearing aid fitting and cochlear implantation.

Cognitive performance in depressed older persons : the impact of vascular burden and remission. A two-year follow-up study

NARCIS (Netherlands)

Zuidersma, Marij; Comijs, Hannie C.; Naarding, Paul; Oude Voshaar, Richard C.

Objectives: Depression is associated with an increased risk of cognitive decline. The present study compared two-year change in cognitive performance between depressed older persons and a non-depressed control group, between remitted and non-remitted patients, and evaluated whether vascular burden

Exploration of the Raven APM-National Adult Reading Test discrepancy as a measure of intellectual decline in older persons

NARCIS (Netherlands)

Berg, E. van den; Nys, G.M.; Brands, A.M.; Ruis, C.; Zandvoort, M.J. Van; Kessels, R.P.C.

2013-01-01

Previous studies have shown that the discrepancy between performance on "fluid" and "crystallized" intelligence measures may serve as an indicator for intellectual decline. The validity of this procedure in older persons is unknown. The present study developed a multiple regression equation, to

Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015.

Science.gov (United States)

Ahmad, Noor Ani; Mohamad Kasim, Noraida; Mahmud, Nur Azna; Mohd Yusof, Yusniza; Othman, Salimah; Chan, Ying Ying; Abd Razak, Mohamad Aznuddin; Yusof, Muslimah; Omar, Maisarah; Abdul Aziz, Fazly Azry; Jamaluddin, Rasidah; Ibrahim Wong, Norazizah; Aris, Tahir

2017-09-29

Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities. This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability. Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least "some difficulty" scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53). Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive. The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.

Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS 2015

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Noor Ani Ahmad

2017-09-01

Full Text Available Abstract Background Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities. Methods This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability. Results Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least “some difficulty” scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53. Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive. Conclusions The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.

A descriptive study of the morbidity pattern of older persons ...

African Journals Online (AJOL)

Data were analyzed using Stata version 13 (Texas, USA). Frequency distributions were used for descriptive analysis, and chi-square test was used to test associations. Results: More than a half, 2919 (59.7%), of the respondents were females and almost three quarters 3501 (71.7%) were aged between 60 and 74 years.

A Descriptive Study of the Morbidity Pattern of Older Persons ...

African Journals Online (AJOL)

2014-12-31

Dec 31, 2014 ... This is an open access article distributed under the terms of the Creative Commons. Attribution-Non Commercial-Share Alike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical ...

Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review

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Goisser S

2015-08-01

Full Text Available Sabine Goisser,1 Wolfgang Kemmler,2 Simone Porzel,3 Dorothee Volkert,1 Cornel Christian Sieber,1,4 Leo Cornelius Bollheimer,1,4 Ellen Freiberger1 1Institute for Biomedicine of Aging (IBA, Friedrich-Alexander-Universität (FAU Erlangen-Nürnberg, Nuremberg, 2Institute of Medical Physics (IMP, Friedrich-Alexander-Universität (FAU Erlangen-Nürnberg, 3Nutricia GmbH, Danone Medical Nutrition, Erlangen, 4Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder, Regensburg, Germany Abstract: One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study

The association between depression and emotional and social loneliness in older persons and the influence of social support, cognitive functioning and personality: A cross-sectional study.

Science.gov (United States)

Peerenboom, L; Collard, R M; Naarding, P; Comijs, H C

2015-08-15

We investigated the association between old age depression and emotional and social loneliness. A cross-sectional study was performed using data from the Netherlands Study of Depression in Older Persons (NESDO). A total of 341 participants diagnosed with a depressive disorder, and 125 non-depressed participants were included. Depression diagnosis was confirmed with the Composite International Diagnostic Interview. Emotional and social loneliness were assessed using the De Jong Gierveld Loneliness Scale. Socio-demographic variables, social support variables, depression characteristics (Inventory of Depressive Symptoms), cognitive functioning (Mini Mental State Examination) and personality factors (the NEO- Five Factor Inventory and the Pearlin Mastery Scale) were considered as possible explanatory factors or confounders. (Multiple) logistic regression analyses were performed. Depression was strongly associated with emotional loneliness, but not with social loneliness. A higher sense of neuroticism and lower sense of mastery were the most important explanatory factors. Also, we found several other explanatory and confounding factors in the association of depression and emotional loneliness; a lower sense of extraversion and higher severity of depression. We performed a cross-sectional observational study. Therefore we cannot add evidence in regard to causation; whether depression leads to loneliness or vice versa. Depression in older persons is strongly associated with emotional loneliness but not with social loneliness. Several personality traits and the severity of depression are important in regard to the association of depression and emotional loneliness. It is important to develop interventions in which both can be treated. Copyright © 2015 Elsevier B.V. All rights reserved.

Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis: An Analysis Across 6 European Cohorts

NARCIS (Netherlands)

de Koning, Elisa J.; Timmermans, E.J.; van Schoor, N.M.; Stubbs, Brendon; van den Kommer, Tessa N.; Dennison, E.M.; Limongi, Federica; Castell, Maria Victoria; Edwards, M.H.; Queipo, Rocio; Cooper, Cyrus; Siviero, Paola; van der Pas, Suzan; Pedersen, N.L.; Sánchez-Martínez, Mercedes; Deeg, D.J.H.; Denkinger, Michael D.; Nikolaus, T.; Denkinger, M.; Peter, R.; Herbolsheimer, F.; Maggi, S.; Zambon, S.; Limongi, F.; Noale, M.; Siviero, P.; Deeg, D.J.H.; van der Pas, S.; van Schoor, N.M.; Schaap, L.A.; Timmermans, E.J.; Lips, P.; Otero, Á.; Castell, M.V.; Sanchez-Martinez, M.; Pedersen, N.L.; Dennison, E.M.; Cooper, C.; Edwards, M.H.

Pain is a key symptom of Osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the

Aging in Saudi Arabia: An Exploratory Study of Contemporary Older Persons' Views About Daily Life, Health, and the Experience of Aging.

Science.gov (United States)

Karlin, Nancy J; Weil, Joyce; Felmban, Wejdan

2016-01-01

Objective: This exploratory study sought to measure current self-reported experiences of older Saudi adults. Method: Self-reported aging perceptions and demographic data from semistructured questions were obtained from 52 community-dwelling older Saudi adults aged 50 or older. A thematic content analysis was completed around issues of family life/social support, daily/weekly activities, health and health programs, and older adults' own thoughts about aging and the experience and future of personal aging. Results: Several key themes emerged from the interviews. The majority of respondents in this preliminary study acknowledge a preference for family care. Formal programs in Saudi Arabia are attended with relative infrequency while older adults recognize family support as the preferred method of support. Older Saudi interviewees hold a positive view of aging, but physical functioning, varying financial resources, and other daily obligations are a concern for those in this study. Discussion: Data suggest as the Saudi population ages, more research is needed on the aging experience with particiular emphasis on issues relevant to older adults . Future research must work to clarify the aging experience as cultural context changes.

Diminished mental- and physical function and lack of social support are associated with shorter survival in community dwelling older persons of Botswana

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Molebatsi Robert M

2007-07-01

Full Text Available Abstract Background Mortality rates for older persons in Botswana have been unavailable and little is known of predictors of mortality in old age. This study may serve as a precursor for more detailed assessments. The objective was to assess diminished function and lack of social support as indicators of short term risk of death. Methods A national population based prospective survey was undertaken in Botswana; twelve rural areas and three urban centers were included. 372 community-dwelling persons aged sixty years and over, were included; 265 were followed-up. Sixteen subjects were deceased at follow-up. Subjects were interviewed and clinically assessed at home. Measures of cognitive function, depression and physical function and sociodemographic information were collected. Subjects were followed-up at average 6.8 months after baseline. Results Overall mortality rate was 10.9 per 100 person years. Age-adjusted odds ratios (OR for death during follow-up were; 4.2 (CI 1.4–12.5 and 3.6 (CI 1.0–12.7 for those with diminished physical- and cognitive function, respectively. Indicators of limited social support; household with only 1 or 2 persons and eating alone, yielded age adjusted ORs of 4.3 (CI 1.5–12.5 and 6.7 (CI 2.2–20, respectively, for death during follow-up. Conclusion Older community dwelling persons with diminished cognitive- or physical function, solitary daily meals and living in a small household have a significantly increased risk of rapid deterioration and death. Health policy should include measures to strengthen informal support and expand formal service provisions to older persons with poor function and limited social networks in order to prevent premature deaths.

Particle swarm optimization using multi-information characteristics of all personal-best information.

Science.gov (United States)

Huang, Song; Tian, Na; Wang, Yan; Ji, Zhicheng

2016-01-01

Convergence stagnation is the chief difficulty to solve hard optimization problems for most particle swarm optimization variants. To address this issue, a novel particle swarm optimization using multi-information characteristics of all personal-best information is developed in our research. In the modified algorithm, two positions are defined by personal-best positions and an improved cognition term with three positions of all personal-best information is used in velocity update equation to enhance the search capability. This strategy could make particles fly to a better direction by discovering useful information from all the personal-best positions. The validity of the proposed algorithm is assessed on twenty benchmark problems including unimodal, multimodal, rotated and shifted functions, and the results are compared with that obtained by some published variants of particle swarm optimization in the literature. Computational results demonstrate that the proposed algorithm finds several global optimum and high-quality solutions in most case with a fast convergence speed.

Multi-person and multi-attribute design evaluations using evidential reasoning based on subjective safety and cost analyses

International Nuclear Information System (INIS)

Wang, J.; Yang, J.B.; Sen, P.

1996-01-01

This paper presents an approach for ranking proposed design options based on subjective safety and cost analyses. Hierarchical system safety analysis is carried out using fuzzy sets and evidential reasoning. This involves safety modelling by fuzzy sets at the bottom level of a hierarchy and safety synthesis by evidential reasoning at higher levels. Fuzzy sets are also used to model the cost incurred for each design option. An evidential reasoning approach is then employed to synthesise the estimates of safety and cost, which are made by multiple designers. The developed approach is capable of dealing with problems of multiple designers, multiple attributes and multiple design options to select the best design. Finally, a practical engineering example is presented to demonstrate the proposed multi-person and multi-attribute design selection approach

Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation seeking.

Science.gov (United States)

Sanbonmatsu, David M; Strayer, David L; Medeiros-Ward, Nathan; Watson, Jason M

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants' perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation--high levels of impulsivity and sensation seeking--reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control--low scorers on the Operation Span task and persons high in impulsivity--tended to report higher levels of multi-tasking activity.

Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation seeking.

Directory of Open Access Journals (Sweden)

David M Sanbonmatsu

Full Text Available The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants' perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation--high levels of impulsivity and sensation seeking--reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control--low scorers on the Operation Span task and persons high in impulsivity--tended to report higher levels of multi-tasking activity.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

Science.gov (United States)

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are not the persons who are most likely to engage in multiple tasks simultaneously. To the contrary, multi-tasking activity as measured by the Media Multitasking Inventory and self-reported cell phone usage while driving were negatively correlated with actual multi-tasking ability. Multi-tasking was positively correlated with participants’ perceived ability to multi-task ability which was found to be significantly inflated. Participants with a strong approach orientation and a weak avoidance orientation – high levels of impulsivity and sensation seeking – reported greater multi-tasking behavior. Finally, the findings suggest that people often engage in multi-tasking because they are less able to block out distractions and focus on a singular task. Participants with less executive control - low scorers on the Operation Span task and persons high in impulsivity - tended to report higher levels of multi-tasking activity. PMID:23372720

Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.

Science.gov (United States)

Sivaram, P; Sreekumar, A

2018-04-01

Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a substantial health problem with significant postoperative morbidity and mortality. This study aimed to find out the association between various preoperative and intraoperative factors with the postoperative mortality and morbidity in patients operated for peptic ulcer perforation. This prospective observational study had a time based sample of 101 perforation peritonitis cases admitted to the surgical wards of a tertiary care center from February 2015 to January 2016 who underwent laparotomy, diagnosed to have peptic ulcer perforation and underwent simple closure with an omental patch. Data regarding age, gender, presenting complaints, time elapsed from the onset of symptoms to surgery, physical examination findings, comorbid diseases, laboratory and imaging findings, intraoperative findings, length of hospital stay, postoperative morbidity, and mortality were recorded and analyzed. Female gender, older age group, perforation surgery interval more than 36 h, and size of perforation more than 1 cm 2 were found to be significant factors influencing postoperative mortality and morbidity. Postoperative morbidity was also associated with comorbid diseases. Abnormal renal function on presentation was identified as an additional risk factor for postoperative morbidity and longer hospital stay. An understanding of these factors, identification of patients at risk and early intervention can help in reducing the postoperative morbidity and mortality in peptic ulcer perforation.

Impact of novelty and type of material on recognition in healthy older adults and persons with mild cognitive impairment.

Science.gov (United States)

Belleville, Sylvie; Ménard, Marie-Claude; Lepage, Emilie

2011-08-01

The goal of this study was to assess the effect of novelty on correct recognition (hit minus false alarms) and on recollection and familiarity processes in normal aging and amnestic mild cognitive impairment (MCI). Recognition tasks compared well-known and novel stimuli in the verbal domain (words vs. pseudowords) and in the musical domain (well-known vs. novel melodies). Results indicated that novel materials associated with lower correct recognition and lower recollection, an effect that can be related to its lower amenability to elaborative encoding in comparison with well-known items. Results also indicated that normal aging impairs recognition of well-known items, whereas MCI impairs recognition of novel items only. Healthy older adults showed impaired recollection and familiarity relative to younger controls and individuals with MCI showed impaired recollection relative to healthy older adults. The recollection deficit in healthy older adults and persons with MCI and their impaired recognition of well-known items is compatible with the difficulty both groups have in encoding information in an elaborate manner. In turn, familiarity deficit could be related to impaired frontal functioning. Therefore, novelty of material has a differential impact on recognition in persons with age-related memory disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prevalence of psychiatric morbidity among medical practitioners in ...

African Journals Online (AJOL)

Background: Mental health problems can affect anybody including Doctors. It can be related to nature of our work and personal factors. Mental ill health includes a range of conditions like depression, bipolar disorder, anxiety and psychosis. Objective: To determine the prevalence of psychiatric morbidity among Medical ...

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

Science.gov (United States)

Soriano, Theresa A; DeCherrie, Linda V; Thomas, David C

2007-01-01

Falls in the elderly are an important independent marker of frailty. Up to half of elderly people over 65 experience a fall every year. They are associated with high morbidity and mortality and are responsible for greater than 20 billion dollars a year in healthcare costs in the United States. This article presents a review and guide for the primary care provider of the predisposing and situational risk factors for falls; comprehensive assessment for screening and tailored intervention; and discussion of single and multicomponent measures for fall prevention and management in the older person living in the community. Interventions for the cognitively impaired and demented elderly will also be addressed. PMID:18225454

PSYCHOSOCIAL MORBIDITY IN PATIENTS UNDERGOING MASTECTOMY FOR BREAST CANCER

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Kavitha Konnakkaparambil Ramakrishnan

2018-02-01

Full Text Available BACKGROUND Breast Cancer is the most common female cancer worldwide and carries significant psychosocial morbidity. The diagnosis of the disease and the treatment modalities like surgery and chemotherapy contribute to the morbidity. The recognition of the psychosocial morbidity associated with mastectomy can help us formulate effective counselling strategies. The objectives of this study were- to assess the psychosocial morbidity in patients undergoing mastectomy for carcinoma breast, to identify the preoperative variables that predict the morbidity and to find out the correlation between degree of neuroticism of the individual and morbidity. MATERIALS AND METHODS 35 female patients who had mastectomy for breast cancer were evaluated at three time-points, preoperatively, immediately after surgery and 2 months after surgery. Anxiety and depression was assessed using Hospital Anxiety and Depression Scale (HADS, psychological distress was measured using General Health Questionnaire (GHQ-12 and neuroticism was assessed by Eysenck Personality Inventory Neuroticism subscale (EPI-N. RESULTS There was a high level of anxiety, depression and GHQ scores preoperatively with a further worsening of these over the three interviews. Age, marital status and menopausal status were factors which had an influence on psychosocial morbidity. Preoperative EPI-N scores positively correlated with psychosocial morbidity. CONCLUSION There is a high level of psychosocial morbidity in patients undergoing mastectomy for breast cancer and mastectomy seems to worsen it in the first two months after surgery. Our study shows that psychosocial morbidity is affected by age, marital status, menopausal status and level of neuroticism.

Agreement between PRE2DUP register data modeling method and comprehensive drug use interview among older persons

Science.gov (United States)

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

2016-01-01

Background PRE2DUP is a modeling method that generates drug use periods (ie, when drug use started and ended) from drug purchases recorded in dispensing-based register data. It is based on the evaluation of personal drug purchasing patterns and considers hospital stays, possible stockpiling of drugs, and package information. Objective The objective of this study was to investigate person-level agreement between self-reported drug use in the interview and drug use modeled from dispensing data with PRE2DUP method for various drug classes used by older persons. Methods Self-reported drug use was assessed from the GeMS Study including a random sample of persons aged ≥75 years from the city of Kuopio, Finland, in 2006. Drug purchases recorded in the Prescription register data of these persons were modeled to determine drug use periods with PRE2DUP modeling method. Agreement between self-reported drug use on the interview date and drug use calculated from register-based data was compared in order to find the frequently used drugs and drug classes, which was evaluated by Cohen’s kappa. Kappa values 0.61–0.80 were considered to represent good and 0.81–1.00 as very good agreement. Results Among 569 participants with mean age of 82 years, the agreement between interview and register data was very good for 75% and very good or good for 93% of the studied drugs or drug classes. Good or very good agreement was observed for drugs that are typically used on regular bases, whereas “as needed” drugs represented poorer results. Conclusion PRE2DUP modeling method validly describes regular drug use among older persons. For most of drug classes investigated, PRE2DUP-modeled register data described drug use as well as interview-based data which are more time-consuming to collect. Further studies should be conducted by comparing it with other methods and in different drug user populations. PMID:27785101

Utilization and yield of nerve conduction studies and electromyography in older adults

LENUS (Irish Health Repository)

Mello, S

2016-02-01

Older adults are at increased risk of both central and peripheral neurological disorders. Impaired nerve and muscle deficits contribute to morbidity and reduced quality of life. Our aim was to define the utilization and yield of nerve conduction studies (NCS) and electromyography (EMG) in older adults. We reviewed NCS and EMG records for all patients older than age 65 in the year 2012. Of 1,530 NCS and EMGs performed, 352 (23%) were in patients older than 65 (mean age 73.7, 52% male). Two hundred and eighty-eight (83.7%) of NCS were abnormal as were 102 (71.8%) of EMGs. The likelihood of having an abnormal test result increased with increasing age. The most common diagnosis was peripheral neuropathy 231 (65.4%). The incidence of peripheral neuropathy is particularly high in this age group, and detection is vital to prevent morbidity and improve quality of life.

Double Jeopardy? Age, Race, and HRQOL in Older Adults with Cancer

International Nuclear Information System (INIS)

Bellizzi, K. M.; Aziz, N. M.; Rowland, J. H.; Arora, N. K.

2012-01-01

Understanding the post-treatment physical and mental function of older adults from ethnic/racial minority backgrounds with cancer is a critical step to determine the services required to serve this growing population. The double jeopardy hypothesis suggests being a minority and old could have compounding effects on health. This population-based study examined the physical and mental function of older adults by age (mean age=75.7, SD=6.1), ethnicity/race, and cancer (breast, prostate, colorectal, and gynecologic) as well as interaction effects between age, ethnicity/race and HRQOL. There was evidence of a significant age by ethnicity/race interaction in physical function for breast, prostate and all sites combined, but the interaction became non-significant (for breast and all sites combined) when co morbidity was entered into the model. The interaction persisted in the prostate cancer group after controlling for co morbidity, such that African Americans and Asian Americans in the 75-79 age group report lower physical health than non-Hispanic Whites and Hispanic Whites in this age group. The presence of double jeopardy in the breast and all sites combined group can be explained by a differential co morbid burden among the older (75-79) minority group, but the interaction found in prostate cancer survivors does not reflect this differential co morbid burden.

Problem drinking and associated factors in older adults in South Africa

African Journals Online (AJOL)

Objective: Alcohol abuse poses special risks for increased morbidity and mortality among older adults. Little attention has focused on assessing alcohol use and associated factors among older adults in transitional societies such as South Africa. This study aimed to determine the prevalence of alcohol use and associated ...

Adherence to a Mediterranean diet and risk of fractures in French older persons.

Science.gov (United States)

Feart, C; Lorrain, S; Ginder Coupez, V; Samieri, C; Letenneur, L; Paineau, D; Barberger-Gateau, P

2013-12-01

Prevention of fractures is a considerable public health challenge. In a population-based cohort of French elderly people, a diet closer to a Mediterranean type had a borderline significant deleterious effect on the risk of fractures, in part linked to a low consumption of dairy products and a high consumption of fruits. Higher adherence to the Mediterranean diet (MeDi) is linked to a lower risk of several chronic diseases, but its association with the risk of fractures is unclear. Our aim was to investigate the association between MeDi adherence and the risk of fractures in older persons. The sample consisted of 1,482 individuals aged 67 years or older, from Bordeaux, France, included in the Three-City Study in 2001-2002. Occurrences of hip, vertebral and wrist fractures were self-reported every 2 years over 8 years, and 155 incident fractures were recorded. Adherence to the MeDi was evaluated at baseline by a MeDi score, on a 10-point scale based on a food frequency questionnaire and a 24-h recall. Multivariate Cox regression tests were performed to estimate the risk of fractures according to MeDi adherence. Higher MeDi adherence was associated with a non-significant increased risk of fractures at any site (hazard ratio [HR] per 1-point increase of MeDi score = 1.10, P = 0.08) in fully adjusted model. Among MeDi components, higher fruits consumption (>2 servings/day) was significantly associated with an increased risk of hip fractures (HR = 1.95, P = 0.04), while low intake of dairy products was associated with a doubled risk of wrist fractures (HR = 2.03, P = 0.007). An inverse U-shaped association between alcohol intake and risk of total fracture was observed (HR high vs. moderate = 0.61, P for trend = 0.03). Greater MeDi adherence was not associated with a decreased risk of fractures in French older persons. The widely recognized beneficial effects of the MeDi do not seem to apply to bone health in these people.

Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption.

Science.gov (United States)

Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

2011-02-01

This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption. Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (n = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family and social functioning. Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking. High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking. © 2010 Society for the Study of Addiction. No claim to US government works.

Problems of older persons using a wheeled walker.

Science.gov (United States)

Lindemann, Ulrich; Schwenk, Michael; Klenk, Jochen; Kessler, Max; Weyrich, Michael; Kurz, Franziska; Becker, Clemens

2016-04-01

Wheeled walkers (WWs) are used to improve mobility and for fall prevention in older persons, but not all users are satisfied with the usability of WWs. Intelligent WWs are being developed to improve the usability. The aim of this study was to support the development of intelligent WWs by investigating possible problems of using a WW. This study investigated 22 geriatric in-patients (median age 82 years) with and without their WW while opening a door against the direction of walking and passing through. Other possible problems when using WWs were identified by interview. Walking through the door was faster without than with using the WW (8.71 versus 12.86 s, p < 0.001), while interference between door and WW was documented in 41 of 44 (93 %) cases. Backward walking performance was better when using a WW with regard to gait speed, step width and walk ratio (all p < 0.002). Most referred problems when using a WW were walking downhill (83 %) and uphill (77 %) and obstacle crossing in general (77 %). Problems with opening a door against the direction of walking and the optimization of downhill and uphill walking as well as obstacle crossing should be regarded when developing an intelligent WW.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

OpenAIRE

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are ...