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Sample records for older adults diabetics

  1. Diabetes: Unique to Older Adults

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

  2. Management of Type 2 Diabetes Mellitus in Older Adults

    Directory of Open Access Journals (Sweden)

    Kyung Soo Kim

    2012-10-01

    Full Text Available In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia, falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in older adults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in older adults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for older adults with diabetes.

  3. Diabetes Self-Care and the Older Adult

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    Weinger, Katie; Beverly, Elizabeth A.; Smaldone, Arlene

    2014-01-01

    The prevalence of diabetes is highest in older adults, a population that is increasing. Diabetes self-care is complex with important recommendations for nutrition, physical activity, checking glucose levels, and taking medication. Older adults with diabetes have unique issues which impact self-care. As people age, their health status, support systems, physical and mental abilities, and nutritional requirements change. Furthermore, comorbidities, complications, and polypharmacy complicate diabetes self-care. Depression is also more common among the elderly and may lead to deterioration in self-care behaviors. Because of concerns about cognitive deficits and multiple comorbidities, adults older than 65 years are often excluded from research trials. Thus, little clinical evidence is available and the most appropriate treatment approaches and how to best support older patients’ self-care efforts are unclear. This review summarizes the current literature, research findings, and expert and consensus recommendations with their rationales. PMID:24510969

  4. Diabetes and risk of hospitalized fall injury among older adults.

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    Yau, Rebecca K; Strotmeyer, Elsa S; Resnick, Helaine E; Sellmeyer, Deborah E; Feingold, Kenneth R; Cauley, Jane A; Vittinghoff, Eric; De Rekeneire, Nathalie; Harris, Tamara B; Nevitt, Michael C; Cummings, Steven R; Shorr, Ronald I; Schwartz, Ann V

    2013-12-01

    To determine whether older adults with diabetes are at increased risk of an injurious fall requiring hospitalization. The longitudinal Health, Aging, and Body Composition Study included 3,075 adults aged 70-79 years at baseline. Hospitalizations that included ICD-9-Clinical Modification codes for a fall and an injury were identified. The effect of diabetes with and without insulin use on the rate of first fall-related injury hospitalization was assessed using proportional hazards models. At baseline, 719 participants had diabetes, and 117 of them were using insulin. Of the 293 participants who were hospitalized for a fall-related injury, 71 had diabetes, and 16 were using insulin. Diabetes was associated with a higher rate of injurious fall requiring hospitalization (hazard ratio [HR] 1.48 [95% CI 1.12-1.95]) in models adjusted for age, race, sex, BMI, and education. In those participants using insulin, compared with participants without diabetes, the HR was 3.00 (1.78-5.07). Additional adjustment for potential intermediaries, such as fainting in the past year, standing balance score, cystatin C level, and number of prescription medications, accounted for some of the increased risk associated with diabetes (1.41 [1.05-1.88]) and insulin-treated diabetes (2.24 [1.24-4.03]). Among participants with diabetes, a history of falling, poor standing balance score, and A1C level ≥8% were risk factors for an injurious fall requiring hospitalization. Older adults with diabetes, in particular those using insulin, are at greater risk of an injurious fall requiring hospitalization than those without diabetes. Among those with diabetes, poor glycemic control may increase the risk of an injurious fall.

  5. Treatment of Diabetic Autonomic Neuropathy in Older Adults with Diabetes Mellitus.

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    Scheinberg, Nataliya; Salbu, Rebecca L; Goswami, Gayotri; Cohen, Kenneth

    2016-11-01

    To review the epidemiology, pathophysiology, screening and diagnosis, and optimal treatment of diabetic autonomic neuropathy (DAN) and its implications in older adults. A search of PubMed using the Mesh terms "diabetes," "type 1," "insulin-dependent," "T1DM," and "diabetic autonomic neuropathy" was performed to find relevant primary literature. Additional search terms "epidemiology," "geriatric," and "risk" were employed. All English-language articles from 2005 to 2015 appearing in these searches were reviewed for relevance. Related articles suggested in the PubMed search and clinical guidelines from the American Diabetes Association and the American Association of Clinical Endocrinologists were reviewed. These uncovered further resources for risk stratification, pathophysiology, diagnosis, and treatment of DAN. DAN is highly prevalent in the diabetes population and increases the risk of morbidity and mortality in older adults, yet, often goes undiagnosed and untreated. Treatment of DAN is complex in the older adult because of poor tolerability of many pharmacologic treatment options; therefore, great care must be taken when selecting therapy as to avoid unwanted adverse effects. With increasing life-expectancy of patients with diabetes mellitus, awareness of DAN and its implications to older adults is needed in primary care. Consistent screening and appropriate treatment of DAN in older adults with diabetes mellitus is essential in helping to maintain functional status and avoid adverse events.

  6. Diabetes and cardiovascular disease in older adults: current status and future directions.

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    Halter, Jeffrey B; Musi, Nicolas; McFarland Horne, Frances; Crandall, Jill P; Goldberg, Andrew; Harkless, Lawrence; Hazzard, William R; Huang, Elbert S; Kirkman, M Sue; Plutzky, Jorge; Schmader, Kenneth E; Zieman, Susan; High, Kevin P

    2014-08-01

    The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular complications. Inflammation and oxidative stress appear to play some role in the mechanisms underlying aging, diabetes, cardiovascular disease, and other complications of diabetes. However, the mechanisms underlying the age-associated increase in risk for diabetes and diabetes-related cardiovascular disease remain poorly understood. Moreover, because of the heterogeneity of the older population, a lack of understanding of the biology of aging, and inadequate study of the effects of treatments on traditional complications and geriatric conditions associated with diabetes, no consensus exists on the optimal interventions for older diabetic adults. The Association of Specialty Professors, along with the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the American Diabetes Association, held a workshop, summarized in this Perspective, to discuss current knowledge regarding diabetes and cardiovascular disease in older adults, identify gaps, and propose questions to guide future research. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  7. Predictors of cognitive decline in older adult type 2 diabetes from the Veterans Affairs Diabetes Trial

    Directory of Open Access Journals (Sweden)

    Mark Zimering

    2016-09-01

    Full Text Available Aims: Cognitive decline disproportionately affects older adult type 2 diabetes. We tested whether randomized intensive glucose-lowering reduces the rate(s of cognitive decline in adults with advanced type 2 diabetes (mean: age, 60 years; diabetes duration, 11 years from the Veterans Affairs Diabetes Trial. Methods: A battery of neuropsychological tests (digit span, digit symbol substitution (DSym, and Trails-making Part B (TMT-B was administered at baseline in ~1700 participants and repeated at year 5. Thirty-six risk factors were evaluated as predictors of cognitive decline in multivariable regression analyses.Results: The mean age-adjusted, DSym or TMT-B declined significantly in all study participants (P < 0.001. Randomized intensive glucose-lowering did not significantly alter the rate of cognitive decline. The final model of risk factors associated with 5-year decline in age-adjusted TMT-B included as significant predictors: longer baseline diabetes duration (beta = -0.028; P = 0.0057, lower baseline diastolic blood pressure (beta = 0.028; P < 0.001, and baseline calcium channel blocker medication use (beta = -0.639; P < 0.001. Higher baseline pulse pressure was significantly associated with decline in age-adjusted TMT-B suggesting a role for both higher systolic and lower diastolic blood pressure. Baseline thiazide diuretic use (beta= -0.549; P =0.015 was an additional significant predictor of 5-year decline in age-adjusted digit symbol score. Post-baseline systolic blood pressure-lowering was significantly associated (P < 0.001 with decline in TMT-B performance. There was a significant inverse association between post-baseline plasma triglyceride- lowering (P = 0.045 and decline in digit symbol substitution task performance.Conclusions: A five-year period of randomized intensive glucose-lowering did not significantly reduce the rate of cognitive decline in older-aged adults with type 2 diabetes. Systolic and diastolic blood pressure as

  8. Mobile application for diabetes self-management in China: Do they fit for older adults?

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    Gao, Chenchen; Zhou, Lanshu; Liu, Zhihui; Wang, Haocen; Bowers, Barbara

    2017-05-01

    Despite the exponential proliferation of Chinese diabetes applications, none are designed to meet the needs of the largest potential user population. The purpose of this study is to examine the features and contents of Chinese diabetes mobile applications in terms of their suitability for use by older adults with diabetes. A search of the Apple application store and the 360 Mobile Assistant was conducted to identify Chinese diabetes applications. Next, we compared the features and contents of all the included and most popular diabetes applications with both the International Diabetes Federation (IDF) clinical guideline and recommended usability criteria for older adults respectively. Seventy-one diabetes apps were randomly selected (from a pool of 552 diabetes apps) and reviewed. The features of most apps failed to include content areas of known importance for managing diabetes in older adults. Usability of all tested applications was rated moderate to good. Designing maximally effective medical applications would benefit from attention to both usability and content guidelines targeted for the largest potential user population. Despite the preponderance of older adults in the potential user group, failing to consider the relevance of content, in addition to usability for the specific population will ultimately limit the usefulness of the app. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Energy intake and expenditure in obese older adults with and without type 2 diabetes

    NARCIS (Netherlands)

    Memelink, R.G.; Verreijen, A.M.; de Vogel-van den Bosch, J.; Weijs, P.J.; Deutz, N.E.P.; Mays, J.A.; Roeske, S.C.

    2017-01-01

    Rationale: Obesity is a risk factor for type 2 diabetes (DM2), however not all obese people develop DM2. We explored differences in energy intake and expenditure between obese older adults with and without DM2. Methods: Baseline data from 2 lifestyle interventions with a total of 202 obese older

  10. Pioglitazone is equally effective for diabetes prevention in older versus younger adults with impaired glucose tolerance.

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    Espinoza, Sara E; Wang, Chen-Pin; Tripathy, Devjit; Clement, Stephen C; Schwenke, Dawn C; Banerji, Mary Ann; Bray, George A; Buchanan, Thomas A; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Stentz, Frankie B; Reaven, Peter D; DeFronzo, Ralph A; Musi, Nicolas

    2016-12-01

    To determine the efficacy of pioglitazone to prevent type 2 diabetes in older compared to younger adults with pre-diabetes. Six hundred two participants with impaired glucose tolerance (IGT) were randomized in double blind fashion to placebo or pioglitazone for diabetes prevention in the ACT NOW study (NEJM 364:1104-1115, 2011). Cox proportional hazard regression was used to compare time to development of diabetes over a mean of 2 years between older (≥61 years) and younger participants. We compared effects of pioglitazone versus placebo on metabolic profiles, inflammatory markers, adipokines, β cell function (disposition index), insulin sensitivity (Matsuda index), and body composition by ANOVA. Diabetes incidence was reduced by 85 % in older and 69 % in younger subjects (p = 0.41). β cell function (disposition index) increased by 35.0 % in the older and 26.7 % in younger subjects (p = 0.83). Insulin sensitivity (Matsuda index) increased by 3.07 (5.2-fold) in older and by 2.54 (3.8-fold) in younger participants (p = 0.58). Pioglitazone more effectively increased adiponectin in older versus younger subjects (22.9 ± 3.2 μg/mL [2.7-fold] vs. 12.7 ± 1.4 μg/mL [2.2-fold], respectively; p = 0.04). Younger subjects tended to have a greater increase in whole body fat mass compared to older subjects (3.6 vs. 3.1 kg; p = 0.061). Younger and older subjects had similar decreases in bone mineral density (0.018 ± 0.0071 vs. 0.0138 ± 0.021 g/cm 2 ). Younger and older pre-diabetic adults taking pioglitazone had similar reductions in conversion to diabetes and older adults had similar or greater improvements in metabolic risk factors, demonstrating that pioglitazone is useful in preventing diabetes in older adults.

  11. Food Insecurity and Food Choices in Rural Older Adults with Diabetes Receiving Nutrition Education via Telemedicine

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    Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.

    2010-01-01

    Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…

  12. A longitudinal analysis of salivary flow in control subjects and older adults with type 2 diabetes.

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

    2001-02-01

    Many diabetics complain of xerostomia, a condition that can affect oral health, nutritional status, and diet selection. This study's purposes were (1) to investigate the effect on salivary flow of type 2 diabetes and change in glycemic control in a group of older adults over time and (2) to compare flow rates with subjective complaints of xerostomia. A total of 39 older adults, 24 with type 2 diabetes and 15 who were nondiabetic (controls), aged 54-90 years, participated in a 1-year follow-up study. Diabetic status was determined by means of glycosylated hemoglobin (HbA1c) levels and 2-hour glucose tolerance tests. Poor glycemic control was defined as HbA1c > 9%. Unstimulated whole, unstimulated parotid, and stimulated parotid saliva flow rates were measured for all subjects by a single examiner at baseline and 1 year later. Each subject completed a standardized xerostomia questionnaire at every visit. Age, sex, and duration of diabetes did not adversely affect salivary flow rates. Subjects with poorly controlled diabetes had significantly lower stimulated parotid saliva flow rates at both visits. There were no significant changes in flow rates over time on the basis of diabetic status or glycemic control. Subjects with diabetes reported significantly more complaints of thirst but not of xerostomia at 1 year. These results suggest that older adults with poorly controlled diabetes may have impaired salivary flow in comparison with subjects with better controlled diabetes and nondiabetic subjects, yet they may not have concomitant xerostomic complaints. There were no significant changes in salivary flow rates or glycemic control over the 1-year period.

  13. Multitasking in older adults with type 2 diabetes: A cross-sectional analysis.

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    Jason L Rucker

    Full Text Available Deficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability.We performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM. Multitasking was examined via the ambulatory Walking and Remembering Test (WART and seated Pursuit Rotor Test (PRT. Self-selected normal and fast walking speed and stride length variability were quantitatively measured, and self-reported functional ability was assessed via the Late Life Function and Disability Index (LLFDI.Participants with DM walked slower and took more steps off path when multitasking during the WART. No between-group differences in multitasking performance were observed on the PRT. Multitasking performance demonstrated little correlation with gait and functional ability in either group.Older adults with DM appear to perform poorly on an ambulatory measure of multitasking. However, we analyzed a relatively small, homogenous sample of older adults with and without type 2 DM and factors such as peripheral neuropathy and the use of multiple comparisons complicate interpretation of the data. Future research should explore the interactions between multitasking and safety, fall risk, and function in this vulnerable population. Clinicians should recognize that an array of factors may contribute to gait and physical dysfunction in older adults with type 2 diabetes, and be prepared to assess and intervene appropriately.

  14. Multitasking in older adults with type 2 diabetes: A cross-sectional analysis.

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    Rucker, Jason L; McDowd, Joan M; Mahnken, Jonathan D; Burns, Jeffrey M; Sabus, Carla H; Britton-Carpenter, Amanda J; Utech, Nora B; Kluding, Patricia M

    2017-01-01

    Deficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM) also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability. We performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM. Multitasking was examined via the ambulatory Walking and Remembering Test (WART) and seated Pursuit Rotor Test (PRT). Self-selected normal and fast walking speed and stride length variability were quantitatively measured, and self-reported functional ability was assessed via the Late Life Function and Disability Index (LLFDI). Participants with DM walked slower and took more steps off path when multitasking during the WART. No between-group differences in multitasking performance were observed on the PRT. Multitasking performance demonstrated little correlation with gait and functional ability in either group. Older adults with DM appear to perform poorly on an ambulatory measure of multitasking. However, we analyzed a relatively small, homogenous sample of older adults with and without type 2 DM and factors such as peripheral neuropathy and the use of multiple comparisons complicate interpretation of the data. Future research should explore the interactions between multitasking and safety, fall risk, and function in this vulnerable population. Clinicians should recognize that an array of factors may contribute to gait and physical dysfunction in older adults with type 2 diabetes, and be prepared to assess and intervene appropriately.

  15. Diabetes and Cognitive Decline in Older Adults: The Ginkgo Evaluation of Memory Study.

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    Palta, Priya; Carlson, Michelle C; Crum, Rosa M; Colantuoni, Elizabeth; Sharrett, A Richey; Yasar, Sevil; Nahin, Richard L; DeKosky, Steven T; Snitz, Beth; Lopez, Oscar; Williamson, Jeff D; Furberg, Curt D; Rapp, Stephen R; Golden, Sherita Hill

    2017-12-12

    Previous studies have shown that individuals with diabetes exhibit accelerated cognitive decline. However, methodological limitations have limited the quality of this evidence. Heterogeneity in study design, cognitive test administration, and methods of analysis of cognitive data have made it difficult to synthesize and translate findings to practice. We analyzed longitudinal data from the Ginkgo Evaluation of Memory Study to test our hypothesis that older adults with diabetes have greater test-specific and domain-specific cognitive declines compared to older adults without diabetes. Tests of memory, visuo-spatial construction, language, psychomotor speed, and executive function were administered. Test scores were standardized to z-scores and averaged to yield domain scores. Linear random effects models were used to compare baseline differences and changes over time in test and domain scores among individuals with and without diabetes. Among the 3,069 adults, aged 72-96 years, 9.3% reported diabetes. Over a median follow-up of 6.1 years, participants with diabetes exhibited greater baseline differences in a test of executive function (trail making test, Part B) and greater declines in a test of language (phonemic verbal fluency). For the composite cognitive domain scores, participants with diabetes exhibited lower baseline executive function and global cognition domain scores, but no significant differences in the rate of decline. Identifying cognitive domains most affected by diabetes can lead to targeted risk modification, possibly in the form of lifestyle interventions such as diet and physical activity, which we know to be beneficial for improving vascular risk factors, such as diabetes, and therefore may reduce the risk of executive dysfunction and possible dementia. © The Author 2017. 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.

  16. Impaired Word and Face Recognition in Older Adults with Type 2 Diabetes.

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    Jones, Nicola; Riby, Leigh M; Smith, Michael A

    2016-07-01

    Older adults with type 2 diabetes mellitus (DM2) exhibit accelerated decline in some domains of cognition including verbal episodic memory. Few studies have investigated the influence of DM2 status in older adults on recognition memory for more complex stimuli such as faces. In the present study we sought to compare recognition memory performance for words, objects and faces under conditions of relatively low and high cognitive load. Healthy older adults with good glucoregulatory control (n = 13) and older adults with DM2 (n = 24) were administered recognition memory tasks in which stimuli (faces, objects and words) were presented under conditions of either i) low (stimulus presented without a background pattern) or ii) high (stimulus presented against a background pattern) cognitive load. In a subsequent recognition phase, the DM2 group recognized fewer faces than healthy controls. Further, the DM2 group exhibited word recognition deficits in the low cognitive load condition. The recognition memory impairment observed in patients with DM2 has clear implications for day-to-day functioning. Although these deficits were not amplified under conditions of increased cognitive load, the present study emphasizes that recognition memory impairment for both words and more complex stimuli such as face are a feature of DM2 in older adults. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

  17. Ethnic and sex differences in ownership of preventive health equipment among rural older adults with diabetes.

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    Bell, Ronny A; Arcury, Thomas A; Stafford, Jeanette M; Golden, Shannon L; Snively, Beverly M; Quandt, Sara A

    2007-01-01

    Diabetes self-management is important for achieving successful health outcomes. Different levels of self-management have been reported among various populations, though little is known about ownership of equipment that can enhance accomplishment of these tasks. This study examined diabetes self-management equipment ownership among rural older adults. Participants included African American, American Indian, and white men and women 65 years of age and older. Data included equipment ownership overall and by ethnicity and sex across diabetes self-management domains (glucose monitoring, foot care, medication adherence, exercise, and diet). Associations between equipment ownership and demographic and health characteristics were assessed using logistic regression. Equipment ownership ranged from 85.0% for blood glucose meters to less than 11% for special socks, modified dishes, and various forms of home exercise equipment. Equipment ownership was associated with ethnicity, living arrangements, mobility, poverty status, and formal education. Rural older adults with diabetes are at risk because they lack equipment to perform some self-management tasks. Providers should be sensitive to and assist patients in overcoming this barrier.

  18. The diabetes online community: Older adults supporting self-care through peer health.

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    Litchman, Michelle L; Rothwell, Erin; Edelman, Linda S

    2018-03-01

    The use of the diabetes online community (DOC) is growing across all age groups. The aim of this exploratory study was to describe why older adults participated in the DOC, and how DOC users interacted with their healthcare providers. Telephone interviews (N=20) were conducted with older adult DOC users (born between 1946 and 1964) living in the United States. Interviews were analyzed using qualitative content analysis adhering to rigor and reproducibility standards. Themes that emerged from the data related to DOC participation included: information to improve self-care, emotional support, belonging to a community, validation of information, cause for concern and interaction with healthcare providers. Participants used the DOC for day to day diabetes management advice and healthcare providers for medical information and care. Participants highly valued the DOC and regarded their participation as a way to increase knowledge to improve self-care and reciprocate emotional support with others for diabetes management. The DOC filled gaps in knowledge and support participants were not able to get elsewhere. The DOC serves as an important source of information and support for individuals with diabetes and may be a cost-effective strategy to augment standard diabetes care. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Relation between BMI and diabetes mellitus and its complications among US older adults.

    Science.gov (United States)

    Gray, Natallia; Picone, Gabriel; Sloan, Frank; Yashkin, Arseniy

    2015-01-01

    This study examined relations between elevated body mass index (BMI) and time to diagnosis with type 2 diabetes mellitus and its complications among older adults in the United States. Data came from the Medicare Current Beneficiary Survey, 1991-2010. A Cox proportional hazard model was used to assess relations between excess BMI at the first Medicare Current Beneficiary Survey interview and time to diabetes mellitus diagnosis, complications, and insulin dependence among Medicare beneficiaries, older than 65 years of age with no prior diabetes mellitus diagnosis, and who were not enrolled in Medicare Advantage (N = 14,657). Among individuals diagnosed as having diabetes mellitus, elevated BMIs were associated with a progressively higher risk of complications from diabetes mellitus. For women with a BMI ≥40, the risk of insulin dependence (hazard ratio [HR] 3.57; 95% confidence interval [CI] 2.36-5.39) was twice that for women with 25 ≤ BMI diabetes mellitus. For men, the increased risk of these complications occurred at higher BMI levels than in women. Ocular complications occurred at higher BMI levels than other complication types in both men and women.

  20. Control of glycemia and other cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: data from the Adult Diabetes Control and Management.

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    Sazlina, Shariff-Ghazali; Mastura, Ismail; Ahmad, Zaiton; Cheong, Ai-Theng; Adam, Bujang-Mohamad; Jamaiyah, Haniff; Lee, Ping-Yein; Syed-Alwi, Syed-Abdul-Rahman; Chew, Boon-How; Sriwahyu, Taher

    2014-01-01

    The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia. A cross-sectional study was carried out using cases notified to the Adult Diabetes Control and Management database between 1 January and 31 December 2009. A total of 10 363 people aged over 60 years with type 2 diabetes mellitus were included in the analyses. A standard online case report form was used to record demographic data, clinical factors (diabetes duration, comorbid condition and treatment modalities), cardiovascular disease risk factors, diabetes complications and laboratory assessments. The cardiovascular disease risk factors controls assessed included glycosylated hemoglobin (HbA(1c)) control of cardiovascular disease risk factors was suboptimal in older adults with type 2 diabetes. The oldest elderly were more likely to achieve target HbA(1c) (<7.0%) and triglycerides (<1.7 mmol/L) than older adults aged 60-69 years. © 2013 Japan Geriatrics Society.

  1. Prevalence of diabetes treatment effect modifiers: the external validity of trials to older adults.

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    Weiss, Carlos O; Boyd, Cynthia M; Wolff, Jennifer L; Leff, Bruce

    2012-08-01

    Potential treatment effect modifiers (TEMs) are specific diseases or conditions with a well-described mechanism for treatment effect modification. The prevalence of TEMs in older adults with type 2 diabetes mellitus (DM) is unknown. Objectives were to 1) determine the prevalence of pre-specified potential TEMs; 2) demonstrate the potential impact of TEMs in the older adult population using a simulated trial; 3) identify TEM combinations associated with number of hospitalizations to test construct validity. Data are from the nationally-representative United States National Health and Examination Survey, 1999-2004: 8646 Civilian, non-institutionalized adults aged 45-64 or 65+ years, including 1443 with DM. TEMs were anemia, congestive heart failure, liver inflammation, polypharmacy, renal insufficiency, cognitive impairment, dizziness, frequent mental distress, mobility difficulty, and visual impairment. A trial was simulated to examine prevalence of potential TEM impact. The cross-sectional association between TEM patterns and number of hospitalizations was estimated to assess construct validity. The prevalence of TEMs was substantial such that 19.0% (95% CI 14.8-23.2) of middle-aged adults and 38.0% (95% CI 33.4-42.5) of older adults had any two. A simulated trial with modest levels of interaction suggested the prevalence of TEMs could nullify treatment benefit in 3.9-27.2% of older adults with DM. Compared to having DM alone, hospitalization rate was increased by several combinations of TEMs with substantial prevalence. We provide national benchmarks that can be used to evaluate TEM prevalence reported by clinical trials of DM, and correspondingly their external validity to older adults.

  2. ETHNIC DISPARITIES IN HEALTH-RELATED QUALITY OF LIFE AMONG OLDER RURAL ADULTS WITH DIABETES

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    Quandt, Sara A.; Graham, Christopher N.; Bell, Ronny A.; Snively, Beverly M.; Golden, Shannon L.; Stafford, Jeanette M.; Arcury, Thomas A.

    2008-01-01

    Diabetes mellitus disproportionately affects ethnic minorities and has serious economic, social, and personal implications. This study examines the effect of diabetes disease burden and social resources on health-related quality of life (HRQOL) among older rural adults with diabetes. Data come from a population-based cross-sectional survey of 701 adults (age ≥65 years) with diabetes in North Carolina from three ethnic groups: African American, Native American, and White. HRQOL was assessed using the 12-item short-form health survey (SF-12). Mean scores were 35.1 ± 11.4 and 50.5 ± 10.8 for the physical and mental components of the SF-12, respectively. In bivariate analyses, scores were significantly lower for Native Americans than Whites for both components. In multivariate analyses, higher physical HRQOL was associated with male sex, greater mobility ability, fewer chronic conditions, exercising vs not exercising, fewer depressive symptoms, and not receiving process assistance. Higher mental HRQOL was associated with greater mobility ability, fewer chronic conditions, and a high school education or more. Diabetes appears to have a substantial effect on physical HRQOL. Physical disability associated with diabetes may have a greater impact in the rural environment than in other areas. Aspects of rural social milieu may help to keep mental HRQOL high, even in the face of severe chronic disease. Ethnic differences in HRQOL are largely accounted for by diabetes disease burden and, to a lesser extent, social resources. Strategies to reduce diabetes-related complications (long term) and assist mobility (short term) may reduce ethnic disparities in HRQOL. (Ethn Dis. 2007;17:471–476) PMID:17985500

  3. Humors Effect on Short-term Memory in Healthy and Diabetic Older Adults.

    Science.gov (United States)

    Bains, Gurinder Singh; Berk, Lee S; Lohman, Everett; Daher, Noha; Petrofsky, Jerrold; Schwab, Ernie; Deshpande, Pooja

    2015-01-01

    With aging, the detrimental effects of stress can impair a person's ability to learn and sustain memory. Humor and its associated mirthful laughter can reduce stress by decreasing the hormone cortisol. Chronic release of cortisol can damage hippocampal neurons, leading to impairment of learning and memory. Objectives • The study intended to examine the effect of watching a humor video on short-term memory in older adults. Design • The research team designed a randomized, controlled trial. The study took place at Loma Linda University in Loma Linda, CA, USA. The study included 30 participants: 20 normal, healthy, older adults-11 males and 9 females-and 10 older adults with type 2 diabetes mellitus (T2DM)-6 males and 4 females. The study included 2 intervention groups of older adults who viewed humorous videos, a healthy group (humor group), aged 69.9 ± 3.7 y, and the diabetic group, aged 67.1 ± 3.8 y. Each participant selected 1 of 2 humorous videos that were 20 min in length, either a Red Skeleton comedy or a montage of America's Funniest Home Videos. The control group, aged 68.7 ± 5.5 y, did not watch a humor video and sat in quiescence. A standardized, neuropsychological, memory-assessment tool, the Rey Auditory Verbal Learning Test (RAVLT), was used to assess the following abilities: (1) learning, (2) recall, and (3) visual recognition. The testing occurred twice, once before (RAVLT1) and once after (RAVLT2) the humorous video for the humor and diabetic groups, and once before (RAVLT1) and once after (RAVLT2) the period of quiescence for the control group. At 5 time points, measurements of salivary cortisol were also obtained. The Kruskal-Wallis test was used to measure significance of the data based on the 3 groups. In the humor, diabetic, and control groups, (1) learning ability improved by 38.5%, 33.4%, and 24.0%, respectively (P = .025); (2) delayed recall improved by 43.6%, 48.1%, and 20.3%, respectively (P = .064); and (3) visual recognition

  4. Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study.

    Science.gov (United States)

    Mozaffarian, Dariush; Kamineni, Aruna; Carnethon, Mercedes; Djoussé, Luc; Mukamal, Kenneth J; Siscovick, David

    2009-04-27

    The combined impact of lifestyle factors on incidence of diabetes mellitus later in life is not well established. The objective of this study was to determine how lifestyle factors, assessed in combination, relate to new-onset diabetes in a broad and relatively unselected population of older adults. We prospectively examined associations of lifestyle factors, measured using repeated assessments later in life, with incident diabetes mellitus during a 10-year period (1989-1998) among 4883 men and women 65 years or older (mean [SD] age at baseline, 73 [6] years) enrolled in the Cardiovascular Health Study. Low-risk lifestyle groups were defined by physical activity level (leisure-time activity and walking pace) above the median; dietary score (higher fiber intake and polyunsaturated to saturated fat ratio, lower trans-fat intake and lower mean glycemic index) in the top 2 quintiles; never smoked or former smoker more than 20 years ago or for fewer than 5 pack-years; alcohol use (predominantly light or moderate); body mass index less than 25 (calculated as weight in kilograms divided by height in meters squared); and waist circumference of 88 cm for women or 92 cm for men. The main outcome measure was incident diabetes defined annually by new use of insulin or oral hypoglycemic medications. We also evaluated fasting and 2-hour postchallenge glucose levels. During 34,539 person-years, 337 new cases of drug-treated diabetes mellitus occurred (9.8 per 1000 person-years). After adjustment for age, sex, race, educational level, and annual income, each lifestyle factor was independently associated with incident diabetes. Overall, the rate of incident diabetes was 35% lower (relative risk, 0.65; 95% confidence interval, 0.59-0.71) for each 1 additional lifestyle factor in the low-risk group. Participants whose physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes (relative risk, 0.18; 95

  5. [Standard control for diabetes in older adults based on practice guidelines--the target values of blood glucose, blood pressure and lipids].

    Science.gov (United States)

    Sugimoto, Ken; Rakugi, Hiromi

    2013-11-01

    As for standard controls for life style diseases in older adults, the standard control for hypertension in elderly is defined in detail by the guideline for hypertension, however, that for diabetes or dyslipidemia is not clearly defined by each guideline although each has additional descriptions for elderly. The reports about 'Diabetes in Older Adults' and 'Standards of Medical Care in Diabetes 2013' have been published from American Diabetes Association (ADA), and the standard controls for diabetes might be reviewed in the light of these reports in Japan. Here we would like to consider the standard control and recent trends for diabetes in older adults on the basis of the current practice guidelines.

  6. Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus: a systematic review.

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    Gravesande, Janelle; Richardson, Julie

    2017-07-01

    To identify the non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus (DM2). A systematic review of randomized controlled trials, prospective cohort studies, cross-sectional studies and before/after studies was conducted. Eligible studies identified non-pharmacological risk factors for falling in older adults with DM2. Medline, Embase, Pubmed and CINAHL were searched for relevant studies published through December 2015. Reference lists were also searched for relevant studies. Search terms were DM2, risk factors, falls and falling, older adults, aging, non-insulin dependent diabetes mellitus, accidental falls and trip. Publication language was restricted to English. Thirteen studies met the inclusion criteria: four cross-sectional, six prospective cohorts, two randomized controlled trials and one before/after study. These studies included a total of 13,104 participants, ≥50 years. The most common risk factors for falling were impaired balance, reduced walking velocity, peripheral neuropathy and comorbid conditions. However, lower extremity pain, being overweight and comorbid conditions had the greatest impact on fall risk. Interventions to reduce falling in older adults with type 2 diabetes mellitus should focus on reducing lower extremity pain, reducing body weight and managing comorbid conditions. Implications for Rehabilitation    Diabetes mellitus:   • Older adults with type 2 diabetes mellitus (DM2) have a higher risk for falling than older adults without.   • Older adults with DM2 are more likely to suffer serious injuries when they fall.   • Comprehensive risk factor identification is necessary for rehabilitation professionals to accurately determine whether their clients are at risk for falling.   • Rehabilitation professionals also need to tailor interventions based on the client's risk factors in order to effectively reduce falls and fall-related injuries.

  7. Low education and lack of spousal relationship are associated with dementia in older adults with diabetes mellitus in Nigeria.

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    Yusuf, Abdulkareem J; Baiyewu, Olusegun; Bakari, Adamu G; Garko, Sani B; Jibril, Mohammed E-B; Suleiman, Aishatu M; Muktar, Haruna M; Amedu, Micheal A

    2018-05-01

    The relationship between dementia and type 2 diabetes mellitus (T2DM) in older adults is well established in the literature. However, there have been few studies on this relationship in older adults living in low- and middle-income countries, and most demographic projections predict that older adult population will increase substantially in these regions by 2050. In this study, older adults with T2DM attending a tertiary health facility were examined and compared with community-dwelling older adults without T2DM. The participants were assessed using the Consortium to Establish Registry for Alzheimer's Disease, the Stick Design Test, the 30-item Geriatric Depression Scale, and the Instrumental Activities of Daily Living Scale. Additionally, all the participants had a physical examination, including assessment of glycated haemoglobin, fasting blood glucose, lipid profile, and HIV status. A consensus diagnosis of dementia was made based on the criteria for dementia in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and the International Classification for Diseases, 10th edition. The data were analyzed using SPSS version 20 for Windows. This study included 224 diabetic patients and 116 controls. A total of 27 diabetic patients (12.1%) had dementia, 19 of whom were women. Of the 27 diabetic patients with dementia, 25 patients (92.6%) had Alzheimer's disease and 2 patients (7.4%) had mixed dementia (vascular dementia and Alzheimer's disease). Only one person among the controls had Alzheimer's type dementia. Dementia in the diabetic patients was significantly associated with advancing age, female gender, education level, duration of diabetes, and absence of a spouse. Dementia is common in older adults with T2DM in this low-resource setting, and the risk factors for dementia were similar to those reported in earlier studies in Western societies. © 2018 Japanese Psychogeriatric Society.

  8. Cancer in Older Adults

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    ... Home > Navigating Cancer Care > For Older Adults For Older Adults A full-text transcript is available. More than ... Advanced Cancer For Children For Teens For Young Adults For Older Adults Aging and Cancer Cancer Care Decisions for ...

  9. Associations of Total and Domain-Specific Sedentary Time With Type 2 Diabetes in Taiwanese Older Adults

    Directory of Open Access Journals (Sweden)

    Ming-Chun Hsueh

    2016-07-01

    Full Text Available Background: The increasing prevalence of type 2 diabetes in older adults has become a public health concern. We investigated the associations of total and domain-specific sedentary time with risk of type 2 diabetes in older adults. Methods: The sample comprised 1046 older people (aged ≥65 years. Analyses were performed using crosssectional data collected via computer-assisted telephone-based interviews in 2014. Data on six self-reported domains of sedentary time (Measure of Older Adults’ Sedentary Time, type 2 diabetes status, and sociodemographic variables were included in the study. Binary logistic regression analysis was performed to calculate the adjusted odds ratios (ORs and 95% confidence intervals (CIs for total and individual sedentary behavior components and likelihood of type 2 diabetes. Results: A total of 17.5% of the participants reported type 2 diabetes. No significant associations were found between total sitting time and risk of type 2 diabetes, after controlling for confounding factors. After total sedentary behavior was stratified into six domains, only watching television for more than 2 hours per day was associated with higher odds of type 2 diabetes (OR 1.56; 95% CI, 1.10–2.21, but no significant associations were found between other domains of sedentary behavior (computer use, reading, socializing, transport, and hobbies and risk of type 2 diabetes. Conclusions: These findings suggest that, among domain-specific sedentary behavior, excessive television viewing might increase the risk of type 2 diabetes among older adults more than other forms of sedentary behavior.

  10. Association of multiple chronic conditions and pain among older black and white adults with diabetes mellitus

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    Tamara A. Baker

    2017-10-01

    Full Text Available Abstract Background Aging is often associated with the challenge of navigating daily tasks with a painful chronic medical illness. Yet, there is concern of the number of older adults impacted with more than one chronic condition. Despite the increasing number of adults diagnosed with diabetes and comorbid chronic illnesses, there remains a lack of understanding in how multiple illnesses relate to experiences of pain. To assess the association between multiple chronic conditions and pain, this study aimed to identify clusters of chronic medical conditions and their association with pain among a sample of older Black and White adults diagnosed with diabetes. Methods Two hundred and thirty-six participants responded to a series of questions assessing pain frequency and severity, as well as health and social characteristics. A factor analysis was used to categorize clusters of medical conditions, and multiple regression models were used to examine predictors of pain. Results Seven of the assessed chronic medical conditions loaded on three factors, and accounted for 57.2% of the total variance, with heart disease (factor 1 accounting for 21.9%, musculoskeletal conditions (factor 2 for another 18.4%, and factor 3 (microvascular diseases accounting for a final 16.9% of the variability among the chronic medical conditions. Covariate-adjusted models showed that fewer years of education and higher scores on the microvascular and musculoskeletal conditions factors were associated with higher pain frequency, with the musculoskeletal conditions factor being the strongest predictor. Conclusions Findings from this study compliment existent literature underscoring the prevalence and importance of comorbid diagnoses in relation to pain. Examining health-related factors beyond a single disease diagnosis also provides an opportunity to explore underlying disease co-occurrences that may persist beyond organ system classifications.

  11. Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study

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    Roman de Mettelinge, Tine; Cambier, Dirk; Calders, Patrick; Van Den Noortgate, Nele; Delbaere, Kim

    2013-01-01

    Background Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. Methods 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Results Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls (“fallers”). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21–4.15, p = 0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Conclusions Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes. PMID:23825617

  12. The association between cognitive decline and incident depressive symptoms in a sample of older Puerto Rican adults with diabetes.

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    Bell, Tyler; Dávila, Ana Luisa; Clay, Olivio; Markides, Kyriakos S; Andel, Ross; Crowe, Michael

    2017-08-01

    Older Puerto Rican adults have particularly high risk of diabetes compared to the general US population. Diabetes is associated with both higher depressive symptoms and cognitive decline, but less is known about the longitudinal relationship between cognitive decline and incident depressive symptoms in those with diabetes. This study investigated the association between cognitive decline and incident depressive symptoms in older Puerto Rican adults with diabetes over a four-year period. Households across Puerto Rico were visited to identify a population-based sample of adults aged 60 years and over for the Puerto Rican Elderly: Health Conditions study (PREHCO); 680 participants with diabetes at baseline and no baseline cognitive impairment were included in analyses. Cognitive decline and depressive symptoms were measured using the Mini-Mental Cabán (MMC) and Geriatric Depression Scale (GDS), respectively. We examined predictors of incident depressive symptoms (GDS ≥ 5 at follow-up but not baseline) and cognitive decline using regression modeling. In a covariate-adjusted logistic regression model, cognitive decline, female gender, and greater diabetes-related complications were each significantly associated with increased odds of incident depressive symptoms (p Puerto Ricans with diabetes who also experienced cognitive decline. Efforts are needed to optimize diabetes management and monitor for depression and cognitive decline in this population.

  13. The Impact of Social Health Insurance on Diabetes and Hypertension Process Indicators among Older Adults in Mexico.

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    Rivera-Hernandez, Maricruz; Rahman, Momotazur; Mor, Vincent; Galarraga, Omar

    2016-08-01

    To examine the impact of Seguro Popular (Mexican social health insurance for the poor; SP) on diabetes and hypertension care, intermediate process indicators for older adults (>50 years): pharmacological treatment, blood glucose tests, the use of complementary and alternative medicine (CAM), and adherence to their nutrition and exercise program. (CAM was defined as products or practices that were not part of the medical standard of care.) Repeated cross-sectional surveys from Encuesta Nacional de Salud y Nutrición (Mexican Health and Nutrition Survey, ENSANUT), a nationally representative health and nutrition survey sampling N = 45,294 older adults in 2000, N = 45,241 older adults in 2005-2006, and N = 46,277 older adults in 2011-2012. Fixed-effects instrumental variable (FE-IV) repeated cross-sectional at the individual level with municipality fixed-effects estimation was performed. We found a marginally significant effect of SP on the use of insulin and oral agents (40 percentage points). Contrary to that expected, no other significant differences were found for diabetes or hypertension treatment and care indicators. Social health insurance for the poor improved some but not all health care process indicators among diabetic and hypertensive older people in Mexico. © Health Research and Educational Trust.

  14. Depression in Older Adults

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    ... here Home » Depression In Older Adults: More Facts Depression In Older Adults: More Facts Depression affects more ... combination of both. [8] Older Adult Attitudes Toward Depression: According to a Mental Health America survey [9] ...

  15. Older Adults and Alcohol

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    ... Other Psychiatric Disorders Other Substance Abuse HIV/AIDS Older Adults A national 2008 survey found that about 40 ... of adults ages 65 and older drink alcohol. Older adults can experience a variety of problems from drinking ...

  16. The Effects of Tai Chi on Peripheral Somatosensation, Balance, and Fitness in Hispanic Older Adults with Type 2 Diabetes: A Pilot and Feasibility Study

    Directory of Open Access Journals (Sweden)

    Elisabeth I. Cavegn

    2015-01-01

    Full Text Available Peripheral neuropathy and loss of somatosensation in older adults with type 2 diabetes can increase risk of falls and disability. In nondiabetic older adult population Tai Chi has been shown to enhance balance and fitness through improvements in somatosensation and neuromuscular control, and it is unclear if Tai Chi would elicit similar benefits in older adults with diabetes. Therefore, the purpose of this study was to investigate the effects of an 8-week, three-hour-per-week Tai Chi intervention on peripheral somatosensation in older adults with type 2 diabetes. Participants were eight Hispanic older adults with type 2 diabetes who participated in the Tai Chi intervention and a convenience sample of Hispanic older adults as a referent group. Baseline and postintervention assessments included ankle proprioception, foot tactile sense, plantar pressure distribution, balance, and fitness. After intervention, older adults with type 2 diabetes showed significant improvements in ankle proprioception and fitness and decreased plantar pressure in the forefoot, with no statistical effect noted in balance or tactile sensation. Study results suggest that Tai Chi may be beneficial for older adults with diabetes as it improves ankle proprioception; however, study findings need to be confirmed in a larger sample size randomized controlled trial.

  17. Relevance of nerve conduction velocity in the assessment of balance performance in older adults with diabetes mellitus.

    Science.gov (United States)

    Wang, Ting-Yun; Chen, Shih-Ching; Peng, Chih-Wei; Kang, Chun-Wei; Chen, Yu-Luen; Chen, Chun-Lung; Chou, Yi-Lin; Lai, Chien-Hung

    2017-03-01

    Purpose This study investigated the relationship between peripheral nerve conduction velocity (NCV) and balance performance in older adults with diabetes. Methods Twenty older adults with diabetes were recruited to evaluate the NCV of their lower limbs and balance performance. The balance assessments comprised the timed up and go (TUG) test, Berg balance scale (BBS), unipedal stance test (UST), multidirectional reach test (MDRT), maximum step length (MSL) test and quiet standing with eyes open and closed. The relationship between NCV and balance performance was evaluated by Pearson's correlation coefficients, and the balance performances of the diabetic patients with and without peripheral neuropathy were compared by using Mann-Whitney U tests. Results The NCV in the lower limbs exhibited a moderate to strong correlation with most of the balance tests including the TUG (r = -0.435 to -0.520, p tests, which are commonly used in clinics. Decline in nerve conduction velocity of the lower limbs may be related to the impairment of balance control in patients with diabetes. Diabetic older adults with peripheral neuropathy exhibited greater postural instability than those without peripheral neuropathy.

  18. Diabetes mellitus, hypertension and frailty: A population-based, cross-sectional study of Mexican older adults.

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    Castrejón-Pérez, Roberto Carlos; Gutiérrez-Robledo, Luis Miguel; Cesari, Matteo; Pérez-Zepeda, Mario Ulises

    2017-06-01

    Chronic diseases are frequent in older adults, particularly hypertension and diabetes. The relationship between frailty and these two conditions is still unclear. The aim of the present analyses was to explore the association between frailty with diabetes and hypertension in Mexican older adults. Analyses of the Mexican Health and Nutrition Survey, a cross-sectional survey, are presented. Data on diabetes and hypertension were acquired along with associated conditions (time since diagnosis, pharmacological treatment, among others). A 36-item frailty index was constructed and rescaled to z-values (individual scores minus population mean divided by one standard deviation). Multiple linear regression models were carried out, adjusted for age and sex. From 7164 older adults, 54.8% were women, and their mean age was 70.6 years with a mean frailty index score of 0.175. The prevalence of diabetes was of 22.2%, and 37.3% for hypertension. An independent association between diabetes, hypertension or both conditions (coefficients 0.28, 0.4 and 0.63, respectively, P diabetic complication was significantly associated with frailty with a coefficient of 0.55 (95% CI 0.45-0.65, P Diabetes and hypertension are associated with frailty. In addition, an incremental association was found when both conditions were present or with worse associated features (any complication, more time since diagnosis). Frailty should be of particular concern in populations with a high prevalence of these conditions. Geriatr Gerontol Int 2017; 17: 925-930. © 2016 Japan Geriatrics Society.

  19. Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study.

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    Godino, Job G; Appel, Lawrence J; Gross, Alden L; Schrack, Jennifer A; Parrinello, Christina M; Kalyani, Rita R; Windham, Beverly Gwen; Pankow, James S; Kritchevsky, Stephen B; Bandeen-Roche, Karen; Selvin, Elizabeth

    2017-01-01

    There is a need for continued surveillance of diabetes-related functional disability. In the present study, we examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. A cross-sectional analysis was conducted of 5035 participants who attended Visit 5 (2011-13) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. Associations of diagnosed diabetes (via self-report) and undiagnosed diabetes and prediabetes (via HbA1c) with functional disability were evaluated using Poisson regression. Participants had a mean age of 75 years, 42 % were male, 22 % were Black, and 31 % had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability than those without diabetes, even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95 % confidence intervals) were 1.24 (1.15, 1.34) for lower extremity mobility, 1.14 (1.07, 1.21) for general physical activities, 1.33 (1.16, 1.52) for instrumental activities of daily living (ADL), and 1.46 (1.24, 1.73) for ADL (all P  0.05). Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors, including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  20. Neuropsychological benefits of stationary bike exercise and a cybercycle exergame for older adults with diabetes: an exploratory analysis.

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    Anderson-Hanley, Cay; Arciero, Paul J; Westen, Sarah C; Nimon, Joseph; Zimmerman, Earl

    2012-07-01

    This quasi-experimental exploratory study investigated neuropsychological effects of exercise among older adults with diabetes mellitus (DM) compared with adults without diabetes (non-DM), and it examined the feasibility of using a stationary bike exergame as a form of exercise for older adults with and without diabetes. It is a secondary analysis that uses a small dataset from a larger randomized clinical trial (RCT) called the Cybercycle Study, which compared cognitive and physiological effects of traditional stationary cycling versus cybercycling. In the RCT and the secondary analysis, older adults living in eight independent living retirement facilities in the state of New York were enrolled in the study and assigned to exercise five times per week for 45 min per session (two times per week was considered acceptable for retention in the study) by using a stationary bicycle over the course of 3 months. They were randomly assigned to use either a standard stationary bicycle or a "cybercycle" with a video screen that displayed virtual terrains, virtual tours, and racing games with virtual competitors. For this secondary analysis, participants in the RCT who had type 2 DM (n = 10) were compared with age-matched non-DM exercisers (n = 10). The relationship between exercise and executive function (i.e., Color Trials 2, Digit Span Backwards, and Stroop C tests) was examined for DM and non-DM patients. Older adults with and without diabetes were able to use cybercycles successfully and complete the study, so the feasibility of this form of exercise for this population was supported. However, in contrast with the larger RCT, this small subset did not demonstrate statistically significant differences in executive function between the participants who used cybercycles and those who used stationary bikes with no games or virtual content on a video screen. Therefore, the study combined the two groups and called them "exercisers" and compared cognitive outcomes for DM versus

  1. Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

    Science.gov (United States)

    ... Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of Blood Glucose, United States, 1994–2010 From ... years or older with diagnosed diabetes performing daily self-monitoring of blood glucose increased by 27.9 points, ...

  2. Elevated HbA1c and Fasting Plasma Glucose in Predicting Diabetes Incidence Among Older Adults

    Science.gov (United States)

    Lipska, Kasia J.; Inzucchi, Silvio E.; Van Ness, Peter H.; Gill, Thomas M.; Kanaya, Alka; Strotmeyer, Elsa S.; Koster, Annemarie; Johnson, Karen C.; Goodpaster, Bret H.; Harris, Tamara; De Rekeneire, Nathalie

    2013-01-01

    OBJECTIVE To determine which measures—impaired fasting glucose (IFG), elevated HbA1c, or both—best predict incident diabetes in older adults. RESEARCH DESIGN AND METHODS From the Health, Aging, and Body Composition study, we selected individuals without diabetes, and we defined IFG (100–125 mg/dL) and elevated HbA1c (5.7–6.4%) per American Diabetes Association guidelines. Incident diabetes was based on self-report, use of antihyperglycemic medicines, or HbA1c ≥6.5% during 7 years of follow-up. Logistic regression analyses were adjusted for age, sex, race, site, BMI, smoking, blood pressure, and physical activity. Discrimination and calibration were assessed for models with IFG and with both IFG and elevated HbA1c. RESULTS Among 1,690 adults (mean age 76.5, 46% men, 32% black), 183 (10.8%) developed diabetes over 7 years. Adjusted odds ratios of diabetes were 6.2 (95% CI 4.4–8.8) in those with IFG (versus those with fasting plasma glucose [FPG] HbA1c (versus those with HbA1c HbA1c were considered together, odds ratios were 3.5 (1.9–6.3) in those with IFG only, 8.0 (4.8–13.2) in those with elevated HbA1c only, and 26.2 (16.3–42.1) in those with both IFG and elevated HbA1c (versus those with normal FPG and HbA1c). Addition of elevated HbA1c to the model with IFG resulted in improved discrimination and calibration. CONCLUSIONS Older adults with both IFG and elevated HbA1c have a substantially increased odds of developing diabetes over 7 years. Combined screening with FPG and HbA1c may identify older adults at very high risk for diabetes. PMID:24135387

  3. Validity and Relative Ability of 4 Balance Tests to Identify Fall Status of Older Adults With Type 2 Diabetes.

    Science.gov (United States)

    Marques, Alda; Silva, Alexandre; Oliveira, Ana; Cruz, Joana; Machado, Ana; Jácome, Cristina

    The Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Mini-BESTest, and the Brief-BESTest are useful tests to assess balance; however, their clinimetric properties have not been studied well in older adults with type 2 diabetes (T2D). This study compared the validity and relative ability of the BBS, BESTest, Mini-BESTest, and Brief-BESTest to identify fall status in older adults with T2D. This study involved a cross-sectional design. Sixty-six older adults with T2D (75 ± 7.6 years) were included and asked to report the number of falls during the previous 12 months and to complete the Activities-specific Balance Confidence scale. The BBS and the BESTest were administered, and the Mini-BESTest and Brief-BESTest scores were computed based on the BESTest performance. Receiver operating characteristics were used to assess the ability of each balance test to differentiate between participants with and without a history of falls. The 4 balance tests were able to identify fall status (areas under the curve = 0.74-0.76), with similar sensitivity (60%-67%) and specificity (71%-76%). The 4 balance tests were able to differentiate between older adults with T2D with and without a history of falls. As the BBS and the BESTest require longer application time, the Brief-BESTest may be an appropriate choice to use in clinical practice to detect fall risk.

  4. Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: A cross-sectional study in community-dwelling Japanese older people.

    Science.gov (United States)

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

    2018-03-26

    Diabetes is associated with not only cardiovascular and cerebrovascular disease, but also reductions in physical and cognitive function. The purpose of the present study was to determine whether muscle strength, walking ability and balance declined in Japanese community-dwelling older adults with diabetes or prediabetes. We analyzed data from comprehensive health checkups carried out for 1689 individuals (710 men, 979 women; mean age 71.4 ± 5.6 years) between 2011 and 2016. Participants were divided into three groups: no diabetes (non-history of diabetes and glycated hemoglobin level 6.4%). Physical and cognitive function were compared between groups after adjusting for covariates. Participants with diabetes showed higher levels of obesity, comorbidity, gonarthrosis, and body fat, and lower levels of physical function relative to those observed in participants with prediabetes or no diabetes. After adjusting covariates, participants with diabetes showed significantly lower grip strength (P functional decline was observed in community-dwelling older adults with diabetes, but not in those with prediabetes. Prevention of the progression of prediabetes to diabetes is important in avoiding reductions in physical function. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  5. Relationship between chronic kidney disease with diabetes or hypertension and frailty in community-dwelling Japanese older adults.

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    Lee, Sungchul; Lee, Sangyoon; Harada, Kazuhiro; Bae, Seongryu; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Park, Hyuntae; Suzuki, Takao; Shimada, Hiroyuki

    2017-10-01

    The aim of the present study was to evaluate the relationship between kidney function with concomitant diabetes or hypertension and frailty in community-dwelling Japanese older adults. The participants were 9606 residents (community-dwelling Japanese older adults) who completed baseline assessments. The estimated glomerular filtration rate (mL/min/1.73 m 2 ) was determined according to the serum creatinine level, and participants were classified into four mutually exclusive categories: ≥60.0 (normal range), 45.0-59.9, 30.0-44.9 and who met three, four or five criteria satisfied the definition of having frailty. Multivariate logistic regression was used to examine the relationships between estimated glomerular filtration rate and frailty. After multivariate adjustment, participants with lower kidney function (estimated glomerular filtration rate hypertension (OR 2.53, 95% CI 1.45-5.12) showed a significantly increased risk of frailty in the lower kidney function group, regardless of multivariate controls. Furthermore, the analyses showed an even greater increase in the risk of frailty in patients with a history of both diabetes and hypertension (OR 3.67, 95% CI 1.13-14.1) CONCLUSIONS: A lower level of kidney function was associated with a higher risk of frailty in community-dwelling Japanese older adults. Geriatr Gerontol Int 2017; 17: 1527-1533. © 2016 Japan Geriatrics Society.

  6. Effects of Functional Disability and Depressive Symptoms on Mortality in Older Mexican-American Adults with Diabetes Mellitus.

    Science.gov (United States)

    Mutambudzi, Miriam; Chen, Nai-Wei; Markides, Kyriakos S; Al Snih, Soham

    2016-11-01

    To examine the effect of co-occurring depressive symptoms and functional disability on mortality in older Mexican-American adults with diabetes mellitus. Longitudinal cohort study. Hispanic Established Populations for the Epidemiological Study of the Elderly (HEPESE) survey conducted in the southwestern United States (Texas, Colorado, Arizona, New Mexico, California). Community-dwelling Mexican Americans with self-reported diabetes mellitus participating in the HEPESE survey (N = 624). Functional disability was assessed using a modified version of the Katz activity of daily living scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Mortality was determined by examining death certificates and reports from relatives. Cox proportional hazards regression analyses were used to examine the hazard of mortality as a function of co-occurring depressive symptoms and functional disability. Over a 9.2-year follow-up, 391 participants died. Co-occurring high depressive symptoms and functional disability increased the risk of mortality (hazard ratio (HR) = 3.02, 95% confidence interval (CI) = 2.11-4.34). Risk was greater in men (HR = 8.11, 95% CI = 4.34-16.31) than women (HR = 2.21, 95% CI = 1.42-3.43). Co-occurring depressive symptoms and functional disability in older Mexican-American adults with diabetes mellitus increases mortality risk, especially in men. These findings have important implications for research, practice, and public health interventions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  7. Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

    Science.gov (United States)

    West, Susan P; Lagua, Carina; Trief, Paula M; Izquierdo, Roberto; Weinstock, Ruth S

    2010-05-01

    To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes. Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit. Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed. Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.

  8. Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population.

    Science.gov (United States)

    Axmon, Anna; Ahlström, Gerd; Höglund, Peter

    2017-11-23

    Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID) have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups. This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936). We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006-2012. The two cohorts were compared using generalized linear models (GLM). People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP) 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists. Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general population. To ensure that this is medically appropriate and not due to

  9. Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population

    Directory of Open Access Journals (Sweden)

    Anna Axmon

    2017-11-01

    Full Text Available Abstract Background Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups. Methods This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936. We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006–2012. The two cohorts were compared using generalized linear models (GLM. Results People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists. Conclusions Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general

  10. Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy.

    Science.gov (United States)

    Morrison, Steven; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

    2014-01-01

    For older adults with type 2 diabetes (T2DM), declines in balance and walking ability are risk factors for falls, and peripheral neuropathy magnifies this risk. Exercise training may improve balance, gait and reduce the risk of falling. This study investigated the effects of 12weeks of aerobic exercise training on walking, balance, reaction time and falls risk metrics in older T2DM individuals with/without peripheral neuropathy. Adults with T2DM, 21 without (DM; age 58.7±1.7years) and 16 with neuropathy (DM-PN; age 58.9±1.9years), engaged in either moderate or intense supervised exercise training thrice-weekly for 12weeks. Pre/post-training assessments included falls risk (using the physiological profile assessment), standing balance, walking ability and hand/foot simple reaction time. Pre-training, the DM-PN group had higher falls risk, slower (hand) reaction times (232 vs. 219ms), walked at a slower speed (108 vs. 113cm/s) with shorter strides compared to the DM group. Following training, improvements in hand/foot reaction times and faster walking speed were seen for both groups. While falls risk was not significantly reduced, the observed changes in gait, reaction time and balance metrics suggest that aerobic exercise of varying intensities is beneficial for improving dynamic postural control in older T2DM adults with/without neuropathy. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Word-stem priming and recognition in type 2 diabetes mellitus, Alzheimer's disease patients and healthy older adults.

    Science.gov (United States)

    Redondo, María Teresa; Beltrán-Brotóns, José Luís; Reales, José Manuel; Ballesteros, Soledad

    2015-11-01

    The present study investigated (a) whether the pattern of performance on implicit and explicit memory of patients with type 2 diabetes mellitus (DM2) is more similar to those of patients with Alzheimer's disease (AD) or to cognitively normal older adults and (b) whether glycosylated hemoglobin levels (a measure of glucose regulation) are related to performance on the two memory tasks, implicit word-stem completion and "old-new" recognition. The procedures of both memory tasks included encoding and memory test phases separated by a short delay. Three groups of participants (healthy older adults, DM2 patients and AD patients) completed medical and psychological assessments and performed both memory tasks on a computer. The results of the word-stem completion task showed similar implicit memory in the three groups. By contrast, explicit recognition of the three groups differed. Implicit memory was not affected by either normal or pathological aging, but explicit memory deteriorated in the two groups of patients, especially in AD patients, showing a severe impairment compared to the cognitively healthy older adults. Importantly, glycosylated hemoglobin levels were not related to performance on either implicit or explicit memory tasks. These findings revealed a clear dissociation between explicit and implicit memory tasks in normal and pathological aging. Neuropsychologists and clinicians working with TM2 patients should be aware that the decline of voluntary, long-term explicit memory could have a negative impact on their treatment management. By contrast, the intact implicit memory of the two clinical groups could be used in rehabilitation.

  12. Changes in IGF-I and its Binding Proteins Are Associated with Diabetes in Older Adults

    Science.gov (United States)

    Aneke, Chino S.; Parrinello, Christina M.; Rajpathak, Swapnil N.; Rohan, Thomas E.; Strotmeyer, Elsa S.; Kritchevsky, Stephen B.; Psaty, Bruce M.; Bůžková, Petra; Kizer, Jorge R.; Newman, Anne B.; Strickler, Howard D.; Kaplan, Robert C.

    2015-01-01

    Objectives Little is known about long-term changes in insulin-like growth Factor (IGF) proteins and glycemic status. We hypothesized that changes in IGF proteins are exaggerated in participants with type 2 diabetes or worsening glycemia versus those that remain normoglycemic over a 9-year follow-up period. Design Retrospective analysis of cohort study. Setting Participants were recruited from four States: North Carolina, California, Maryland and Pennsylvania. Participants 897 participants enrolled in CHS All Stars, a cohort study of community dwelling adults aged ≥65 years. Measurements Plasma IGF-I, IGFBP-1, and IGFBP-3 levels were assessed and ADA cut-points for IGT, IFG, and diabetes were used to classify participants at baseline (1996–1997) and follow-up (2005–2006). Results At baseline, mean age was 76.3 years (± 3.6) and 18.5% had diabetes. Individuals with IFG alone and IGT+IFG had the highest levels of IGF-I and lowest levels of IGFBP-1, compared to individuals with normoglycemia or diabetes. The greatest percent change in IGF levels occurred in those who had diabetes at baseline (9-year changes: −9.3% for IGF-I, 59.7% for IGFBP-1, −13.4% for IGFBP-3); the smallest in individuals who remained normoglycemic at follow-up (9-year changes: −3.7% for IGF-I, 25.6% for IGFBP-1, −6.4% for IGFBP-3); and intermediate changes in those who were normoglycemic but developed IFG at follow-up. Conclusion Our results demonstrate that degrees of glycemic impairment are associated with varying levels of changes in IGF proteins. The exaggerated changes observed in the diabetes group have been previously shown to be associated with heart failure, cancer and non-cancer mortality. PMID:25989565

  13. 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'.

  14. Supervised Balance Training and Wii Fit-Based Exercises Lower Falls Risk in Older Adults With Type 2 Diabetes.

    Science.gov (United States)

    Morrison, Steven; Simmons, Rachel; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

    2018-02-01

    This study examined the benefits of and differences between 12 weeks of thrice-weekly supervised balance training and an unsupervised at-home balance activity (using the Nintendo Wii Fit) for improving balance and reaction time and lowering falls risk in older individuals with type 2 diabetes mellitus (T2DM). Before-after trial. University research laboratory, home environment. Sixty-five older adults with type 2 diabetes were recruited for this study. Participants were randomly allocated to either supervised balance training (mean age 67.8 ± 5.2) or unsupervised training using the Nintendo Wii Fit balance board (mean age 66.1 ± 5.6). The training period for both groups lasted for 12 weeks. Individuals were required to complete three 40-minute sessions per week for a total of 36 sessions. The primary outcome measure was falls risk, which was as derived from the physiological profile assessment. In addition, measures of simple reaction time, lower limb proprioception, postural sway, knee flexion, and knee extension strength were also collected. Persons also self-reported any falls in the previous 6 months. Both training programs resulted in a significant lowering of falls risk (P general balance ability. Interestingly, the reduced falls risk occurred without significant changes in leg strength, suggesting that interventions to reduce falls risk that target intrinsic risk factors related to balance control (over muscle strength) may have positive benefits for the older adult with T2DM at risk for falls. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  15. Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance.

    Directory of Open Access Journals (Sweden)

    Andrea R Zammit

    Full Text Available The aims of the study were to examine the association between CKD and the metabolic syndrome (MetS and its components in older adults. We also explored two possible pathways linking the metabolic syndrome with CKD: inflammation as measured by high sensitivity C-Reactive Protein (hsCRP and insulin resistance as measured by HOMA-IR.Community-dwelling non-diabetic 70+ adults from the Einstein Aging Study participated in the study. We defined CKD as eGFR below 60mL/min/1.73m2. MetS was defined according to recent guidelines from the National Cholesterol Education Program. Binary logistic regressions were used to assess the association between the metabolic syndrome, its components and CKD with adjustments for demographics, HOMA-IR and hsCRP.Of 616 participants (mean age = 79.3 years, 65.5% female, 25% had MetS and 26.5% had CKD. Participants with CKD had a significantly higher prevalence of the MetS than individuals without CKD (34.4% vs. 24.3%. Binary logistic regression models showed that CKD was associated with MetS (OR = 1.72, 95%CI = 1.13-2.61. The association was unaltered by adjustment for hsCRP but altered by adjustment for HOMA-IR. As the number of MetS components increased the relative odds of CKD also increased. None of the individual components was independently associated with CKD.MetS is associated with CKD in non-diabetic older adults. Results showed that as the number of MetS components increased so did the odds for CKD. HOMA-IR seems to be in the casual pathway linking MetS to CKD.

  16. Innovative biomarkers for predicting type 2 diabetes mellitus: relevance to dietary management of frailty in older adults.

    Science.gov (United States)

    Ikwuobe, John; Bellary, Srikanth; Griffiths, Helen R

    2016-06-01

    Type 2 diabetes mellitus (T2DM) increases in prevalence in the elderly. There is evidence for significant muscle loss and accelerated cognitive impairment in older adults with T2DM; these comorbidities are critical features of frailty. In the early stages of T2DM, insulin sensitivity can be improved by a "healthy" diet. Management of insulin resistance by diet in people over 65 years of age should be carefully re-evaluated because of the risk for falling due to hypoglycaemia. To date, an optimal dietary programme for older adults with insulin resistance and T2DM has not been described. The use of biomarkers to identify those at risk for T2DM will enable clinicians to offer early dietary advice that will delay onset of disease and of frailty. Here we have used an in silico literature search for putative novel biomarkers of T2DM risk and frailty. We suggest that plasma bilirubin, plasma, urinary DPP4-positive microparticles and plasma pigment epithelium-derived factor merit further investigation as predictive biomarkers for T2DM and frailty risk in older adults. Bilirubin is screened routinely in clinical practice. Measurement of specific microparticle frequency in urine is less invasive than a blood sample so is a good choice for biomonitoring. Future studies should investigate whether early dietary changes, such as increased intake of whey protein and micronutrients that improve muscle function and insulin sensitivity, affect biomarkers and can reduce the longer term complication of frailty in people at risk for T2DM.

  17. Strategies for enhancing information, motivation, and skills for self-management behavior changes: a qualitative study of diabetes care for older adults in Korea.

    Science.gov (United States)

    Choi, Suyoung; Song, Misoon; Chang, Sun Ju; Kim, Se-An

    2014-01-01

    To describe strategies for enhancing information, motivation, and skills related to changes in diabetes self-management behavior among community-dwelling older adults in Korea. A total of five focus group interviews (three separate focus groups) were conducted with 12 older adults with type 2 diabetes and five diabetes educators. Qualitative content analysis was used. "One's own willingness and ability" emerged as a fundamental belief about the strategies for diabetes self-management. Six major themes under three categories were identified. Under the information category, the recurrent themes were: 1) repeatedly offering detailed knowledge regarding self-management, 2) providing information about current health status, and 3) identifying experiential knowledge of blood glucose control. The recurrent themes in the motivation category were: 1) ensuring a positive attitude regarding self-management, and 2) encouragement or feedback from significant others. Furthermore, in the skills category, we found that the following theme emerged: hands-on skills training with numerical standards. This study identified six tailored strategies for enhancing information, motivation, and skills for diabetes self-management behavior changes. These strategies can be used in the development of a culturally sensitive diabetes self-management program for older adults.

  18. Preventing Unnecessary Costs of Drug-Induced Hypoglycemia in Older Adults with Type 2 Diabetes in the United States and Canada.

    Science.gov (United States)

    Boulin, Mathieu; Diaby, Vakaramoko; Tannenbaum, Cara

    2016-01-01

    The costs of drug-induced hypoglycemia are a critical but often neglected component of value-based arguments to reduce tight glycemic control in older adults with type 2 diabetes. An economic (decision-tree) analysis compared rates, costs, quality-adjusted life-years, and incremental costs per quality-adjusted life-year gained associated with mild, moderate and severe hypoglycemic events for 6 glucose-lowering medication classes in type 2 diabetic adults aged 65-79 versus those 80 years and older. The national U.S. (Center for Medicare Services) and Canadian public health payer perspectives were adopted. Incidence rates of drug-induced hypoglycemia were the highest for basal insulin and sulfonylureas: 8.64 and 4.32 events per person-year in 65-79 year olds, and 12.06 and 6.03 events per person-year for 80 years and older. In both the U.S. and Canada, metformin dominated sulfonylureas, basal insulin and glucagon-like peptide1 receptor agonists. Relative to sulfonylureas, thiazolidinediones had the lowest incremental cost-effectiveness ratios in the U.S. and dominated sulfonylureas in Canada for adults 80 years and older. Relative to sulfonylureas, dipeptidyl peptidase4 inhibitors were cost-effective for adults 80 years and older in both countries, and for 65-79 year olds in Canada. Annual costs of hypoglycemia for older adults attaining very tight glycemic control with the use of insulin or sulfonylureas were estimated at U.S.$509,214,473 in the U.S. and CAN$65,497,849 in Canada. Optimizing drug therapy for older type 2 diabetic adults through the avoidance of drug-induced hypoglycemia will dramatically improve patient health while also generating millions of dollars by saving unnecessary medical costs.

  19. Preventing Unnecessary Costs of Drug-Induced Hypoglycemia in Older Adults with Type 2 Diabetes in the United States and Canada.

    Directory of Open Access Journals (Sweden)

    Mathieu Boulin

    Full Text Available The costs of drug-induced hypoglycemia are a critical but often neglected component of value-based arguments to reduce tight glycemic control in older adults with type 2 diabetes.An economic (decision-tree analysis compared rates, costs, quality-adjusted life-years, and incremental costs per quality-adjusted life-year gained associated with mild, moderate and severe hypoglycemic events for 6 glucose-lowering medication classes in type 2 diabetic adults aged 65-79 versus those 80 years and older. The national U.S. (Center for Medicare Services and Canadian public health payer perspectives were adopted.Incidence rates of drug-induced hypoglycemia were the highest for basal insulin and sulfonylureas: 8.64 and 4.32 events per person-year in 65-79 year olds, and 12.06 and 6.03 events per person-year for 80 years and older. In both the U.S. and Canada, metformin dominated sulfonylureas, basal insulin and glucagon-like peptide1 receptor agonists. Relative to sulfonylureas, thiazolidinediones had the lowest incremental cost-effectiveness ratios in the U.S. and dominated sulfonylureas in Canada for adults 80 years and older. Relative to sulfonylureas, dipeptidyl peptidase4 inhibitors were cost-effective for adults 80 years and older in both countries, and for 65-79 year olds in Canada. Annual costs of hypoglycemia for older adults attaining very tight glycemic control with the use of insulin or sulfonylureas were estimated at U.S.$509,214,473 in the U.S. and CAN$65,497,849 in Canada.Optimizing drug therapy for older type 2 diabetic adults through the avoidance of drug-induced hypoglycemia will dramatically improve patient health while also generating millions of dollars by saving unnecessary medical costs.

  20. Older Adults and Depression

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

  1. Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity.

    Science.gov (United States)

    Markle-Reid, Maureen; Ploeg, Jenny; Fraser, Kimberly D; Fisher, Kathryn A; Bartholomew, Amy; Griffith, Lauren E; Miklavcic, John; Gafni, Amiram; Thabane, Lehana; Upshur, Ross

    2018-02-01

    To compare the effect of a 6-month community-based intervention with that of usual care on quality of life, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with type 2 diabetes mellitus (T2DM) and 2 or more comorbidities. Multisite, single-blind, parallel, pragmatic, randomized controlled trial. Four communities in Ontario, Canada. Community-dwelling older adults (≥65) with T2DM and 2 or more comorbidities randomized into intervention (n = 80) and control (n = 79) groups (N = 159). Client-driven, customized self-management program with up to 3 in-home visits from a registered nurse or registered dietitian, a monthly group wellness program, monthly provider team case conferences, and care coordination and system navigation. Quality-of-life measures included the Physical Component Summary (PCS, primary outcome) and Mental Component Summary (MCS, secondary outcome) scores of the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Other secondary outcome measures were the Generalized Anxiety Disorder Scale, Center for Epidemiologic Studies Depression Scale (CES-D-10), Summary of Diabetes Self-Care Activities (SDSCA), Self-Efficacy for Managing Chronic Disease, and healthcare costs. Morbidity burden was high (average of eight comorbidities). Intention-to-treat analyses using analysis of covariance showed a group difference favoring the intervention for the MCS (mean difference = 2.68, 95% confidence interval (CI) = 0.28-5.09, P = .03), SDSCA (mean difference = 3.79, 95% CI = 1.02-6.56, P = .01), and CES-D-10 (mean difference = -1.45, 95% CI = -0.13 to -2.76, P = .03). No group differences were seen in PCS score, anxiety, self-efficacy, or total healthcare costs. Participation in a 6-month community-based intervention improved quality of life and self-management and reduced depressive symptoms in older adults with T2DM and comorbidity without increasing total healthcare costs.

  2. Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study.

    Science.gov (United States)

    Strotmeyer, Elsa S; Cauley, Jane A; Schwartz, Ann V; Nevitt, Michael C; Resnick, Helaine E; Bauer, Douglas C; Tylavsky, Frances A; de Rekeneire, Nathalie; Harris, Tamara B; Newman, Anne B

    2005-07-25

    Diabetes mellitus (DM) and related complications may increase clinical fracture risk in older adults. Our objectives were to determine if type 2 diabetes mellitus or impaired fasting glucose was associated with higher fracture rates in older adults and to evaluate how diabetic individuals with fractures differed from those without fractures. The Health, Aging, and Body Composition Study participants were well-functioning, community-dwelling men and women aged 70 to 79 years (N = 2979; 42% black), of whom 19% had DM and 6% had impaired fasting glucose at baseline. Incident nontraumatic clinical fractures were verified by radiology reports for a mean +/- SD of 4.5 +/- 1.1 years. Cox proportional hazards regression models determined how DM and impaired fasting glucose affected subsequent risk of fracture. Diabetes mellitus was associated with elevated fracture risk (relative risk, 1.64; 95% confidence interval, 1.07-2.51) after adjustment for a hip bone mineral density (BMD) and fracture risk factors. Impaired fasting glucose was not significantly associated with fractures (relative risk, 1.34; 95% confidence interval, 0.67-2.67). Diabetic participants with fractures had lower hip BMD (0.818 g/cm(2) vs 0.967 g/cm(2); Pbattery score (5.0 vs 7.0), and falls (37% vs 21%) compared with diabetic participants without fractures (P<.05). These results indicate that older white and black adults with DM are at higher fracture risk compared with nondiabetic adults with a similar BMD since a higher risk of nontraumatic fractures was found after adjustment for hip BMD. Fracture prevention needs to target specific risk factors found in older adults with DM.

  3. Hemoglobin A1c and Mortality in Older Adults With and Without Diabetes: Results From the National Health and Nutrition Examination Surveys (1988-2011).

    Science.gov (United States)

    Palta, Priya; Huang, Elbert S; Kalyani, Rita R; Golden, Sherita H; Yeh, Hsin-Chieh

    2017-04-01

    Hemoglobin A 1c (HbA 1c ) level has been associated with increased mortality in middle-aged populations. The optimal intensity of glucose control in older adults with diabetes remains uncertain. We sought to estimate the risk of mortality by HbA 1c levels among older adults with and without diabetes. We analyzed data from adults aged ≥65 years ( n = 7,333) from the Third National Health and Nutrition Examination Survey (NHANES III) (1998-1994) and Continuous NHANES (1999-2004) and their linked mortality data (through December 2011). Cox proportional hazards models were used to examine the relationship of HbA 1c with the risk of all-cause and cause-specific (cardiovascular disease [CVD], cancer, and non-CVD/noncancer) mortality, separately for adults with diabetes and without diabetes. Over a median follow-up of 8.9 years, 4,729 participants died (1,262 from CVD, 850 from cancer, and 2,617 from non-CVD/noncancer causes). Compared with those with diagnosed diabetes and an HbA 1c 8.0%. HRs were 1.6 (95% CI 1.02, 2.6) and 1.8 (95% CI 1.3, 2.6) for HbA 1c 8.0-8.9% and ≥9.0%, respectively ( P for trend 6.5% had a 1.3 (95% CI 1.03, 1.8) times greater risk of all-cause mortality compared with participants without diabetes and HbA 1c 5.0-5.6%. An HbA 1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. Our results support the idea that better glycemic control is important for reducing mortality; however, in light of the conflicting evidence base, there is also a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities. © 2017 by the American Diabetes Association.

  4. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life

    OpenAIRE

    Ho, Hsiu-Yu; Chen, Mei-Hui; Lou, Meei-Fang

    2018-01-01

    Hsiu-Yu Ho,1,2 Mei-Hui Chen,2,3 Meei-Fang Lou1 1School of Nursing, College of Medicine, National Taiwan University, 2Department of Nursing, Yuanpei University of Medical Technology, 3National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China Background: Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adult...

  5. Quadriceps strength, quadriceps power, and gait speed in older U.S. adults with diabetes mellitus: results from the National Health and Nutrition Examination Survey, 1999-2002.

    Science.gov (United States)

    Kalyani, Rita Rastogi; Tra, Yolande; Yeh, Hsin-Chieh; Egan, Josephine M; Ferrucci, Luigi; Brancati, Frederick L

    2013-05-01

    To examine the independent association between diabetes mellitus (and its duration and severity) and quadriceps strength, quadriceps power, and gait speed in a national population of older adults. Cross-sectional nationally representative survey. United States. Two thousand five hundred seventy-three adults aged 50 and older in the National Health and Nutrition Examination Survey 1999-2002 who had assessment of quadriceps strength. Diabetes mellitus was ascertained according to questionnaire. Measurement of isokinetic knee extensor (quadriceps) strength was performed at 60º/s. Gait speed was assessed using a 20-foot walk test. Multiple linear regression analyses were used to assess the association between diabetes mellitus status and outcomes, adjusting for potential confounders or mediators. Older U.S. adults with diabetes mellitus had significantly slower gait speed (0.96 ± 0.02 m/s) than those without (1.08 ± 0.01 m/s; P diabetes mellitus was also associated with significantly lower quadriceps strength (-4.6 ± 1.9 Nm; P = .02) and power (-4.9 ± 2.0 W; P = .02) and slower gait speed (-0.05 ± 0.02 m/s; P = .002). Associations remained significant after adjusting for physical activity and C-reactive protein. After accounting for comorbidities (cardiovascular disease, peripheral neuropathy, amputation, cancer, arthritis, fracture, chronic obstructive pulmonary disease), diabetes mellitus was independently associated only with gait speed (-0.04 ± 0.02 m/s; P = .02). Diabetes mellitus duration in men and women was negatively associated with age-adjusted quadriceps strength (-5.7 and -3.5 Nm/decade of diabetes mellitus, respectively) and power (-6.1 and -3.8 W/decade of diabetes mellitus, respectively) (all P ≤ .001, no significant interactions according to sex). Glycosylated hemoglobin was not associated with outcomes after accounting for body weight. Older U.S. adults with diabetes mellitus have lower quadriceps strength and quadriceps power that is related

  6. Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses.

    Science.gov (United States)

    Chapman, Anna; Meyer, Claudia; Renehan, Emma; Hill, Keith D; Browning, Colette J

    2017-03-01

    Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. A systematic search for all years to September 2015 identified available literature. Eligibility criteria included: appropriate exercise intervention/s; assessed falls-related outcomes; older adults with DM. Effect sizes were pooled using a random effects model. Positive effect sizes favoured the intervention. Ten RCTs were eligible for the meta-analyses. Exercise interventions were more effective than the control condition for static balance (0.53, 95% CI: 0.13 to 0.93), lower-limb strength (0.63, 95% CI: 0.09 to 1.18), and gait (0.59, 95% CI: 0.22 to 0.96). No RCTs assessed falls-risk; one RCT reported 12month falls-rate, with no differential treatment effect observed. Exercise interventions can improve certain falls-related outcomes among older adults with DM. Substantial heterogeneity and limited numbers of studies should be considered when interpreting results. Among older adults, where DM burden is increasing, exercise interventions may provide promising approaches to assist the improvement of falls-related outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Insulin provision therapy and mortality in older adults with diabetes mellitus and stable ischemic heart disease: Insights from BARI-2D trial.

    Science.gov (United States)

    Damluji, Abdulla A; Cohen, Erin R; Moscucci, Mauro; Myerburg, Robert J; Cohen, Mauricio G; Brooks, Maria M; Rich, Michael W; Forman, Daniel E

    2017-08-15

    Optimal strategies for glucose control in very old adults with diabetes and stable ischemic heart disease (SIHD) are unclear. To compare the effects of insulin provision (IP) therapy versus insulin sensitizing (IS) therapy for glycemic control in older (≥75years) and younger (type II diabetes (DM) and SIHD. Adults enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) were studied. The BARI 2D study population (all with type II DM and SIHD) was randomized twice: (1) between revascularization plus intensive medical therapy versus intensive medical therapy alone, and (2) between IP versus IS therapies. The primary endpoint was all-cause-mortality over five-year follow-up. In this substudy outcomes related to IP vs. IS are assessed in relation to age. Adults aged ≥75years who received IP versus IS are compared to those 182 (8%) were ≥75years. Compared to younger subjects, the older cohort had lower BMI, higher diuretic use, worse kidney function, and increased history of heart failure. Within the older cohort, the IP and IS subgroups were similar in respect to baseline cardiovascular risk factors, medications, and coronary artery disease severity. During follow-up, the older subjects receiving IP therapy had higher cardiovascular mortality compared to those receiving IS therapy (16% vs. 11%, p=0.040). Using Cox proportional hazards analysis, the older IP subjects were at increased risk for all-cause-mortality (hazard ratio 1.89, CI 1.1-3.2, p=0.020). No mortality difference between IP and IS was observed in those diabetes and SIHD aged ≥75years, IP therapy may be associated with increased mortality compared to IS therapy. Additional studies are needed to further refine optimal treatment strategies for diabetes and SIHD in old age. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life

    Directory of Open Access Journals (Sweden)

    Ho HY

    2018-01-01

    Full Text Available Hsiu-Yu Ho,1,2 Mei-Hui Chen,2,3 Meei-Fang Lou1 1School of Nursing, College of Medicine, National Taiwan University, 2Department of Nursing, Yuanpei University of Medical Technology, 3National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China Background: Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adults living with comorbidities that include diabetes. Aim: The aim of this study was to explore the experience of older adults living with comorbidities including diabetes. Methods: A qualitative approach was employed. Data were collected from a selected field of 12 patients with diabetes mellitus in a medical center in northern Taiwan. The data were analyzed by Colaizzi’s phenomenological methodology, and four criteria of Lincoln and Guba were used to evaluate the rigor of the study. Results: The following 5 themes and 14 subthemes were derived: 1 expecting to heal or reduce the symptoms of the disease (trying to alleviate the distress of symptoms and trusting in health practitioners combining the use of Chinese and Western medicines; 2 comparing complex medical treatments (differences in physician practices and presentation, conditionally adhering to medical treatment, and partnering with medical professionals; 3 inconsistent information (inconsistent health information and inconsistent medical advice; 4 impacting on daily life (activities are limited and hobbies cannot be maintained and psychological distress; and 5 weighing the pros and cons (taking the initiative to deal with issues, limiting activity, adjusting mental outlook and pace of life, developing strategies for individual health regimens, and seeking support. Surmounting these challenges in order to live a normal life was explored. Conclusion: This study found that the experience of older adults

  9. Day napping and short night sleeping are associated with higher risk of diabetes in older adults.

    Science.gov (United States)

    Xu, Qun; Song, Yiqing; Hollenbeck, Albert; Blair, Aaron; Schatzkin, Arthur; Chen, Honglei

    2010-01-01

    To examine whether day napping or short night sleeping is associated with higher risk of diabetes. This was a prospective study of hours of day napping and night sleeping assessed in 1996-1997 in relation to diabetes diagnosed between 2000 and 2006 (n = 10,143) among 174,542 participants in the National Institutes of Health (NIH)-AARP Diet and Health Study. Odds ratios (ORs) and 95% CI were derived from multivariate logistic regression models. Longer day napping was associated with a higher risk of diabetes. After adjustment for potential confounders, ORs were 1.23 (95% CI 1.18-1.29) for those reporting or =1 h of napping compared with individuals who did not nap (P(trend) or =9 h. In both analyses, additional adjustment for BMI only modestly attenuated the associations. Further analysis showed a statistically significant interaction between hours of napping and sleeping on diabetes (P(interaction) napping, only short night sleeping was associated with higher occurrence of diabetes, whereas among those with > or =1 h of napping, both long and short sleeping was associated with higher risk. Day napping and short night sleeping are associated with higher risk of diabetes. The association between sleep duration and diabetes may be modified by napping habit.

  10. Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

    Directory of Open Access Journals (Sweden)

    Elsa S. Strotmeyer

    2011-01-01

    Full Text Available Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years were followed 10.9 ± 4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG ≥126 mg/dL. Peripheral artery disease (PAD was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9 and BMI ≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7, but similar for BMI ≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78. PAD (HR = 1.25 (95% CI: 0.92–1.57 and longer walk time (HR = 1.07 (95% CI: 1.04–1.10 modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57. Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.

  11. Development of a situation-specific theory for explaining health-related quality of life among older South Korean adults with type 2 diabetes.

    Science.gov (United States)

    Chang, Sun Ju; Im, Eun-Ok

    2014-01-01

    The purpose of the study was to develop a situation-specific theory for explaining health-related quality of life (QOL) among older South Korean adults with type 2 diabetes. To develop a situation-specific theory, three sources were considered: (a) the conceptual model of health promotion and QOL for people with chronic and disabling conditions (an existing theory related to the QOL in patients with chronic diseases); (b) a literature review using multiple databases including Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and two Korean databases; and (c) findings from our structural equation modeling study on health-related QOL in older South Korean adults with type 2 diabetes. The proposed situation-specific theory is constructed with six major concepts including barriers, resources, perceptual factors, psychosocial factors, health-promoting behaviors, and health-related QOL. The theory also provides the interrelationships among concepts. Health care providers and nurses could incorporate the proposed situation-specific theory into development of diabetes education programs for improving health-related QOL in older South Korean adults with type 2 diabetes.

  12. Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study.

    Science.gov (United States)

    Baptista, Liliana C; Dias, Gonçalo; Souza, Nelba R; Veríssimo, Manuel T; Martins, Raul A

    2017-08-01

    To establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D). This longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n = 279). Participants underwent one of two conditions: LTMEX (n = 241) trained three times per week; and unchanged lifestyle-the control group (CO; n = 38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO 2 peak). LTMEX improves HRQoL, specifically physical functioning (P health (P health (MH; P older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.

  13. Risk Factors for Macro- and Microvascular Complications among Older Adults with Diagnosed Type 2 Diabetes: Findings from The Irish Longitudinal Study on Ageing.

    LENUS (Irish Health Repository)

    Tracey, Marsha L

    2016-01-01

    Objective. To explore risk factors for macro- and microvascular complications in a nationally representative sample of adults aged 50 years and over with type 2 diabetes in Ireland. Methods. Data from the first wave of The Irish Longitudinal Study on Ageing (TILDA) (2009-2011) was used in cross-sectional analysis. The presence of doctor diagnosis of diabetes, risk factors, and macro- and microvascular complications were determined by self-report. Gender-specific differences in risk factor prevalence were assessed with the chi-squared test. Binomial regression analysis was conducted to explore independent associations between established risk factors and diabetes-related complications. Results. Among 8175 respondents, 655 were classified as having type 2 diabetes. Older age, being male, a history of smoking, a lower level of physical activity, and a diagnosis of high cholesterol were independent predictors of macrovascular complications. Diabetes diagnosis of 10 or more years, a history of smoking, and a diagnosis of hypertension were associated with an increased risk of microvascular complications. Older age, third-level education, and a high level of physical activity were protective factors (p < 0.05). Conclusions. Early intervention to target modifiable risk factors is urgently needed to reduce diabetes-related morbidity in the older population in Ireland.

  14. Relationship between continuity of care and adverse outcomes varies by number of chronic conditions among older adults with diabetes

    Directory of Open Access Journals (Sweden)

    Eva H. DuGoff

    2016-06-01

    Full Text Available Follow us on Twitter Co-Editors-in-Chief Martin Fortin Jane Gunn Stewart W. Mercer Susan Smith Marjan van den Akker Society for Academic Primary Care Journal Help USER You are logged in as... avalster My Profile Log Out JOURNAL CONTENT Search Search Scope Search Browse By Issue By Author By Title By Sections By Identify Types OPEN JOURNAL SYSTEMS FONT SIZE Make font size smallerMake font size defaultMake font size larger INFORMATION For Readers For Authors For Librarians ARTICLE TOOLS Print this article Indexing metadata How to cite item Supplementary files Finding References Email this article Email the author Post a Comment NOTIFICATIONS View (378 new Manage IRCMO NEWS ‘Addressing the global challenge of... Publications on multimorbidity... The CARE Plus study Prevalence of multimorbidity in the... Multimorbidity in adults from a... CURRENT ISSUE Atom logo RSS2 logo RSS1 logo HOSTED BY Part of the PKP Publishing Services Network HOME ABOUT USER HOME SEARCH CURRENT ARCHIVES ANNOUNCEMENTS PUBLISHER AUTHOR GUIDELINES SUBMISSIONS WHY PUBLISH WITH US? Home > Vol 6, No 2 (2016 >\tDuGoff Relationship between continuity of care and adverse outcomes varies by number of chronic conditions among older adults with diabetes Eva H. DuGoff, Karen Bandeen-Roche, Gerard F. Anderson Abstract Background: Continuity of care is a basic tenant of primary care practice. However, the evidence on the importance of continuity of care for older adults with complex conditions is mixed. Objective: To assess the relationship between measurement of continuity of care, number of chronic conditions, and health outcomes. Design: We analyzed data from a cohort of 1,600 US older adults with diabetes and ≥1 other chronic condition in a private Medicare health plan from July 2010 to December 2011. Multivariate regression models were used to examine the association of baseline continuity (the first 6 months and the composite outcome of any emergency room use or inpatient

  15. Differentiating Approaches to Diabetes Self-Management of Multi-Ethnic Rural Older Adults at the Extremes of Glycemic Control

    Science.gov (United States)

    Brewer-Lowry, Aleshia Nichol; Arcury, Thomas A.; Bell, Ronny A.; Quandt, Sara A.

    2010-01-01

    Purpose of the Study: This study identified approaches to diabetes self-management that differentiate persons with well-controlled from poorly controlled diabetes. Previous research has focused largely on persons participating in self-management interventions. Design and Methods: In-depth qualitative interviews were conducted with 48 adults, drawn…

  16. Dance for Older Adults.

    Science.gov (United States)

    Pruett, Diane Milhan, Ed.; And Others

    1983-01-01

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

  17. Smoking and Older Adults

    Centers for Disease Control (CDC) Podcasts

    2008-10-27

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

  18. Higher protein intake is not associated with decreased kidney function in pre-diabetic older adults following a one-year intervention

    DEFF Research Database (Denmark)

    Møller, Grith; Andersen, Jens Rikardt; Ritz, Christian

    2018-01-01

    Concerns about detrimental renal effects of a high-protein intake have been raised due to an induced glomerular hyperfiltration, since this may accelerate the progression of kidney disease. The aim of this sub-study was to assess the effect of a higher intake of protein on kidney function in pre-diabetic...... intake and creatinine clearance, eGFR, ACR, or serum creatinine. We found no indication of impaired kidney function after one year with a higher protein intake in pre-diabetic older adults....

  19. The geography of diabetes among the general adults aged 35 years and older in Bangladesh: recent evidence from a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Md Mobarak Hossain Khan

    Full Text Available To report geographical variations of sex-specific diabetes by place of residence (large cities/city corporations, small towns/other urban areas, rural areas and region of residence (divided into seven divisions among general adults (35+ years of age in Bangladesh.The recent cross-sectional data, extracted from the nationally representative Bangladesh Demographic and Health Survey 2011, was used. A total of 3,720 men and 3,823 women aged 35+ years, who participated in the fasting blood sugar testing, were analysed. Any person with either fasting plasma glucose level (mmol/L ≥7.0 or taking medication for diabetes was considered as a person with diabetes.The prevalence of diabetes was 10.6% in men and 11.3% in women. Bivariable analyses indicated significant variations of diabetes by both geographical variables. The prevalence was highest in city corporations (men 18.0%, women 22.3%, followed by small towns (men 13.6%, women 15.2% and rural areas (men 9.3%, women 9.5%. Regional disparities in diabetes prevalence were also remarkable, with the highest prevalence in Chittagong division and lowest prevalence in Khulna division. Multivariable logistic regression analyses provided mixed patterns of geographical disparities (depending on the adjusted variables. Some other independent risk factors for diabetes were advancing age, higher level of education and wealth, having TV (a proxy indicator of physical activity, overweight/obesity and hypertension.Over 10% of the general adults aged 35 years and older were having diabetes. Most of the persons with diabetes were unaware of this before testing fasting plasma glucose level. Although significant disparities in diabetes prevalence by geographical variables were observed, such disparities are very much influenced by the adjusted variables. Finally, we underscore the necessities of area-specific strategies including early diagnosis and health education programmes for changing lifestyles to reduce the risk

  20. Diabetes in South African older adults: prevalence and impact on quality of life and functional disability - as assessed using SAGE Wave 1 data.

    Science.gov (United States)

    Werfalli, Mahmoud; Kassanjee, Reshma; Kalula, Sebastiana; Kowal, Paul; Phaswana-Mafuya, Nancy; Levitt, Naomi S

    2018-01-01

    Diabetes is a chronic disease with severe late complications. It is known to impact the quality of life and cause disability, which may affect an individual's capacity to manage and maintain longer-term health and well-being. To examine the prevalence of self-report diabetes, and association between diabetes and each of health-related quality of life and disability amongst South Africa's older adults. To study both the direct relationship between diabetes and these two measures, as well as moderation effects, i.e. whether associations between other factors and these measures of well-being differed between individuals with diabetes and those without. Secondary analyses of data on participants aged 50 years and older from the Study on global AGEing and adult health (SAGE) in South Africa Wave 1 (2007-2008) were conducted. Prevalence of self-reported diabetes was assessed. Multivariable regressions describe the relationships between each of quality of life (WHOQoL) and disability (WHODAS), and diabetes, while controlling for selected socio-demographic characteristics, health risk behaviours and co-morbid conditions. In the regression models, we also investigated whether diabetes moderates the relationships between these additional factors and WHOQoL/WHODAS. Self-reported diabetes prevalence was 9.2% (95% CI: 7.8,10.9) and increased with age. Having diabetes was associated with poorer WHOQoL scores (additive effect: -4.2; 95% CI: -9.2,0.9; p-value disability (multiplicative effect: 2.1; 95% CI: 1.5,2.9; p-value disability were both related to not being in a relationship, lower education, less wealth, lower physical activity and a larger number of chronic conditions. Diabetes is associated with lower quality of life and greater disability amongst older South Africans. Attention needs to be given to enhancing the capacity of health systems to meet the changing needs of ageing populations with diabetes in SA as well as facilitating social support networks in communities.

  1. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life

    Science.gov (United States)

    Ho, Hsiu-Yu; Chen, Mei-Hui

    2018-01-01

    Background Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adults living with comorbidities that include diabetes. Aim The aim of this study was to explore the experience of older adults living with comorbidities including diabetes. Methods A qualitative approach was employed. Data were collected from a selected field of 12 patients with diabetes mellitus in a medical center in northern Taiwan. The data were analyzed by Colaizzi’s phenomenological methodology, and four criteria of Lincoln and Guba were used to evaluate the rigor of the study. Results The following 5 themes and 14 subthemes were derived: 1) expecting to heal or reduce the symptoms of the disease (trying to alleviate the distress of symptoms and trusting in health practitioners combining the use of Chinese and Western medicines); 2) comparing complex medical treatments (differences in physician practices and presentation, conditionally adhering to medical treatment, and partnering with medical professionals); 3) inconsistent information (inconsistent health information and inconsistent medical advice); 4) impacting on daily life (activities are limited and hobbies cannot be maintained and psychological distress); and 5) weighing the pros and cons (taking the initiative to deal with issues, limiting activity, adjusting mental outlook and pace of life, developing strategies for individual health regimens, and seeking support). Surmounting these challenges in order to live a normal life was explored. Conclusion This study found that the experience of older adults living with comorbidities including diabetes was similar to that of a single disease, but the extent was greater than a single disease. The biggest difference is that the elderly think that their most serious problem is not diabetes, but rather, the comorbidities causing life limitations

  2. The resist diabetes trial: Rationale, design, and methods of a hybrid efficacy/effectiveness intervention trial for resistance training maintenance to improve glucose homeostasis in older prediabetic adults.

    Science.gov (United States)

    Marinik, Elaina L; Kelleher, Sarah; Savla, Jyoti; Winett, Richard A; Davy, Brenda M

    2014-01-01

    Advancing age is associated with reduced levels of physical activity, increased body weight and fat, decreased lean body mass, and a high prevalence of type 2 diabetes (T2D). Resistance training (RT) increases muscle strength and lean body mass, and reduces risk of T2D among older adults. The Resist Diabetes trial will determine if a social cognitive theory (SCT)-based intervention improves RT maintenance in older, prediabetic adults, using a hybrid efficacy/effectiveness approach. Sedentary, overweight/obese (BMI: 25-39.9 kg/m(2)) adults aged 50-69 (N = 170) with prediabetes (impaired fasting glucose and/or impaired glucose tolerance) completed a supervised 3-month RT (2×/wk) initiation phase and were then randomly assigned (N = 159; 94% retention) to one of two 6-month maintenance conditions: SCT or standard care. The SCT intervention consisted of faded contacts compared to standard care. Participants continue RT at an approved, self-selected community facility during maintenance. A subsequent 6-month period involves no contact for both conditions. Assessments occur at baseline and months 3 (post-initiation), 9 (post-intervention), and 15 (six months after no contact). Primary outcomes are prediabetes indices (i.e., impaired fasting and 2-hour glucose concentration) and strength. Secondary measures include insulin sensitivity, beta-cell responsiveness, and disposition index (oral glucose and C-peptide minimal model); adherence; body composition; and SCT measures. Resist Diabetes is the first trial to examine the effectiveness of a high fidelity SCT-based intervention for maintaining RT in older adults with prediabetes to improve glucose homeostasis. Successful application of SCT constructs for RT maintenance may support translation of our RT program for diabetes prevention into community settings. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Vaccines for Older Adults.

    Science.gov (United States)

    Worz, Chad; Martin, Caren McHenry; Travis, Catherine

    2017-09-01

    Several vaccine-preventable diseases-influenza, pneumonia, herpes zoster, and pertussis-threaten the health of older adults in the United States. Both the costs associated with treating these diseases and the potential to increase morbidity and mortality are high for this patient population. Pharmacists and other health care professionals play a significant role in ensuring the elderly patient receives the recommended vaccines at the recommended intervals.

  4. Advanced BrainAGE in older adults with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Katja eFranke

    2013-12-01

    Full Text Available Aging alters brain structure and function and diabetes mellitus (DM may accelerate this process. This study investigated the effects of type 2 DM on individual brain aging as well as the relationships between individual brain aging, risk factors and functional measures. To differentiate a pattern of brain atrophy that deviates from normal brain aging, we used the novel BrainAGE approach, which determines the complex multidimensional aging pattern within the whole brain by applying established kernel regression methods to anatomical brain MRIs. The Brain Age Gap Estimation (i.e., BrainAGE score was then calculated as the difference between chronological age and estimated brain age. 185 subjects (98 with type 2 DM completed an MRI at 3T, laboratory and clinical assessments. Twenty-five subjects (12 with type 2 DM also completed a follow-up visit after 3.8 ± 1.5 years. The estimated brain age of DM subjects was 4.6 ± 7.2 years greater than their chronological age (p = 0.0001, whereas within the control group, estimated brain age was similar to chronological age. As compared to baseline, the average BrainAGE scores of DM subjects increased by 0.2 years per follow-up year (p = 0.034, whereas the BrainAGE scores of controls did not change between baseline and follow-up. At baseline, across all subjects, higher BrainAGE scores were associated with greater smoking and alcohol consumption, higher tumor necrosis factor (TNFα levels, lower verbal fluency scores and more severe depression. Within the DM group, higher BrainAGE scores were associated with longer diabetes duration (r = 0.31, p = 0.019 and increased fasting blood glucose levels (r = 0.34, p = 0.025. In conclusion, type 2 DM is independently associated with structural changes in the brain that reflect advanced aging. The BrainAGE approach may thus serve as a clinically relevant biomarker for the detection of abnormal patterns of brain aging associated with type 2 DM.

  5. The effectiveness of health literacy oriented programs on physical activity behaviour in middle aged and older adults with type 2 diabetes: a systematic review

    Directory of Open Access Journals (Sweden)

    Michael Huen Sum Lam

    2016-06-01

    Full Text Available Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theorybased intervention with respect to patients’ cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.

  6. OR25: Validity of predictive equations for resting energy expenditure for overweight older adults with and without diabetes

    NARCIS (Netherlands)

    Verreijen, A. M.; Garrido, V.; Engberink, M.F.; Memelink, R. G.; Visser, M.; Weijs, P. J.

    2017-01-01

    Rationale: Predictive equations for resting energy expenditure (REE) are used in the treatment of overweight and obesity, but the validity of these equations in overweight older adults is unknown. This study evaluates which predictive REE equation is the best alternative to indirect calorimetry in

  7. Prevalence and Predictors of Pre-Diabetes and Diabetes among Adults 18 Years or Older in Florida: A Multinomial Logistic Modeling Approach.

    Directory of Open Access Journals (Sweden)

    Ifechukwude Obiamaka Okwechime

    Full Text Available Individuals with pre-diabetes and diabetes have increased risks of developing macro-vascular complications including heart disease and stroke; which are the leading causes of death globally. The objective of this study was to estimate the prevalence of pre-diabetes and diabetes, and to investigate their predictors among adults ≥18 years in Florida.Data covering the time period January-December 2013, were obtained from Florida's Behavioral Risk Factor Surveillance System (BRFSS. Survey design of the study was declared using SVYSET statement of STATA 13.1. Descriptive analyses were performed to estimate the prevalence of pre-diabetes and diabetes. Predictors of pre-diabetes and diabetes were investigated using multinomial logistic regression model. Model goodness-of-fit was evaluated using both the multinomial goodness-of-fit test proposed by Fagerland, Hosmer, and Bofin, as well as, the Hosmer-Lemeshow's goodness of fit test.There were approximately 2,983 (7.3% and 5,189 (12.1% adults in Florida diagnosed with pre-diabetes and diabetes, respectively. Over half of the study respondents were white, married and over the age of 45 years while 36.4% reported being physically inactive, overweight (36.4% or obese (26.4%, hypertensive (34.6%, hypercholesteremic (40.3%, and 26% were arthritic. Based on the final multivariable multinomial model, only being overweight (Relative Risk Ratio [RRR] = 1.85, 95% Confidence Interval [95% CI] = 1.41, 2.42, obese (RRR = 3.41, 95% CI = 2.61, 4.45, hypertensive (RRR = 1.69, 95% CI = 1.33, 2.15, hypercholesterolemic (RRR = 1.94, 95% CI = 1.55, 2.43, and arthritic (RRR = 1.24, 95% CI = 1.00, 1.55 had significant associations with pre-diabetes. However, more predictors had significant associations with diabetes and the strengths of associations tended to be higher than for the association with pre-diabetes. For instance, the relative risk ratios for the association between diabetes and being overweight (RRR = 2.00, 95

  8. Cancer: Unique to Older Adults

    Science.gov (United States)

    ... A to Z › Cancer › Unique to Older Adults Font size A A A Print Share Glossary Unique ... group with other older people with the same type of cancer. Researchers have found that support groups ...

  9. Obesity Prevention in Older Adults.

    Science.gov (United States)

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

    2016-06-01

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

  10. AIDS and the Older Adult.

    Science.gov (United States)

    Allers, Christopher T.

    1990-01-01

    Older adults are finding themselves the neighbors of Acquired Immunodeficiency Syndrome (AIDS) patients as well as the primary caregivers of infected adult children. Focuses on roles, issues, and conflicts older adults face in dealing with relatives or neighbors with AIDS. Case management and educational intervention strategies are also offered.…

  11. Impact of a brief intervention on self-regulation, self-efficacy and physical activity in older adults with type 2 diabetes

    Science.gov (United States)

    Olson, Erin A.; McAuley, Edward

    2015-01-01

    Despite evidence of the benefits of physical activity, most individuals with type 2 diabetes do not meet physical activity recommendations. The purpose of this study was to test the efficacy of a brief intervention targeting self-efficacy and self-regulation to increase physical activity in older adults with type 2 diabetes. Older adults (Mage = 61.8 ± 6.4) with type 2 diabetes or metabolic syndrome were randomized into a titrated physical activity intervention (n = 58) or an online health education course (n = 58). The intervention included walking exercise and theory-based group workshops. Self-efficacy, self-regulation and physical activity were assessed at baseline, post-intervention, and a follow-up. Results indicated a group by time effect for self-regulation [F(2,88) = 14.021, p self-efficacy [F(12,77) = 2.322, p self-efficacy and self-regulation. Future research warrants adjusting intervention strategies to increase long-term change. PMID:26162648

  12. Investigating innovative means of prompting activity uptake in older adults with type 2 diabetes: a feasibility study of exergaming.

    Science.gov (United States)

    Senior, Hugh; Henwood, Tim; DE Souza, Daniel; Mitchell, Geoffrey

    2016-10-01

    Physical activity is effective in improving glycemic control in diabetes mellitus. Yet only 40% of people meet the recommended level of physical activity. Nintendo Wii tennis has an energy expenditure of moderate intensity, and may be a viable part of a physical activity programme. Eleven older people with diabetes who were sedentary participated in a pre-post-test designed study to examine physical activity levels, muscle strength, and physical performance after 4 weeks of group Nintendo Wii training. Significant effects occurred on moderate physical activity time, total physical activity, dominant handgrip strength, non-dominant handgrip strength, 30 second chair stand and 400m walk test. No effect was observed for BMI, quality of life, or balance. This study provided preliminary evidence of the effectiveness of group-based active video game programme on physical activity levels.

  13. 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.

  14. Exercise in the healthy older adult.

    Science.gov (United States)

    Karani, R; McLaughlin, M A; Cassel, C K

    2001-01-01

    Habitual exercise provides numerous health benefits to the older adult. While dynamic aerobic activities increase stamina and lung capacity, isometric or resistance training improves muscle strength and endurance. Long-term benefits of continued exercise include a decreased risk of death from heart disease, enhanced balance and mobility, a decreased risk of diabetes, and an improvement in depressive symptoms. While the hazards of exercise relate predominantly to extremes of intensity and duration, all older adults should consult with a physician before beginning a new activity program. A prescription for exercise should include both aerobic and resistance training components, and frequent follow-up to improve adherence is highly recommended. (c)2001 CVRR, Inc.

  15. Sexuality in older adults

    Directory of Open Access Journals (Sweden)

    Adrián Sapetti

    2015-07-01

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

  16. Effectiveness and safety of dipeptidyl peptidase 4 inhibitors in the management of type 2 diabetes in older adults: a systematic review and development of recommendations to reduce inappropriate prescribing.

    Science.gov (United States)

    Schott, Gisela; Martinez, Yolanda V; Ediriweera de Silva, R Erandie; Renom-Guiteras, Anna; Vögele, Anna; Reeves, David; Kunnamo, Ilkka; Marttila-Vaara, Minna; Sönnichsen, Andreas

    2017-10-16

    Preventable drug-related hospital admissions can be associated with drugs used in diabetes and the benefits of strict diabetes control may not outweigh the risks, especially in older populations. The aim of this study was to look for evidence on risks and benefits of DPP-4 inhibitors in older adults and to use this evidence to develop recommendations for the electronic decision support tool of the PRIMA-eDS project. Systematic review using a staged approach which searches for systematic reviews and meta-analyses first, then individual studies only if prior searches were inconclusive. The target population were older people (≥65 years old) with type 2 diabetes. We included studies reporting on the efficacy and/or safety of DPP-4 inhibitors for the management of type 2 diabetes. Studies were included irrespective of DPP-4 inhibitors prescribed as monotherapy or in combination with any other drug for the treatment of type 2 diabetes. The target intervention was DPP-4 inhibitors compared to placebo, no treatment, other drugs to treat type 2 diabetes or a non-pharmacological intervention. Thirty studies (reported in 33 publications) were included: 1 meta-analysis, 17 intervention studies and 12 observational studies. Sixteen studies were focused on older adults and 14 studies reported subgroup analyses in participants ≥65, ≥70, or ≥75 years. Comorbidities were reported by 26 studies and frailty or functional status by one study. There were conflicting findings regarding the effectiveness of DPP-4 inhibitors in older adults. In general, DPP-4 inhibitors showed similar or better safety than placebo and other antidiabetic drugs. However, these safety data are mainly based on short-term outcomes like hypoglycaemia in studies with HbA1c control levels recommended for younger people. One recommendation was developed advising clinicians to reconsider the use of DPP-4 inhibitors for the management of type 2 diabetes in older adults with HbA1c companies and authored or

  17. Clinical Interviewing with Older Adults

    Science.gov (United States)

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

    2012-01-01

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

  18. Higher Protein Intake Is Not Associated with Decreased Kidney Function in Pre-Diabetic Older Adults Following a One-Year Intervention—A Preview Sub-Study

    Directory of Open Access Journals (Sweden)

    Grith Møller

    2018-01-01

    Full Text Available Concerns about detrimental renal effects of a high-protein intake have been raised due to an induced glomerular hyperfiltration, since this may accelerate the progression of kidney disease. The aim of this sub-study was to assess the effect of a higher intake of protein on kidney function in pre-diabetic men and women, aged 55 years and older. Analyses were based on baseline and one-year data in a sub-group of 310 participants included in the PREVIEW project (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World. Protein intake was estimated from four-day dietary records and 24-hour urinary urea excretion. We used linear regression to assess the association between protein intake after one year of intervention and kidney function markers: creatinine clearance, estimated glomerular filtration rate (eGFR, urinary albumin/creatinine ratio (ACR, urinary urea/creatinine ratio (UCR, serum creatinine, and serum urea before and after adjustments for potential confounders. A higher protein intake was associated with a significant increase in UCR (p = 0.03 and serum urea (p = 0.05 after one year. There were no associations between increased protein intake and creatinine clearance, eGFR, ACR, or serum creatinine. We found no indication of impaired kidney function after one year with a higher protein intake in pre-diabetic older adults.

  19. 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.

  20. Different impacts of hypertension and diabetes mellitus on all-cause and cardiovascular mortality in community-dwelling older adults: the Rancho Bernardo Study.

    Science.gov (United States)

    Oh, Jee-Young; Allison, Matthew A; Barrett-Connor, Elizabeth

    2017-01-01

    Although the prevalence rates of hypertension (HTN) and diabetes mellitus are slowing in some high-income countries, HTN and diabetes mellitus remain as the two major risk factors for atherosclerotic cardiovascular disease (CVD), the leading cause of death in the United States and worldwide. We aimed to observe the association of HTN and diabetes mellitus with all-cause and CVD mortality in older white adults. All community-dwelling Rancho Bernardo Study participants who were at least 55 years old and had carefully measured blood pressure and plasma glucose from 75-g oral glucose tolerance test at the baseline visit (1984-1987, n = 2186) were followed up until death or the last clinic visit in 2013 (median 14.3 years, interquartile range 8.4-21.3). In unadjusted analyses, diabetes mellitus was associated with all-cause mortality [hazard ratio 1.40, 95% confidence interval (CI) 1.23-1.60] and CVD mortality (hazard ratio 1.67, 95% CI 1.39-2.00); HTN with all-cause mortality [hazard ratio 1.93 (1.73-2.15)] and CVD mortality [hazard ratio 2.45 (2.10-2.93)]. After adjustment for cardiovascular risk factors, including age, BMI, triglycerides, HDL-cholesterol, smoking, exercise, and alcohol consumption, diabetes mellitus was associated with CVD mortality only (hazard ratio 1.25, P = 0.0213). Conversely, HTN was associated with both all-cause (hazard ratio 1.34, P diabetes mellitus and HTN was associated with all-cause (hazard ratio 1.38, P = 0.0002) and CVD mortality (hazard ratio 1.70, P diabetes mellitus. Having both confers a modest increase in the hazards for these types of mortality.

  1. Motor function is associated with 1,25(OH)(2)D and indices of insulin-glucose dynamics in non-diabetic older adults.

    Science.gov (United States)

    Justice, Jamie N; Pierpoint, Lauren A; Mani, Diba; Schwartz, Robert S; Enoka, Roger M

    2014-06-01

    Advancing age is accompanied by changes in metabolic characteristics, such as reduced insulin sensitivity and low levels of vitamin D, which may exacerbate age-related declines in physical function. The aim of the present study was to determine the associations between insulin-glucose dynamics, vitamin D metabolites, and performance on a battery of motor tasks in healthy, non-diabetic older adults. Sixty-nine community-dwelling men and women (65-90 years) were recruited. Insulin-glucose dynamics were determined by an intravenous glucose tolerance test, and vitamin D metabolites were measured. Motor function was characterized by the time to walk 500 m, chair-rise time, lower body strength, dorsiflexor steadiness and endurance time, and muscle coactivation. Significant unadjusted correlations were found between insulin-glucose dynamics and 1,25-dihydroxyvitamin D [1,25(OH)2D] with walk time, strength, steadiness, endurance time, and muscle activation (p glucose (R (2) = 0.55, p glucose dynamics and the bio-active vitamin D metabolite 1,25(OH)2D. Walking endurance and strength were explained by 1,25(OH)2D and fasting blood glucose and insulin, even after adjusting for age, sex, and body fat. Motor function in a relatively small sample of non-diabetic older men and women was associated with metabolic factors that increase in prevalence with aging.

  2. Delirium: Issues for Older Adults

    Science.gov (United States)

    ... a bone. Common fractures are those of the hip, wrist, or a bone in the back (vertebra). ... leading cause for dehydration among older adults is water pills (diuretics). In addition to not feeling thirsty, ...

  3. Hip Fractures among Older Adults

    Science.gov (United States)

    ... out some of our online STEADI resources for older adults. These resources include: Stay Independent brochure What You Can Do to Prevent Falls brochure Check for Safety brochure Postural Hypotension brochure Chair Rise Exercise Related Pages Important ...

  4. Heat Stress in Older Adults

    Science.gov (United States)

    ... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

  5. Pain management in older adults.

    Science.gov (United States)

    Tracy, Bridget; Sean Morrison, R

    2013-11-01

    Chronic pain is prevalent among older adults but is underrecognized and undertreated. The approach to pain assessment and management in older adults requires an understanding of the physiology of aging, validated assessment tools, and common pain presentations among older adults. To identify the overall principles of pain management in older adults with a specific focus on common painful conditions and approaches to pharmacologic treatment. We searched PubMed for common pain presentations in older adults with heart failure, end-stage renal disease, dementia, frailty, and cancer. We also reviewed guidelines for pain management. Our review encompassed 2 guidelines, 10 original studies, and 22 review articles published from 2000 to the present. This review does not discuss nonpharmacologic treatments of pain. Clinical guidelines support the use of opioids in persistent nonmalignant pain. Opioids should be used in patients with moderate or severe pain or pain not otherwise controlled but with careful attention to potential toxic effects and half-life. In addition, clinical practice guidelines recommend use of oral nonsteroidal anti-inflammatory drugs with extreme caution and for defined, limited periods. An understanding of the basics of pain pathophysiology, assessment, pharmacologic management, and a familiarity with common pain presentations will allow clinicians to effectively manage pain for older adults. © 2013 Elsevier HS Journals, Inc. All rights reserved.

  6. Exercise but not metformin improves health-related quality of life and mood states in older adults with type 2 diabetes.

    Science.gov (United States)

    Baptista, Liliana C; Machado-Rodrigues, Aristides M; Martins, Raul A

    2017-07-01

    The aim of this cohort study is to analyse the effect of three types of treatment: (i) exercise training with multicomponent exercise (E); (ii) pharmacologic treatment with oral hypoglycaemic drug - metformin (M); and (iii) a combined therapy - exercise and metformin (E + M) on health-related quality of life (HRQoL) and mood states in older adults with type 2 diabetes (T2D) with comorbidity in an early stage of the disease. Participants (n = 284) underwent 1 of the following 3 conditions: (i) E (n = 59) trained three times/week; (ii) M (n = 30) used 850 mg of metformin twice daily; and (iii) E + M (n = 195) combined exercise and metformin. Furthermore, participants completed baseline and 2-year follow-up evaluations including a Shortform Health Survey 36, Profile of Mood States - Short-form, the health history questionnaires, anthropometric, and blood biochemistry. E and E + M revealed improved mood states, with large effect size on the vigour domain, and moderate effect size in the anger and total mood disturbance (TMD) domains (P  0.05). Metformin had no significant effect on the self-referred HRQoL in T2D participants aged above 60 years, in an early stage of the disease. The E and E + M were the most effective long-term therapies to improve mood states and HRQoL in older adults with T2D.

  7. Dietary management of older people with diabetes.

    Science.gov (United States)

    McClinchy, Jane

    2018-05-02

    Diabetes UK's revised nutrition guidelines for the prevention and management of diabetes, published recently, encourage education in self-management and include additional guidance for older people with diabetes. The incidence of diabetes in older people is increasing. Many older people with diabetes are healthy and mobile, and live in the community, but a number are frail and living in care homes. Those who are frail are at increased risk of malnutrition from a range of causes. Older people with diabetes should be assessed for malnutrition risk and referred to a dietitian if required. Management of these patients focuses on foods that are high in protein and energy foods. A case study gives an example of how a community nurse may be involved.

  8. Sexuality in Older Adults (65+)

    DEFF Research Database (Denmark)

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

    2017-01-01

    with their bodies than men, particularly in sexual contexts, older women appear to be less vulnerable to body-related dissatisfaction than younger women. Despite the age-specific dynamics of sexual satisfaction and sexual well-being, which parallel age-related decrease in the frequency of sexual activity, research...... findings from different countries show that substantial proportions of aging men and women are satisfied with their sex life. There is some limited evidence that this proportion may be increasing across cohorts. Gender differences in factors that influence sexual satisfaction among older adults appear...... marginal. Conclusion: Older age can affect sexual satisfaction on individual, interpersonal, and culture-related levels. Future research in older adults' sexuality should focus on sexual well-being in women who are without partners, sexual satisfaction among aging lesbian, gay, bisexual, and transgender...

  9. Identifying the causes of the changes in the prevalence patterns of diabetes in older U.S. adults: A new trend partitioning approach.

    Science.gov (United States)

    Akushevich, Igor; Yashkin, Arseniy P; Kravchenko, Julia; Fang, Fang; Arbeev, Konstantin; Sloan, Frank; Yashin, Anatoliy I

    2018-04-01

    To identify how efforts to control the diabetes epidemic and the resulting changes in diabetes mellitus, type II (T2D) incidence and survival have affected the time-trend of T2D prevalence. A newly developed method of trend decomposition was applied to a 5% sample of Medicare administrative claims filed between 1991 and 2012. Age-adjusted prevalence of T2D for adults age 65+ increased at an average annual percentage change of 2.31% between 1992 and 2012. Primary contributors to this trend were (in order of magnitude): improved survival at all ages, increased prevalence of T2D prior to age of Medicare eligibility, decreased incidence of T2D after age of Medicare eligibility. Health services supported by the Medicare system, coupled with improvements in medical technology and T2D awareness efforts provide effective care for individuals age 65 and older. However, policy maker attention should be shifted to the prevention of T2D in younger age groups to control the increase in prevalence observed prior to Medicare eligibility. Copyright © 2018. Published by Elsevier Inc.

  10. Health Literacy and Older Adults

    Science.gov (United States)

    Chesser, Amy K.; Keene Woods, Nikki; Smothers, Kyle; Rogers, Nicole

    2016-01-01

    Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults. PMID:28138488

  11. 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.

  12. Functional Balance and Its Determinants in Older People with Diabetes.

    Science.gov (United States)

    Tsai, Yi-Ju; Yang, Yi-Ching; Lu, Feng-Hwa; Lee, Pei-Yun; Lee, I-Ting; Lin, Sang-I

    2016-01-01

    To determine functional balance abilities of older adults with diabetes, and identify determinants of these abilities. Eighty diabetic and 67 healthy non-diabetic community-dwelling older adults completed the Mini Mental Status Examination (MMSE) and questionnaires about their medical and fall histories. Participants were also assessed for vision, plantar sensitivity, muscle strength, and functional balance, including Functional Reach (FR), Five Times Sit-to-Stand (FTSTS), and 180° turn (TURN). In addition to between-group comparisons, hierarchical regression analysis was conducted to identify the independent determinants for each of the individual balance tasks for the diabetes and control group separately. The diabetes group had significantly greater body mass index, higher rate of cardiac disease, and poorer plantar sensitivity, mental status, grip and lower limb strength. The diabetes group performed significantly poorer in FTSTS and TURN (both pdeterminants for the balance tasks varied substantially between tasks and groups. For the diabetes group, they included visual and plantar sensitivity and MMSE for FR (R2 = 0.39), ankle dorsiflexion strength for FTSTS (R2 = 0.377), and plantar sensitivity, knee extension strength and MMSE for TURN (R2 = 0.391). For the control group, knee extension strength emerged as the common and only significant determinant and only explained approximately 10% of the variance for FR and TURN. Impairments in functional balance abilities were evident for older adults with diabetes. Their underpinning functional limitations were different for different tasks and were also different from those of the control group. Screening of functional balance and mental status, lower limb strength and sensory function, and interventions to address these impairments may be important to maintain function, independence and safety for older clients with diabetes.

  13. Mortality risk attributable to smoking, hypertension and diabetes among English and Brazilian older adults (The ELSA and Bambui cohort ageing studies)

    Science.gov (United States)

    Marmot, Michael G.; Demakakos, Panayotes; Vaz de Melo Mambrini, Juliana; Peixoto, Sérgio Viana; Lima-Costa, Maria Fernanda

    2016-01-01

    Background: The main aim of this study was to quantify and compare 6-year mortality risk attributable to smoking, hypertension and diabetes among English and Brazilian older adults. This study represents a rare opportunity to approach the subject in two different social and economic contexts. Methods: Data from the data from the English Longitudinal Study of Ageing (ELSA) and the Bambuí Cohort Study of Ageing (Brazil) were used. Deaths in both cohorts were identified through mortality registers. Risk factors considered in this study were baseline smoking, hypertension and diabetes mellitus. Both age–sex adjusted hazard ratios and population attributable risks (PAR) of all-cause mortality and their 95% confidence intervals for the association between risk factors and mortality were estimated using Cox proportional hazards models. Results: Participants were 3205 English and 1382 Brazilians aged 60 years and over. First, Brazilians showed much higher absolute risk of mortality than English and this finding was consistent in all age, independently of sex. Second, as a rule, hazard ratios for mortality to smoking, hypertension and diabetes showed more similarities than differences between these two populations. Third, there was strong difference among English and Brazilians on attributable deaths to hypertension. Conclusions: The findings indicate that, despite of being in more recent transitions, the attributable deaths to one or more risk factors was twofold among Brazilians relative to the English. These findings call attention for the challenge imposed to health systems to prevent and treat non-communicable diseases, particularly in populations with low socioeconomic level. PMID:26666869

  14. Catastrophic events and older adults.

    Science.gov (United States)

    Cloyd, Elizabeth; Dyer, Carmel B

    2010-12-01

    The plight of older adults during catastrophic events is a societal concern. Older persons have an increased prevalence of cognitive disorders, chronic illnesses, and mobility problems that limit their ability to cope. These disorders may result in a lack of mental capacity and the ability to discern when they should evacuate or resolve problems encountered during a catastrophe. Some older persons may have limited transportation options, and many of the elderly survivors are at increased risk for abuse, neglect, and exploitation. Recommendations for future catastrophic events include the development of a federal tracking system for elders and other vulnerable adults, the designation of separate shelter areas for elders and other vulnerable adults, and involvement of gerontological professionals in all aspects of emergency preparedness and care delivery, including training of frontline workers. Preparation through preevent planning that includes region-specific social services, medical and public health resources, volunteers, and facilities for elders and vulnerable adults is critical. Elders need to be protected from abuse and fraud during catastrophic events. A public health triage system for elders and other vulnerable populations in pre- and postdisaster situations is useful, and disaster preparedness is paramount. Communities and members of safety and rescue teams must address ethical issues before an event. When older adults are involved, consideration needs to be given to triage decision making, transporting those who are immobile, the care of older adults who receive palliative care, and the equitable distribution of resources. Nurses are perfectly equipped with the skills, knowledge, and training needed to plan and implement disaster preparedness programs. In keeping with the tradition of Florence Nightingale, nurses can assume several crucial roles in disaster preparedness for older adults. Nurses possess the ability to participate and lead community

  15. Sexuality in Older Adults (65+)

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  16. Thermal comfort and older adults

    NARCIS (Netherlands)

    Hoof, van J.; Hensen, J.L.M.

    2006-01-01

    The majority of the increasing number of older adults wishes to age-in-place. Appropriate and comfortable housing is of great importance to facilitate this desire. One of the aspects of concern is thermal comfort. This is normally assessed using the model of Fanger, however, one might ask if this

  17. Health Literacy in Older Adults

    Centers for Disease Control (CDC) Podcasts

    2011-09-20

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

  18. Visuomotor Binding in Older Adults

    Science.gov (United States)

    Bloesch, Emily K.; Abrams, Richard A.

    2010-01-01

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

  19. Oral Health and Older Adults

    Centers for Disease Control (CDC) Podcasts

    2008-10-27

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

  20. Physiological Parameters Database for Older Adults

    Data.gov (United States)

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

  1. Pilot study of the Mini Nutritional Assessment on predicting outcomes in older adults with type 2 diabetes.

    Science.gov (United States)

    Liu, Gong-Xiang; Chen, Yan; Yang, Ying-Xue; Yang, Kun; Liang, Jin; Wang, Shuang; Gan, Hua-Tian

    2017-12-01

    To date, few studies have focused on the nutritional status of elderly hospitalized patients with diabetes. Our aims were to explore the prevalence of malnutrition among elderly diabetes patients admitted to the hospital, and to explore the relationships between malnutrition and geriatric syndromes, diabetic complications, and clinical outcomes. A prospective, observational study including diabetes patients aged ≥65 years was carried out in a central hospital in Western China. Nutritional status was assessed using the Mini Nutritional Assessment incorporated into a comprehensive geriatric assessment. Follow up was carried out for ≤2.8 years. Of 302 participants, the prevalence of malnutrition, risk of malnutrition, and normal nutrition was 18.5%, 33.1% and 48.3%, respectively. In multivariate analysis, incontinence (odds ratio [OR] 3.17, 95% confidence interval [CI] 1.08-9.36), diabetic microvascular complications (OR 2.22, 95% CI 1.06-4.61) and activities of daily living (ADL) dependence (OR 11.6, 95% CI 5.10-26.5) were independently associated with malnutrition. Malnourished patients had longer hospital stays (P = 0.003) and higher mortality rates (P 1) than patients either at risk of malnutrition or with a normal nutritional status. Multivariate analysis also showed that malnutrition was independently associated with an increased risk of death (OR 2.86, 95% CI 1.30-6.28). The present study showed a high prevalence of malnutrition among elderly diabetes patients hospitalized for geriatric care. Considering the negative impact of malnutrition on hospital stay and mortality, adequate nutritional care should be emphasized for each elderly patient with diabetes, regardless of body mass index. Geriatr Gerontol Int 2017; 17: 2485-2492. © 2017 Japan Geriatrics Society.

  2. Sexuality in the Older Adult.

    Science.gov (United States)

    Morton, Laura

    2017-09-01

    Sexuality is an important part of a person's life continuing into older age. Physiologic changes that occur with aging can affect sexual function and may be exacerbated by comorbid disease. To diagnose sexual dysfunction, providers must obtain a thorough history and physical examination, including psychosocial factors. The causes of sexual dysfunction along with patient preferences within the patient's social system serve as the foundation for developing person-centered strategies to address these concerns. To improve care of older adults with sexual concerns, providers should initiate discussions with, listen to, and work with patients to create a comprehensive management plan. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Changing Medical Students' Attitudes toward Older Adults

    Science.gov (United States)

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

    2010-01-01

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

  4. Older Adults and Gambling: A Review

    Science.gov (United States)

    Ariyabuddhiphongs, Vanchai

    2012-01-01

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

  5. Sexuality in Nigerian older adults

    Science.gov (United States)

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

    2015-01-01

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

  6. Osteoporotic fractures in older adults

    OpenAIRE

    Colón-Emeric, Cathleen S.; Saag, Kenneth G.

    2006-01-01

    Osteoporotic fractures are emerging as a major public health problem in the aging population. Fractures result in increased morbidity, mortality and health expenditures. This article reviews current evidence for the management of common issues following osteoporotic fractures in older adults including: (1) thromboembolism prevention; (2) delirium prevention; (3) pain management; (4) rehabilitation; (5) assessing the cause of fracture; and (6) prevention of subsequent fractures. Areas for prac...

  7. Sexuality in Nigerian older adults.

    Science.gov (United States)

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

    2015-01-01

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

  8. Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes.

    Science.gov (United States)

    Wang, Hai-Bin; Yan, Wen-Hua; Dou, Jing-Tao; Lu, Zhao-Hui; Wang, Bao-An; Mu, Yi-Ming

    2017-04-05

    Several previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population. A cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes. A total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1-1.4, Pprediabetes was observed only in individuals with TC prediabetes, but only in individuals with TC <5.6 mmol/L. Further prospective studies are needed to confirm this finding.

  9. DIABETES, DEPRESSION, AND DEATH: A RANDOMIZED CONTROLLED TRIAL OF A DEPRESSION TREATMENT PROGRAM FOR OLDER ADULTS BASED IN PRIMARY CARE (PROSPECT)

    Science.gov (United States)

    Bogner, Hillary R; Morales, Knashawn H; Post, Edward P; Bruce, Martha L

    2009-01-01

    OBJECTIVE Our a priori hypothesis was that depressed patients with diabetes in practices implementing a depression management program would have a decreased risk of mortality compared to depressed patients with diabetes in usual care practices. RESEARCH DESIGN AND METHODS Multi-site practice-randomized controlled trial PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) with patient recruitment from 5/99-8/01 and supplemented with a search of the National Death Index. Twenty primary care practices participated from New York City, Philadelphia, and Pittsburgh. In all, 584 participants who were identified though a two-stage, age-stratified (60-74; 75+) depression screening of randomly sampled patients and were classified as depressed with complete information on diabetes status are included in these analyses. Of all the 584 participants, 123 (21.2%) reported a history of diabetes. A depression care manager worked with primary care physicians to provide algorithm-based care. Vital status was assessed at 5 years. RESULTS After a median follow-up of 52.0 months, 110 depressed patients had died. Depressed patients with diabetes in the Intervention Condition were less likely to have died during the 5-year follow-up interval than were depressed persons with diabetes in Usual Care after accounting for baseline differences among patients (adjusted hazard ratio 0.49, 95% CI [0.24, 0.98]). CONCLUSIONS Older depressed primary care patients with diabetes in practices implementing depression care management were less likely to die over the course of a 5-year interval than were depressed patients with diabetes in usual care practices. PMID:17717284

  10. Lateral step initiation behavior in older adults

    OpenAIRE

    Sparto, Patrick J; Jennings, J Richard; Furman, Joseph M; Redfern, Mark S

    2013-01-01

    Older adults have varied postural responses during induced and voluntary lateral stepping. The purpose of the research was to quantify the occurrence of different stepping strategies during lateral step initiation in older adults and to relate the stepping responses to retrospective history of falls. Seventy community-ambulating older adults (mean age 76 y, range 70–94 y) performed voluntary lateral steps as quickly as possible to the right or left in response to a visual cue, in a blocked de...

  11. Diabetes and Depression in Older Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-11

    This women's health podcast focuses on the association between diabetes and depression in older women and the importance of getting help when feeling depressed.  Created: 5/11/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/11/2009.

  12. Routine monitoring of diabetes mellitus in adults at primary health ...

    African Journals Online (AJOL)

    Glycaemic targets for control in type 1 diabetes mellitus* .... CGM can be useful in selected adults older than 25 years with type 1 diabetes to lower the HbA1c .... Lifestyle modifications should be addressed regularly, including weight loss if ...

  13. Attitudes of neurology specialists toward older adults.

    Science.gov (United States)

    Seferoğlu, Meral; Yıldız, Demet; Pekel, Nilüfer Büyükkoyuncu; Güneş, Aygül; Yıldız, Abdülmecit; Tufan, Fatih

    2017-08-01

    Attitude of healthcare providers toward older people is very important in the aging world. Neurologists contact older adults very frequently. We aimed to investigate the attitudes of neurologists toward older adults. We recorded participants age; sex; duration of clinical practice in neurology; existence of older adult relatives; and history of geriatrics education, nursing home visits, older adult patient density in their clinical practice, and participation in voluntary public activities. UCLA Geriatrics Attitude Scale was used to evaluate participants' attitudes. A total of 100 neurologists participated in this study. Seventy-seven percent had positive, 3 % had neutral, and 20 % had negative attitudes. Twenty-seven percent of the participants had history of geriatrics education, and these participants tended to have a higher rate of positive attitudes. Neurologists with positive attitudes tended to be older than those with negative attitudes. Participants with history of living with older adult relatives had lower rates of positive attitudes. The most common diagnoses of the patients the participants encountered were stroke and dementia. Independent factors associated with positive attitudes were history of geriatrics education and older age. History of living with older relatives tended to have a negative effect. Most of the negative items of the attitude scale were associated with the natural course and behavior of the common diseases in neurology practice. Generalization of geriatrics education may translate into a better understanding and improved care for older patients. Development of instruments and implementation of qualitative studies to assess attitudes of neurologists toward older adults are needed.

  14. Predictors of diabetes in older people in urban China.

    Directory of Open Access Journals (Sweden)

    Ruoling Chen

    Full Text Available China has the largest number of people with diabetes in the world. Over the last 30 years China has experienced rapid economic growth and a growing income gap between rich and poor. The population is ageing, however diabetes in older people has not been well studied to date. In this study we determined incidence and predictors of diabetes in older Chinese people.During 2001, using a standard interview method, we examined 1,317 adults aged ≥65 years who did not have diabetes in the city of Hefei, and characterized baseline risk factors. Over 7.5 years of follow up, we documented incident diabetes using self-reported doctor diagnosis and the cause of death in the whole cohort, and HbA(1C ≥48 mmol/mol in a nested case-control sample. A multivariate Cox regression model was employed to investigate risk of diabetes in relation to baseline risk factors.During follow up, 119 persons had newly diagnosed diabetes. World age-standardised incidence of diabetes was 24.5 (95% CI 19.5-29.5 per 1,000 person-years. Risk of diabetes was significantly and positively associated with income, waist circumference and body mass index, smoking and uncontrolled hypertension, but negatively associated with having a hobby of walking and frequency of visiting children/other relatives and contacting neighbours/friends. Higher income was significantly associated with increased diabetes risk regardless of cardiovascular and psychosocial risk factors. Compared to those with middle income and no psychosocial risk factors, the hazard ratio for incident diabetes among participants with high income and psychosocial risk was 2.13 (95% CI 1.02-4.45.Increasing incidence of diabetes in relation to high income has become an important public health issue in China. Maintaining social networks and gentle physical activities and reducing psychosocial factors may be integrated into current multi-faceted preventive strategies for curbing the epidemic of diabetes in the older population.

  15. Associations between active travel and weight, blood pressure and diabetes in six middle income countries: a cross-sectional study in older adults.

    Science.gov (United States)

    Laverty, Anthony A; Palladino, Raffaele; Lee, John Tayu; Millett, Christopher

    2015-05-20

    There is little published data on the potential health benefits of active travel in low and middle-income countries. This is despite increasing levels of adiposity being linked to increases in physical inactivity and non-communicable diseases. This study will examine: (1) socio-demographic correlates of using active travel (walking or cycling for transport) among older adults in six populous middle-income countries (2) whether use of active travel is associated with adiposity, systolic blood pressure and self-reported diabetes in these countries. Data are from the WHO Study on Global Ageing and Adult Health (SAGE) of China, India, Mexico, Ghana, Russia and South Africa with a total sample size of 40,477. Correlates of active travel (≥150 min/week) were examined using logistic regression. Logistic and linear regression analyses were used to examine health related outcomes according to three groups of active travel use per week. 46.4% of the sample undertook ≥150 min of active travel per week (range South Africa: 21.9% Ghana: 57.8%). In pooled analyses those in wealthier households were less likely to meet this level of active travel (Adjusted Risk Ratio (ARR) 0.77, 95% Confidence Intervals 0.67; 0.88 wealthiest fifth vs. poorest). Older people and women were also less likely to use active travel for ≥150 min per week (ARR 0.71, 0.62; 0.80 those aged 70+ years vs. 18-29 years old, ARR 0.82, 0.74; 0.91 women vs. men). In pooled fully adjusted analyses, high use of active travel was associated with lower risk of overweight (ARR 0.71, 0.59; 0.86), high waist-to-hip ratio (ARR 0.71, 0.61; 0.84) and lower BMI (-0.54 kg/m(2), -0.98;- 0.11). Moderate (31-209 min/week) and high use (≥210 min/week) of active travel was associated with lower waist circumference (-1.52 cm (-2.40; -0.65) and -2.16 cm (3.07; -1.26)), and lower systolic blood pressure (-1.63 mm/Hg (-3.19; -0.06) and -2.33 mm/Hg (-3.98; -0.69)). In middle-income countries use of active travel for ≥150 min

  16. High Blood Pressure: Unique to Older Adults

    Science.gov (United States)

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

  17. The Danish adult diabetes registry

    DEFF Research Database (Denmark)

    Jørgensen, Marit Eika; Kristensen, Jette K.; Husted, Gitte Reventlov

    2016-01-01

    Aim of the database: The aim of the Danish Adult Diabetes Registry (DADR) is to provide data from both the primary health care sector (general practice [GP]) and the secondary sector (specialized outpatient clinics) to assess the quality of treatment given to patients with diabetes. The indicators...... represent process and outcome indicators selected from the literature. Study population: The total diabetes population in Denmark is estimated to be ∼300,000 adult diabetes patients. Approximately 10% have type 1 diabetes, which is managed mainly in the secondary sector, and 90% have type 2 diabetes......, glucose-, blood pressure-, and lipid-lowering treatment (yes/no), insulin pump treatment (yes/ no), and date of last eye and foot examination. Descriptive data: In 2014, the annual report included data regarding over 38,000 patients from outpatient clinics, which is assumed to have included almost all...

  18. Cognitive performance, psychological well-being, and brain magnetic resonance imaging in older patients with type 1 diabetes.

    NARCIS (Netherlands)

    Brands, A.M.; Kessels, R.P.C.; Hoogma, R.P.L.M.; Henselmans, J.M.L.; Beek-Boter, J.W. van der; Kappelle, L.J.; Haan, E.H.F. de; Biessels, G.J.

    2006-01-01

    Modest cognitive impairment has been reported in young-adult patients with type 1 diabetes. In older patients with type 2 diabetes, cognitive impairments are more pronounced, which might be due to age but also to differential effects of type 1 diabetes and type 2 diabetes on the brain. This study

  19. Stumbling over obstacles in older adults compared to young adults

    NARCIS (Netherlands)

    Schillings, AM; Mulder, T; Duysens, J

    Falls are a major problem in older adults. Many falls occur because of stumbling. The aim of the present study is to investigate stumbling reactions of older adults and to compare them with young adults. While subjects walked on a treadmill, a rigid obstacle unexpectedly obstructed the forward sway

  20. Older Adults' Acceptance of Information Technology

    Science.gov (United States)

    Wang, Lin; Rau, Pei-Luen Patrick; Salvendy, Gavriel

    2011-01-01

    This study investigated variables contributing to older adults' information technology acceptance through a survey, which was used to find factors explaining and predicting older adults' information technology acceptance behaviors. Four factors, including needs satisfaction, perceived usability, support availability, and public acceptance, were…

  1. Online Attention Training for Older Adults

    OpenAIRE

    Wennberg, Alexandra; Kueider, Alexandra; Spira, Adam; Adams, Gregory; Rager, Robert; Rebok, George

    2014-01-01

    Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention– coordination, allocation, and selective focus...

  2. Exploring Older Adults' Health Information Seeking Behaviors

    Science.gov (United States)

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

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

  3. Changing Students' Stereotypes of Older Adults

    Science.gov (United States)

    Wurtele, Sandy K.; Maruyama, LaRae

    2013-01-01

    Research suggests that university students tend to hold negative attitudes about older adults. However, there is some evidence to suggest that these ageist attitudes can be challenged and changed through curricular intervention. The current study was designed to determine whether the "Activities of Older Adults" exercise as part of a…

  4. Older Adults Have Difficulty in Decoding Sarcasm

    Science.gov (United States)

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

    2015-01-01

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

  5. Risk of Diabetes in Older Adults with Co-Occurring Depressive Symptoms and Cardiometabolic Abnormalities: Prospective Analysis from the English Longitudinal Study of Ageing.

    Directory of Open Access Journals (Sweden)

    Cassandra Freitas

    Full Text Available High depressive symptoms and cardiometabolic abnormalities are independently associated with an increased risk of diabetes. The purpose of this study was to assess the association of co-occurring depressive symptoms and cardiometabolic abnormalities on risk of diabetes in a representative sample of the English population aged 50 years and older. Data were from the English Longitudinal Study of Ageing. The sample comprised of 4454 participants without diabetes at baseline. High depressive symptoms were based on a score of 4 or more on the 8-item binary Centre for Epidemiologic Studies-Depression scale. Cardiometabolic abnormalities were defined as 3 or more cardiometabolic risk factors (hypertension, impaired glycemic control, systemic inflammation, low high-density lipoprotein cholesterol, high triglycerides, and central obesity. Cox proportional hazards regressions assessed the association between co-occurring depressive symptoms and cardiometabolic abnormalities with incidence of diabetes. Multiple imputation by chained equations was performed to account for missing data. Covariates included age, sex, education, income, smoking status, physical activity, alcohol consumption, and cardiovascular comorbidity. The follow-up period consisted of 106 months, during which 193 participants reported a diagnosis of diabetes. Diabetes incidence rates were compared across the following four groups: 1 no or low depressive symptoms and no cardiometabolic abnormalities (reference group, n = 2717; 2 high depressive symptoms only (n = 338; 3 cardiometabolic abnormalities only (n = 1180; and 4 high depressive symptoms and cardiometabolic abnormalities (n = 219. Compared to the reference group, the hazard ratio for diabetes was 1.29 (95% CI 0.63, 2.64 for those with high depressive symptoms only, 3.88 (95% CI 2.77, 5.44 for those with cardiometabolic abnormalities only, and 5.56 (95% CI 3.45, 8.94 for those with both high depressive symptoms and cardiometabolic

  6. Factors associated with bone mineral density and risk of fall in Korean adults with type 2 diabetes mellitus aged 50 years and older.

    Science.gov (United States)

    Lee, Kyoung Min; Chung, Chin Youb; Kwon, Soon-Sun; Lee, Seung Yeol; Kim, Tae Gyun; Choi, Young; Park, Moon Seok

    2014-11-01

    Osteoporotic fractures in subjects with diabetes mellitus (DM) carry higher mortality and morbidity. Because bone strength and minor trauma, such as a falls, are considered to be significant factors contributing to osteoporotic fractures, it is important to elucidate the associated factors with these. This study was performed to investigate the factors associated with bone mineral density (BMD) and falls in noninstitutionalized subjects with DM aged 50 years or older. We used the database from the 2010 Fifth Korea National Health and Nutrition Examination Survey. Subjects with DM aged 50 years or older were selected and included in the data analyses. Associated factors with BMD of the femoral neck and lumbar spine and those with falls were analyzed using multiple linear regression and binary logistic regression analyses, respectively. Three hundred sixty-two subjects [209 males; 153 females; average age, 66.0 y (SD 8.2 y)] were included. Among the male subjects, the total body muscle mass (P factors with femoral neck BMD, whereas age (P risk of falls. Total body muscle mass was the most prominent factor predicting femoral neck BMD and risk of falls in community-dwelling elderly subjects with DM. Further investigation is required to determine their role in preventing osteoporotic fractures in diabetic subjects.

  7. Perceptions of exercise screening among older adults.

    Science.gov (United States)

    Stathokostas, Liza; Petrella, Andrea F M; Blunt, Wendy; Petrella, Robert J

    2018-06-01

    Prephysical activity screening is important for older adults' participating in physical activity. Unfortunately, many older adults face barriers to exercise participation and thus, may not complete proper physical activity screening. The purpose of this project was to conduct a thematic analysis of perceptions and experiences of community-dwelling older adults regarding prephysical activity screening (i.e., Get Active Questionnaire (GAQ) and a standardized exercise stress test). A convenience sample of adults (male n = 58, female n = 54) aged 75 ± 7 years living in the City of London, Ontario, Canada, was used. Participants completed a treadmill stress test and the GAQ at a research laboratory for community-based referrals. One week later, participants completed the GAQ again and were asked questions by a research assistant about their perceptions of the screening process. Thematic analysis of the responses was conducted. The results indicated that older adults view physical activity screening as acceptable, but not always necessary. Also, the experiences expressed by this sample of older adults indicated that physical activity screening can contribute to continued confidence (through reassurance) and can contribute to increased motivation (through yearly fitness results) in exercise participation. In conclusion, older adults may perceive screening as supportive in exercise adoption, if screening is simple, convenient, and supports older adults' motivation and confidence to exercise.

  8. Older adults and mobile phones for health: a review.

    Science.gov (United States)

    Joe, Jonathan; Demiris, George

    2013-10-01

    To report on the results of a review concerning the use of mobile phones for health with older adults. PubMed and CINAHL were searched for articles using "older adults" and "mobile phones" along with related terms and synonyms between 1965 and June 2012. Identified articles were filtered by the following inclusion criteria: original research project utilizing a mobile phone as an intervention, involve/target adults 60 years of age or older, and have an aim emphasizing the mobile phone's use in health. Twenty-one different articles were found and categorized into ten different clinical domains, including diabetes, activities of daily life, and dementia care, among others. The largest group of articles focused on diabetes care (4 articles), followed by COPD (3 articles), Alzheimer's/dementia Care (3 articles) and osteoarthritis (3 articles). Areas of interest studied included feasibility, acceptability, and effectiveness. While there were many different clinical domains, the majority of studies were pilot studies that needed more work to establish a stronger base of evidence. Current work in using mobile phones for older adult use are spread across a variety of clinical domains. While this work is promising, current studies are generally smaller feasibility studies, and thus future work is needed to establish more generalizable, stronger base of evidence for effectiveness of these interventions. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Suicide in older adults: current perspectives

    Science.gov (United States)

    Conejero, Ismael; Olié, Emilie; Courtet, Philippe; Calati, Raffaella

    2018-01-01

    Suicidal behavior in older adults (65 years old and over) is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts. PMID:29719381

  10. Framing effects in younger and older adults.

    Science.gov (United States)

    Kim, Sunghan; Goldstein, David; Hasher, Lynn; Zacks, Rose T

    2005-07-01

    A growing literature on decision making in older adults suggests that they are more likely to use heuristic processing than are younger adults. We assessed this tendency in the context of a framing effect, a decision-making phenomenon whereby the language used to describe options greatly influences the decision maker's choice. We compared decision making under a standard ("heuristic") condition and also under a "justification" condition known to reduce reliance on heuristics. In the standard condition, older adults were more susceptible than younger adults to framing but the two groups did not differ when participants were asked to provide a justification. Thus, although older adults may spontaneously rely more on heuristic processing than younger adults, they can be induced to take a more systematic approach to decision making.

  11. Heart Failure: Unique to Older Adults

    Science.gov (United States)

    ... to Z › Heart Failure › Unique to Older Adults Font size A A A Print Share Glossary Unique ... will suffer from depression at some point. This type of severe depression is more serious than the ...

  12. Falls Among Older Adults: An Overview

    Science.gov (United States)

    ... out some of our online STEADI resources for older adults. These resources include: Stay Independent brochure What You Can Do to Prevent Falls brochure Check for Safety brochure Postural Hypotension brochure Chair Rise Exercise Related Pages Costs ...

  13. Advances in Psychotherapy for Depressed Older Adults.

    Science.gov (United States)

    Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

    2017-09-01

    We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

  14. Four Medication Safety Tips for Older Adults

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates 4 Medication Safety Tips for Older Adults Share Tweet ... you are experiencing could be due to medications. 4. Review Medications with Your Health Care Provider Ideally, ...

  15. Population Health Management for Older Adults

    Science.gov (United States)

    Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Alsgaard, Kathleen; Hawkins, Kevin; Yeh, Charlotte S.

    2016-01-01

    Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted. PMID:28680938

  16. Older Adults' Knowledge of Internet Hazards

    Science.gov (United States)

    Grimes, Galen A.; Hough, Michelle G.; Mazur, Elizabeth; Signorella, Margaret L.

    2010-01-01

    Older adults are less likely to be using computers and less knowledgeable about Internet security than are younger users. The two groups do not differ on trust of Internet information. The younger group shows no age or gender differences. Within the older group, computer users are more trusting of Internet information, and along with those with…

  17. Crying and Depression Among Older Adults.

    Science.gov (United States)

    Hastrup, Janice L.; And Others

    1986-01-01

    Self-reports of frequency of crying episodes are described for two nonclinical samples of younger and older adult men and women. Comparison of samples revealed no evidence for either a decreased or increased frequency of crying among the older sample. Crying episodes function as an adaptive coping response to and should not be automatically…

  18. Dietary intake modification in response to a participation in a resistance training program for sedentary older adults with prediabetes: findings from the Resist Diabetes study.

    Science.gov (United States)

    Halliday, Tanya M; Davy, Brenda M; Clark, Adrienne G; Baugh, Mary Elizabeth; Hedrick, Valisa E; Marinik, Elaina L; Flack, Kyle D; Savla, J; Winett, Sheila; Winett, Richard A

    2014-08-01

    Engagement in one type of health behavior change may exert a "spillover" effect resulting in other behavior changes. Few studies have examined dietary intake following prolonged training, and none have evaluated spontaneous dietary changes beyond alterations in energy or macronutrient intake following initiation of strength/resistance training (RT). The purpose of this observational investigation was to determine if spontaneous dietary intake modifications occur in response to initiation of an RT program, among older adults. Previously sedentary adults with prediabetes (n=134, age=59±1 years) were enrolled in a supervised 12-week RT program. Participants were not given dietary advice or encouraged to change eating behaviors. Three non-consecutive 24-hour dietary recalls were collected at baseline and after 12 weeks of RT. Reductions in intake of energy (1914±40 kcal vs. 1834±427 kcal, p=0.010), carbohydrate (211.6±4.9 g vs. 201.7±5.2 g, p=0.015), total sugar (87.4±2.7 g vs. 81.5±3.1 g, p=0.030), glycemic load (113.4±3.0 vs. 108.1±3.2, p=0.031), fruits and vegetables (4.6±0.2 servings vs. 4.1±0.2 servings, p=0.018), and sweets and desserts (1.1±0.07 servings vs. 0.89±0.07 servings, p=0.023) were detected over time. No changes in other dietary intake variables were observed. Mode of exercise and disease state may be important factors in determining whether dietary modifications occur with exercise initiation, among previously sedentary adults. Successful initiation of RT may represent an opportunity for health care professionals to promote beneficial changes in dietary habits, among older adults with prediabetes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Optimizing Sleep in Older Adults: Treating Insomnia

    OpenAIRE

    Wennberg, Alexandra M.; Canham, Sarah L.; Smith, Michael T.; Spira, Adam P.

    2013-01-01

    As the world’s population ages, the elevated prevalence of insomnia in older adults is a growing concern. Insomnia is characterized by difficulty falling or remaining asleep, or by non-restorative sleep, and resultant daytime dysfunction. In addition to being at elevated risk for primary insomnia, older adults are at greater risk for comorbid insomnia, which results from, or occurs in conjunction with another medical or psychiatric condition. In this review, we discuss normal changes in sleep...

  20. Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016.

    Science.gov (United States)

    Nanayakkara, Natalie; Pease, Anthony; Ranasinha, Sanjeeva; Wischer, Natalie; Andrikopoulos, Sofianos; Speight, Jane; de Courten, Barbora; Zoungas, Sophia

    2018-05-18

    This study explores the prevalence of, and factors associated with, likely depression and diabetes distress in adults with type 2 diabetes in a large, national sample. Australian National Diabetes Audit data were analysed from adults with type 2 diabetes attending 50 diabetes centres. The Brief Case find for Depression and Diabetes Distress Score 17 were administered to screen for likely depression and diabetes-related distress, respectively. A total of 2,552 adults with type 2 diabetes participated: (mean ± SD) age was 63 ± 13 years, diabetes duration was 12 ± 10 years, and HbA1c was 8 ± 2%. Twenty-nine percent of patients had likely depression, 7% had high diabetes distress, and 5% had both. Difficulty following dietary recommendations, smoking, forgetting medications, and diabetes distress were all associated with greater odds of depression whereas higher own health rating was associated with lower odds (all p < 0.02). Female gender, increasing HbA1c, insulin use, difficulty following dietary recommendations and depression were all associated with greater odds of diabetes distress & older age, higher own health rating and monitoring blood glucose levels as recommended were associated with lower odds (all p < 0.04). Depression was associated with sub-optimal self-care, while diabetes distress was associated with higher HbA1c and sub-optimal self-care.

  1. Suicide in older adults: current perspectives

    Directory of Open Access Journals (Sweden)

    Conejero I

    2018-04-01

    Full Text Available Ismael Conejero,1,2 Emilie Olié,1–3 Philippe Courtet,1–3 Raffaella Calati1–3 1Institut National de la Santé Et de la Recherche Médicale (INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; 2Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU Montpellier, Montpellier, France; 3FondaMental Foundation, Créteil, France Abstract: Suicidal behavior in older adults (65 years old and over is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts. Keywords: suicide, attempted suicide, older adults, risk

  2. Pulmonary hypertension in older adults.

    Science.gov (United States)

    McArdle, John R; Trow, Terence K; Lerz, Kathryn

    2007-12-01

    Pulmonary hypertension is a frequently encountered problem in older patients. True idiopathic pulmonary arterial hypertension can also be seen and requires careful exclusion in older patients. Institution of therapies must be tempered with an appreciation of individual comorbidities and functional limitations that may affect patients' ability to comply and benefit from the complex treatments available for pulmonary arterial hypertension. This article reviews the existing data on the various forms of pulmonary hypertension presenting in older patients and on appropriate therapy in this challenging population.

  3. Statin treatment and mortality in community-dwelling frail older patients with diabetes mellitus : A retrospective observational study

    NARCIS (Netherlands)

    A. Pilotto (Alberto); F. Panza (Francesco); Copetti, M. (Massimiliano); Simonato, M. (Matteo); D. Sancarlo; P. Gallina (Pietro); T.E. Strandberg (Timo); A.J. Cruz-Jentoft (A.); Daragjati, J. (Julia); L. Ferrucci (Luigi); A. Fontana (Andrea); S. Maggi; F.U.S. Mattace Raso (Francesco); M. Paccalin; Polidori, M.C. (Maria Cristina); Schulz, R.-J. (Ralf-Joachim); E. Topinkova; G. Trifirò (Gianluca); A.-K. Welmer

    2015-01-01

    textabstractBackground: Older adults are often excluded from clinical trials. Decision making for administration of statins to older patients with diabetes mellitus (DM) is under debate, particularly in frail older patients with comorbidity and high mortality risk. We tested the hypothesis that

  4. Older adult education in Lithuanian ageing society

    Directory of Open Access Journals (Sweden)

    Zemaitaityte I.

    2016-01-01

    Full Text Available The article analyzes the phenomenon of the demographic ageing of the population and educational opportunities for older adults in Lithuania. Ageing population is a natural outcome of demographic evolution of society. However, a growing number of older people in Lithuania as well as in other European countries requires continuous revision of societal resources in social security, economics, education, health care areas and their adjustment to the new demands. Though current discussion in Lithuania highlights the inclusion of older adults into active social life through educational activities, the studies in diverse areas show that a small number of older people take part in lifelong learning. For this reason and in the attempt to make older people feel satisfaction with life it is necessary to encourage their activity, to promote their social roles, to give them opportunities to take up voluntary tasks, educational and cultural functions and study new subjects.

  5. Coping and health in older adults.

    Science.gov (United States)

    Yancura, Loriena A; Aldwin, Carolyn M

    2008-02-01

    Although coping has been shown to influence physical health in younger populations, whether coping affects health in older adults appears to depend upon how coping and health are conceptualized. This article reviews recent literature on coping and health in older adults in three areas. First, we discuss coping's distinct relevance to health in older adults. Second, we describe ways in which coping may differ between older and younger populations. Third, we detail recent and notable findings of coping's specific effects on biomedical health and health in general. The recent literature suggests that coping may be a developmental and multifaceted process. Positive coping strategies may have positive and even protective effects on health, whereas negative strategies may have negative effects.

  6. Subjective Wellbeing Among Adults with Diabetes

    DEFF Research Database (Denmark)

    Holmes-Truscott, Elizabeth; Browne, Jessica L; Pouwer, Frans

    2016-01-01

    duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health....... These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.......This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent...

  7. A prospective association between dietary folate intake and type 2 diabetes risk among Korean adults aged 40 years or older: the Korean Multi-Rural Communities Cohort (MRCohort) Study.

    Science.gov (United States)

    Hong, Sang M; Woo, Hey W; Kim, Mi K; Kim, Se Y; Lee, Young-Hoon; Shin, Dong H; Shin, Min-Ho; Chun, Byung-Yeol; Choi, Bo Y

    2017-12-01

    It has not been well established whether dietary folate intake reduces the risk of diabetes development. We aimed to clarify the prospective association between dietary folate intake and type 2 diabetes (T2D) risk among 7333 Korean adults aged 40 years or older who were included in the Multi-Rural Communities Cohort. Dietary folate intake was estimated from all 106 food items listed on a FFQ, not including folate intake from supplements. Two different measurements of dietary folate intake were used: the baseline consumption and the average consumption from baseline until just before the end of follow-up. The association between folate intake and T2D risk was determined through a modified Poisson regression model with a robust error estimator controlling for potential confounders. For 29 745 person years, 319 cases of diabetes were ascertained. In multivariable analyses, dietary folate intake was inversely associated with risk of T2D for women, not for men. For women, the incidence rate ratio of diabetes in the third tertile compared with the first tertile was 0·57 (95 % CI 0·38-0·87, P for trend=0·0085) in the baseline consumption model and 0·64 (95 % CI 0·43-0·95, P for trend=0·0244) in the average consumption model. These inverse associations was found in both normal fasting blood glucose group and impaired fasting glucose group among women. Among non-users of multinutrients and vitamin supplements, the significant inverse association remained. Thus, higher dietary intake of folate is prospectively associated with lower risk of diabetes for women.

  8. The Digital Divide and urban older adults.

    Science.gov (United States)

    Cresci, M Kay; Yarandi, Hossein N; Morrell, Roger W

    2010-01-01

    Computers and the Internet offer older adults opportunities and resources for independent living. However, many urban older adults do not use computers. This study examined the demographic, health, and social activities of urban older adults to determine variables that might predict the use and nonuse of computers in this population. A secondary data analysis was performed using the 2001 Detroit City-Wide Needs Assessment of Older Adults (n = 1410) data set. Logistic regression was used to explore potential differences in predictor variables between computer users and nonusers. Overall, computer users were younger (27%), had a higher level of education, were more likely to be employed, had an annual income greater than $20,000, and were healthier and more active than nonusers. They also were more likely to have memberships in community organizations and do volunteer work. Preferred computer activities included conducting Internet searches, playing games, writing, and communicating with family members and friends. The results suggest significant differences in demographic and health-related characteristics between computer users and nonusers among urban older adults. Although about a quarter of participants in this study used computers, the Digital Divide continues to exist in urban settings for scores of others.

  9. The secrets of highly active older adults.

    Science.gov (United States)

    Franke, Thea; Tong, Catherine; Ashe, Maureen C; McKay, Heather; Sims-Gould, Joanie

    2013-12-01

    Although physical activity is a recognized component in the management of many chronic diseases associated with aging, activity levels tend to progressively decline with increasing age (Manini & Pahor, 2009; Schutzer & Graves, 2004). In this article we examine the key factors that facilitate physical activity in highly active community-dwelling older adults. Using a strengths based approach, we examined the factors that facilitated physical activity in our sample of highly active older adults. Twenty-seven older adults participated in face-to face interviews. We extracted a sub-sample of 10 highly active older adults to be included in the analyses. Based on a framework analysis of our transcripts we identified three factors that facilitate physical activity in our sample, these include: 1) resourcefulness: engagement in self-help strategies such as self-efficacy, self-control and adaptability; 2) social connections: the presence of relationships (friend, neighborhood, institutions) and social activities that support or facilitate high levels of physical activity; and 3) the role of the built and natural environments: features of places and spaces that support and facilitate high levels of physical activity. Findings provide insight into, and factors that facilitate older adults' physical activity. We discuss implications for programs (e.g., accessible community centers, with appropriate programming throughout the lifecourse) and policies geared towards the promotion of physical activity (e.g., the development of spaces that facilitate both physical and social activities). © 2013.

  10. Positive messaging promotes walking in older adults.

    Science.gov (United States)

    Notthoff, Nanna; Carstensen, Laura L

    2014-06-01

    Walking is among the most cost-effective and accessible means of exercise. Mounting evidence suggests that walking may help to maintain physical and cognitive independence in old age by preventing a variety of health problems. However, older Americans fall far short of meeting the daily recommendations for walking. In 2 studies, we examined whether considering older adults' preferential attention to positive information may effectively enhance interventions aimed at promoting walking. In Study 1, we compared the effectiveness of positive, negative, and neutral messages to encourage walking (as measured with pedometers). Older adults who were informed about the benefits of walking walked more than those who were informed about the negative consequences of failing to walk, whereas younger adults were unaffected by framing valence. In Study 2, we examined within-person change in walking in older adults in response to positively- or negatively-framed messages over a 28-day period. Once again, positively-framed messages more effectively promoted walking than negatively-framed messages, and the effect was sustained across the intervention period. Together, these studies suggest that consideration of age-related changes in preferences for positive and negative information may inform the design of effective interventions to promote healthy lifestyles. Future research is needed to examine the mechanisms underlying the greater effectiveness of positively- as opposed to negatively-framed messages and the generalizability of findings to other intervention targets and other subpopulations of older adults. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  11. Hypothyroidism: challenges when treating older adults.

    Science.gov (United States)

    Pearson, Tamera

    2013-01-01

    Hypothyroidism frequently affects older adults' general sense of health, their cognitive abilities, and quality of life. Management decisions regarding when to start treatment and at what dosage to begin medication are influenced by both laboratory values and patient symptoms. Although specific guidelines regarding management of hypothyroidism in older adults do not exist, general recommendations include initiating hormone replacement with levothyroxine (Levoxyl(®), Synthroid(®), and others) at 12.5 mcg to 25 mcg and titrating the dose slowly based on response at 6-week intervals. Multiple medications and certain foods can interact with levothyroxine; therefore, the best dosage time is when a person is fasting or 4 hours postprandial. Using a consistent brand-name drug for hormone replacement with levothyroxine is important due to variations in the active ingredient in generic formulations. Providers need to be aware of the prevalence of hypothyroidism and management issues when caring for older adults. Copyright 2013, SLACK Incorporated.

  12. Cohabitation among older adults: a national portrait.

    Science.gov (United States)

    Brown, Susan L; Lee, Gary R; Bulanda, Jennifer Roebuck

    2006-03-01

    Older adults are increasingly likely to experience cohabitation, or living together unmarried in an intimate, heterosexual union. In order to begin building a conceptual framework, we provide a descriptive portrait of older adult cohabitors, emphasizing how they compare to older remarrieds and unpartnereds. We used data from both Census 2000 and the 1998 Health and Retirement Study ( HRS; Health and Retirement Study, 1998) to estimate the size and composition of the cohabiting population aged 51 and older. Also, using HRS data, we estimated multinomial logistic regression models to identify the correlates associated with cohabitation and remarriage (vs being unpartnered) among women and men who were previously married. More than 1 million older adults, composing 4% of the unmarried population, currently cohabit. About 90% of these individuals were previously married. We identify significant differences among cohabitors, remarrieds, and unpartnereds across several dimensions, including sociodemographic characteristics, economic resources, physical health, and social relationships. Cohabitors appear to be more disadvantaged than remarrieds, and this is especially evident for women. Older cohabitors differ from individuals of other marital statuses, and therefore future work on marital status should explicitly incorporate cohabitation.

  13. Using informatics to capture older adults' wellness.

    Science.gov (United States)

    Demiris, George; Thompson, Hilaire J; Reeder, Blaine; Wilamowska, Katarzyna; Zaslavsky, Oleg

    2013-11-01

    The aim of this paper is to demonstrate how informatics applications can support the assessment and visualization of older adults' wellness. A theoretical framework is presented that informs the design of a technology enhanced screening platform for wellness. We highlight an ongoing pilot demonstration in an assisted living facility where a community room has been converted into a living laboratory for the use of diverse technologies (including a telehealth component to capture vital signs and customized questionnaires, a gait analysis component and cognitive assessment software) to assess the multiple aspects of wellness of older adults. A demonstration project was introduced in an independent retirement community to validate our theoretical framework of informatics and wellness assessment for older adults. Subjects are being recruited to attend a community room and engage in the use of diverse technologies to assess cognitive performance, physiological and gait variables as well as psychometrics pertaining to social and spiritual components of wellness for a period of eight weeks. Data are integrated from various sources into one study database and different visualization approaches are pursued to efficiently display potential correlations between different parameters and capture overall trends of wellness. Preliminary findings indicate that older adults are willing to participate in technology-enhanced interventions and embrace different information technology applications given appropriate and customized training and hardware and software features that address potential functional limitations and inexperience with computers. Informatics can advance health care for older adults and support a holistic assessment of older adults' wellness. The described framework can support decision making, link formal and informal caregiving networks and identify early trends and patterns that if addressed could reduce adverse health events. Copyright © 2011 Elsevier Ireland

  14. Neuropsychological Mechanisms for Falls in Older Adults

    Directory of Open Access Journals (Sweden)

    Yu eLiu

    2014-04-01

    Full Text Available Falls, a common cause of injury among older adults, have become increasingly prevalent. As the world’s population ages, the increase in – and the prevalence of – falls among older people makes this a serious and compelling societal and healthcare issue. Physical weakness is a critical predictor in falling. While considerable research has examined this relationship, comprehensive reviews of neuropsychological predictors of falls have been lacking. In this paper, we examine and discuss current studies of the neuropsychological predictors of falls in older adults, as related to sporting and non-sporting contexts. By integrating the existing evidence, we propose that brain aging is an important precursor of the increased risk of falls in older adults. Brain aging disrupts the neural integrity of motor outputs and reduces neuropsychological abilities. Older adults may shift from unconscious movement control to more conscious or attentive motor control. Increased understanding of the causes of falls will afford opportunities to reduce their incidence, reduce consequent injuries, improve overall well-being and quality of life, and possibly to prolong life.

  15. Effective communication and counseling with older adults.

    Science.gov (United States)

    Giordano, J A

    2000-01-01

    Age-sensitive communication skills must be developed to achieve greater effectiveness in assisting older adults. These skills should be guided by research findings on the development changes related to normal aging. A listening-responding technique is presented outlining six principles that can be applied in a wide variety of situations. These principles are governed by the intention to preserve self-esteem and to clarify the needs of elderly clients. By using this approach with the older adult, the practitioner will achieve an effective communication process that generates accurate information, supports self-determination, and achieves a therapeutic process.

  16. Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

    Science.gov (United States)

    Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

    2010-01-01

    Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

  17. Independent older adults perspectives on oral health.

    Science.gov (United States)

    Khabra, K K; Compton, S M; Keenan, L P

    2017-11-01

    The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services. An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes. Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health. Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Self-reported diabetes in older people: comparison of prevalences and control measures

    Directory of Open Access Journals (Sweden)

    Sheila Rizzato Stopa

    2014-08-01

    Full Text Available OBJECTIVE The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. METHODS Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5% and the Pearson’s Chi-square (Rao-Scott tests were performed. The variables without overlap between the confidence intervals were not tested. RESULTS The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6 in 2003 and 20.1% (95%CI 17.3;23.1 in 2008, which indicates a growth over this period (p at the limit of significance. The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. CONCLUSIONS Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients.

  19. Optimizing Tailored Health Promotion for Older Adults

    Science.gov (United States)

    Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

    2016-01-01

    Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

  20. Attitudes toward Advertisements of the Older Adults

    Science.gov (United States)

    Estrada, M.; Moliner, M. A.; Sanchez, J.

    2010-01-01

    In this study we will analyze the attitude of older adults to advertisements, differentiating between advertisements that contain rhetorical figures (trope ads) and those that do not (explicit ads). We will also study their attitude toward the brand advertised according to their degree of involvement with the product. In the course of the…

  1. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  2. Filipino older adults' beliefs about exercise activity.

    Science.gov (United States)

    Ceria-Ulep, Clementina D; Serafica, Reimund C; Tse, Alice

    2011-01-01

    This study explored how the older traditional Filipino adults 65 years old and above living in Honolulu, Hawaii, describe their beliefs regarding exercise activity. The location of this research setting is unique because a blending of traditional Filipino culture exists within an acculturated social setting. The Filipino older adults who have relocated to this U.S. location may have also stayed close to their own cultural traditions. A perception of exercise activity was generated through the lens of 47 participants using qualitative methodology. While focusing on the older adults' beliefs about exercise activity, it became evident that exercise may have been seen as a proxy measure of physical activity. The study revealed four main domains: balancing barriers against benefits; engaging capabilities; intervening factors; and defining exercise. The data suggest that the four themes are juxtaposed among each other, with overarching social obligations to the kin group governing the older adults' engagement in what constitutes structured exercise by Western definition. Further investigation is needed to conceptualize what types of physical activities traditional Filipino elders perceive as exercise, and whether these activities fall into the Western definition of exercise. © 2011 Wiley Periodicals, Inc.

  3. Older adults abuse in three Brazilian cities

    Directory of Open Access Journals (Sweden)

    Rosalina Aparecida Partezani Rodrigues

    Full Text Available ABSTRACT Objective: To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013. Method: Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence. Results: Psychological abuse predominated and most cases occurred in the older adults own home. In the cities of Ribeirão Preto and João Pessoa, the older adults presented similar rates for both gender. Regarding the standardized rates, in João Pessoa, there was a rise of this type of abuse in the two first years, and later there was a certain stability. In the city of Teresina, there was an increase, also observed in the city of Ribeirão Preto in the three first years, followed by a decrease. Conclusion: Older adults abuse is a cultural phenomenon difficult to be reported by them, since it occurs in the family context.

  4. Online Attention Training for Older Adults.

    Science.gov (United States)

    Wennberg, Alexandra; Kueider, Alexandra; Spira, Adam; Adams, Gregory; Rager, Robert; Rebok, George

    Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention- coordination , allocation , and selective focus -in community-dwelling older adults randomized to either an abbreviated (n=13) or an extended (n=17) practice training program over a 6-week period. Participants in the extended practice group significantly improved on selective focus reading distraction tasks with unrelated words (U=39.5; Z=-2.34; p =.02) and blanks (U=26.5; Z=-3.05; p =.002) as well as a matching attributes task (U=49.5; Z=-2.33; p =.02). The extended practice group significantly improved on three tasks of coordinating attention - radio-tuning (U=30; Z=-2.73; p =.01), circuit-breaker resetting (U=46; Z=-2.24; p =.03), and the combination of the two tasks (U=15; Z=-3.51; p attention training programs, like ATTENTION WORKOUT, can improve attention-related skills in community-dwelling older adults.

  5. Emergency Preparedness Concerns for Older Adults

    Centers for Disease Control (CDC) Podcasts

    2009-01-26

    This podcast discusses the special concerns many older adults face during a disaster. It is primarily targeted to public health and aging services professionals.  Created: 1/26/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) and Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER).   Date Released: 1/26/2009.

  6. Persuasive robotic assistant for health self-management of older adults: Design and evaluation of social behaviors

    NARCIS (Netherlands)

    Looije, R.; Neerincx, M.A.; Cnossen, F.

    2010-01-01

    Daily health self-management, such as the harmonization of food, exercise and medication, is a major problem for a large group of older adults with obesity or diabetics. Computer-based personal assistance can help to behave healthy by persuading and guiding older adults. For effective persuasion,

  7. Persuasive robotic assistant for health self-management of older adults : Design and evaluation of social behaviors

    NARCIS (Netherlands)

    Looije, Rosemarijn; Neerincx, Mark A.; Cnossen, Fokie

    Daily health self-management, such as the harmonization of food, exercise and medication, is a major problem for a large group of older adults with obesity or diabetics Computer-based personal assistance can help to behave healthy by persuading and guiding older adults For effective persuasion, the

  8. Sociality and intergenerational transfer of older adults' nostalgia.

    Science.gov (United States)

    Wildschut, Tim; Sedikides, Constantine; Robertson, Sara

    2018-05-03

    Interest in nostalgia has blossomed, yet its nature in older adulthood and potential for intergenerational transfer to younger adults has remained neglected. In Experiment 1, we focused on the content of older adults' nostalgic (vs. ordinary) recollections and asked whether older adults' nostalgia could be transferred to younger adults. We showed that nostalgia expressed in older adults' narratives was positively associated with nostalgia reported by young-adult readers. In Experiment 2, undergraduates read a nostalgic or ordinary narrative written by an older adult. Then they rated their own nostalgia as well as their perceived social connectedness, self-continuity, and meaning in life. Exposure to older adults' nostalgic (vs. ordinary) narratives promoted concurrent nostalgia among young adults, along with associated psychological benefits (social connectedness, self-continuity, meaning). The findings illustrate the potential for intergenerational transfer of nostalgia through written narratives, and attest to the universality of nostalgic themes across younger and older adults.

  9. Dementia literacy in older adults.

    Science.gov (United States)

    Loi, Samantha M; Lautenschlager, Nicola T

    2015-09-01

    With the increasing aging population, it is predicted that there will also be a rise in the number of people with dementia. Although there is no definitive cure, early detection and access to treatment and services remains the cornerstone of management. Misinformation and poor knowledge about dementia may lead to delayed diagnosis. A study of dementia literacy was undertaken to explore current knowledge in a metropolitan city in Australia. A vignette describing an older person with symptoms of cognitive impairment was posted out to volunteers at the local hospital. The majority of participants surveyed correctly identified that the person in the vignette was suffering from symptoms of dementia or cognitive impairment. However, there was more variation with regard to types of treatment available and appropriate help-seeking behavior. Although people are able to identify symptoms of dementia when they are presented in a scenario, the reality is often not as clear. More education to improve knowledge with regard to this increasingly common disorder is required so that appropriate interventions can be made available. © 2014 Wiley Publishing Asia Pty Ltd.

  10. Lateral step initiation behavior in older adults.

    Science.gov (United States)

    Sparto, Patrick J; Jennings, J Richard; Furman, Joseph M; Redfern, Mark S

    2014-02-01

    Older adults have varied postural responses during induced and voluntary lateral stepping. The purpose of the research was to quantify the occurrence of different stepping strategies during lateral step initiation in older adults and to relate the stepping responses to retrospective history of falls. Seventy community-ambulating older adults (mean age 76 y, range 70-94 y) performed voluntary lateral steps as quickly as possible to the right or left in response to a visual cue, in a blocked design. Vertical ground reaction forces were measured using a forceplate, and the number and latency of postural adjustments were quantified. Subjects were assigned to groups based on their stepping strategy. The frequency of trials with one or two postural adjustments was compared with data from 20 younger adults (mean age 38 y, range 21-58 y). Logistic regression was used to relate presence of a fall in the previous year with the number and latency of postural adjustments. In comparison with younger adults, who almost always demonstrated one postural adjustment when stepping laterally, older adults constituted a continuous distribution in the percentage of step trials made with one postural adjustment (from 0% to 100% of trials). Latencies of the initial postural adjustment and foot liftoff varied depending on the number of postural adjustments made. A history of falls was associated a larger percentage of two postural adjustments, and a longer latency of foot liftoff. In conclusion, the number and latency of postural adjustments made during voluntary lateral stepping provides additional evidence that lateral control of posture may be a critical indicator of aging. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Low Blood Sodium in Older Adults: A Concern?

    Science.gov (United States)

    ... sodium in older adults: A concern? Why is low blood sodium a health concern for older adults? ... treated? Answers from Paul Y. Takahashi, M.D. Low blood sodium (hyponatremia) occurs when you have an ...

  12. Older Adults and Drinking | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Rethinking Drinking Older Adults and Drinking Past Issues / Spring 2014 Table of ... quickly than when they were younger. Drinking puts older adults at greater risk for falls, car crashes, and ...

  13. What Older Adults Need to Know about Retail Clinics

    Science.gov (United States)

    What Older Adults Need to Know about Retail Clinics Expert Information from Healthcare Professionals Who Specialize in the Care of Older Adults Retail clinics are medical clinics based in pharmacies, ...

  14. Quick Guide to Health Literacy and Older Adults

    Science.gov (United States)

    ... Health Promotion Quick Guide to Health Literacy and Older Adults skip to content ODPHP Health Communication Healthy People ... and Patient e-Health Resources Health Literacy and Older Adults Who is this guide for? Why are health ...

  15. Preventing Elder Abuse and Neglect in Older Adults

    Science.gov (United States)

    ... Documents PDF Preventing Elder Abuse and Neglect in Older Adults Download Join our e-newsletter! Resources Preventing Elder Abuse and Neglect in Older Adults Tools and Tips Printer-friendly PDF Click here ...

  16. Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults

    DEFF Research Database (Denmark)

    Shah, Amil M.; Claggett, Brian; Kitzman, Dalane

    2017-01-01

    Background: Although age-Associated changes in left ventricular diastolic function are well recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values...

  17. Overview of persistent pain in older adults.

    Science.gov (United States)

    Molton, Ivan R; Terrill, Alexandra L

    2014-01-01

    With the shifting age demographics of the U.S. population, more psychologists will be asked to provide clinical services to older adults. Given the high prevalence of persistent pain in aging, in many cases this will mean providing empirically supported interventions for pain and the interference it creates. The purpose of this review is to provide a broad overview of the scope and impact of persistent pain in older people and to discuss mechanisms by which persistent geriatric pain can lead to suffering and disability. We consider the unique context of pain in older adulthood and review differences between older and younger people in terms of pain perception, the social network, beliefs about pain, pain-related coping, and adherence to pain medication. Finally, we discuss special issues affecting pain management in older adults, including dementia, polypharmacy, and barriers to accessing adequate pain care. This review also highlights a need for greater provider training in pain management to meet the needs of a changing U.S. population. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  18. Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study

    NARCIS (Netherlands)

    K. Dhana (Klodian); J. Nano (Jana); S. Ligthart (Symen); A. Peeters (Andrea); A. Hofman (Albert); W.J. Nusselder (Wilma); A. Dehghan (Abbas); O.H. Franco (Oscar)

    2016-01-01

    textabstractBackground: Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived

  19. The association between Western and Prudent dietary patterns and fasting blood glucose levels in type 2 diabetes and normal glucose metabolism in older Australian adults.

    Science.gov (United States)

    Walsh, Erin I; Jacka, Felice N; Butterworth, Peter; Anstey, Kaarin J; Cherbuin, Nicolas

    2017-06-01

    High blood glucose and type 2 diabetes are associated with a range of adverse health and cognitive outcomes. One factor that contributes to high blood glucose and type 2 diabetes is dietary intake. This study investigated the relationship between dietary patterns, fasting blood glucose and diabetes status in a sample of 209 participants aged 60-65. Blood plasma glucose was measured from venous blood samples. Individual Prudent and Western dietary patterns were estimated from a self-completed food frequency questionnaire. The relationship between dietary patterns, diabetes, and blood glucose was assessed via general linear model analyses controlling for age, sex, height, and total caloric intake. Results indicated that there was no association between Prudent diet and fasting blood glucose levels, or type 2 diabetes. In contrast, an individual in the upper tertile for Western dietary score had a significantly higher risk of having diabetes than an individual in the lower tertile for Western dietary score. However, there was no significant association between Western diet and fasting blood glucose. Western diet may be associated with type 2 diabetes through mechanisms beyond impacting blood plasma glucose directly. The fact that the association between Western diet and type 2 diabetes remained even when total caloric intake was controlled for highlights the need for policy and population health interventions targeting the reduction of unhealthy food consumption.

  20. Erectile Dysfunction in the Older Adult Male.

    Science.gov (United States)

    Mola, Joanna R

    2015-01-01

    Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options.

  1. The Mental Health of Older LGBT Adults.

    Science.gov (United States)

    Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

    2016-06-01

    There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.

  2. Managing Status Epilepticus in the Older Adult

    Science.gov (United States)

    Legriel, Stephane; Brophy, Gretchen M.

    2016-01-01

    The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome. Stroke (acute or remote symptomatic), miscellaneous metabolic causes, dementia, infections hypoxemia, and brain injury are among the main causes of status epilepticus occurrence in this age category. The use of anticonvulsive agents can be problematic as well. Thus, it is important to take into account the specific aspects related to the pharmacokinetic and pharmacodynamic changes in older critically-ill adults. Beyond these precautions, the management may be identical to that of the younger adult, including prompt initiation of symptomatic and anticonvulsant therapies, and a broad and thorough etiological investigation. Such management strategies may improve the vital and functional prognosis of these patients, while maintaining a high overall quality of care. PMID:27187485

  3. Effects of a Forgiveness Intervention for Older Adults

    Science.gov (United States)

    Allemand, Mathias; Steiner, Marianne; Hill, Patrick L.

    2013-01-01

    The authors' aim in the present study was to examine the effects of a brief forgiveness intervention for older adults. The psychoeducational group intervention consists of (a) established core components of previous forgiveness interventions and (b) additional components considering specific needs of older adults. Seventy-eight older adults (mean…

  4. Resilience in Rural Community-Dwelling Older Adults

    Science.gov (United States)

    Wells, Margaret

    2009-01-01

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

  5. Older Adults with and without Depressive Symptoms

    Directory of Open Access Journals (Sweden)

    Leilani Feliciano

    2011-01-01

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

  6. Alcohol consumption and risk type 2 diabetes among older women

    NARCIS (Netherlands)

    Beulens, J.W.J.; Stolk, R.P.; Schouw, van der Y.T.; Grobbee, D.E.; Hendriks, H.F.J.; Bots, M.L.

    2005-01-01

    OBJECTIVE—This study aimed to investigate the relation between alcohol consumption and type 2 diabetes among older women. RESEARCH DESIGN AND METHODS—Between 1993 and 1997, 16,330 women aged 49–70 years and free from diabetes were enrolled in one of the Dutch Prospect-EPIC (European Prospective

  7. Perceived age discrimination in older adults.

    Science.gov (United States)

    Rippon, Isla; Kneale, Dylan; de Oliveira, Cesar; Demakakos, Panayotes; Steptoe, Andrew

    2014-05-01

    to examine perceived age discrimination in a large representative sample of older adults in England. this cross-sectional study of over 7,500 individuals used data from the fifth wave of the English Longitudinal Study of Ageing (ELSA), a longitudinal cohort study of men and women aged 52 years and older in England. Wave 5 asked respondents about the frequency of five everyday discriminatory situations. Participants who attributed any experiences of discrimination to their age were treated as cases of perceived age discrimination. Multivariable logistic regression analysis was used to estimate the odds ratios of experiencing perceived age discrimination in relation to selected sociodemographic factors. approximately a third (33.3%) of all respondents experienced age discrimination, rising to 36.8% in those aged 65 and over. Perceived age discrimination was associated with older age, higher education, lower levels of household wealth and being retired or not in employment. The correlates of age discrimination across the five discriminatory situations were similar. understanding age discrimination is vital if we are to develop appropriate policies and to target future interventions effectively. These findings highlight the scale of the challenge of age discrimination for older adults in England and illustrate that those groups are particularly vulnerable to this form of discrimination.

  8. Brain natriuretic peptide and insulin resistance in older adults.

    Science.gov (United States)

    Kim, F; Biggs, M L; Kizer, J R; Brutsaert, E F; de Filippi, C; Newman, A B; Kronmal, R A; Tracy, R P; Gottdiener, J S; Djoussé, L; de Boer, I H; Psaty, B M; Siscovick, D S; Mukamal, K J

    2017-02-01

    Higher levels of brain natriuretic peptide (BNP) have been associated with a decreased risk of diabetes in adults, but whether BNP is related to insulin resistance in older adults has not been established. N-terminal of the pro hormone brain natriuretic peptide (NT-pro BNP) was measured among Cardiovascular Health Study participants at the 1989-1990, 1992-1993 and 1996-1997 examinations. We calculated measures of insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), Gutt index, Matsuda index] from fasting and 2-h concentrations of glucose and insulin among 3318 individuals with at least one measure of NT-proBNP and free of heart failure, coronary heart disease and chronic kidney disease, and not taking diabetes medication. We used generalized estimating equations to assess the cross-sectional association of NT-proBNP with measures of insulin resistance. Instrumental variable analysis with an allele score derived from nine genetic variants (single nucleotide polymorphisms) within or near the NPPA and NPPB loci was used to estimate an un-confounded association of NT-proBNP levels on insulin resistance. Lower NT-proBNP levels were associated with higher insulin resistance even after adjustment for BMI, waist circumference and other risk factors (P insulin resistance (P = 0.38; P = 0.01 for comparison with the association of measured levels of NT-proBNP). In older adults, lower NT-proBNP is associated with higher insulin resistance, even after adjustment for traditional risk factors. Because related genetic variants were not associated with insulin resistance, the causal nature of this association will require future study. © 2016 Diabetes UK.

  9. Recognition of dementia in hospitalized older adults.

    Science.gov (United States)

    Maslow, Katie; Mezey, Mathy

    2008-01-01

    Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.

  10. Chronic use of benzodiazepines among older adults

    Directory of Open Access Journals (Sweden)

    Jussara Mendonça Alvarenga

    2014-12-01

    Full Text Available OBJECTIVE To analyze the perception of and motivation for the chronic use of benzodiazepine among older adults. METHODS A qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the “signs, meanings, and actions” model. RESULTS The main reasons pointed out for the use of benzodiazepines were “nervousness”, “sleep problems”, and “worry” due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems. CONCLUSIONS Benzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life’s problems in old age. Although it relieves the “nerves”, the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population.

  11. Older adults abuse in three Brazilian cities

    OpenAIRE

    Rodrigues, Rosalina Aparecida Partezani; Monteiro, Edilene Araújo; Santos, Ana Maria Ribeiro dos; Pontes, Maria de Lourdes de Farias; Fhon, Jack Roberto Silva; Bolina, Alisson Fernandes; Seredynskyj, Fernanda Laporti; Almeida, Vanessa Costa; Giacomini, Suelen Borelli Lima; Defina, Giovanna Partezani Cardoso; Silva, Luipa Michele

    2017-01-01

    ABSTRACT Objective: To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013. Method: Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence. Result...

  12. Everyday memory errors in older adults.

    Science.gov (United States)

    Ossher, Lynn; Flegal, Kristin E; Lustig, Cindy

    2013-01-01

    Despite concern about cognitive decline in old age, few studies document the types and frequency of memory errors older adults make in everyday life. In the present study, 105 healthy older adults completed the Everyday Memory Questionnaire (EMQ; Sunderland, Harris, & Baddeley, 1983 , Journal of Verbal Learning and Verbal Behavior, 22, 341), indicating what memory errors they had experienced in the last 24 hours, the Memory Self-Efficacy Questionnaire (MSEQ; West, Thorn, & Bagwell, 2003 , Psychology and Aging, 18, 111), and other neuropsychological and cognitive tasks. EMQ and MSEQ scores were unrelated and made separate contributions to variance on the Mini Mental State Exam (MMSE; Folstein, Folstein, & McHugh, 1975 , Journal of Psychiatric Research, 12, 189), suggesting separate constructs. Tip-of-the-tongue errors were the most commonly reported, and the EMQ Faces/Places and New Things subscales were most strongly related to MMSE. These findings may help training programs target memory errors commonly experienced by older adults, and suggest which types of memory errors could indicate cognitive declines of clinical concern.

  13. Neighborhood Characteristics and Disability in Older Adults

    Science.gov (United States)

    Blaney, Shannon; Cerda, Magda; Frye, Victoria; Lovasi, Gina S.; Ompad, Danielle; Rundle, Andrew; Vlahov, David

    2009-01-01

    Objective To characterize the influence of the residential neighborhood of older adults on the prevalence of disability. Methods We combined Census data on disability in older adults living in New York City with environmental information from a comprehensive geospatial database. We used factor analysis to derive dimensions of compositional and physical neighborhood characteristics and linear regression to model their association with levels of disability. Measures of neighborhood collective efficacy were added to these models to explore the impact of the social environment. Results Low neighborhood socioeconomic status, residential instability, living in areas with low proportions of foreign born and high proportions of Black residents, and negative street characteristics were associated with higher prevalence of both “physical” disability and “going outside the home” disability. High crime levels were additionally associated with physical disability, although this relationship disappeared when misdemeanor arrests were removed from the crime variable. Low levels of collective efficacy were associated with more going-outside-the-home disability, with racial/ethnic composition dropping out of this model to be replaced by an interaction term. Conclusion The urban environment may have a substantial impact on whether an older adult with a given level of functional impairment is able to age actively and remain independent. PMID:19181694

  14. Treatment of specific phobia in older adults

    Directory of Open Access Journals (Sweden)

    Nancy A Pachana

    2007-10-01

    Full Text Available Nancy A Pachana1, Rana M Woodward1, Gerard JA Byrne21School of Psychology, University of Queensland, Brisbane, Australia 2School of Medicine, University of Queensland, Brisbane, AustraliaAbstract: Phobias are common in later life, yet treatment research in this population remains scant. The efficacy of exposure therapy, in combination with other Cognitive-Behavioral Therapy (CBT components, in the treatment of specific phobia with a middle and older aged sample was examined. Sixteen adults aged 45–68 with DSM-IV diagnosis of a specific phobia received a manualized intervention over ten weeks, and were compared with a control group. Results indicated significant time effects in the treatment group for the primary outcome variables of phobic severity and avoidance as well as secondary outcome variables including depression and anxiety. Symptom presence and severity also significantly declined in the treatment group. No significant changes in state anxiety were noted across the treatment period. Such results provide support for the efficacy of exposure combined with CBT treatment for specific phobia in middle to older aged adults.Keywords: anxiety, phobia, older adults, cognitive behavioral therapy

  15. Socioeconomic and lifestyle factors associated with chronic conditions among older adults in Ecuador.

    Science.gov (United States)

    Guevara, Pilar Egüez; Andrade, Flávia Cristina Drumond

    2015-09-01

    To explore socioeconomic and lifestyle factors associated with the prevalence of self-reported chronic conditions among older adults in Ecuador. The sample was drawn from the nationally representative observational cross-sectional data of the Health, Well-Being, and Aging survey conducted in Ecuador in 2009. Logistic regression models were used to explore the association between socioeconomic and lifestyle factors and the prevalence of selected chronic conditions. Older women in Ecuador are more likely than men to have been previously diagnosed with diabetes, heart disease, high blood pressure, and arthritis. Results suggest no difference by education or health insurance on number and type of self-reported chronic conditions. However, older adults who resided in the coastal area were more likely to report having diabetes, heart disease, high blood pressure, and stroke than those in the highlands. Living in rural areas was associated with lower odds of having diabetes and high blood pressure. Compared to white older adults, indigenous older adults were less likely to report having high blood pressure, but more likely to report having arthritis. Older age in Ecuador is marked by low educational levels and poverty. Female gender and living in coastal areas were associated with higher risks of self-reported chronic conditions.

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

    Science.gov (United States)

    Singer, Jefferson; Rexhaj, Blerim; Baddeley, Jenna

    2007-11-01

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

  17. Optimal management of ADHD in older adults

    Directory of Open Access Journals (Sweden)

    Torgersen T

    2016-01-01

    Full Text Available Terje Torgersen,1,2 Bjorn Gjervan,2,3 Michael B Lensing,4 Kirsten Rasmussen5,6 1Department of Østmarka, St Olav’s Hospital, 2Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 3Department of Psychiatry, Helse Nord-Trondelag Hospital Trust, Kirkegata, Levanger, 4NevSom, Norwegian Center of Expertise for Neurodevelopmental Disorders and Hypersomnias, Women and Children’s Division, Oslo University Hospital, Oslo, 5St Olav’s Hospital, Broset Center for Research and Education in Forensic Psychiatry, Trondheim, 6Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway Background: The manifestation of attention-deficit/hyperactivity disorder (ADHD among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed.Method: A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years.Results: ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should

  18. Systematic review of the evidence for a liberalized diet in the management of diabetes mellitus in older adults residing in aged care facilities.

    Science.gov (United States)

    Farrer, Olivia; Yaxley, Alison; Walton, Karen; Healy, Erin; Miller, Michelle

    2015-04-01

    A systematic review of the literature was conducted to review and evaluate the evidence supporting a liberalized diet for the management of diabetes mellitus in aged care homes and examine the effect of this on glycaemia, nutritional status and diabetes comorbidity risk factors. A 3 step search of eight databases followed by independent data extraction and quality assessment by two authors was undertaken. Studies which compared therapeutic diets to a liberalized diet or observation studies reviewing the effects of therapeutic diets on glycaemia and nutritional status were included. Of the 546 studies identified, six met the inclusion criteria. Methodological quality of the studies was rated poor and the majority concluded no statistically significant change in diabetes management outcomes with a liberalized diet, but modest increases in glycaemia were observed. Inadequate data was available to determine effects of diet change on nutritional status or diabetes risk factors. Overall studies were in support of a liberalized diet but due to the low quality of the evidence and a lack of significant findings it may not be appropriate to extrapolate these conclusions to inform dietetic practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Asthma Is More Severe in Older Adults

    Science.gov (United States)

    Dweik, Raed A.; Comhair, Suzy A.; Bleecker, Eugene R.; Moore, Wendy C.; Peters, Stephen P.; Busse, William W.; Jarjour, Nizar N.; Calhoun, William J.; Castro, Mario; Chung, K. Fan; Fitzpatrick, Anne; Israel, Elliot; Teague, W. Gerald; Wenzel, Sally E.; Love, Thomas E.; Gaston, Benjamin M.

    2015-01-01

    Background Severe asthma occurs more often in older adult patients. We hypothesized that the greater risk for severe asthma in older individuals is due to aging, and is independent of asthma duration. Methods This is a cross-sectional study of prospectively collected data from adult participants (N=1130; 454 with severe asthma) enrolled from 2002 – 2011 in the Severe Asthma Research Program. Results The association between age and the probability of severe asthma, which was performed by applying a Locally Weighted Scatterplot Smoother, revealed an inflection point at age 45 for risk of severe asthma. The probability of severe asthma increased with each year of life until 45 years and thereafter increased at a much slower rate. Asthma duration also increased the probability of severe asthma but had less effect than aging. After adjustment for most comorbidities of aging and for asthma duration using logistic regression, asthmatics older than 45 maintained the greater probability of severe asthma [OR: 2.73 (95 CI: 1.96; 3.81)]. After 45, the age-related risk of severe asthma continued to increase in men, but not in women. Conclusions Overall, the impact of age and asthma duration on risk for asthma severity in men and women is greatest over times of 18-45 years of age; age has a greater effect than asthma duration on risk of severe asthma. PMID:26200463

  20. Visual function affects prosocial behaviors in older adults.

    Science.gov (United States)

    Teoli, Dac A; Smith, Merideth D; Leys, Monique J; Jain, Priyanka; Odom, J Vernon

    2016-02-01

    Eye-related pathological conditions such as glaucoma, diabetic retinopathy, and age-related macular degeneration commonly lead to decreased peripheral/central field, decreased visual acuity, and increased functional disability. We sought to answer if relationships exist between measures of visual function and reported prosocial behaviors in an older adult population with eye-related diagnoses. The sample consisted of adults, aged ≥ 60 years old, at an academic hospital's eye institute. Vision ranged from normal to severe impairment. Medical charts determined the visual acuities, ocular disease, duration of disease (DD), and visual fields (VF). Measures of giving help were via validated questionnaires on giving formal support (GFS) and giving informal support; measures of help received were perceived support (PS) and informal support received (ISR). ISR had subscales: tangible support (ISR-T), emotional support (ISR-E), and composite (ISR-C). Visual acuities of the better and worse seeing eyes were converted to LogMAR values. VF information converted to a 4-point rating scale of binocular field loss severity. DD was in years. Among 96 participants (mean age 73.28; range 60-94), stepwise regression indicated a relationship of visual variables to GFS (p T (p prosocial behavior in older adults.

  1. Organizational Support and Volunteering Benefits for Older Adults

    Science.gov (United States)

    Tang, Fengyan; Choi, Eunhee; Morrow-Howell, Nancy

    2010-01-01

    Purpose: This study tested a theoretical model of volunteering benefits and examined the mechanism through which volunteering benefits older adults. Design and Methods: This is a 2-wave study of 253 older adult volunteers serving in 10 volunteer programs. Older volunteers completed the mailed surveys in 2005 and 2006. Structural equation modeling…

  2. Ethical Concerns in Usability Testing Involving Older Adults

    DEFF Research Database (Denmark)

    Møller, Margrethe Hansen

    Based on experience from the research project “User Manuals for Older Adults”, this paper discusses whether there are special ethical concerns with older adults as test persons in a usability test involving the think-aloud method. In this context, older adults are defined as individuals with normal...

  3. A review of the relationship between leg power and selected chronic disease in older adults

    DEFF Research Database (Denmark)

    Strollo, S. E.; Caserotti, Paolo; Ward, R. E.

    2015-01-01

    characterized. Importantly, individuals with these conditions have shown improved leg power with training. METHODS: A search was performed using PubMed to identify original studies published in English from January 1998 to August 2013. Leg power studies, among older adults ≥ 50 years of age, which assessed......OBJECTIVE: This review investigates the relationship between leg muscle power and the chronic conditions of osteoarthritis, diabetes mellitus, and cardiovascular disease among older adults. Current literature assessing the impact of chronic disease on leg power has not yet been comprehensively......), diabetes mellitus (n=5), and cardiovascular disease (n=6). Studies generally supported associations of lower leg power among older adults with chronic disease, although small sample sizes, cross-sectional data, homogenous populations, varied disease definitions, and inconsistent leg power methods limited...

  4. Self-Regulation, Self-Efficacy and Health Behavior Change in Older Adults.

    Science.gov (United States)

    Purdie, Nola; McCrindle, Andrea

    2002-01-01

    Presents an overview of self-regulation models: theory of planned behavior, protection motivation theory, health belief model, action control theory, transtheoretical model of behavior change, health action process, and precaution adoption process. Applies models to health behavior change in older adults with cardiovascular disease or diabetes.…

  5. Alcohol Consumption and Factors Associated with Depressive Symptoms among Older Adults in Mainland China

    Science.gov (United States)

    Liu, Yujun; Xie, Yimeng; Brossoie, Nancy; Roberto, Karen A.; Redican, Kerry J.

    2017-01-01

    Background: High levels of alcohol consumption have been shown to be related to cardiovascular disease, cancer, diabetes, and other chronic disease and is an important variable in the global burden of disease. Purpose: This study explored the relationship between alcohol consumption and depressive symptoms among older Chinese adults in mainland…

  6. Implementing reverse mentoring to address social isolation among older adults.

    Science.gov (United States)

    Breck, Bethany M; Dennis, Cory B; Leedahl, Skye N

    2018-07-01

    Reverse mentoring is a means to address the social work Grand Challenge of social isolation. Among older adults, reverse mentoring can improve social connection by increasing the digital competence of older adults so they can use technology for social benefit, and by facilitating intergenerational connections with young adult mentors. In this paper, reverse mentoring is examined within an intergenerational program that serves older adults and utilizes the native technological knowledge and skills of young adults who mentor older adult participants. Qualitative data were collected through young adult mentor logs of each session, and through open-ended questions on the post-surveys collected from older adults and young adult mentors. Qualitative analysis revealed three themes related to social connection: (1) an increased sense of self-efficacy for older adults as they build confidence in technological use, and for young adults as they develop leadership skills through mentoring, (2) the breaking down of age-related stereotypes, and (3) intergenerational engagement and connection. The findings demonstrate that reverse mentoring can be used in various settings to decrease the social isolation of older adults by developing intergenerational connections and increasing older adult usage of technology.

  7. Older adults abuse in three Brazilian cities.

    Science.gov (United States)

    Rodrigues, Rosalina Aparecida Partezani; Monteiro, Edilene Araújo; Santos, Ana Maria Ribeiro Dos; Pontes, Maria de Lourdes de Farias; Fhon, Jack Roberto Silva; Bolina, Alisson Fernandes; Seredynskyj, Fernanda Laporti; Almeida, Vanessa Costa; Giacomini, Suelen Borelli Lima; Defina, Giovanna Partezani Cardoso; Silva, Luipa Michele

    2017-01-01

    To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013. Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence. Psychological abuse predominated and most cases occurred in the older adults own home. In the cities of Ribeirão Preto and João Pessoa, the older adults presented similar rates for both gender. Regarding the standardized rates, in João Pessoa, there was a rise of this type of abuse in the two first years, and later there was a certain stability. In the city of Teresina, there was an increase, also observed in the city of Ribeirão Preto in the three first years, followed by a decrease. Older adults abuse is a cultural phenomenon difficult to be reported by them, since it occurs in the family context. Analisar os boletins de ocorrência registrados por idosos que sofreram violência, a fim de identificar características sociodemográficas das vítimas e dos agressores, tipo de violência, local, bem como comparar as taxas em três municípios brasileiros no período de 2009 a 2013. Estudo ecológico, em que foram analisados 2.612 boletins de ocorrência registrados em Delegacias do Idoso. Utilizou-se um instrumento para obter dados da vítima, do agressor e tipo de violência. Predominou a violência psicológica, na maioria dos casos na própria residência do idoso. Em Ribeirão Preto e João Pessoa, os idosos mais jovens apresentaram taxas semelhantes entre ambos os sexos. Na comparação das taxas padronizadas, em João Pessoa, houve ascensão deste tipo de violência nos dois primeiros anos, e, posteriormente, certa estabilidade. Em Teresina, houve ascensão, também observada em Ribeirão Preto nos tr

  8. Falls and patient safety for older adults.

    Science.gov (United States)

    Aronovitch, Sharon A

    2006-10-01

    The risk of falling increases with age. Falls in the elderly have been found to raise mortality and morbidity rates and are a leading cause of premature admission to long-term care facilities. Attention to known intrinsic and extrinsic factors that predispose to falling is important in community dwelling and institutionalized older adults. New government guidelines for long-term care facilities have helped focus attention on the safety aspect of fall risk and information about the physical and psychological impact of falling is increasing. Implementation of fall prevention protocols, including the use of fall risk assessment tools, may help reduce the incidence of falls and resultant complications.

  9. The Quality of Health Care Received by Older Adults

    National Research Council Canada - National Science Library

    2004-01-01

    .... Older adults suffer from a multitude of conditions and are especially susceptible to the effects of poor care, yet we know relatively little about the quality of health care older people receive...

  10. Parameters of glucose metabolism and the aging brain: a magnetization transfer imaging study of brain macro- and micro-structure in older adults without diabetes.

    Science.gov (United States)

    Akintola, Abimbola A; van den Berg, Annette; Altmann-Schneider, Irmhild; Jansen, Steffy W; van Buchem, Mark A; Slagboom, P Eline; Westendorp, Rudi G; van Heemst, Diana; van der Grond, Jeroen

    2015-08-01

    Given the concurrent, escalating epidemic of diabetes mellitus and neurodegenerative diseases, two age-related disorders, we aimed to understand the relation between parameters of glucose metabolism and indices of pathology in the aging brain. From the Leiden Longevity Study, 132 participants (mean age 66 years) underwent a 2-h oral glucose tolerance test to assess glucose tolerance (fasted and area under the curve (AUC) glucose), insulin sensitivity (fasted and AUC insulin and homeostatic model assessment of insulin sensitivity (HOMA-IS)) and insulin secretion (insulinogenic index). 3-T brain MRI was used to detect macro-structural damage (atrophy, white matter hyper-intensities, infarcts and/or micro-bleeds) and magnetization transfer imaging (MTI) to detect loss of micro-structural homogeneity that remains otherwise invisible on conventional MRI. Macro-structurally, higher fasted glucose was significantly associated with white matter atrophy (P = 0.028). Micro-structurally, decreased magnetization transfer ratio (MTR) peak height in gray matter was associated with higher fasted insulin (P = 0.010), AUCinsulin (P = 0.001), insulinogenic index (P = 0.008) and lower HOMA-IS index (P glucose was associated with macro-structural damage, impaired insulin action was associated more strongly with reduced micro-structural brain parenchymal homogeneity. These findings offer some insight into the association between different parameters of glucose metabolism (impairment of which is characteristic of diabetes mellitus) and brain aging.

  11. Motivation to Learn among Older Adults in Taiwan

    Science.gov (United States)

    Chang, Dian-Fu; Lin, Sung-Po

    2011-01-01

    This study analyzed the survey on adults administered by the Ministry of Education in Taiwan in 2008, and logistic regression analysis showed a close relationship between learning motivations of older adults. The finding revealed that the higher age or the lower education attainment of older adults, the lower their learning motivation. The…

  12. Ankle-brachial index and inter-artery blood pressure differences as predictors of cognitive function in overweight and obese older adults with diabetes: results from the Action for Health in Diabetes movement and memory study.

    Science.gov (United States)

    Espeland, Mark A; Beavers, Kristen M; Gibbs, Bethany Barone; Johnson, Karen C; Hughes, Timothy M; Baker, Laura D; Jakicic, John; Korytkowski, Mary; Miller, Marsha; Bray, George A

    2015-10-01

    Ankle-brachial index (ABI) and interartery systolic blood pressure differences, as markers of vascular disease, are plausible risk factors for deficits in cognitive function among overweight and obese adults with type 2 diabetes. The ABI and maximum interartery differences (MIAD) in systolic blood pressures were assessed annually for five years among 479 participants assigned to the control condition in a randomized clinical trial of a behavioral weight loss intervention. A battery of standardized cognitive function tests was administered 4 to 5 years later. Analyses of covariance were used to assess relationships that ABI, MIAD, and progression of ABI and MIAD had with cognitive function. There was a curvilinear relationship between ABI and a composite index of cognitive function (p = 0.03), with lower ABI being associated with poorer function. In graded fashions, both greater MIAD and increases in MIAD over time also had modest relationships with poorer verbal memory (both p ≤ 0.05), processing speed (both p ≤ 0.05), and composite cognitive function (both p cognitive function 4-5 years later. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Epidemiology of falls in older adults in Texas.

    Science.gov (United States)

    Alamgir, Hasanat; Wong, Nicole J; Hu, Yueha; Yu, Mo; Marshall, Amanda; Yu, Shicheng

    2015-02-01

    The expected increase in the US older adult population implies an increased risk of fall-related injury among these individuals. We describe the epidemiology of fall morbidity among older adults in Texas, a large US state with a diverse population base. Texas Behavioral Risk Factor Surveillance System 2010 data were analyzed. The falls outcome was defined as falling: any fall in the past 3 months and a serious fall: a fall resulting in limited activities for at least 1 day or requiring medical attention. A total of 5996 subjects were included in this analysis; 17.6% (n = 1055) reported falling 1 to 5 times in the previous 3 months, and 361 (6%) experienced serious falls. Risk of falling had a significant positive association among respondents who rated their general health as fair to poor (relative risk [RR] 2.39, 95% confidence interval [CI] 1.55-3.68) and a negative association for those who reported regular physical activity (RR 0.59, 95% CI 0.42-0.82). A similar model examined the risk of serious falls and found statistically positive associations in respondents who reported fair or poor general health (RR 3.29, 95% CI 2.00-5.43). Negative associations were found for those who reported regular physical activity (RR 0.56, 95% CI 0.38-0.83) and for men (RR 0.62, 95% CI 0.39-0.98). No statistically significant correlations for either of the fall outcomes were found with residence, obesity, education, income, age, ethnicity, employment, marital status, diabetes mellitus, or cardiovascular disease. Interventions aimed at the prevention of falls should focus on maintaining and improving general health and promoting physical activity among older adults.

  14. The prevalence of metabolic syndrome among older adults in Ecuador: Results of the SABE survey.

    Science.gov (United States)

    Orces, Carlos H; Gavilanez, Enrique Lopez

    2017-12-01

    To describe the prevalence of metabolic syndrome among older adults in Ecuador. A secondary objective was to examine the relationship between metabolic syndrome and its components and insulin resistance among non-diabetic participants. The National Survey of Health, Wellbeing, and Aging survey was used to examine the prevalence of metabolic syndrome according to demographic, behavioral, and health characteristics of the participants. Logistic regression models adjusted for covariates were used to examine the independent association of metabolic syndrome and its components and insulin resistance in non-diabetic older adults. Of 2298 participants with a mean age of 71.6 (SD 8.1) years, the prevalence of metabolic syndrome was 66.0% (95% CI, 62.6%, 69.3%) in women and 47.1% (95% CI, 43.2%, 50.9) in men. However, even higher prevalence rates were seen among literate individuals, residents from urban areas of the coastal and Andes Mountains region, obese subjects, those diagnosed with diabetes, and participants with≥2 comorbidities. Overall, abdominal obesity followed by elevated blood pressure were the metabolic syndrome components more prevalent and associated with insulin resistance among older Ecuadorians. Moreover, after adjustment for covariates, older adults defined as having metabolic syndrome had a 3-fold higher odds of having insulin resistance as compared with those without. The prevalence of metabolic syndrome is high among older adults in Ecuador. The present findings may assist public health authorities to implement programs of lifestyle and behavioral modification targeting older adults at increased risk for this cardio metabolic disorder. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  15. Cognitive remediation therapy for older adults

    Directory of Open Access Journals (Sweden)

    Indira Sharma

    2016-01-01

    Full Text Available There is a large body of research on cognitive interventions for older adults the review which suggests the following: (1 Cognition remediation therapy is indicated for healthy elderly, and in mild cognitive impairment (MCI, early dementia, brain disease and injury, and severe mental illness (SMI. (2 Studies on healthy elderly demonstrate that with cognitive training (CT, cognitive stimulation (CS, and/or cognitive rehabilitation (CR age-related cognitive decline can be reversed, at least partially if not fully, even in advanced age, with improved social functioning and quality of life. Better results are obtained if cognitive remediation therapy (CRT is combined with vocational/psychosocial rehabilitation. Generalization of training to activities of daily living (ADL and to secondary outcome measures such as quality of life and self-esteem are issues that need to be addressed in older adults. (3 Research in MCI has indicated that CRT, especially memory training, has some role. Future studies should place focus on the assessment of dose-response relationship, training generalization, and ecologically relevant approaches. (4 Findings of earlier work in early-stage dementia were frustrating, more recent work, especially randomized controlled trials of high quality, has provided a ray of rope with respect to effectiveness of CT and CR. Further well-designed studies are required to provide more definitive evidence. (5 Significant therapeutic effects of CR have been observed on cognitive function and ADL in the elderly patients with stroke. Routine screening for stroke patients and those with brain injury for cognitive impairment is recommended. (6 Available research provides evidence that cognitive remediation benefits people with SMI, and when combined with psychiatric rehabilitation this benefit generalizes to functioning. Elderly with SMI need special focus. Further needs to be carried out on older people with SMI.

  16. Hyposalivation and xerostomia in dentate older adults

    Science.gov (United States)

    Wiener, R. Constance; Wu, Bei; Crout, Richard; Wiener, Michael; Plassman, Brenda; Kao, Elizabeth; McNeil, Daniel

    2010-01-01

    Background Older adults are susceptible to reduced saliva production related to certain medications, radiation and chronic conditions. Many of these people have many physical and oral health problems and limited access to dental care. The use of effective screening tools for xerostomia and hyposalivation would be helpful in identifying those at risk. The authors conducted a study to investigate the association between three measures of oral dryness: hyposalivation (low unstimulated salivary flow), self-reported xerostomia and clinically assessed dry mouth. Methods The authors included a convenience sample of 252 nondemented and dentate West Virginia participants 70 years and older who were part of a larger study on oral health and cognition among older adults. Participants completed a self-reported xerostomia index, provided an unstimulated salivary sample and underwent an oral assessment for the study. Results Twenty-eight (11.1 percent) had hyposalivation, eight of whom reported having xerostomia (sensitivity = 28.6 percent). Of the 43 participants who reported having xerostomia, only eight had hyposalivation (positive predictive value = 18.6 percent). Hyposalivation and self-reported xerostomia were not significantly related. Clinically assessed dry mouth correlated modestly, but significantly, with hyposalivation and self-reported xerostomia. Conclusions Obtaining routine unstimulated salivary flow rates in addition to self-reported information and oral evaluations may increase early detection of oral dryness, which would assist in implementing early interventions to improve patients’ quality of life. Clinical Implications Visually inspecting oral tissues for dryness and asking a patient if his or her mouth is dry are insufficient measures for clinicians to use to determine if the patient has hyposalivation. The authors recommend that clinicians determine the patients’ unstimulated salivary flow rate. PMID:20194383

  17. Social, Economic, and Health Disparities Among LGBT Older Adults.

    Science.gov (United States)

    Emlet, Charles A

    2016-01-01

    LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery.

  18. Modifying Older Adults' Daily Sedentary Behaviour Using an Asset-based Solution: Views from Older Adults.

    Science.gov (United States)

    Leask, Calum F; Sandlund, Marlene; Skelton, Dawn A; Tulle, Emmanuelle; Chastin, Sebastien Fm

    2016-01-01

    There is a growing public health focus on the promotion of successful and active ageing. Interventions to reduce sedentary behaviour (SB) in older adults are feasible and are improved by tailoring to individuals' context and circumstances. SB is ubiquitous; therefore part of the tailoring process is to ensure individuals' daily sedentary routine can be modified. The aim of this study was to understand the views of older adults and identify important considerations when creating a solution to modify daily sedentary patterns. This was a qualitative research study. Fifteen older adult volunteers (mean age = 78 years) participated in 1 of 4 focus groups to identify solutions to modify daily sedentary routine. Two researchers conducted the focus groups whilst a third took detailed fieldnotes on a flipchart to member check the findings. Data were recorded and analysed thematically. Participants wanted a solution with a range of options which could be tailored to individual needs and circumstances. The strategy suggested was to use the activities of daily routine and reasons why individuals already naturally interrupting their SB, collectively framed as assets. These assets were categorised into 5 sub-themes: physical assets (eg. standing up to reduce stiffness); psychological assets (eg. standing up to reduce feelings of guilt); interpersonal assets (eg. standing up to answer the phone); knowledge assets (eg. standing up due to knowing the benefits of breaking SB) and activities of daily living assets (eg. standing up to get a drink). This study provides important considerations from older adults' perspectives to modify their daily sedentary patterns. The assets identified by participants could be used to co-create a tailored intervention with older adults to reduce SB, which may increase effectiveness and adherence.

  19. Face Age and Eye Gaze Influence Older Adults' Emotion Recognition.

    Science.gov (United States)

    Campbell, Anna; Murray, Janice E; Atkinson, Lianne; Ruffman, Ted

    2017-07-01

    Eye gaze has been shown to influence emotion recognition. In addition, older adults (over 65 years) are not as influenced by gaze direction cues as young adults (18-30 years). Nevertheless, these differences might stem from the use of young to middle-aged faces in emotion recognition research because older adults have an attention bias toward old-age faces. Therefore, using older face stimuli might allow older adults to process gaze direction cues to influence emotion recognition. To investigate this idea, young and older adults completed an emotion recognition task with young and older face stimuli displaying direct and averted gaze, assessing labeling accuracy for angry, disgusted, fearful, happy, and sad faces. Direct gaze rather than averted gaze improved young adults' recognition of emotions in young and older faces, but for older adults this was true only for older faces. The current study highlights the impact of stimulus face age and gaze direction on emotion recognition in young and older adults. The use of young face stimuli with direct gaze in most research might contribute to age-related emotion recognition differences. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Efficacy and safety of liraglutide for overweight adult patients with type 1 diabetes and insufficient glycaemic control (Lira-1)

    DEFF Research Database (Denmark)

    Dejgaard, Thomas Fremming; Frandsen, Christian Seerup; Hansen, Tanja Stenbæk

    2016-01-01

    to insulin for overweight adult patients with type 1 diabetes. Methods We did a randomised, double-blind, placebo-controlled trial at Steno Diabetes Center (Gentofte, Denmark). Patients aged 18 years or older with type 1 diabetes, insufficient glycaemic control (HbA1c >8% [64 mmol/mol]), and overweight (BMI...

  1. Snow and Rain Modify Neighbourhood Walkability for Older Adults.

    Science.gov (United States)

    Clarke, Philippa; Hirsch, Jana A; Melendez, Robert; Winters, Meghan; Sims Gould, Joanie; Ashe, Maureen; Furst, Sarah; McKay, Heather

    2017-06-01

    The literature has documented a positive relationship between walkable built environments and outdoor mobility in older adults. Yet, surprisingly absent is any consideration of how weather conditions modify the impact of neighbourhood walkability. Using archived weather data linked to survey data collected from a sample of older adults in Vancouver, Canada, we found that car-dependent neighbourhoods (featuring longer block lengths, fewer intersections, and greater distance to amenities) became inaccessible in snow. Even older adults who lived in very walkable neighbourhoods walked to 25 per cent fewer destinations in snow. It is crucial to consider the impact of weather in the relationship between neighbourhood walkability and older adult mobility.

  2. Can technology adoption for older adults be co-created?

    DEFF Research Database (Denmark)

    Lu, Yuan; Valk, Carlijn; Steenbakkers, Jim

    2017-01-01

    -creation ideation process can contribute to the technology adoption of older adults conducted in an EU project with multi-stakeholder teams with the aim of promoting physical activities of older adult citizens. This ideation process is adapted from Method A. By analyzing the co-creation ideation process from three......Technology can be very valuable to support older adults to remain healthy and active in their daily living. How to design technological product and service systems that will be adopted by older adults however still remains a challenge. This paper reports on an empirical study on how a co...

  3. Hypnosis for pain management in the older adult.

    Science.gov (United States)

    Cuellar, Norma G

    2005-09-01

    Pain is a physical, emotional and psychologic phenomenon that is often ignored in older adults causing depression and poor quality of life. Older adults report the use of complementary and alternative medicine in some form with 80% of these users reporting improvement in their health conditions. Although physical pain in the older adult is usually managed with pharmacologic interventions, methods that may reduce the use of prescription drugs may decrease adverse effects that can compromise the physiologic state of the older adult. Hypnosis has continued to gain acceptance within mainstream medicine as an appropriate treatment and can be integrated safely with conventional medicine as an effective treatment for a variety of conditions in the older adult. It is an intervention that can be used for relaxation and pain control, especially when conventional pharmacologic regimens have failed. The purpose of this article is to review the concepts related to pain in older adults; the use of complementary and alternative medicine in the older adult; hypnosis and the older adult (i.e., background, definition, benefits, research, mechanism of action, hypnotizability, and the process); and the implications of using hypnosis for pain management in the older adult.

  4. Young Adults' Implicit and Explicit Attitudes towards the Sexuality of Older Adults.

    Science.gov (United States)

    Thompson, Ashley E; O'Sullivan, Lucia F; Byers, E Sandra; Shaughnessy, Krystelle

    2014-09-01

    Sexual interest and capacity can extend far into later life and result in many positive health outcomes. Yet there is little support for sexual expression in later life, particularly among young adults. This study assessed and compared young adults' explicit and implicit attitudes towards older adult sexuality. A sample of 120 participants (18-24 years; 58% female) completed a self-report (explicit) measure and a series of Implicit Association Tests capturing attitudes towards sexuality among older adults. Despite reporting positive explicit attitudes, young people revealed an implicit bias against the sexual lives of older adults. In particular, young adults demonstrated implicit biases favouring general, as compared to sexual, activities and young adults as compared to older adults. Moreover, the bias favouring general activities was amplified with regard to older adults as compared to younger adults. Our findings challenge the validity of research relying on self-reports of attitudes about older adult sexuality.

  5. The role of chiropractic care in older adults

    Directory of Open Access Journals (Sweden)

    Dougherty Paul E

    2012-02-01

    Full Text Available Abstract There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

  6. How Arousal Affects Younger and Older Adults' Memory Binding

    Science.gov (United States)

    Nashiro, Kaoru; Mather, Mara

    2009-01-01

    A number of recent studies have shown that associative memory for within-item features is enhanced for emotionally arousing items, whereas arousal-enhanced binding is not seen for associations between distinct items (for a review see Mather, 2007). The costs and benefits of arousal in memory binding have been examined for younger adults but not for older adults. The present experiment examined whether arousal would enhance younger and older adults' within-item and between-item memory binding. The results revealed that arousal improved younger adults' within-item memory binding but not that of older adults. Arousal worsened both groups' between-item memory binding. PMID:21240821

  7. Interference from previous distraction disrupts older adults' memory.

    Science.gov (United States)

    Biss, Renée K; Campbell, Karen L; Hasher, Lynn

    2013-07-01

    Previously relevant information can disrupt the ability of older adults to remember new information. Here, the researchers examined whether prior irrelevant information, or distraction, can also interfere with older adults' memory for new information. Younger and older adults first completed a 1-back task on pictures that were superimposed with distracting words. After a delay, participants learned picture-word paired associates and memory was tested using picture-cued recall. In 1 condition (high interference), some pairs included pictures from the 1-back task now paired with new words. In a low-interference condition, the transfer list used all new items. Older adults had substantially lower cued-recall performance in the high- compared with the low-interference condition. In contrast, younger adults' performance did not vary across conditions. These findings suggest that even never-relevant information from the past can disrupt older adults' memory for new associations.

  8. How retellings shape younger and older adults' memories.

    Science.gov (United States)

    Barber, Sarah J; Mather, Mara

    2014-04-01

    The way a story is retold influences the way it is later remembered; after retelling an event in a biased manner people subsequently remember the event in line with their distorted retelling. This study tested the hypothesis that this should be especially true for older adults. To test this, older and younger adults retold a story to be entertaining, to be accurate, or did not complete an initial retelling. Later, all participants recalled the story as accurately as possible. On this final test younger adults were unaffected by how they had previously retold the story. In contrast, older adults had better memory for the story's content and structure if they had previously retold the story accurately. Furthermore, for older adults, greater usage of storytelling language during the retelling was associated with lower subsequent recall. In summary, retellings exerted a greater effect on memory in older, compared with younger, adults.

  9. Both Younger and Older Adults Have Difficulty Updating Emotional Memories

    OpenAIRE

    Nashiro, Kaoru; Sakaki, Michiko; Huffman, Derek; Mather, Mara

    2012-01-01

    Objective. The main purpose of the study was to examine whether emotion impairs associative memory for previously seen items in older adults, as previously observed in younger adults. \\ud Method. Thirty-two younger adults and 32 older adults participated. The experiment consisted of 2 parts. In Part 1, participants learned picture–object associations for negative and neutral pictures. In Part 2, they learned picture–location associations for negative and neutral pictures; half of these pictur...

  10. Feasibility of a multi-modal exercise program on cognition in older adults with Type 2 diabetes - a pilot randomised controlled trial.

    Science.gov (United States)

    Callisaya, M L; Daly, R M; Sharman, J E; Bruce, D; Davis, T M E; Greenaway, T; Nolan, M; Beare, R; Schultz, M G; Phan, T; Blizzard, L C; Srikanth, V K

    2017-10-16

    Type 2 Diabetes (T2D) is associated with increased risk of dementia. We aimed to determine the feasibility of a randomised controlled trial (RCT) examining the efficacy of exercise on cognition and brain structure in people with T2D. A 6-month pilot parallel RCT of a progressive aerobic- and resistance-training program versus a gentle movement control group in people with T2D aged 50-75 years (n = 50) at the University of Tasmania, Australia. Assessors were blinded to group allocation. Brain volume (total, white matter, hippocampus), cortical thickness and white matter microstructure (fractional anisotrophy and mean diffusivity) were measured using magnetic resonance imaging, and cognition using a battery of neuropsychological tests. Study design was assessed by any changes (during the pilot or recommended) to the protocol, recruitment by numbers screened and time to enrol 50 participants; randomisation by similarity of characteristics in groups at baseline, adherence by exercise class attendance; safety by number and description of adverse events and retention by numbers withdrawn. The mean age of participants was 66.2 (SD 4.9) years and 48% were women. There were no changes to the design during the study. A total of 114 people were screened for eligibility, with 50 participants with T2D enrolled over 8 months. Forty-seven participants (94%) completed the study (23 of 24 controls; 24 of 26 in the intervention group). Baseline characteristics were reasonably balanced between groups. Exercise class attendance was 79% for the intervention and 75% for the control group. There were 6 serious adverse events assessed as not or unlikely to be due to the intervention. Effect sizes for each outcome variable are provided. This study supports the feasibility of a large scale RCT to test the benefits of multi-modal exercise to prevent cognitive decline in people with T2D. Design changes to the future trial are provided. ANZCTR 12614000222640 ; Registered 3/3/2014; First

  11. Prospective association between added sugars and frailty in older adults.

    Science.gov (United States)

    Laclaustra, Martin; Rodriguez-Artalejo, Fernando; Guallar-Castillon, Pilar; Banegas, Jose R; Graciani, Auxiliadora; Garcia-Esquinas, Esther; Ordovas, Jose; Lopez-Garcia, Esther

    2018-04-09

    Sugar-sweetened beverages and added sugars (monosaccharides and disaccharides) in the diet are associated with obesity, diabetes, and cardiovascular disease, which are all risk factors for decline in physical function among older adults. The aim of this study was to examine the association between added sugars in the diet and incidence of frailty in older people. Data were taken from 1973 Spanish adults ≥60 y old from the Seniors-ENRICA cohort. In 2008-2010 (baseline), consumption of added sugars (including those in fruit juices) was obtained using a validated diet history. Study participants were followed up until 2012-2013 to assess frailty based on Fried's criteria. Statistical analyses were performed with logistic regression adjusted for age, sex, education, smoking status, body mass index, energy intake, self-reported comorbidities, Mediterranean Diet Adherence Score (excluding sweetened drinks and pastries), TV watching time, and leisure-time physical activity. Compared with participants consuming added sugars (lowest tertile), those consuming ≥36 g/d (highest tertile) were more likely to develop frailty (OR: 2.27; 95% CI: 1.34, 3.90; P-trend = 0.003). The frailty components "low physical activity" and "unintentional weight loss" increased dose dependently with added sugars. Association with frailty was strongest for sugars added during food production. Intake of sugars naturally appearing in foods was not associated with frailty. The consumption of added sugars in the diet of older people was associated with frailty, mainly when present in processed foods. The frailty components that were most closely associated with added sugars were low level of physical activity and unintentional weight loss. Future research should determine whether there is a causal relation between added sugars and frailty.

  12. Assessing shyness in Chinese older adults.

    Science.gov (United States)

    Chou, Kee-Lee

    2005-09-01

    The Shyness Scale (SS) is a brief instrument for assessing shyness as a personality trait. The psychometric properties of the Chinese version of the SS were investigated in a random sample of 192 Macau Chinese older adults. The Chinese version of the SS possesses high internal consistency and exhibited satisfactory short-term test-retest reliability. The Chinese version of the SS exhibited acceptable convergent validity with other negative measures of psychological well-being including negative emotional states (assessed by the Negative Affect Scale), loneliness (assessed by the UCLA Loneliness Scale), and state anxiety and trait anxiety (assessed by STAI). The divergent validity of the Chinese version of the SS was demonstrated by the negative but significant association between the SS and self esteem (assessed by Rosenberg Self Esteem Inventory).

  13. Factors underlying tiredness in older adults

    DEFF Research Database (Denmark)

    Avlund, Kirsten; Rantanen, Taina; Schroll, Marianne

    2007-01-01

    BACKGROUND AND AIMS: The purpose of the present study was to examine for factors related to tiredness, cross-sectionally at the age of 75 years, and factors related to subsequent onset of tiredness, from age 75 to 80 in a non-disabled community-living population. METHODS: The study is part...... modifiable factors, which may be fully treated or at least alleviated, thus increasing the well-being of the individual, as well as potentially slowing the progression of disability....... analyses showed that onset of tiredness was significantly or marginally significantly influenced by use of more than three drugs, muscle impairment, pain and cognitive impairment. CONCLUSIONS: The present study showed that tiredness in non-disabled older adults is a result of multiple potentially...

  14. Assertiveness by Older Adults with Visual Impairment: Context Matters

    Science.gov (United States)

    Ryan, Ellen Bouchard; Anas, Ann P.; Mays, Heather

    2008-01-01

    Within a communication predicament of aging and disability framework, this study examined the impact of two types of contextual variation on perceptions of older adult assertiveness within problematic service encounters. Young (N = 66) and older (N = 66) participants evaluated conversational scenarios in which a visually-impaired older woman…

  15. Data Sources Available for Modeling Environmental Exposures in Older Adults

    Science.gov (United States)

    This report, “Data Sources Available for Modeling Environmental Exposures in Older Adults,” focuses on information sources and data available for modeling environmental exposures in the older U.S. population, defined here to be people 60 years and older, with an emphasis on those...

  16. Driving patterns in older adults with glaucoma.

    Science.gov (United States)

    van Landingham, Suzanne W; Hochberg, Chad; Massof, Robert W; Chan, Emilie; Friedman, David S; Ramulu, Pradeep Y

    2013-02-21

    The ability to drive is important for ensuring quality of life for many older adults. Glaucoma is prevalent in this age group and may affect driving. The purpose of this study is to determine if glaucoma and glaucomatous visual field (VF) loss are associated with driving cessation, limitations, and deference to another driver in older adults. Cross-sectional study. Eighty-one glaucoma subjects and 58 glaucoma suspect controls between age 60 and 80 reported if they had ceased driving, limited their driving in various ways, or preferred another to drive. Twenty-three percent of glaucoma subjects and 6.9% of suspects had ceased driving (p = 0.01). Glaucoma subjects also had more driving limitations than suspects (2.0 vs. 1.1, p = 0.007). In multivariable models, driving cessation was more likely for glaucoma subjects as compared to suspects (OR = 4.0; 95% CI = 1.1-14.7; p = 0.03). The odds of driving cessation doubled with each 5 decibel (dB) decrement in the better-eye VF mean deviation (MD) (OR = 2.0; 95% CI = 1.4-2.9; p driving limitations (OR = 4.7; 95% CI = 1.3-16.8; p = 0.02). The likelihood of reporting more limitations increased with the VF loss severity (OR = 1.6 per 5 dB decrement in the better-eye VF MD; 95% CI = 1.1-2.4; p = 0.02). Neither glaucoma nor VF MD was associated with other driver preference (p > 0.1 for both). Glaucoma and glaucomatous VF loss are associated with greater likelihood of driving cessation and greater limitation of driving in the elderly. Further prospective study is merited to assess when and why people with glaucoma change their driving habits, and to determine if their observed self-regulation of driving is adequate to ensure safety.

  17. Anxiety disorders and falls among older adults.

    Science.gov (United States)

    Holloway, K L; Williams, L J; Brennan-Olsen, S L; Morse, A G; Kotowicz, M A; Nicholson, G C; Pasco, J A

    2016-11-15

    Falls are common among older adults and can lead to serious injuries, including fractures. We aimed to determine associations between anxiety disorders and falls in older adults. Participants were 487 men and 376 women aged ≥60 years enrolled in the Geelong Osteoporosis Study, Australia. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Non-patient edition (SCID-I/NP), lifetime history of anxiety disorders was determined. Falls were determined by self-report. In men, a falls-risk score (Elderly Falls Screening Test (EFST)) was also calculated. Among fallers, 24 of 299 (8.0%) had a lifetime history of anxiety disorder compared to 36 of 634 (5.7%) non-fallers (p=0.014). Examination of the association between anxiety and falls suggested differential relationships for men and women. In men, following adjustment for psychotropic medications, mobility and blood pressure, lifetime anxiety disorder was associated with falling (OR 2.96; 95%CI 1.07-8.21) and with EFST score (OR 3.46; 95%CI 1.13-10.6). In women, an association between lifetime anxiety disorder and falls was explained by psychotropic medication use, poor mobility and socioeconomic status. Sub-group analyses involving types of anxiety and anxiety disorders over the past 12-months were not performed due to power limitations. Although anxiety disorders were independently associated with a 3-fold increase in likelihood of reported falls and high falls risk among men, an independent association was not detected among women. These results may aid in prevention of falls through specific interventions aimed at reducing anxiety, particularly in men. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Home care to Older adult with cancer

    International Nuclear Information System (INIS)

    Villagra, J; Castro, C; Meneses, S.

    2004-01-01

    Objective: Home care of the elderly with cancer. After the development of a program of oncology home care and over a period of five years, we believe that the evaluation allows us to have our proposal and challenges in the continuity of the program. This evidence is based in our old advanced Uruguayan population, and consequently increase this cancer population, we should define which pointed toward our objective, in order to get the best quality life. After one year with a project based on general rules, the evidence threw an evaluation, that we should review the model of care with which we were working. We continue to Auto-care model Dorothea Orem. The main objective became q uality of life : Take care as the primary Older Adult; Specific care their cancer to become symptomatic secondary complications to the evolution of tumor biology; Secondary prevention of cause therapeutic effect; Family integration, without changing the pace of life that the elderly had before being with cancer. Nursing challenge: Maintain autonomy achieved in these 5 years. Deepen the social equilibrium that we are committed daily between patient and family.Do not miss the professionalism achieved today.Proposal for nursing: Consider a wide field of nursing and for this achievement is need knowledge of 2nd level of community work, knowledge Clinical knowledge in Oncology Nursing, autonomy in decision making. For older adults with cancer: No out of its middle. Maintain priority habits and customs. Do not let it lose their self-esteem with their own values. Caution changes must take care to better manage the evolution of their illness. Conclusion: Oncology nursing is a specialty. Without this formation will be ever more away the development of these programs in our environment, or fall in applying for only economic convenience, losing professionalism. Our population is increasing

  19. Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

    Science.gov (United States)

    O'Brien, Kelly K; Solomon, Patricia; Trentham, Barry; MacLachlan, Duncan; MacDermid, Joy; Tynan, Anne-Marie; Baxter, Larry; Casey, Alan; Chegwidden, William; Robinson, Greg; Tran, Todd; Wu, Janet; Zack, Elisse

    2014-01-01

    Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effectiveness of rehabilitation interventions for common comorbidities experienced by older adults ageing with HIV (stream B). We extracted and synthesised relevant data from the evidence to draft evidence-informed recommendations for rehabilitation. Draft recommendations were refined based on people living with HIV (PLHIV) and clinician experience, values and preferences, reviewed by an interprofessional team for Grading of Recommendations Assessment, Development, and Evaluation (GRADE) (quality) rating and revision and then circulated to PLHIV and clinicians for external endorsement and final refinement. We then devised overarching recommendations to broadly guide rehabilitation with older adults living with HIV. Results This synthesis yielded 8 overarching and 52 specific recommendations. Thirty-six specific recommendations were derived from 108 moderate-level or high-level research articles (meta-analyses and systematic reviews) that described the effectiveness of rehabilitation interventions for comorbidities that may be experienced by older adults with HIV. Recommendations addressed rehabilitation interventions across eight health conditions: bone and joint disorders, cancer, stroke, cardiovascular disease, mental health challenges, cognitive impairments, chronic obstructive pulmonary disease and diabetes. Sixteen specific recommendations were derived from 42 research articles specific to rehabilitation with older adults with HIV. The quality of evidence from which these

  20. Diabetes and diabetic retinopathy in people aged 50 years and older in the Republic of Suriname.

    Science.gov (United States)

    Minderhoud, Janna; Pawiroredjo, Jerrel C; Bueno de Mesquita-Voigt, Anne-Marie T; Themen, Herman Ci; Siban, Michael R; Forster-Pawiroredjo, Cindy M; Limburg, Hans; van Nispen, Ruth Ma; Mans, Dennis Ra; Moll, Annette C

    2016-06-01

    Population-based surveys on diabetes and diabetic retinopathy (DR) are necessary to increase awareness and develop screening and therapeutic programmes. The aim was to estimate the prevalence of DR in older adults of different ethnic backgrounds in Suriname. Fifty clusters of 60 people aged ≥50 years were randomly selected with a probability proportional to the size of the population unit. Eligible people were randomly selected through compact segment sampling and examined using the Rapid Assessment of Avoidable Blindness plus Diabetic Retinopathy (RAAB + DR) protocol. Participants were classified as having diabetes if they: were previously diagnosed with diabetes; were receiving treatment for glucose control; had a random blood glucose level >200 mg/dL. These participants were dilated for funduscopy, assessed for DR following the Scottish DR grading protocol and evaluated for ethnicity and DR ophthalmic screening frequencies. A total of 2806 individuals was examined (response 93.6%). The prevalence of diabetes was 24.6%. In these patients any type of DR and/or maculopathy occurred in 21.6% and sight-threatening DR in 8.0%. Of the known diabetics, 34.2% never had an eye examination for DR and in 13.0% the last examination was >24 months ago. The prevalence of diabetes was significantly higher in Hindustani people compared with other major ethnic groups. The prevalence of diabetes and diabetics without regular DR control in people aged ≥50 years in Suriname was higher than expected. The uptake for special services for DR has to be expanded to decrease patient delay and DR-induced blindness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. 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,

  2. Past experiences and older adults' attitudes: a lifecourse perspective

    NARCIS (Netherlands)

    Poortman, A.; van Tilburg, T.

    2005-01-01

    In this study we apply a lifecourse perspective to an examination of older adults' attitudes about gender roles and moral issues. The study goes beyond previous research in that it examines the relationships between older adults' attitudes and: (a) experiences in the parental home, (b) people's own

  3. 1976 Survey of Collegiate Programs for Older Adults. Summary Report.

    Science.gov (United States)

    Florio, Carol

    Questionnaires were mailed to the directors of continuing education or special programs at 816 colleges and universities in the United States that were believed to offer programs for older adults. 84 percent of the 286 responding institutions reported programs for older adults; 1 percent had them in the planning stages; 3 percent had…

  4. Gender Differences in Performance of Script Analysis by Older Adults

    Science.gov (United States)

    Helmes, E.; Bush, J. D.; Pike, D. L.; Drake, D. G.

    2006-01-01

    Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical…

  5. The Nature of Subjective Cognitive Complaints of Older Adults

    Science.gov (United States)

    Newson, Rachel S.; Kemps, Eva B.

    2006-01-01

    The current study investigated the nature of subjective cognitive complaints of older adults in relation to a broad array of individual cognitive functions known to decline with age. A 60-item questionnaire was developed to examine: (1) whether older adults experience problems with these cognitive functions (problems with cognition); (2) the…

  6. Can technology adoption for older adults be co-created?

    NARCIS (Netherlands)

    Lu, Y.; Valk, C.A.L.; Steenbakkers, J.J.H.; Bekker, M.M.; Visser, T.; Proctor, G.M.; Toshniwal, O.; Langberg, H.

    2017-01-01

    Technology can be very valuable to support older adults to remain healthy and active in their daily living. How to design technological product and service systems that will be adopted by older adults however still remains a challenge. This paper reports on an empirical study on how a co-creation

  7. Circumvention of suddenly appearing obstacles in young and older adults

    NARCIS (Netherlands)

    Pijnappels, M.; Kingma, I.; Van Dieën, J. H.

    2010-01-01

    Reduced ability to circumvent an obstacle, which is noticed only shortly before collision, could be a cause of falls and injury, especially in older adults. In this study, we investigated differences in strategies and their characteristics between young and older adults when circumventing a suddenly

  8. Dare to Dream: New Venture Incubator for Older Adults

    Science.gov (United States)

    Hantman, Shira; Gimmon, Eli

    2014-01-01

    The purpose of this article is to describe a project that aims to foster active aging through entrepreneurial activities among older adults. The project establishes the feasibility of implementing an intervention program that assimilates the concept and capabilities of entrepreneurship among older adults and supports them while launching new…

  9. Older Adults: What Every Paediatric Nurse Should Know

    Science.gov (United States)

    Barba, Beth Ellen; Tesh, Anita Starr; Cowen, Kay; Hancock, Debbie; Moore, Catherine

    2010-01-01

    Older adults have always been important parts of children's lives, playing a variety of roles including grandparent, caregiver, friend, and neighbour. Grandparents also play a variety of roles in families. Often a child's first encounter with serious illness or death involves a grandparent or other older adult. Grandparents are also increasingly…

  10. Videogames to Promote Physical Activity in Older Adults with Schizophrenia.

    Science.gov (United States)

    Leutwyler, Heather; Hubbard, Erin M; Vinogradov, Sophia; Dowling, Glenna A

    2012-10-01

    Older adults with schizophrenia need physical activity interventions to improve their physical health. The purpose of this report is to describe the preliminary acceptability of a videogame-based physical activity program using the Kinect™ for Xbox 360 game system (Microsoft, Redmond, WA) in older adults with schizophrenia.

  11. Sleep Quality among Older Adults in Mehriz, Yazd Province, Iran

    Directory of Open Access Journals (Sweden)

    Hassan Rezaeipandari

    2015-06-01

    Conclusion: Regarding the significant relation of sleep quality and some chronic conditions, the importance of educatingthe older adults who suffer from chronic conditions and also their families in this area is displayed. As with planning suitable interventions, we may not only increase the sleep quality among older adults but also treat or reduce the risk of chronic conditions among them.

  12. Older Adults' Motivation to Learn in Higher Education

    Science.gov (United States)

    Lin, Yi-Yin

    2011-01-01

    A limited amount of literature has discussed older adults in formal education, especially their motivations to learn in higher education. This study aims to understand older adults' learning in the context of higher education. Specifically, this study argues that higher education can function as a stimulating learning environment that helps older…

  13. Older Adults' Comprehension of Transformational and Deactivation Negation

    Science.gov (United States)

    Margolin, Sara J.

    2015-01-01

    The present research aimed to examine young and older adults' comprehension of negated text to determine the locus of older adults' difficulty in understanding this text construction. Participants were asked to read short passages at their own pace, complete a lexical decision task, and answer a comprehension question about what they had read.…

  14. 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

  15. 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

  16. Older Adults' Memory for Verbally Presented Medical Information

    Science.gov (United States)

    Bankoff, Sarah M.; Sandberg, Elisabeth Hollister

    2012-01-01

    Previous research demonstrates that patients typically have difficulty remembering information presented during healthcare consultations. This study examined how older adults learn and remember verbally presented medical information. Healthy older adults were tested for recall in experimental and field settings. Participants viewed a five-minute…

  17. Coping with loneliness: what do older adults suggest?

    NARCIS (Netherlands)

    Schoenmakers, E.; van Tilburg, T.; Fokkema, C.M.

    2012-01-01

    Objectives: A limited amount of information is available on how older adults cope with loneliness. Two ways of coping are distinguished here, i.e., active coping by improving relationships and regulative coping by lowering expectations about relationships. We explore how often older adults suggest

  18. The Meaning of Older Adults' Peer Teaching: A Phenomenological Study

    Science.gov (United States)

    Choi, Ilseon

    2009-01-01

    This study investigated older adults' peer teaching experiences at a Lifelong Learning Institute through interviews with eight teachers and observations of their classes. Thematic analysis revealed themes of peer-to-peer teaching, volunteer teaching, and explorative teaching. Discussion of the themes examines the meaning of older adults' peer…

  19. Observational Learning among Older Adults Living in Nursing Homes

    Science.gov (United States)

    Story, Colleen D.

    2010-01-01

    The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

  20. 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

  1. INTERVENTIONS FOR INCREASING BALANCE & CONFIDENCE IN OLDER ADULTS: A REVIEW

    OpenAIRE

    Foram Dhebar

    2014-01-01

    Elderly is defined as being 65 years of age or older. Geriatrics or geriatric medicine is a specialty that focuses on health care of elderly people. The number of persons above the age of 60 years is fast growing, especially in India. Falls are the leading cause of traumatic brain injury, fractures & the leading cause of emergency department visits by older adults. Low balance confidence is a major health problem among older adults restricting their participation in daily life. Objective of t...

  2. An examination of electronic health information privacy in older adults.

    Science.gov (United States)

    Le, Thai; Thompson, Hilaire; Demiris, George

    2013-01-01

    Older adults are the quickest growing demographic group and are key consumers of health services. As the United States health system transitions to electronic health records, it is important to understand older adult perceptions of privacy and security. We performed a secondary analysis of the Health Information National Trends Survey (2012, Cycle 1), to examine differences in perceptions of electronic health information privacy between older adults and the general population. We found differences in the level of importance placed on access to electronic health information (older adults placed greater emphasis on provider as opposed to personal access) and tendency to withhold information out of concerns for privacy and security (older adults were less likely to withhold information). We provide recommendations to alleviate some of these privacy concerns. This may facilitate greater use of electronic health communication between patient and provider, while promoting shared decision making.

  3. Non-native Speech Learning in Older Adults.

    Science.gov (United States)

    Ingvalson, Erin M; Nowicki, Casandra; Zong, Audrey; Wong, Patrick C M

    2017-01-01

    Though there is an extensive literature investigating the ability of younger adults to learn non-native phonology, including investigations into individual differences in younger adults' lexical tone learning, very little is known about older adults' ability to learn non-native phonology, including lexical tone. There are several reasons to suspect that older adults would use different learning mechanisms when learning lexical tone than younger adults, including poorer perception of dynamic pitch, greater reliance on working memory capacity in second language learning, and poorer category learning in older adulthood. The present study examined the relationships among older adults' baseline sensitivity for pitch patterns, working memory capacity, and declarative memory capacity with their ability to learn to associate tone with lexical meaning. In older adults, baseline pitch pattern sensitivity was not associated with generalization performance. Rather, older adults' learning performance was best predicted by declarative memory capacity. These data suggest that training paradigms will need to be modified to optimize older adults' non-native speech sound learning success.

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

    Science.gov (United States)

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

  5. Falls' problematization and risk factors identification through older adults' narrative.

    Science.gov (United States)

    Morsch, Patricia; Myskiw, Mauro; Myskiw, Jociane de Carvalho

    2016-11-01

    Falling is an important event for older adults as they might cause physical and psychological impairment, institutionalization and increased mortality risk. Adherence in falls prevention programs depends on older adults' perceptions in relation to falling. The current study aims to investigate the fall problematization and older adults' perception about the risk factors for falls. This is an exploratory qualitative research, conducted through content analysis approach. The sample consisted of older adults aged 60 years and older who participate in community groups in Porto Alegre (Brazil), and professors from two local universities. Final sample consisted of 22 participants, mean age was 70.2 ± 7.1. Coding and interpretation of data resulted in two thematic categories, named: falls' problematization and the perception of the risk factors for falling. The first category highlights that many older adults do not realize falling as a potential problem, which suggests that current preventive measures may not be reaching the target population. The second category shows that older adults' perceptions in relation to the risk factors exist, but often they are not avoided, because older adults consider their ability to "take care" as the main method of prevention, and due to the multifactorial nature of falls, this cannot be considered an efficient solution.

  6. Older Adults in Public Open Spaces: Age and Gender Segregation.

    Science.gov (United States)

    Noon, Rinat Ben; Ayalon, Liat

    2018-01-18

    There is a substantial body of literature on the importance of the environment in the lives of older adults. Nonetheless, to date, there has been limited research on everyday activities of urban older adults in public open spaces. The present study examined the activities of older adults in public open spaces in Israel with a specific focus on age and gender as potential variables of relevance. Using still photography, we systematically photographed four sessions in two different public outdoor settings attended by older Israelis. Still photographs were converted to narrative descriptions, and then coded, quantified, and compared using descriptive statistics. The majority (311, 97%) of older adults arrived alone to the public setting. Of these, 44% formed a social group of two or more people, whereas the remaining older adults stayed alone. When social interactions occurred, they were primarily gender homogenous (69%); women were more likely to integrate in spontaneous social conversations and men were more likely to participate in common games. Our findings call attention to the important role played by the outdoor environment as a venue for social activities among older adults. The findings further stress the high levels of aloneness experienced by older adults, which do not seem to be alleviated by the mere attendance of public spaces. © The Author 2017. 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.

  7. Domestic violence and mental health in older adults.

    Science.gov (United States)

    Knight, Lucy; Hester, Marianne

    2016-10-01

    Domestic violence affects every age group and is present throughout the life span, but, while the mental health impact of domestic violence is clearly established in working age adults, less is known about the nature and impact of domestic violence among older adults. This review, therefore, aimed to synthesize findings on the prevalence, nature, and impact of domestic violence among older adults, and its identification and management. Electronic searches were conducted of Medline, PsycINFO, Cinahl, and Embase to identify studies reporting on the mental health and domestic violence in older adults. Findings suggested that, although prevalence figures are variable, the likely lifetime prevalence for women over the age of 65 is between 20-30%. Physical abuse is suggested to decrease with age, but rates of emotional abuse appear to be stable over the lifespan. Among older adults, domestic violence is strongly associated with physical and mental health problems, and the scarce research comparing the impact of domestic violence across the age cohorts suggests that the physical health of older victims may be more severely affected than younger victims. In contrast, there is evidence that older victims may experience less psychological distress in response to domestic violence than younger victims. Internationally, evidence on the management of domestic violence in older adults is sparse. Findings suggest, however, that identification of domestic violence is poor among older adults, and there are very limited options for onwards referral and support.

  8. A comparative study of negative life events and depressive symptoms among healthy older adults and older adults with chronic disease.

    Science.gov (United States)

    Zhang, Han; Gao, Tingting; Gao, Jinglei; Kong, Yixi; Hu, Yueyang; Wang, Ruimei; Mei, Songli

    2017-12-01

    This study aims to study internal relations and functionary mechanism between social support, coping style, negative life events and depressive symptoms and compare these relations in healthy older adults and older adults with chronic disease. A cross-sectional study was conducted in 2015. In total, 1,264 older adults with chronic disease and 749 healthy older adults participated in this investigation which consist of socio-demographic characters, negative life events, social support, coping style and depressive symptoms. The path and direction of variable function in healthy older adults were inconsistent with older adults with chronic disease. Older adults with chronic disease had more severe depressive symptoms and negative life events, and lower social support and positive coping style. Negative life events, subjective support, positive coping style and negative coping style were significantly predicted depressive symptoms. Objective support may weaken the influence of negative life events on depressive symptoms in chronic disease group. Utilization of support and positive coping style worsen the effect of negative life events on depressive symptoms in healthy older adults. This study implied that to improve their mental health, attention should be paid to the role of biological, psychological and social stress factors and its inherent law of interaction.

  9. Both younger and older adults have difficulty updating emotional memories.

    Science.gov (United States)

    Nashiro, Kaoru; Sakaki, Michiko; Huffman, Derek; Mather, Mara

    2013-03-01

    The main purpose of the study was to examine whether emotion impairs associative memory for previously seen items in older adults, as previously observed in younger adults. Thirty-two younger adults and 32 older adults participated. The experiment consisted of 2 parts. In Part 1, participants learned picture-object associations for negative and neutral pictures. In Part 2, they learned picture-location associations for negative and neutral pictures; half of these pictures were seen in Part 1 whereas the other half were new. The dependent measure was how many locations of negative versus neutral items in the new versus old categories participants remembered in Part 2. Both groups had more difficulty learning the locations of old negative pictures than of new negative pictures. However, this pattern was not observed for neutral items. Despite the fact that older adults showed overall decline in associative memory, the impairing effect of emotion on updating associative memory was similar between younger and older adults.

  10. Feasibility of mobile mental wellness training for older adults.

    Science.gov (United States)

    Similä, Heidi; Immonen, Milla; Toska-Tervola, Jaana; Enwald, Heidi; Keränen, Niina; Kangas, Maarit; Jämsä, Timo; Korpelainen, Raija

    2018-03-09

    Mobile technology has been increasingly adopted in promotion of mental health among older people. This study assessed the feasibility of a mobile mental wellness training application for individual use and for group work from the perspectives of older adults and social care professionals. The older individuals recruited for the study were participants in a Circle of Friends group and family caregivers' peer support group offered by the communal senior services. The qualitative and quantitative results of interviews, questionnaires, observation, and application usage were reported. Seven older adults started using the application independently at home in parallel with the group activity. This study revealed new information regarding the barriers to the older adults' full adoption of such mobile technologies. The results indicated that there may be potential in the incorporation of mobile technologies in promotion of mental health of older people at group settings. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Adult-Onset Type 1 Diabetes and Pregnancy: Three Case Reports

    Directory of Open Access Journals (Sweden)

    Barbara Bonsembiante

    2013-01-01

    Full Text Available From 5% to 10% of diabetic patients have type 1 diabetes. Here we describe three cases of adult-onset type 1 diabetes in pregnancy treated at our clinic between 2009 and 2012. Two patients came for specialist examination during pregnancy, the third after pregnancy. These women had no prior overt diabetes and shared certain characteristics, that is, no family diabetes history, age over 35, normal prepregnancy BMI, need for insulin therapy as of the early weeks of pregnancy, and high-titer anti-GAD antibody positivity. The patients had persistent diabetes after delivery, suggesting that they developed adult-onset type 1 diabetes during pregnancy. About 10% of GDM patients become pancreatic autoantibody positive and the risk of developing overt diabetes is higher when two or more autoantibodies are present (particularly GAD and ICA. GAD-Ab shows the highest sensitivity for type 1 diabetes prediction. We need to bear in mind that older patients might conceivably develop an adult-onset type 1 diabetes during or after pregnancy. So we suggest that women with GDM showing the described clinical features shall be preferably tested for autoimmunity. Pregnant patients at risk of type 1 diabetes should be identified to avoid the maternal and fetal complications and the acute onset of diabetes afterwards.

  12. Developing Culturally Targeted Diabetes Educational Materials for Older Russian-Speaking Immigrants.

    Science.gov (United States)

    Van Son, Catherine R

    2014-07-01

    Older adults who immigrate late in life face many challenges adapting to a new country. Immigrants bring their cultural beliefs and behaviors with them, which can influence their ability to make dietary changes required when they have type 2 diabetes. Culturally targeted patient education materials are needed to improve immigrants' health literacy and abilities to self-manage diabetes. Currently, there is a scarcity of diabetes patient education materials to meet the educational needs of the Russian-speaking immigrant group. The purpose of this article is to describe a project in which culturally targeted diabetes education materials for older Russian-speaking immigrants were designed and developed. Culturally targeted patient education materials are essential if they are to be accepted and used by clients from different ethnic minority populations. The creation of culturally relevant materials requires a team effort and community stakeholder input. The availability of materials on the internet facilitates access and use by health care providers. Culturally targeted education materials are an important component in addressing health literacy in ethnic minority populations. Next steps require that these materials be evaluated to test their impact on diabetes self-management behaviors and clinical outcomes such as adherence, amount of physical activity, and blood glucose levels. © 2014 The Author(s).

  13. Prevalence of abnormal plasma liver enzymes in older people with Type 2 diabetes.

    Science.gov (United States)

    Morling, J R; Strachan, M W J; Hayes, P C; Butcher, I; Frier, B M; Reynolds, R M; Price, J F

    2012-04-01

    To determine the prevalence and distribution of abnormal plasma liver enzymes in a representative sample of older adults with Type 2 diabetes. Plasma concentrations of alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase were measured in a randomly selected, population-based cohort of 1066 men and women aged 60-75 years with Type 2 diabetes (the Edinburgh Type 2 Diabetes Study). Overall, 29.1% (95% CI 26.1-31.8) of patients had one or more plasma liver enzymes above the upper limit of the normal reference range. Only 10.1% of these patients had a prior history of liver disease and a further 12.4% reported alcohol intake above recommended limits. Alanine aminotransferase was the most commonly raised liver enzyme (23.1% of patients). The prevalence of abnormal liver enzymes was significantly higher in men (odds ratio 1.40, 95% CI 1.07-1.83), in the youngest 5-year age band (odds ratio 2.02, 95% CI 1.44-2.84), in patients with diabetes duration enzyme abnormality. The prevalence of elevated liver enzymes in people with Type 2 diabetes is high, with only modest variation between clinically defined patient groups. Further research is required to determine the prognostic value of raised, routinely measured liver enzymes to inform decisions on appropriate follow-up investigations. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  14. Design of smart home sensor visualizations for older adults.

    Science.gov (United States)

    Le, Thai; Reeder, Blaine; Chung, Jane; Thompson, Hilaire; Demiris, George

    2014-07-24

    Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date.CONCLUSIONS: Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

  15. Perspectives on wellness self-monitoring tools for older adults.

    Science.gov (United States)

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

    2013-11-01

    Our purpose was to understand different stakeholder perceptions about the use of self-monitoring tools, specifically in the area of older adults' personal wellness. In conjunction with the advent of personal health records, tracking personal health using self-monitoring technologies shows promising patient support opportunities. While clinicians' tools for monitoring of older adults have been explored, we know little about how older adults may self-monitor their wellness and health and how their health care providers would perceive such use. We conducted three focus groups with health care providers (n=10) and four focus groups with community-dwelling older adults (n=31). Older adult participants' found the concept of self-monitoring unfamiliar and this influenced a narrowed interest in the use of wellness self-monitoring tools. On the other hand, health care provider participants showed open attitudes toward wellness monitoring tools for older adults and brainstormed about various stakeholders' use cases. The two participant groups showed diverging perceptions in terms of: perceived uses, stakeholder interests, information ownership and control, and sharing of wellness monitoring tools. Our paper provides implications and solutions for how older adults' wellness self-monitoring tools can enhance patient-health care provider interaction, patient education, and improvement in overall wellness. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Dental Care Utilization among North Carolina Rural Older Adults

    Science.gov (United States)

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

    2012-01-01

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

  17. Health, family strains, dependency, and life satisfaction of older adults.

    Science.gov (United States)

    Chokkanathan, Srinivasan; Mohanty, Jayashree

    2017-07-01

    Using stress process theory and structural equation modelling, this study investigated the complex relationship between health status, family strain, dependency, and the life satisfaction of rural older adults with reported functional impairments in India. Data were extracted from a large-scale study of 903 randomly selected adults aged 61 years and older from 30 rural clusters of India. The sample for this study was confined to 653 older adults who reported functional impairments. Structural equation modelling showed that poor health status indirectly lowered the life satisfaction of older adults through family strains. Moreover, poor health status also indirectly influenced life satisfaction through dependency and family strain (poor health→dependency→family strains→life satisfaction). The findings indicate that for professionals who deal with the health of older adults, exploring relationship strains and dependency is vital to the assessment and intervention of subjective wellbeing. Inter-sectoral coordination and communication between healthcare and social service agencies might facilitate effective management of health problems among older adults. Moreover, taking family strains and dependency into account when caring for older adults with health problems is critical to help improve their quality of life and maintain their wellbeing. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Pilot testing a digital pet avatar for older adults.

    Science.gov (United States)

    Chi, Nai-Ching; Sparks, Olivia; Lin, Shih-Yin; Lazar, Amanda; Thompson, Hilaire J; Demiris, George

    Social isolation in older adults is a major public health concern. An embodied conversational agent (ECA) has the potential to enhance older adults' social interaction. However, little is known about older adults' experience with an ECA. In this paper, we conducted a pilot study to examine the perceived acceptance and utility of a tablet-based conversational agent in the form of an avatar (termed "digital pet") for older adults. We performed secondary analysis of data collected from a study that employed the use of a digital pet in ten older adults' homes for three months. Most of the participants enjoyed the companionship, entertainment, reminders, and instant assistance from the digital pet. However, participants identified limited conversational ability and technical issues as system challenges. Privacy, dependence, and cost were major concerns. Future applications should maximize the agent's conversational ability and the system's overall usability. Our results can inform future designs of conversational agents for older adults, which need to include older adults as system co-designers to maximize usability and acceptance. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Design of smart home sensor visualizations for older adults.

    Science.gov (United States)

    Le, Thai; Reeder, Blaine; Chung, Jane; Thompson, Hilaire; Demiris, George

    2014-01-01

    Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date. Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

  20. Depression and Mobility Among Older Adults in Mexico: ENSANUT 2012.

    Science.gov (United States)

    Picazzo-Palencia, Esteban

    2016-06-01

    Depression among older people can be associated with limitations in physical mobility. The ENSANUT 2012 data set was used. A secondary data analysis was conducted on a total sample of 6,525 Mexicans 60 years and older. Findings indicate that depressive symptoms among older people derive from their limitations in mobility rather than from their age. In Mexico, the prevalence of major depressive disorders is higher among older adults than among the rest of the adults. Hence, as the prevalence of this problem grows, the need for appropriate mental health attention will increase in Mexico. © The Author(s) 2016.

  1. Personality and Lung Function in Older Adults.

    Science.gov (United States)

    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.

  2. Anxiety in older adults often goes undiagnosed.

    Science.gov (United States)

    Koychev, Ivan; Ebmeier, Klaus P

    2016-01-01

    Anxiety disorder in the elderly is twice as common as dementia and four to six times more common than major depression. Anxiety is associated with poorer quality of life, significant distress and contributes to the onset of disability. Mortality risks are also increased, through physical causes, especially cardiovascular disease, and suicide. Diagnosing anxiety disorders in older adults remains a challenge because of the significant overlap in symptoms between physical disorders (shortness of breath; abdominal and chest pain; palpitations) and depression (disturbed sleep; poor attention, concentration and memory; restlessness). Good history taking is crucial in elucidating whether the complaint is of new onset or a recurrence of a previous disorder. The presence of comorbid depression should be clarified. If present, its temporal relationship with the anxiety symptoms will indicate whether there is an independent anxiety disorder. A medication review is warranted, as a number of drugs may be causative (calcium channel blockers, alpha- and beta-blockers, digoxin, L-thyroxine, bronchodilators, steroids, theophylline, antihistamines) or may cause anxiety in withdrawal (e.g. benzodiazepines). Substance and alcohol abuse should be excluded, as withdrawal from either may cause anxiety. A new or exacerbated physical illness may be related to anxiety. Medical investigations will help clarify the extent to which a particular somatic symptom is the result of anxiety.

  3. New horizons in multimorbidity in older adults.

    Science.gov (United States)

    Yarnall, Alison J; Sayer, Avan A; Clegg, Andrew; Rockwood, Kenneth; Parker, Stuart; Hindle, John V

    2017-11-01

    The concept of multimorbidity has attracted growing interest over recent years, and more latterly with the publication of specific guidelines on multimorbidity by the National Institute for Health and Care Excellence (NICE). Increasingly it is recognised that this is of particular relevance to practitioners caring for older adults, where multimorbidity may be more complex due to the overlap of physical and mental health disorders, frailty and polypharmacy. The overlap of frailty and multimorbidity in particular is likely to be due to the widespread health deficit accumulation, leading in some cases to functional impairment. The NICE guidelines identify 'target groups' who may benefit from a tailored approach to care that takes their multimorbidity into account, and make a number of research recommendations. Management includes a proactive individualised assessment and care plan, which improves quality of life by reducing treatment burden, adverse events, and unplanned or uncoordinated care. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com.

  4. Differences in Risk Aversion between Young and Older Adults.

    Science.gov (United States)

    Albert, Steven M; Duffy, John

    2012-01-15

    Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision-making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than younger adults (p Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision-making across the lifespan.

  5. Improving associative memory in older adults with unitization.

    Science.gov (United States)

    Ahmad, Fahad N; Fernandes, Myra; Hockley, William E

    2015-01-01

    We examined if unitization inherent preexperimentally could reduce the associative deficit in older adults. In Experiment 1, younger and older adults studied compound word (CW; e.g., store keeper) and noncompound word (NCW; e.g., needle birth) pairs. We found a reduction in the age-related associative deficit such that older but not younger adults showed a discrimination advantage for CW relative to NCW pairs on a yes-no associative recognition test. These results suggest that CW compared to NCW word pairs provide schematic support that older adults can use to improve their memory. In Experiment 2, reducing study time in younger adults decreased associative recognition performance, but did not produce a discrimination advantage for CW pairs. In Experiment 3, both older and younger adults showed a discrimination advantage for CW pairs on a two-alternative forced-choice recognition test, which encourages greater use of familiarity. These results suggest that test format influenced young adults' use of familiarity during associative recognition of unitized pairs, and that older adults rely more on familiarity than recollection for associative recognition. Unitization of preexperimental associations, as in CW pairs, can alleviate age-related associative deficits.

  6. Aging and the Socioeconomic Life of Older Adults in India

    Directory of Open Access Journals (Sweden)

    Sanjeev Bakshi

    2016-01-01

    Full Text Available The study attempts to approach aging in India from three perspectives, namely, the well-being of an aging individual, the aging household, and the aging population. The aspects, namely, work, financial dependence, integration, empowerment, and elder abuse are studied and their relation to age, gender, and marital status is investigated. The data sets pertaining to the National Sample Surveys for the reference periods 1986-1987, 1995-1996, and 2004 are primarily utilized for the purpose. The data sets from Building Knowledge Base on Population Ageing in India Survey, 2011, are also utilized for information on elder abuse. The results show that the older males are more likely to participate in household activities when compared with the older females. The married older adults are also more likely to participate in household activities when compared with their widowed counterparts. In a similar way, gender and marital status are found to be associated with empowerment of older adults. The working older adults, those who possess property and/or assets are more likely to be financially independent. Furthermore, the older females and the financially dependent older adults are more likely to face abuses of different kinds. Households are classified into three different types. Type I households have no older adults, Type II households have older adults and other younger members, and Type III households have older adults only. Results show that Type III households are found to be relatively more deprived and report higher average monthly expenditure when compared with other types of households.

  7. Emergency Department and Older Adult Motor Vehicle Collisions

    Directory of Open Access Journals (Sweden)

    Lotfipour, Shahram

    2013-11-01

    Full Text Available In 2009, the Center for Disease Control and Prevention reported there were 33 million licensed drivers 65 years and older in the U.S. This represents a 23 percent increase from 1999, number that is predicted to double by 2030. Although, motor vehicle collisions (MVC-related to emergency department (ED visits for older adults are lower per capita than for younger adults, the older-adults MVCs require more resources, such as additional diagnostic imaging and increased odds of admission. Addressing the specific needs of older-adults could lead to better outcomes yet not enough research currently exists. It is important to continue training emergency physicians to treat the increasing older-patient population, but its also imperative we increase our injury prevention and screening methodology. We review research findings from the article: Emergency Department Visits by Older Adults for Motor Vehicle Collisions: A Five-year national study, with commentary on current recommendation and policies for the growing older-adult driving population. [West J Emerg Med.2013;14(6:582–584.

  8. Reduced Syntactic Processing Efficiency in Older Adults During Sentence Comprehension

    Directory of Open Access Journals (Sweden)

    Zude Zhu

    2018-03-01

    Full Text Available Researchers have frequently reported an age-related decline in semantic processing during sentence comprehension. However, it remains unclear whether syntactic processing also declines or whether it remains constant as people age. In the present study, 26 younger adults and 20 older adults were recruited and matched in terms of working memory, general intelligence, verbal intelligence and fluency. They were then asked to make semantic acceptability judgments while completing a Chinese sentence reading task. The behavioral results revealed that the older adults had significantly lower accuracy on measures of semantic and syntactic processing compared to younger adults. Event-related potential (ERP results showed that during semantic processing, older adults had a significantly reduced amplitude and delayed peak latency of the N400 compared to the younger adults. During syntactic processing, older adults also showed delayed peak latency of the P600 relative to younger adults. Moreover, while P600 amplitude was comparable between the two age groups, larger P600 amplitude was associated with worse performance only in the older adults. Together, the behavioral and ERP data suggest that there is an age-related decline in both semantic and syntactic processing, with a trend toward lower efficiency in syntactic ability.

  9. Barriers to treatment for older adults seeking psychological therapy.

    Science.gov (United States)

    Wuthrich, Viviana M; Frei, Jacqueline

    2015-07-01

    Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

  10. Gun Access and Safety Practices among Older Adults

    Directory of Open Access Journals (Sweden)

    Hillary D. Lum

    2016-01-01

    Full Text Available Background. Given high rates of gun ownership among older adults, geriatric providers can assess firearm safety practices using a “5 Ls” approach: Locked; Loaded; Little children; feeling Low; and Learned owner. This study describes gun access and the “5 Ls” among US older adults. Methods. Data on the “5 Ls” from the Second Injury Control and Risk Survey (ICARIS-2, a national telephone survey conducted by the Centers for Disease Control and Prevention, were analyzed. Weighted variables were used to generate national estimates regarding prevalence of gun ownership and associated gun safety among older adults (≥55 years. Results. Of 2939 older adults, 39% (95% CI 37%–42% reported ≥1 gun stored at home. Among those with guns at home, 21% (95% CI 18–24% stored guns loaded and unlocked; 9.2% (95% CI 6.6–12% had ≥1 child in household; 5.1% (95% CI 3.5–6.8% reported past-year suicidal ideation and 3.6% (95% CI 2.1–5.2% reported history of a suicide attempt; and 55% (95% CI 51–59% stated that ≥1 adult had attended firearm safety workshop. Conclusion. Some older adults may be at elevated risk of firearm injury because of storage practices, suicidal thoughts, or limited safety training. Future work should assess effective approaches to reduce the risk of gun-related injuries among older adults.

  11. Gaps in nutritional research among older adults with cancer

    Science.gov (United States)

    Presley, Carolyn J.; Dotan, Efrat; Soto-Perez-de-Celis, Enrique; Jatoi, Aminah; Mohile, Supriya G.; Won, Elizabeth; Alibhai, Shabbir; Kilari, Deepak; Harrison, Robert; Klepin, Heidi D.; Wildes, Tanya M.; Mustian, Karen; Demark-Wahnefried, Wendy

    2016-01-01

    Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research. PMID:27197919

  12. Misconceptions about diabetes mellitus among adult male ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus (DM) is a major public health problem in Saudi Arabia. Its prevalence is on the increase, being as high as 23.7% among adult citizens. Misconceptions and wrong beliefs regarding DM and its management among those attending primary health care centres (PHCCs) can result in poor control, ...

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

    Science.gov (United States)

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

    2015-09-01

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

  14. Polypharmacy among older adults in Tehran

    Directory of Open Access Journals (Sweden)

    B. Ahmadi

    2006-08-01

    Full Text Available Background: Multiple drug use is frequently considered to be hazardous for the elderly because of their greater vulnerability to the complications. The purpose of this study was to determine the prevalence of polypharmacy in Tehran and to assess the relative demographic characteristics of patients. Methods: In a cross-sectional study 400 persons aging 55 years and older were interviewed in order to determine the presence of polypharmacy (daily intake of three or more drugs. The cases were randomly selected and asked to answer a questionnaire through interview at home. The questionnaire contained questions about all taking drugs, pattern of using each drug and also patients' personal, social and medical history. Chi-square and fisher exact tests and determination of odds ratios were used in order to data analysis. Results: Medium number of drugs used was 3.4 ± 1.9 in studied cases and %39.6 of cases were exposed to polypharmacy. The prevalence of physician prescribed drug usage was observed to be increased by increasing number of total used drugs in each case (P<0.002. The most commonly used drugs were A.S.A, Atenolol and propranolol and these drugs were prescribed by physician in over than %90 of cases. There was a positive correlations between polypharmacy with referring to multiple physicians (OR=1.96, CI 95%, 1.28-2.98 (P<0.002 and adverse drug reactions (OR=2.44, CI 95%, 1.47-4.05 (P<0.001. Polypharmacy was more prevalent in the age group of 65-75 years (P<0.04 and lower levels of education (P<0.004 and less prevalent in the group with moderate income (P<0.001. Conclusion: Polypharmacy is common among adults aging 55 years and more in Tehran and is affected by age, education level and economic status.

  15. Occupational Therapy Use by Older Adults With Cancer

    OpenAIRE

    Pergolotti, Mackenzi; Cutchin, Malcolm P.; Weinberger, Morris; Meyer, Anne-Marie

    2014-01-01

    A retrospective cohort study of 27,131 older adults diagnosed with cancer between 2004 and 2007 found that survivors who used occupational therapy after diagnosis also had the highest levels of comorbidities.

  16. Antimnemonic effects of schemas in young and older adults

    Science.gov (United States)

    Badham, Stephen P.; Maylor, Elizabeth A.

    2016-01-01

    Schema-consistent material that is aligned with an individual’s knowledge and experience is typically more memorable than abstract material. This effect is often more extreme in older adults and schema use can alleviate age deficits in memory. In three experiments, young and older adults completed memory tasks where the availability of schematic information was manipulated. Specifying nonobvious relations between to-be-remembered word pairs paradoxically hindered memory (Experiment 1). Highlighting relations within mixed lists of related and unrelated word pairs had no effect on memory for those pairs (Experiment 2). This occurred even though related word pairs were recalled better than unrelated word pairs, particularly for older adults. Revealing a schematic context in a memory task with abstract image segments also hindered memory performance, particularly for older adults (Experiment 3). The data show that processing schematic information can come with costs that offset mnemonic benefits associated with schema-consistent stimuli. PMID:25980799

  17. In Defense of Offering Educational Programs for Older Adults.

    Science.gov (United States)

    Mehrotra, Chandra M.

    2003-01-01

    Older adults participate in education to fulfil coping, expressive, contributive, influence, and transcendence needs. Learning can promote sustained mental functioning and increase self-efficacy and social support. (Contains 15 references.) (SK)

  18. When touch matters: an affective tactile intervention for older adults.

    Science.gov (United States)

    Mammarella, Nicola; Fairfield, Beth; Di Domenico, Alberto

    2012-10-01

    Our goal was to test the hypothesis that positive tactile experiences can lead to an improvement in cognitive, emotional skills and perceived quality of life in a group of healthy community-dwelling older adults. During a 10-week period, older adults completed a series of activities that required manipulating either a piece of velvet, a piece of canvas or velcro. Only older adults who worked with velvet showed an increase in cognitive and emotional skills, and the perceived quality of life. Our study is one of the first to show that positive tactile experiences might have a beneficial effect on the psychological well-being of healthy community-dwelling older adults across different domains. © 2012 Japan Geriatrics Society.

  19. Familism and Health Care Provision to Hispanic Older Adults.

    Science.gov (United States)

    Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen

    2016-01-01

    The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described. Copyright 2016, SLACK Incorporated.

  20. Relationship between perceived sleep and polysomnography in older adult patients

    Directory of Open Access Journals (Sweden)

    Mayra dos Santos Silva

    2015-04-01

    Conclusion: These results suggest that the older adult population have a good perception of their sleep. The questionnaires aimed at this population should be used as an alternative to polysomnography.

  1. Stereotype threat can reduce older adults' memory errors.

    Science.gov (United States)

    Barber, Sarah J; Mather, Mara

    2013-01-01

    Stereotype threat often incurs the cost of reducing the amount of information that older adults accurately recall. In the current research, we tested whether stereotype threat can also benefit memory. According to the regulatory focus account of stereotype threat, threat induces a prevention focus in which people become concerned with avoiding errors of commission and are sensitive to the presence or absence of losses within their environment. Because of this, we predicted that stereotype threat might reduce older adults' memory errors. Results were consistent with this prediction. Older adults under stereotype threat had lower intrusion rates during free-recall tests (Experiments 1 and 2). They also reduced their false alarms and adopted more conservative response criteria during a recognition test (Experiment 2). Thus, stereotype threat can decrease older adults' false memories, albeit at the cost of fewer veridical memories, as well.

  2. Hydrate for health: listening to older adults' need for information.

    Science.gov (United States)

    Palmer, Mary H; Marquez, Celine S; Kline, Katherine V; Morris, Erin; Linares, Brenda; Carlson, Barbara W

    2014-10-01

    An interdisciplinary team of faculty and students developed the Hydrate for Health project to provide relevant and evidence-based information to community-dwelling older adults. Evidence-based factsheets on bladder health, nighttime urination, medication safety, and physical activity/exercise, as well as a fluid intake self-monitoring tool, were developed. Four focus groups were conducted and included older adults (N = 21) who participated in activities at two local senior centers to obtain their feedback about the relevance of the factsheets. Extensive revisions were required based on the feedback received. Older adults expressed a desire for pragmatic information (i.e., how to determine fluid sources from food, how to measure water, how to determine their own fluid needs). They also wanted information that could be easily incorporated into daily life. Nurses play a central role in listening to and incorporating older adults' voices into consumer education materials. Copyright 2014, SLACK Incorporated.

  3. Major depressive and anxiety disorders in visually impaired older adults

    NARCIS (Netherlands)

    van der Aa, H.P.A.; Comijs, H.C.; Penninx, B.W.J.H.; van Rens, G.H.M.B.; van Nispen, R.M.A.

    2015-01-01

    PURPOSE. We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymic, and anxiety disorders (panic disorder, agoraphobia, social phobia, and general anxiety disorder) in visually impaired older adults and compared these estimates with those of normally sighted

  4. Designing a Tablet Touch-Screen Interface for Older Adults

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Grönvall, Erik

    Sustaining daily, unsupervised healthcare activities in a private home setting can challenge, among others, older adults. In this paper, we discuss experiences from designing a tablet mobile application, MediFrame, to support older adults’ medication management at home. In relation to Medi...

  5. Prevalence and associated factors of diabetes and impaired fasting glucose in Chinese hypertensive adults aged 45 to 75 years.

    Directory of Open Access Journals (Sweden)

    Xianhui Qin

    Full Text Available This study examined the prevalence of impaired fasting glucose (IFG and diabetes and their associated factors in 17,184 Chinese hypertensive adults aged 45-75 years.A cross-sectional investigation was carried out in a rural area of Lianyungang, China. Previously undiagnosed diabetes [fasting plasma glucose (FPG ≥ 7.0 mmol/l] and IFG (6.1-6.9 mmol/l were defined based on FPG concentration. Previously diagnosed diabetes was determined on the basis of self-report. Total diabetes included both previously diagnosed diabetes and previously undiagnosed diabetes.The prevalence of previously diagnosed diabetes, undiagnosed diabetes, and IFG were 3.4%, 9.8%, and 14.1%, respectively. About 74.2% of the participants with diabetes had not previously been diagnosed. In the multivariable logistic-regression model, older age, men, antihypertensive treatment, obesity (BMI ≥ 25 kg/m(2, abdominal obesity (waist circumference ≥ 90 cm for men and ≥ 80 cm for women, non-current smoking, a family history of diabetes, higher heart rate, lower physical activity levels, and inland residence (versus coastal were significantly associated with both total diabetes and previously undiagnosed diabetes. Furthermore, methylene- tetrahydrofolate reductase (MTHFR 677 TT genotype was an independent associated factor for total diabetes, and current alcohol drinking was an independent associated factor for previously undiagnosed diabetes. At the same time, older age, men, abdominal obesity, non-current smoking, current alcohol drinking, a family history of diabetes, higher heart rate, and inland residence (versus coastal were important independent associated factors for IFG.In conclusion, we found a high prevalence of diabetes in Chinese hypertensive adults. Furthermore, about three out of every four diabetic adults were undiagnosed. Our results suggest that population-level measures aimed at the prevention, identification (even if only based on the FPG evaluation, and

  6. Stigma Perceived and Experienced by Adults with Type 1 Diabetes

    DEFF Research Database (Denmark)

    Hansen, Ulla Møller; Willaing, Ingrid; Ventura, Adriana D

    2017-01-01

    OBJECTIVES: We aimed to (a) culturally and linguistically adapt the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) from English (for Australia) into Danish and (b) examine psychometric properties of the measure among Danish adults with type 1 diabetes. METHODS: We performed a forward......-backward translation, face validity interviews with experts and cognitive debriefing of the Danish version (DSAS-1 DK) with ten adults from the target group. The DSAS-1 DK was then completed by 1594 adults with type 1 diabetes. Electronic clinical records provided age, diabetes duration, diabetes-related complications...... to advance research into the stigma perceived and experienced by adults with type 1 diabetes in a Danish context....

  7. Symptom distress in older adults following cancer surgery.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2013-01-01

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

  9. Healthcare-Associated Meningitis or Ventriculitis in Older Adults.

    Science.gov (United States)

    Srihawan, Chanunya; Habib, Onaizah; Salazar, Lucrecia; Hasbun, Rodrigo

    2017-12-01

    Healthcare-associated meningitis or ventriculitis (HCAMV) is a serious and life-threatening complication of invasive neurosurgical procedures or penetrating head trauma. Older adults are at higher risk of adverse outcomes in community-acquired meningitis but studies of HCAMV are lacking. Therefore, we perform the study to define the differences in clinical outcomes between older and younger adults with HCAMV. Retrospective study. A large tertiary care hospital in Houston, Texas, from July 2003 to November 2014. Adults with a diagnosis of HCAMV (N = 160) aged ≥65 (n = 35), aged 18-64 (n = 125). Demographic characteristics, clinical presentation, laboratory results, treatments, and outcomes (Glasgow Outcome Scale). Older adults had more comorbidities and CSF abnormalities [pleocytosis, high cerebrospinal fluid (CSF) protein, low CSF glucose) and were more likely to have altered mental status than younger adults (P older (97%) and younger (86%) adults (P = .13). On logistic regression analysis, abnormal neurological examination (adjusted odds ratio (aOR) = 7.13, 95% confidence interval (CI) = 2.15-23.63, P = .001) and mechanical ventilation (aOR = 11.03, 95% CI = 1.35-90.51, P = .02) were associated with adverse clinical outcomes. Older adults with HCAMV have more comorbidities and CSF abnormalities and are more likely to have altered mental status than younger adults but have similar high rates of adverse clinical outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. Reward-Enhanced Memory in Younger and Older Adults

    OpenAIRE

    Julia Spaniol; Cécile Schain; Holly J. Bowen

    2014-01-01

    Objectives. We investigated how the anticipation of remote monetary reward modulates intentional episodic memory formation in younger and older adults. On the basis of prior findings of preserved reward–cognition interactions in aging, we predicted that reward anticipation would be associated with enhanced memory in both younger and older adults. On the basis of previous demonstrations of a time-dependent effect of reward anticipation on memory, we expected the memory enhancement to increase ...

  11. Depressive symptoms among adolescents and older adults in Mexico City.

    Science.gov (United States)

    Sánchez-García, Sergio; García-Peña, Carmen; González-Forteza, Catalina; Jiménez-Tapia, Alberto; Gallo, Joseph J; Wagner, Fernando A

    2014-06-01

    Determine the structure of depressive symptoms among adolescents and older adults through the person-centered approach of latent class analysis (LCA). The study is based on data from two independent samples collected in Mexico City (2,444 adolescents and 2,223 older adults) which included the revised version of the CES-D. The presence or absence of depressed mood (dysphoria), diminished pleasure (anhedonia), drastic change in weight, sleep problems, thinking and concentration difficulties, excessive or inappropriate guilt, fatigue, psychomotor agitation/retardation, and suicide ideation were used in LCA to determine the structure of depressive symptoms for adolescents and older adults. Adolescents reported higher excessive or inappropriate guilt compared to older adults, while older adults had higher proportions of anhedonia, sleep problems, fatigue, and psychomotor agitation/retardation. Similar proportions were found in other symptoms. The LCA analysis showed the best fit with four latent classes (LC): LC 1, "symptoms suggestive of major depressive episode (MDE)" with prevalence of 5.9 % (n = 144) and 10.3 % (n = 230) among adolescents and older adults, respectively; LC 2, "probable MDE symptoms" 18.2 % (n = 446) and 23.0 % (n = 512); LC 3, "possible MDE" 27.7 % (n = 676) and 21.8 % (n = 485); LC 4, "without significant depressive symptoms" 48.2 % (n = 1,178) and 44.8 % (n = 996). The differences in item thresholds between the two groups (adolescents vs. older adults) were statistically significant (Wald test = 255.684, df = 1, p depressive symptoms between adolescents and older adults that merit acknowledgment, further study, and consideration of their potential clinical and public health implications.

  12. FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

    OpenAIRE

    Michaela Dingová; Eva Králová

    2017-01-01

    Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged...

  13. Time-of-day influences postural balance in older adults

    DEFF Research Database (Denmark)

    Jorgensen, M G; Rathleff, Michael Skovdal; Laessoe, U

    2012-01-01

    Postural balance assessments are performed in both clinical and basic research settings on a daily basis. During a 24-h time span our physiology and physical performance undergo radical changes as we are influenced by the circadian rhythm. The time-of-day interaction on postural balance is unknow...... in older adults. The aim of this study was to investigate the time-of-day effect on postural balance in older adults....

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

    OpenAIRE

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

    2017-01-01

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

  15. 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,...

  16. Falls among older adults in the South of Brazil: prevalence and determinants

    Directory of Open Access Journals (Sweden)

    Luna S Vieira

    2018-02-01

    Full Text Available ABSTRACT OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p < 0.05 were considered to be associated with the outcome. RESULTS The prevalence of falls among older adults in the last year was 28.1% (95%CI 25.9–30.5, and most occurred in the person’s own residence. Among the older adults who fell, 51.5% (95%CI 46.6–56.4 had a single fall and 12.1% (95%CI 8.9–15.3 had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.

  17. Falls among older adults in the South of Brazil: prevalence and determinants.

    Science.gov (United States)

    Vieira, Luna S; Gomes, Ana Paula; Bierhals, Isabel O; Farías-Antúnez, Simone; Ribeiro, Camila G; Miranda, Vanessa I A; Lutz, Bárbara H; Barbosa-Silva, Thiago G; Lima, Natália P; Bertoldi, Andréa D; Tomasi, Elaine

    2018-01-01

    OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p falls among older adults in the last year was 28.1% (95%CI 25.9-30.5), and most occurred in the person's own residence. Among the older adults who fell, 51.5% (95%CI 46.6-56.4) had a single fall and 12.1% (95%CI 8.9-15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.

  18. Walking through doorways causes forgetting: Younger and older adults.

    Science.gov (United States)

    Radvansky, Gabriel A; Pettijohn, Kyle A; Kim, Joonsung

    2015-06-01

    Previous research on event cognition has found that walking through doorways can cause forgetting. The explanation for this finding is that there is a competition between event models, producing interference, and depressing performance. The current study explored the degree to which this might be affected by the natural aging process. This is of interest because there is some evidence that older adults have trouble coordinating sources of interference, which is what is thought to underlie this effect. This would suggest that older adults should do worse on this task. Alternatively, there is also evidence that older adults are typically not disrupted at the event level of processing per se. This would suggest that older adults should perform similarly to younger adults on this task. In the study reported here, younger and older participants navigated through a virtual environment, and memory was tested with probes either before or after a shift and for objects that were associated with the participant (i.e., just picked up). In general, both younger and older adults had memory disrupted after walking through a doorway. Importantly, the magnitude of this disruption was similar in the 2 age groups. This is consistent with the idea that processing at the event level is relatively unaffected by the natural aging process. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  19. Drug treatment of hypertension in older patients with diabetes mellitus.

    Science.gov (United States)

    Yandrapalli, Srikanth; Pal, Suman; Nabors, Christopher; Aronow, Wilbert S

    2018-05-01

    Hypertension is more prevalent in the elderly (age>65 years) diabetic population than in the general population and shows an increasing prevalence with advancing age. Both diabetes mellitus (DM) and hypertension are independent risk factors for cardiovascular (CV) related morbidity and mortality. Optimal BP targets were not identified in elderly patients with DM and hypertension. Areas covered: In this review article, the authors briefly discuss the pathophysiology of hypertension in elderly diabetics, present evidence with various antihypertensive drug classes supporting the treatment of hypertension to reduce CV events in older diabetics, and then discuss the optimal target BP goals in these patients. Expert opinion: Clinicians should have a BP goal of less than 130/80 mm in all elderly patients with hypertension and DM, especially in those with high CV-risk. When medications are required for optimal BP control in addition to lifestyle measures, either thiazide diuretics, angiotensin-converting-enzyme inhibitors, angiotensin receptor blockers, or calcium channel blockers should be considered as initial therapy. Combinations of medications are usually required in these patients because BP control is more difficult to achieve in diabetics than those without DM.

  20. Association between Nighttime Sleep and Napping in Older Adults

    Science.gov (United States)

    Goldman, Suzanne E.; Hall, Martica; Boudreau, Robert; Matthews, Karen A.; Cauley, Jane A.; Ancoli-Israel, Sonia; Stone, Katie L.; Rubin, Susan M.; Satterfield, Suzanne; Simonsick, Eleanor M.; Newman, Anne B.

    2008-01-01

    Study Objectives: Napping might indicate deficiencies in nighttime sleep, but the relationship is not well defined. We assessed the association of nighttime sleep duration and fragmentation with subsequent daytime sleep. Design: Cross-sectional study. Participants: 235 individuals (47.5% men, 29.7% black), age 80.1 (2.9) years. Measurements and Results: Nighttime and daytime sleep were measured with wrist actigraphy and sleep diaries for an average of 6.8 (SD 0.7) nights. Sleep parameters included total nighttime sleep (h), movement and fragmentation index (fragmentation), and total daytime sleep (h). The relationship of total nighttime sleep and fragmentation to napping (yes/no) was assessed using logistic regression. In individuals who napped, mixed random effects models were used to determine the association between the previous night sleep duration and fragmentation and nap duration, and nap duration and subsequent night sleep duration. All models were adjusted for age, race, gender, BMI, cognitive status, depression, cardiovascular disease, respiratory symptoms, diabetes, pain, fatigue, and sleep medication use. Naps were recorded in sleep diaries by 178 (75.7%) participants. The odds ratios (95% CI) for napping were higher for individuals with higher levels of nighttime fragmentation (2.1 [0.8, 5.7]), respiratory symptoms (2.4 [1.1, 5.4]), diabetes (6.1 [1.2, 30.7]), and pain (2.2 [1.0, 4.7]). Among nappers, neither sleep duration nor fragmentation the preceding night was associated with nap duration the next day. Conclusion: More sleep fragmentation was associated with higher odds of napping although not with nap duration. Further research is needed to determine the causal association between sleep fragmentation and daytime napping. Citation: Goldman SE; Hall M; Boudreau R; Matthews KA; Cauley JA; Ancoli-Israel S; Stone KL; Rubin SM; Satterfield S; Simonsick EM; Newman AB. Association between nighttime sleep and napping in older adults. SLEEP 2008

  1. Older Californians and the Mental Health Services Act: Is an Older Adult System of Care Supported?

    Science.gov (United States)

    Kietzman, Kathryn G; Dupuy, Danielle; Damron-Rodriguez, JoAnn; Palimaru, Alina; del Pino, Homero E; Frank, Janet C

    2018-01-01

    This policy brief summarizes findings from the first study to evaluate how California's public mental health delivery system has served older adults (60 years of age and over) since the passage of the Mental Health Services Act (MHSA) in 2004. Study findings indicate that there are unmet needs among older adults with mental illness in the public mental health delivery system. There are deficits in the involvement of older adults in the required MHSA planning processes and in outreach and service delivery, workforce development, and outcomes measurement and reporting. There is also evidence of promising programs and strategies that counties have advanced to address these deficits. Recommendations for improving mental health services for older adults include designating a distinct administrative and leadership structure for older adult services in each county; enhancing older adult outreach and documentation of unmet need; promoting standardized geriatric training of providers; instituting standardized data-reporting requirements; and increasing service integration efforts, especially between medical, behavioral health, aging, and substance use disorder services.

  2. Trends in substance use admissions among older adults.

    Science.gov (United States)

    Chhatre, Sumedha; Cook, Ratna; Mallik, Eshita; Jayadevappa, Ravishankar

    2017-08-22

    Substance abuse is a growing, but mostly silent, epidemic among older adults. We sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Treatment Episode Data Set - Admissions (TEDS-A) for period between 2000 and 2012 was used. The trends in admission for primary substances, demographic attributes, characteristics of substance abused and type of admission were analyzed. While total number of substance abuse treatment admissions between 2000 and 2012 changed slightly, proportion attributable to older adults increased from 3.4% to 7.0%. Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. Majority of the admissions were for alcohol as the primary substance. However there was a decreasing trend in this proportion (77% to 64%). The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics. Also, admissions for older adults increased between 2000 and 2012 for African Americans (21% to 28%), females (20% to 24%), high school graduates (63% to 75%), homeless (15% to 19%), unemployed (77% to 84%), and those with psychiatric problems (17% to 32%).The proportion of admissions with prior history of substance abuse treatment increased from 39% to 46% and there was an increase in the admissions where more than one problem substance was reported. Ambulatory setting continued to be the most frequent treatment setting, and individual (including self-referral) was the most common referral source. The use of medication assisted therapy remained low over the years (7% - 9%). The changing demographic and substance use pattern of older adults implies that a wide array of psychological, social, and physiological needs will arise. Integrated, multidisciplinary and tailored policies for prevention and treatment are necessary to

  3. [Factors associated with slow walking speed in older adults of a district in Lima, Peru].

    Science.gov (United States)

    Rodríguez, Gabriela; Burga-Cisneros, Daniella; Cipriano, Gabriela; Ortiz, Pedro J; Tello, Tania; Casas, Paola; Aliaga, Elizabeth; Varela, Luis F

    2017-01-01

    To determine the factors associated with slow walking speed in older adults living in a district of Lima, Peru. Analysis of secondary data. Adults older than 60 years were included in the study, while adults with physical conditions who did not allow the evaluation of the walking speed were excluded. The dependent variable was slow walking speed (less than 1 m/s), and the independent variables were sociodemographic, clinical, and geriatric data. Raw and adjusted prevalence ratios (PR) were calculated with 95% confidence intervals (95% CI). The study sample included 416 older adults aged 60 to 99 years, and 41% of the participants met the slow walking speed criterion. The factors associated with slow walking speed in this sample were female gender (PR, 1.45; 95% CI, 1.13-1.88), age > 70 years (PR, 1.73; 95% CI, 1.30- 2.30), lower level of education (PR, 2.07, 95% CI, 1.20-3.55), social-familial problems (PR, 1.66; 95% CI, 1.08-2.54), diabetes mellitus (PR, 1.35; 95% CI, 1.01-1.80), and depression (PR, 1.41; 95% CI, 1.02-1.95). The modifiable factors associated with slow walking speed in older adults included clinical and social-familial problems, and these factors are susceptible to interventions from the early stages of life.

  4. Suicide in older adults: a comparison with middle-aged adults using the Queensland Suicide Register.

    Science.gov (United States)

    Koo, Yu Wen; Kõlves, Kairi; De Leo, Diego

    2017-03-01

    Globally, suicide rates increase with age, being highest in older adults. This study analyzed differences in suicides in older adults (65 years and over) compared to middle-aged adults (35-64 years) in Queensland, Australia, during the years 2000-2012. The Queensland Suicide Register was utilized for the analysis. Annual suicide rates were calculated by gender and age group, and odds ratios with 95% confidence intervals were examined. In Queensland, the average annual rate of suicides for older adults was 15.27 per 100,000 persons compared to 18.77 in middle-aged adults in 2000-2012. There were no significant changes in time trends for older adults in 2002-2012. Suicide methods differed between gender and age groups. Older adults who died by suicide were more likely to be male, widowed, living alone or in a nursing home, and out of the work force. The prevalence of untreated psychiatric conditions, diagnosed psychiatric disorders, and consultations with a mental health professional three months prior to death was lower in older adults than middle-aged adults. Somatic illness, bereavement, and attention to suicide in the media were more common among older adults than middle-age adults. Older females were particularly more likely to pay attention to suicide in the media. Our findings show older adults who died by suicide were more likely to experience somatic illnesses, bereavement, and pay attention to suicide in the media compared to middle aged. Preventing suicide in older adults would therefore require holistic and comprehensive approaches.

  5. Self-rated Driving and Driving Safety in Older Adults

    OpenAIRE

    Ross, Lesley A.; Dodson, Joan; Edwards, Jerri D.; Ackerman, Michelle L.; Ball, Karlene

    2012-01-01

    Many U.S. states rely on older adults to self-regulate their driving and determine when driving is no longer a safe option. However, the relationship of older adults’ self-rated driving in terms of actual driving competency outcomes is unclear. The current study investigates self-rated driving in terms of (1) systematic differences between older adults with high (good/excellent) versus low (poor/fair/average) self-ratings, and (2) the predictive nature of self-rated driving to adverse driving...

  6. Reverse correlating trustworthy faces in young and older adults

    Directory of Open Access Journals (Sweden)

    Catherine eÉthier-Majcher

    2013-09-01

    Full Text Available Little is known about how older persons determine if someone deserves their trust or not based on their facial appearance, a process referred to as facial trustworthiness. In the past few years, Todorov and colleagues have argued that, in young adults, trustworthiness judgments are an extension of emotional judgments, and therefore, that trust judgments are made based on a continuum between anger and happiness (Engell, Todorov & Haxby, 2010; Todorov, 2008. Evidence from the literature on emotion processing suggest that older adults tend to be less efficient than younger adults in the recognition of negative facial expressions (Chaby & Narme, 2009; Ruffman, Henry, Livingstone et al., 2008; Firestone, Turk-Browne & Ryan, 2007; Calder, Keane, Manly et al., 2003. Based on Todorov’s theory and the fact that older adults seem to be less efficient than younger adults in identifying emotional expressions, one could expect that older individuals would have different representations of trustworthy faces and that they would use different cues than younger adults in order to make such judgments. We verified this hypothesis using a variation of Mangini and Biederman's (2004 reverse correlation method in order to test and compare classification images resulting from trustworthiness (in the context of money investment, from happiness, and from anger judgments in two groups of participants: young adults and older healthy adults. Our results show that for elderly participants, both happy and angry representations are correlated with trustworthiness judgments. However, in young adults, trustworthiness judgments are mainly correlated with happiness representations. These results suggest that young and older adults differ in their way of judging trustworthiness.

  7. Postural adaptations to repeated optic flow stimulation in older adults

    Science.gov (United States)

    O’Connor, Kathryn W.; Loughlin, Patrick J.; Redfern, Mark S.; Sparto, Patrick J.

    2008-01-01

    The purpose of this study is to understand the processes of adaptation (changes in within-trial postural responses) and habituation (reductions in between-trial postural responses) to visual cues in older and young adults. Of particular interest were responses to sudden increases in optic flow magnitude. The postural sway of 25 healthy young adults and 24 healthy older adults was measured while subjects viewed anterior-posterior 0.4 Hz sinusoidal optic flow for 45 s. Three trials for each of three conditions were performed: 1) constant 12 cm optic flow amplitude (24 cm peak-to-peak), 2) constant 4 cm amplitude (8 cm p-t-p), and 3) a transition in amplitude from 4 to 12 cm. The average power of head sway velocity (Pvel) was calculated for consecutive 5 s intervals during the trial to examine the changes in sway within and between trials. A mixed factor repeated measures ANOVA was performed to examine the effects of subject Group, Trial, and Interval on the Pvel. Pvel was greater in older adults in all conditions (p Pvel of the older adults decreased significantly between all 3 trials, but decreased only between trial 1 and 2 in young adults. While the responses of the young adults to the transition in optic flow from 4 to 12 cm did not significantly change, older adults had an increase in Pvel following the transition, ranging from 6.5 dB for the first trial to 3.4 dB for the third trial. These results show that older adults can habituate to repeated visual perturbation exposures; however, this habituation requires a greater number of exposures than young adults. This suggests aging impacts the ability to quickly modify the relative weighting of the sensory feedback for postural stabilization. PMID:18329878

  8. Self-care behaviors of Filipino-American adults with type 2 diabetes mellitus.

    Science.gov (United States)

    Jordan, Deovina N; Jordan, James L

    2010-01-01

    To examine the diabetes self-care behaviors of Filipino-American (FA) adults with type 2 diabetes mellitus (DM). The Summary of Diabetes Self Care Activities-Revised and Expanded measure was administered to 192 (74 males and 118 females) FA adult immigrants with type 2 DM. Older FAs (> or =65 years), females, those who were older when they immigrated, and participants diagnosed with type 2 DM longer were more likely to follow recommended medication regimens. Younger FAs (healthful eating plans. Likewise, females reported eating five or more servings of fruits and/or vegetables daily. Moreover, older FAs reported evenly spacing carbohydrate intake everyday. Furthermore, older participants, those with less education, participants who were older when they immigrated, and those older when diagnosed with type 2 DM ate fewer foods high in fats. As to physical activity, FA males and participants with higher education exercised more frequently. Younger FAs were less likely to perform optimum type 2 DM self-care behaviors pertaining to diet, medication taking, and blood glucose testing compared to their older counterparts. This finding suggests an increased risk for type 2 DM comorbidities and/or complications in younger FAs, which may require more intensive treatments in later years. Copyright 2010. Published by Elsevier Inc.

  9. Organizational support and volunteering benefits for older adults.

    Science.gov (United States)

    Tang, Fengyan; Choi, Eunhee; Morrow-Howell, Nancy

    2010-10-01

    This study tested a theoretical model of volunteering benefits and examined the mechanism through which volunteering benefits older adults. This is a 2-wave study of 253 older adult volunteers serving in 10 volunteer programs. Older volunteers completed the mailed surveys in 2005 and 2006. Structural equation modeling was used to define the latent variables and to test direct and indirect relationships among organizational support, socioemotional benefits, and self-reported health. Organizational support (measured by choice of volunteer activity, training, and ongoing support) had significant direct associations with 2 latent factors of socioemotional benefits, that is, perceived contribution and personal benefits. Perceived contribution was significantly related to mental health. Additionally, older volunteers with lower socioeconomic status (SES) committed more hours and perceived more personal benefits than higher SES peers. These findings suggest that volunteer programs can provide various organizational supports to older volunteers, especially to low-SES volunteers, in order to promote the socioemotional and health benefits of volunteering to older adults. Psychological well-being of older adults can be improved through engagement in meaningful volunteer activities and contribution to others.

  10. Executive functioning in older adults with hoarding disorder.

    Science.gov (United States)

    Ayers, Catherine R; Wetherell, Julie Loebach; Schiehser, Dawn; Almklov, Erin; Golshan, Shahrokh; Saxena, Sanjaya

    2013-11-01

    Hoarding disorder (HD) is a chronic and debilitating psychiatric condition. Midlife HD patients have been found to have neurocognitive impairment, particularly in areas of executive functioning, but the extent to which this is due to comorbid psychiatric disorders has not been clear. The purpose of the present investigation was to examine executive functioning in geriatric HD patients without any comorbid Axis I disorders (n = 42) compared with a healthy older adult comparison group (n = 25). We hypothesized that older adults with HD would perform significantly worse on measures of executive functioning (Wisconsin Card Sort Task [Psychological Assessment Resources, Lutz, Florida, USA] ( Psychological Assessment Resources, 2003) and the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests [Pearson, San Antonio, TX, USA]). Older adults with HD showed significant differences from healthy older controls in multiple aspects of executive functioning. Compared with healthy controls, older adults with HD committed significantly more total, non-perseverative errors and conceptual level responses on the Wisconsin Card Sort Task and had significantly worse performance on the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests. Hoarding symptom severity was strongly correlated with executive dysfunction in the HD group. Compared with demographically-matched controls, older adults with HD have dysfunction in several domains of executive functioning including mental control, working memory, inhibition, and set shifting. Executive dysfunction is strongly correlated with hoarding severity and is not because of comorbid psychiatric disorders in HD patients. These results have broad clinical implications suggesting that executive functioning should be assessed and taken into consideration when developing intervention strategies for older adults with HD. Copyright © 2013 John Wiley & Sons, Ltd.

  11. Dietary intake and nutritional status in cancer patients: comparing adults and older adults

    OpenAIRE

    Gómez Valiente da Silva, Henyse; Fonseca de Andrade, Camila; Seixas Bello Moreira, Annie

    2014-01-01

    Objective: Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category Methods: Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Bo...

  12. Alcohol and prescription drug safety in older adults

    Directory of Open Access Journals (Sweden)

    Zanjani F

    2013-02-01

    Full Text Available Faika Zanjani,1,2 Aasha I Hoogland,1 Brian G Downer11Department of Gerontology, 2Building Interdisciplinary Research Careers in Women's Health University of Kentucky, Lexington, KY, USABackground: The objectives of this study were to investigate older adults' knowledge of prescription drug safety and interactions with alcohol, and to identify pharmacists' willingness to disseminate prescription drug safety information to older adults.Methods: The convenience sample consisted of 48 older adults aged 54–89 years who were recruited from a local pharmacy and who completed surveys addressing their alcohol consumption, understanding of alcohol and prescription drug interactions, and willingness to change habits regarding alcohol consumption and prescription drugs. To address pharmacist willingness, 90 pharmacists from local pharmacies volunteered and answered questions regarding their willingness to convey prescription drug safety information to older adults.Results: Older adults reported low knowledge of alcohol and prescription drug safety, with women tending to be slightly more knowledgeable. More importantly, those who drank in the previous few months were less willing to talk to family and friends about how alcohol can have harmful interactions with prescription drugs, or to be an advocate for safe alcohol and prescription drug use than those who had not had a drink recently. Pharmacists reported that they were willing to convey prescription drug safety information to older adults via a variety of formats, including displaying or distributing a flyer, and directly administering a brief intervention.Conclusion: In this study, older adults were found to have inadequate knowledge of prescription drug safety and interactions with alcohol, but pharmacists who regularly come in contact with older adults indicated that they were ready and willing to talk to older adults about prescription drug safety. Future research should focus on interventions

  13. Assessing and Meeting the Needs of LGBT Older Adults via the Older Americans Act.

    Science.gov (United States)

    Adams, Michael; Tax, Aaron D

    2017-12-01

    SAGE and its partners have been focused on bridging the chasm between the greater need that LGBT older adults have for care, services, and supports, and the lower rate at which they access them, compared with their heterosexual and cisgender counterparts. The chasm is caused by discrimination, social isolation, disproportionate poverty and health disparities, and a lack of access to culturally competent providers. SAGE has used federal administrative and legislative advocacy to encourage the Aging Network to bridge this chasm by assessing and meeting the needs of LGBT older adults that can be addressed via the programs created under the Older Americans Act.

  14. Effect of an AIDS education program for older adults.

    Science.gov (United States)

    Rose, M A

    1996-01-01

    The purpose of this study was to examine the effect of an age-specific AIDS education program on HIV/AIDS knowledge, perceived susceptibility to AIDS, and perceived severity of AIDS in older adults. The health belief model served as a framework. The age-specific AIDS education program was developed based on a knowledge, beliefs, and behaviors survey of 458 older adults at senior citizen centers. The program included case study presentations of actual older people with AIDS along with an emphasis on myths identified in the initial survey. There was a significant increase in total knowledge about AIDS (p < .001), perceived susceptibility (p < .01), and perceived severity (p < .001) after the educational program. Based on the results of this study, nurses are in an excellent position to provide primary and secondary AIDS prevention strategies for all age groups, including the older adult population.

  15. Exploring Life Satisfaction Among Older Adults in Dakar.

    Science.gov (United States)

    Macia, Enguerran; Duboz, Priscilla; Montepare, Joann M; Gueye, Lamine

    2015-12-01

    Studies on correlates of subjective well-being of older adults are virtually non-existent in sub-Saharan Africa. Yet, understanding and improving the well-being of older adults should be a focal point of research and policy directed at this fast growing population. The aim of this study was to assess the links between socio-demographic factors, economic conditions, health, social relations, and the life satisfaction of older adults in Dakar. To this end, a survey was conducted on a sample of 500 dwellers of the Senegalese capital, aged 50 to 100, using the quota method for greater representativeness. Results revealed that with advancing age older adults expressed greater life satisfaction, and that older women were more satisfied than older men. As well, economic conditions were a main predictor of life satisfaction, along with good social relations. In contrast to findings with Western populations, neither self-rated health nor physical disabilities were associated with aging adults' life satisfaction. Findings suggest a number of avenues for future research.

  16. Do older adults perceive postural constraints for reach estimation?

    Science.gov (United States)

    Cordova, Alberto; Gabbard, Carl

    2014-01-01

    BACKGROUND/STUDY CONTEXT: Recent evidence indicates that older persons have difficulty mentally representing intended movements. Furthermore, in an estimation of reach paradigm using motor imagery, a form of mental representation, older persons significantly overestimated their ability compared with young adults. The authors tested the notion that older adults may also have difficulty perceiving the postural constraints associated with reach estimation. The authors compared young (Mage = 22 years) and older (Mage = 67) adults on reach estimation while seated and in a more postural demanding standing and leaning forward position. The expectation was a significant postural effect with the standing condition, as evidenced by reduced overestimation. Whereas there was no difference between groups in the seated condition (both overestimated), older adults underestimated whereas the younger group once again overestimated in the standing condition. From one perspective, these results show that older adults do perceive postural constraints in light of their own physical capabilities. That is, that group perceived greater postural demands with the standing posture and elected to program a more conservative strategy, resulting in underestimation.

  17. Understanding and Reducing Disability in Older Adults Following Critical Illness

    Science.gov (United States)

    Brummel, N.E.; Balas, M.C.; Morandi, A.; Ferrante, L.E.; Gill, T.M.; Ely, E.W.

    2015-01-01

    Objective To review how disability can develop in older adults with critical illness and to explore ways to reduce long-term disability following critical illness. Data Sources Review of the literature describing post-critical illness disability in older adults and expert opinion. Results We identified 19 studies evaluating disability outcomes in critically ill patients age 65 years and older. Newly acquired disability in activities of daily living, instrumental activities of daily living and mobility activities was commonplace among older adults who survived a critical illness. Incident dementia and less-severe cognitive impairment was also highly prevalent. Factors related to the acute critical illness, intensive care unit practices such as heavy sedation, physical restraints and immobility as well as aging physiology and coexisting geriatric conditions can combine to result in these poor outcomes. Conclusion Older adults who survive critical illness suffer physical and cognitive declines resulting in disability at greater rates than hospitalized, non-critically ill and community dwelling older adults. Interventions derived from widely available geriatric care models in use outside of the ICU, which address modifiable risk factors including immobility and delirium, are associated with improved functional and cognitive outcomes and can be used to complement ICU-focused models such as the ABCDEs. PMID:25756418

  18. Acquired Inhibitors: A Special Case of Bleeding in Older Adults

    Directory of Open Access Journals (Sweden)

    Richard G. Stefanacci

    2012-01-01

    Full Text Available This literature review is intended to familiarize physicians and healthcare providers of older adults with the potential causes of acute bleeding in older adults and to review diagnostic approaches that can produce prompt identification of acute bleeding and facilitate timely treatment. Adverse events from anticoagulant treatment and nonsteroidal anti-inflammatory drug (NSAID and aspirin use and abuse are among the most common causes of bleeding in older adults. Diagnoses infrequently considered—mild congenital hemophilia, acquired hemophilia, von Willebrand disease, and platelet dysfunction—can contribute to acute bleeding in older adults. The approach to management of bleeding varies. Management of acute bleeding in older adults can be challenging because these patients often have chronic comorbidity and have been prescribed long-term concomitant medications that can complicate diagnosis and treatment. Prompt recognition of acquired hemophilia, referral to an expert hematologist, and timely initiation of treatment could improve outcome in older patients who experience bleeding episodes resulting from this condition.

  19. Approximate Quantification in Young, Healthy Older Adults', and Alzheimer Patients

    Science.gov (United States)

    Gandini, Delphine; Lemaire, Patrick; Michel, Bernard Francois

    2009-01-01

    Forty young adults, 40 healthy older adults, and 39 probable AD patients were asked to estimate small (e.g., 25) and large (e.g., 60) collections of dots in a choice condition and in two no-choice conditions. Participants could choose between benchmark and anchoring strategies on each collection of dots in the choice condition and were required to…

  20. Health Literacy, Social Support, and Health Status among Older Adults

    Science.gov (United States)

    Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel

    2009-01-01

    The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…

  1. Creative Ageing? Selfhood, Temporality and the Older Adult Learner

    Science.gov (United States)

    Sabeti, Shari

    2015-01-01

    This paper is based on a long-term ethnography of an adult creative writing class situated in a major urban art gallery in the United Kingdom. It takes the claims of one group of older adults--that creative writing made them "feel younger"--as the starting point for exploring this connection further. It places these claims broadly within…

  2. Incidence of Dementia in Older Adults with Intellectual Disabilities

    Science.gov (United States)

    Strydom, Andre; Chan, Trevor; King, Michael; Hassiotis, Angela; Livingston, Gill

    2013-01-01

    Dementia may be more common in older adults with intellectual disability (ID) than in the general population. The increased risk for Alzheimer's disease in people with Down syndrome (DS) is well established, but much less is known about dementia in adults with ID who do not have DS. We estimated incidence rates from a longitudinal study of…

  3. Semantic Priming During Sentence Processing by Young and Older Adults.

    Science.gov (United States)

    Burke, Deborah M.; Yee, Penny L.

    1984-01-01

    Compares the semantic processing skills of younger adults (mean age 25) and older adults (mean age 68). After reading a sentence, subjects performed a task in which responses did not depend on retention. Results provided no evidence for age-related changes, including those associated with access to implied information. (Author/RH)

  4. Entity versus incremental theories predict older adults' memory performance.

    Science.gov (United States)

    Plaks, Jason E; Chasteen, Alison L

    2013-12-01

    The authors examined whether older adults' implicit theories regarding the modifiability of memory in particular (Studies 1 and 3) and abilities in general (Study 2) would predict memory performance. In Study 1, individual differences in older adults' endorsement of the "entity theory" (a belief that one's ability is fixed) or "incremental theory" (a belief that one's ability is malleable) of memory were measured using a version of the Implicit Theories Measure (Dweck, 1999). Memory performance was assessed with a free-recall task. Results indicated that the higher the endorsement of the incremental theory, the better the free recall. In Study 2, older and younger adults' theories were measured using a more general version of the Implicit Theories Measure that focused on the modifiability of abilities in general. Again, for older adults, the higher the incremental endorsement, the better the free recall. Moreover, as predicted, implicit theories did not predict younger adults' memory performance. In Study 3, participants read mock news articles reporting evidence in favor of either the entity or incremental theory. Those in the incremental condition outperformed those in the entity condition on reading span and free-recall tasks. These effects were mediated by pretask worry such that, for those in the entity condition, higher worry was associated with lower performance. Taken together, these studies suggest that variation in entity versus incremental endorsement represents a key predictor of older adults' memory performance. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Older adults' intrinsic and extrinsic motivation toward physical activity.

    Science.gov (United States)

    Dacey, Marie; Baltzell, Amy; Zaichkowsky, Len

    2008-01-01

    To examine how motives discriminate 3 physical activity levels of inactive, active, and sustained maintainers. Six hundred forty-five adults (M age = 63.8) completed stage-of-change and Exercise Motivations Inventory (EMI-2) scales. Exploratory factor analysis established psychometric properties of the EMI-2 suitable for older adults. Six factors emerged in the EMI-2: health and fitness, social/emotional benefits, weight management, stress management, enjoyment, and appearance. Enjoyment contributed most to differentiating activity levels. Moderators of age and gender were delineated. Intrinsic motivation and self-determined extrinsic motivation distinguish older adults' activity levels.

  6. Postural adaptations to repeated optic flow stimulation in older adults

    OpenAIRE

    O’Connor, Kathryn W.; Loughlin, Patrick J.; Redfern, Mark S.; Sparto, Patrick J.

    2008-01-01

    The purpose of this study is to understand the processes of adaptation (changes in within-trial postural responses) and habituation (reductions in between-trial postural responses) to visual cues in older and young adults. Of particular interest were responses to sudden increases in optic flow magnitude. The postural sway of 25 healthy young adults and 24 healthy older adults was measured while subjects viewed anterior-posterior 0.4 Hz sinusoidal optic flow for 45 s. Three trials for each of ...

  7. Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

    Science.gov (United States)

    Hsu, Joy; Chen, Jessica; Mirabelli, Maria C

    Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described. The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to asthma control. Data were obtained from 14,076 older adults ≥65 years with active asthma participating in the 2006-2010 Behavioral Risk Factor Surveillance System Asthma Call-back Survey (a random-digit dialed survey) in 40 US states, the District of Columbia, and Puerto Rico, representative of >2.6 million persons. Weighted, adjusted logistic regression was conducted. One or more asthma-related hospitalizations in the past year were reported by 5.7% (95% confidence interval [95% CI] = 5.0% to 6.4%) of participants; 10.6% (95% CI = 9.7% to 11.5%) reported ≥1 asthma-related ED/UCV. Compared with older adults without asthma-related hospitalizations, adjusted odds were higher among those with ≥1 asthma-related hospitalization for chronic obstructive pulmonary disease (COPD), coronary artery disease, depression, cockroaches or mold in the home, and cost barriers to asthma-related health care or medication. All these factors, except for cockroaches, were associated with asthma-related ED/UCV. Compared with males, adjusted odds were higher among females for COPD, depression, obesity, and cost barriers to asthma-related health care or medication. Among older adults, asthma-related hospitalizations and ED/UCV were associated with clinical comorbidities, mold in the home, and financial barriers to asthma-related health care. Interventions addressing modifiable factors could reduce asthma morbidity among older adults. Published by Elsevier Inc.

  8. FDA drug safety communications: a narrative review and clinical considerations for older adults.

    Science.gov (United States)

    Marcum, Zachary A; Vande Griend, Joseph P; Linnebur, Sunny A

    2012-08-01

    adults. Finally, several warnings were made about statins. Routine periodic monitoring of liver enzymes does not appear to be effective in detecting or preventing serious liver injury from statin use; thus, liver enzymes are no longer recommended to be routinely monitored. Statin-induced cognitive changes are rare, and insufficient evidence is currently available to establish causality. Statins appear to moderately increase the risk of developing diabetes (versus placebo), and regular screening for diabetes should be considered, especially for patients taking high-dose statins and patients with multiple risk factors for diabetes. FDA drug safety communications incorporate complex methodologies that investigate the risks (and relative benefits) of medication therapy. Clinicians caring for older adults need to be aware of the most current evidence behind these drug risks to effectively communicate with and care for their patients. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

  9. Reducing misinformation effects in older adults with cognitive interview mnemonics.

    Science.gov (United States)

    Holliday, Robyn E; Humphries, Joyce E; Milne, Rebecca; Memon, Amina; Houlder, Lucy; Lyons, Amy; Bull, Ray

    2012-12-01

    We examined the effect of a prior Modified Cognitive Interview on young and older adults' recall of a short film of a staged crime and subsequent reporting of misinformation. Participants viewed the film followed the next day by misinformation presented in a postevent summary. They were then interviewed with either a Modified Cognitive Interview or a control interview followed by a recognition memory test. A Modified Cognitive Interview elicited more correct details and improved overall accuracy compared to a control interview in both age groups, although the young adults recollected three times more correct information in a Modified Cognitive Interview than the older adults. In both age groups, correct recollections of person and action details were higher in a Modified Cognitive Interview than a control interview. Importantly, older adults who were interviewed with a Modified Cognitive Interview were not susceptible to misinformation effects. 2013 APA, all rights reserved

  10. Relational integration, inhibition, and analogical reasoning in older adults.

    Science.gov (United States)

    Viskontas, Indre V; Morrison, Robert G; Holyoak, Keith J; Hummel, John E; Knowlton, Barbara J

    2004-12-01

    The difficulty of reasoning tasks depends on their relational complexity, which increases with the number of relations that must be considered simultaneously to make an inference, and on the number of irrelevant items that must be inhibited. The authors examined the ability of younger and older adults to integrate multiple relations and inhibit irrelevant stimuli. Young adults performed well at all but the highest level of relational complexity, whereas older adults performed poorly even at a medium level of relational complexity, especially when irrelevant information was presented. Simulations based on a neurocomputational model of analogical reasoning, Learning and Inference with Schemas and Analogies (LISA), suggest that the observed decline in reasoning performance may be explained by a decline in attention and inhibitory functions in older adults. copyright (c) 2004 APA, all rights reserved.

  11. Handgrip force steadiness in young and older adults

    DEFF Research Database (Denmark)

    Blomkvist, Andreas W; Eika, Fredrik; de Bruin, Eling D

    2018-01-01

    ) was investigated in a test-retest design with seven days between sessions. Ten young and thirty older adults were recruited and handgrip steadiness was tested at 5%, 10% and 25% of maximum voluntary contraction (MVC) using Nintendo Wii Balance Board (WBB). Coefficients of variation were calculated from the mean...... force produced (CVM) and the target force (CVT). Area between the force curve and the target force line (Area) was also calculated. For the older adults we explored reliability using intraclass correlation coefficient (ICC) and agreement using standard error of measurement (SEM), limits of agreement......, CVT and Area was 0.815, 0.806 and 0.464, respectively. Averaged ICC on 5%, 10%, and 25% of MVC was 0.751, 0.667 and 0.668, respectively. Measures of agreement showed similar trends with better results for CVM and CVT than for Area. Young adults had better handgrip steadiness than older adults across...

  12. Factors related to gait and balance deficits in older adults

    Directory of Open Access Journals (Sweden)

    Al-Momani M

    2016-08-01

    disability, stroke, heart disease, arthritis, joint diseases, diabetes, and hypertension recorded higher risks of falls as measured by TAB test compared to those with low and moderate TAB scores. Also, impairment in cognitive abilities and psychiatric disorders was shown to be associated with gait and balance problems, with a higher risk of falls in 47.5% and 46.1% of the residents, respectively.Conclusion: This study revealed a significant impact of upper limb disability, stroke, heart disease, arthritis, joint diseases, diabetes, and hypertension as well as psychiatric disorders and cognitive disabilities on gait and balance deficits among home-resident older adults. Keywords: risk factors, gait and balance deficits, upper limb disability, arthritis

  13. Creating grander families: older adults adopting younger kin and nonkin.

    Science.gov (United States)

    Hinterlong, James; Ryan, Scott

    2008-08-01

    There is a dearth of research on older adoptive parents caring for minor children, despite a growing number of such adoptions finalized each year. This study offers a large-scale investigation of adoptive families headed by older parents. We describe these families and explore how preadoptive kinship between the adoptive parent and the child impacts adoption outcomes. We analyze data from kin (n = 98) and nonkin (n = 310) adoptive families headed by adults aged 60 years and older. We find that older kin adoptive families are smaller, report lower income, and include adoptive mothers with less formal education. Children in these families had less severe needs for special care at the time of placement. Although kin and nonkin older parents offer similar assessments of their parent-child relationships, kin adopters indicate a greater willingness to adopt the same child again and yet report less positive current family functioning. Multivariate regression analyses reveal that preadoptive kinship predicts more negative parental assessment of the adoption's impact on the family and less positive family functioning net of other parent, family, and child characteristics. Externalizing behavior by the child (e.g., delinquency or aggression) is the strongest predictor of deleterious outcomes for both groups. Kin adoption by older adults creates new families under strain but does not reduce parental commitment to the child. We conclude that older adults serve as effective adoptive parents but would benefit from preadoption and postadoption services to assist them in preparing for and positively addressing the challenging behaviors exhibited by adopted children.

  14. A concept analysis of dignity for older adults.

    Science.gov (United States)

    Jacelon, Cynthia S; Connelly, Thomas W; Brown, Rana; Proulx, Kathy; Vo, Thuy

    2004-10-01

    Human dignity is an essential value of professional nursing education as well as a component of the American Nurses Association Code of Ethics. Nurses are exhorted to treat patients with dignity, and older adults want to be treated with dignity and die with dignity. Although dignity, particularly the dignity of older adults, is often discussed in the health care literature, its meaning is not always clear. The aim of this paper is to describe a concept analysis to develop a definition of dignity in older adults. Data were collected using a literature review and five focus groups composed of older adults. The literature provided data about professionals' ideas of dignity and the focus groups provided qualitative data about the nature of dignity in older people. The literature review and focus groups were carried out concurrently, followed by synthesis of the findings. Dignity is an inherent characteristic of being human, it can be subjectively felt as an attribute of the self, and is made manifest through behaviour that demonstrates respect for self and others. Dignity must be learned, and an individual's dignity is affected by the treatment received from others. A behavioural definition of dignity was constructed and this could provide the theoretical basis for nurses to develop interventions that foster dignity for older people.

  15. Prevalence of ototoxic medication use among older adults in Beaver Dam, Wisconsin.

    Science.gov (United States)

    Joo, Yoonmee; Cruickshanks, Karen J; Klein, Barbara E K; Klein, Ronald; Hong, OiSaeng; Wallhagen, Margaret

    2018-01-01

    Drug-related ototoxicity may exacerbate presbycusis (age-related hearing loss); yet, few data are available on the prevalence of ototoxic medication use by older adults. The purposes of this study were to assess the impact of aging and ototoxicity on hearing loss, the prevalence of ototoxic medication use, and select characteristics associated with ototoxic medication use among older adults. Cross-sectional analyses were conducted using select variables extracted from the baseline and 10-year follow-up assessments of the two population-based epidemiological studies to compare two points in time. Ninety-one percent of the sample was taking a medication reported to be ototoxic. Nonsteroidal anti-inflammatory drugs were the most commonly used (75.2%), followed by acetaminophen (39.9%) and diuretics (35.6%). Hypertension, diabetes, cardiovascular disease, and history of smoking were associated with ototoxic medication use. Participants with hearing loss were taking a significantly greater number of ototoxic medications than those without hearing loss. Known ototoxic medications are widely used. Any subsequent ototoxicity may interact with age changes and a more severe hearing loss than that associated with only age. Nurse practitioners should inform older adults about the possibility of drug-related ototoxicity and monitor hearing acuity of all older adults taking known ototoxic medications.

  16. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.

    Science.gov (United States)

    Tan, Ming Yeong; Magarey, Judy

    2008-08-01

    To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01). There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.

  17. Younger people with Type 2 diabetes have poorer self-care practices compared with older people: results from the Australian National Diabetes Audit.

    Science.gov (United States)

    Nanayakkara, N; Pease, A J; Ranasinha, S; Wischer, N; Andrikopoulos, S; de Courten, B; Zoungas, S

    2018-05-05

    This cross-sectional study compares the self-care practices of younger and older people with Type 2 diabetes. Data were analysed from the Australian National Diabetes Audit (ANDA) including 2552 adults with Type 2 diabetes from Australian Diabetes Centres. Pre-specified demographic and clinical variables were obtained. Self-care variables (physical activity, following dietary recommendations, medication adherence and monitoring blood glucose levels) were compared in people ≤ 64 and > 64 years of age. Mean age (± sd) of participants was 63 ± 13 years overall, 53 ± 9 years for the younger group and 73 ± 6 years for the older group. A greater proportion of younger people had HbA 1c levels > 53 mmol/mol (> 7.0%) (76% vs. 68%), reported difficulty following dietary recommendations (50% vs. 32%) and forgetting medications (37% vs. 22%) compared with older people (all P-values  64 years required insulin therapy (59% vs. 57%, P = 0.200). Younger age was associated with a twofold increase in the odds of not following the recommended self-care practices after adjustment for gender, smoking, insulin therapy, depression and allied health attendance (all P < 0.001). Despite shorter diabetes duration, younger age was associated with worse glycaemic control and poorer diabetes self-care practices among people with Type 2 diabetes. Targeted strategies are required to optimize diabetes self-care practices and thereby glycaemic control. © 2018 Diabetes UK.

  18. Older Adults Do Not Notice Their Names: A New Twist to a Classic Attention Task

    Science.gov (United States)

    Naveh-Benjamin, Moshe; Kilb, Angela; Maddox, Geoffrey B.; Thomas, Jenna; Fine, Hope C.; Chen, Tina; Cowan, Nelson

    2014-01-01

    Although working memory spans are, on average, lower for older adults than young adults, we demonstrate in 5 experiments a way in which older adults paradoxically resemble higher capacity young adults. Specifically, in a selective-listening task, older adults almost always failed to notice their names presented in an unattended channel. This is an…

  19. Bridging the digital divide in older adults: a study from an initiative to inform older adults about new technologies.

    Science.gov (United States)

    Wu, Ya-Huei; Damnée, Souad; Kerhervé, Hélène; Ware, Caitlin; Rigaud, Anne-Sophie

    2015-01-01

    In a society where technology progresses at an exponential rate, older adults are often unaware of the existence of different kinds of information and communication technologies (ICTs). To bridge the gap, we launched a 2-year project, during which we conducted focus groups (FGs) with demonstrations of ICTs, allowing older adults to try them out and to share their opinions. This study aimed at investigating how participants perceived this kind of initiative and how they reacted to different kinds of ICTs. In total, 14 FGs were conducted with community-dwelling older adults, with a frequency of two FGs on the same topic once per trimester. Twenty-three older adults (four men and 19 women) attended at least one FG but only nearly half of them were regular attendants (ten participating in at least five sessions). Age of participants ranged from 63 years to 88 years, with a mean of 77.1 years. All of them had completed secondary education. The analyses of the data were performed according to inductive thematic analysis. Four overarching themes emerged from the analysis. The first concerned participants' motivation for and assessment of the project. The second theme identified the underlying factors of the "digital divide" between the younger and the older generations. The third theme concerned the factors of technology adoption among older adults. The fourth one identified participants' attitudes toward assistive ICTs, designed specifically for older adults ("gerontechnologies"). This project encouraging older adults to be informed about different kinds of ICTs was positively rated. With regard to ICTs, participants perceived a digital divide. The underlying factors are generation/cohort effects, cognitive and physical decline related to aging, and negative attitudes toward technologies. However, more and more older adults adopt different kinds of ICTs in order to fit in with the society. Concerning assistive ICTs, they manifested a lack of perceived need and usefulness

  20. Validity of the International Fitness Scale "IFIS" in older adults.

    Science.gov (United States)

    Merellano-Navarro, Eugenio; Collado-Mateo, Daniel; García-Rubio, Javier; Gusi, Narcís; Olivares, Pedro R

    2017-09-01

    To validate the "International Fitness Scale" (IFIS) in older adults. Firstly, cognitive interviews were performed to ensure that the questionnaire was comprehensive for older Chilean adults. After that, a transversal study of 401 institutionalized and non-institutionalized older adults from Maule region in Chile was conducted. A battery of validated fitness tests for this population was used in order to compare the responses obtained in the IFIS with the objectively measured fitness performance (back scratch, chair sit-and-reach, handgrip, 30-s chair stand, timed up-and-go and 6-min walking). Indicated that IFIS presented a high compliance in the comprehension of the items which defined it, and it was able of categorizing older adults according to their measured physical fitness levels. The analysis of covariance ANCOVA adjusted by sex and age showed a concordance between IFIS and the score in physical fitness tests. Based on the results of this study, IFIS questionnaire is a good alternative to assess physical fitness in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. OLDER ADULTS: AN ENVIRONMENTALLY SUSCEPTIBLE POPULATION

    Science.gov (United States)

    The baby boom generation is quickly becoming the geriatric generation. The over-65 age bracket hit 13% of Americans in 1997, and is expected to reach 20% by 2030 accounting for 73 million Americans. World-wide the total number of older people (>60years) is expected to double from...

  2. Dietary intake and nutritional status in cancer patients; comparing adults and older adults.

    Science.gov (United States)

    Gómez Valiente da Silva, Henyse; Fonseca de Andrade, Camila; Bello Moreira, Annie Seixas

    2014-04-01

    Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category. Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p cancer, nor with nutritional status. The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  3. Hemoglobin A1c and arterial and ventricular stiffness in older adults.

    Directory of Open Access Journals (Sweden)

    Susan J Zieman

    Full Text Available Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE are implicated in this stiffening pathophysiology. We examined the association between HbA(1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes.Baseline HbA(1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG with like measures.HbA(1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP, carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM. FG levels were positively associated with systolic, diastolic and PP and LVM.In this sample of older adults without diabetes, HbA(1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.

  4. Elements of effective nutrition education for adults with Diabetes ...

    African Journals Online (AJOL)

    Elements of effective nutrition education for adults with Diabetes mellitus in resource poor settings: A review. ... Journal Home > Vol 14, No 1 (2009) >. Log in or Register to get access ... Type 2 diabetes is increasing to epidemic levels globally.

  5. Diabetes distress and related factors in South African adults with ...

    African Journals Online (AJOL)

    aDepartment of Behavioural Medicine, School of Nursing and Public Health, College of ... Keywords: adults, depression, diabetes-related distress, glycaemic index, South Africa ... self-care and glycaemic control.7,8 Diabetes-related distress is.

  6. Physical activity during hospitalization: Activities and preferences of adults versus older adults.

    Science.gov (United States)

    Meesters, Jorit; Conijn, D; Vermeulen, H M; Vliet Vlieland, Tpm

    2018-04-16

    Inactivity during hospitalization leads to a functional decline and an increased risk of complications. To date, studies focused on older adults. This study aims to compare the physical activities performed by older adult and adult hospitalized patients. Patients hospitalized for >3 days at a university hospital completed a questionnaire regarding their physical activities (% of days on which an activity was performed divided by the length of stay) and physical activity needs during hospitalization. Crude and adjusted comparisons of older adult (>60 years) and adult (≤60 years) patients were performed using parametric testing and regression analyses. Of 524 patients, 336 (64%) completed the questionnaire, including 166 (49%) older adult patients. On average, the patients were physically active on 35% or less of the days during their hospitalization. Linear regression analysis showed no significant associations between being an older adult and performing physical activities after adjusting for gender, length of stay, surgical intervention, and meeting physical activity recommendations prior to hospitalization. Most patients were well informed regarding physical activity during hospitalization; however, the older adult patients reported a need for information regarding physical activities after hospitalization more frequently (odds ratios, 2.47) after adjusting for educational level, gender, and physical therapy during hospitalization. Both older adult and adult patients are physically inactive during hospitalization, and older adult patients express a greater need for additional information regarding physical activity after hospitalization than adult patients. Therefore, personalized strategies that inform and motivate patients to resume physical activities during hospitalization are needed regardless of age.

  7. Appetizing muffins designed for nutritional needs of older adults

    OpenAIRE

    Höglund, Evelina; Albinsson, Berit; Rothenberg, Elisabet; Wendin, Karin

    2016-01-01

    Introduction: Due to good living conditions, the population of older adults is growing. Increased age increases prevalence of diseases and thereby also the risk of disease related malnutrition (DRM) increases. Appetizing and nutritious food products are needed to counteract DRM. One possible way to enable increased nutritional intake for older people with poor appetite is to offer energy/protein rich snacks between meals. In Sweden, afternoon coffee is an appreciated part of the day. It has a...

  8. Effects of aging and insulin resistant states on protein anabolic responses in older adults.

    Science.gov (United States)

    Morais, Jose A; Jacob, Kathryn Wright; Chevalier, Stéphanie

    2018-07-15

    Insulin is the principal postprandial anabolic hormone and resistance to its action could contribute to sarcopenia. We developed different types of hyperinsulinemic clamp protocols to measure simultaneously glucose and protein metabolism in insulin resistant states (older adults, obesity, diabetes, etc.). To define effects of healthy aging in response to insulin, we employed the hyperinsulinemic, euglycemic and isoaminoacidemic (HYPER-1) clamp. The net whole-body anabolic (protein balance) response to hyperinsulinemia was lower in the elderly vs young (p = 0.007) and was highly correlated with the clamp glucose rate of disposal (r = 0.671, p anabolism compared with young ones. As most of the anabolism occurs during feeding, we studied the fed-state metabolic responses with aging using the hyperinsulinemic, hyperglycemic and hyperaminoacidemic clamp, including muscle biopsies. Older women showed comparable whole-body protein anabolic responses and stimulation of mixed-muscle protein synthesis by feeding to the young. The responses of skeletal muscle insulin signaling through the Akt-mTORC1 pathway were also unaltered, and therefore consistent with muscle protein synthesis results. Given that type 2 diabetes infers insulin resistance of protein metabolism with aging, we studied 10 healthy, 8 obese, and 8 obese type 2 diabetic elderly women using the HYPER-1 clamp. When compared to the group of young lean women to define the effects of obesity and diabetes with aging, whole-body change in net protein balance with hyperinsulinemia was similarly blunted in obese and diabetic older women. However, only elderly obese women with diabetes had lower net balance than lean older women. We conclude that with usual aging, the blunted whole-body anabolic response in elderly subjects is mediated by the failure of insulin to stimulate protein synthesis to the same extent as in the young, especially in men. This blunted response can be overcome at the whole-body and muscle

  9. Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

    Directory of Open Access Journals (Sweden)

    Teresita M. Hogan

    2014-07-01

    Full Text Available Introduction: The demands of our rapidly expanding older population strain many emergency departments (EDs, and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods: Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results: 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score. Attitudes trended to more negative in successive post-graduate year (PGY levels. Conclusion: EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. [West J Emerg Med. 2014;15(4:511–517.

  10. Hearing aid user guides: suitability for older adults.

    Science.gov (United States)

    Caposecco, Andrea; Hickson, Louise; Meyer, Carly

    2014-02-01

    The aim of this study was to analyse the content, design, and readability of printed hearing aid user guides to determine their suitability for older adults, who are the main users of hearing aids. Hearing aid user guides were assessed using four readability formulae and a standardized tool to assess content and design (SAM - Suitability Assessment of Materials). A sample of 36 hearing aid user guides (four user guides from nine different hearing aid manufacturers) were analysed. Sixty nine percent of user guides were rated 'not suitable' and 31% were rated 'adequate' for their suitability. Many scored poorly for scope, vocabulary, aspects of layout and typography, and learning stimulation and motivation. The mean reading grade level for all user guides was grade 9.6 which is too high for older adults. The content, design, and readability of hearing aid user guides are not optimal for older adults and thus may serve as a barrier to successful hearing aid outcomes for this population.

  11. Gender differences in performance of script analysis by older adults.

    Science.gov (United States)

    Helmes, E; Bush, J D; Pike, D L; Drake, D G

    2006-12-01

    Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical scripts. Results were not significant but a tendency was present, with genders making fewer impossible errors on the gender-typical script. Such an interaction was also noted in Study 2, which contrasted 50 older with 50 younger adults on three scripts, including a script with neutral familiarity. The pattern of significant interactions for errors suggested the need to use scripts that are based upon tasks that are equally familiar to both genders.

  12. Daily Living Functioning, Social Engagement and Wellness of Older Adults

    Directory of Open Access Journals (Sweden)

    Noor Zainab

    2017-08-01

    Full Text Available AimThe present study aim to investigate the contributing role of daily living functioning and social engagement in enhancing wellness and various dimensions of wellness in older adults.MethodA correlational research was designed. Socio-demographic data was collected. Lawton Instrumental Activities of Daily Living, Lubben Social Network Scale, and Perceived Wellness Survey were administered on a sample of 112 participants, including 56 men and 56 women.ResultsA correlation analysis found positive correlations between daily living functioning, social engagement and wellness of older adults. The results of regression analysis concluded that both the daily living functioning and social engagement predicted wellness and domains of wellness as well.ConclusionThe obtained results indicate that older adults who are self-reliant lead a more satisfied life in old age and demonstrate to be more adjusted to the effects of aging.

  13. The Burden of ADHD in Older Adults: A Qualitative Study.

    Science.gov (United States)

    Michielsen, M; de Kruif, J Th C M; Comijs, H C; van Mierlo, S; Semeijn, E J; Beekman, A T F; Deeg, D J H; Kooij, J J S

    2018-04-01

    To explore how ADHD may have affected the lives of older adults who meet the diagnostic criteria of ADHD, but are unaware of their diagnosis. Our second aim was to examine whether the reported symptoms change over the life span. A qualitative study was conducted. Seventeen Dutch older people (>65 years) diagnosed in this study with ADHD participated in in-depth interviews. Data were analyzed according to techniques of thematic approach. Seven themes emerged from the analyses. Four themes correspond to ADHD symptoms: "being active," "being impulsive," "attention problems," and "mental restlessness." In addition, the themes "low self-esteem," "overstepping boundaries," and "feeling misunderstood" emerged. The impact of ADHD symptoms seems to have declined with age. ADHD has a negative impact on late life, and older adults with the disorder may benefit from treatment. Moreover, this study's findings call for early detection and treatment of ADHD in children and adults.

  14. Altered characteristics of balance control in obese older adults.

    Science.gov (United States)

    Melzer, Itshak; Oddsson, Lars I E

    2016-01-01

    Obesity is one of the most significant epidemiological trends of the last decades. Recently it was found that obese individuals show postural instability. Balance control mechanisms in obese older adults were less studied. Therefore we aimed to investigate the effect of obesity on balance control mechanisms in older adults. Parameters from Stabilogram-Diffusion Analysis (SDA) and measures from summary statistics of foot centre-of-pressure (COP) displacements along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions were used to characterize postural control in 22 obese (30-postural control process in obese older adults. A greater sway displacement before closed-loop feedback mechanisms are called into play was seen in the ML direction that may lead to a higher risk of instability and fall events. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  15. Personality traits and perceived social support among depressed older adults.

    Science.gov (United States)

    Cukrowicz, Kelly C; Franzese, Alexis T; Thorp, Steven R; Cheavens, Jennifer S; Lynch, Thomas R

    2008-09-01

    The contribution of personality traits and social support to mental health is well established, but to our knowledge there have been no longitudinal investigations of the relation between personality and social support in depressed older adults. In the current study, we examined a repeated measures multi-level mixed model of change in perceived social support to determine whether personality traits and depressive symptoms were associated with changes in perceived social support over the 3 year study interval in a sample of depressed older adults. Results suggest that Conscientiousness and Extraversion were personality traits that were significantly predictive of changes in perceived social support over this time interval. Based on these results it appears that, among depressed older adults, those with conscientious or extraverted personality traits are more likely to resist impulses to withdraw from relationships. In addition, these traits may lead to more satisfying interactions and greater perceived social support over time. The implications of these results are discussed.

  16. An integrated dementia intervention for Korean older adults.

    Science.gov (United States)

    Kang, Hee-Young; Bae, Yeong-Suk; Kim, Eun-Hee; Lee, Kap-Soon; Chae, Myeong-Jeong; Ju, Ree-Aie

    2010-12-01

    Called dotage in Korea, dementia is primarily characterized by cognitive impairments. Secondary manifestations include mental-emotional problems, including depression. This study was designed to examine the effects of an integrated dementia intervention for Korean older adults. The intervention is composed of cognitive stimulation training, exercise, music, art, and horticultural therapy. Participants included 38 older adults with mild dementia. Twenty were assigned to the experimental group and 18 to the control group. Participants in the experimental group attended 18 program sessions. Significant differences were found postintervention between the two groups in measures of cognitive function, depression levels, and mental-emotional health. The findings indicate that this integrated dementia intervention can be applied to help older adults with mild dementia. Copyright 2010, SLACK Incorporated.

  17. Risky choice in younger versus older adults: Affective context matters

    Directory of Open Access Journals (Sweden)

    Yumi Huang

    2013-03-01

    Full Text Available Earlier frameworks have indicated that older adults tend to experience decline in their deliberative decisional capacity, while their affective abilities tend to remain intact (Peters, Hess, Vastfjall, and Auman, 2007. The present study applied this framework to the study of risky decision-making across the lifespan. Two versions of the Columbia Card Task (CCT were used to trigger either affective decision-making (i.e., the ``warm'' CCT or deliberative decision-making (i.e., the ``cold'' CCT in a sample of 158 individuals across the lifespan. Overall there were no age differences in risk seeking. However, there was a significant interaction between age and condition, such that older adults were relatively more risk seeking in the cold condition only. In terms of everyday decision-making, context matters and risk propensity may shift within older adults depending upon the context.

  18. Non-Digital Game Playing by Older Adults.

    Science.gov (United States)

    Mortenson, W Ben; Sixsmith, Andrew; Kaufman, David

    2017-09-01

    Research on video games' effect on cognition and behaviour has been extensive, yet little research has explored non-digital forms of game playing, especially among older adults. As part of a larger survey on game playing, 886 respondents (≥ age 55) filled out questionnaires about non-digital game play. The study aims were to determine perceived benefits of non-digital game play and to determine socio-demographic factors that might predict perceived benefits. Survey results indicate that non-digital game playing is social in nature and common (73% of respondents) among older adults. Older adults play for fun, but also to help maintain their cognition. Regression analyses indicated various socio-demographic factors - age, education, gender, and race - were independently associated with perceived benefits from game playing. The results thus emphasize the importance of non-digital game playing in this population and suggest that efforts to facilitate game playing may improve social interactions and quality of life.

  19. Health promotion among older adults in Austria: a qualitative study.

    Science.gov (United States)

    Boggatz, Thomas; Meinhart, Christoph Matthias

    2017-04-01

    To determine the types of attitudes to health promotion among older Austrians. Health promotion in old age becomes increasingly important in the current period of demographic transition. Interventions are likely to be successful if they take the attitude of older persons into consideration. There may be several types of attitudes to health promotion among older adults. Cross-sectional qualitative study. Semi-structured interviews were conducted in a purposive sample consisting of 36 home-dwelling older persons from local communities in the federal province of Salzburg, Austria. Data were analysed using qualitative content analysis according to Mayring and subsequent construction of types. There are three main types of attitudes to health promotion. 'Health promoters through everyday activities' considered domestic work and walks to be sufficient in keeping up their health. Fitness-oriented persons practised sports of some type. Users of complementary methods practised such methods to some degree. These types of attitudes could be further differentiated according to their outcome expectations. In addition to benefits for health, socialising was also an important outcome. Physical decline may reduce a fitness-oriented attitude, whereas encouragement by others may trigger it. Older adults have various attitudes to health promotion, but these are not immutable. Health promotion programmes that are not restricted to a narrow focus on health but provide the opportunity to socialise may support older adults in maintaining a healthy lifestyle. © 2016 John Wiley & Sons Ltd.

  20. Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

    NARCIS (Netherlands)

    Verweij, L.M.; Wehrens, R.; Oldenhof, L.; Bal, R.; Francke, A.L.

    2018-01-01

    Background: The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program

  1. Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program

    NARCIS (Netherlands)

    Verweij, L.M. (Lisanne Marlieke); R.L.E. Wehrens (Rik); L.E. Oldenhof (Lieke); R.A. Bal (Roland); Francke, A.L. (Anneke)

    2018-01-01

    textabstractBackground: The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide

  2. Orthostatic hypotension, diabetes, and falling in older patients : a cross-sectional study

    NARCIS (Netherlands)

    van Hateren, Kornelis J. J.; Kleefstra, Nanne; Blanker, Marco H.; Ubink-Veltmaat, Lielith J.; Groenier, Klaas H.; Houweling, Sebastiaan; Kemper, Adriaan M.; van der Meer, Klaas; Bilo, Henk J. G.

    2012-01-01

    Background: Although orthostatic hypotension (OH) is more prevalent in old age, and in patients with diabetes, the prevalence of OH in older patients with type 2 diabetes mellitus is unknown. Aim: To establish the prevalence of OH, and its association with falling, in home-dwelling older

  3. Emergency Department Visits by Older Adults for Motor Vehicle Collisions

    Directory of Open Access Journals (Sweden)

    Vogel, Jody A.

    2013-11-01

    Full Text Available Introduction: To describe the epidemiology and characteristics of emergency department (ED visits by older adults for motor vehicle collisions (MVC in the United States (U.S..Methods: We analyzed ED visits for MVCs using data from the 2003–2007 National Hospital Ambulatory Medical Care Survey (NHAMCS. Using U.S. Census data, we calculated annual incidence rates of driver or passenger MVC-related ED visits and examined visit characteristics, including triage acuity, tests performed and hospital admission or discharge. We compared older (65+ years and younger (18-64 years MVC patients and calculated odds ratios (OR and 95% confidence intervals (CIs to measure the strength of associations between age group and various visit characteristics. Multivariable logistic regression was used to identify independent predictors of admissions for MVC-related injuries among older adults.Results: From 2003–2007, there were an average of 237,000 annual ED visits by older adults for MVCs. The annual ED visit rate for MVCs was 6.4 (95% CI 4.6-8.3 visits per 1,000 for older adults and 16.4 (95% CI 14.0-18.8 visits per 1,000 for younger adults. Compared to younger MVC patients, after adjustment for gender, race and ethnicity, older MVC patients were more likely to have at least one imaging study performed (OR 3.69, 95% CI 1.46-9.36. Older MVC patients were not significantly more likely to arrive by ambulance (OR 1.47; 95% CI 0.76–2.86, have a high triage acuity (OR 1.56; 95% CI 0.77-3.14, or to have a diagnosis of a head, spinal cord or torso injury (OR 0.97; 95% CI 0.42-2.23 as compared to younger MVC patients after adjustment for gender, race and ethnicity. Overall, 14.5% (95% CI 9.8-19.2 of older MVC patients and 6.1% (95% CI 4.8-7.5 of younger MVC patients were admitted to the hospital. There was also a non-statistically significant trend toward hospital admission for older versus younger MVC patients (OR 1.78; 95% CI 0.71-4.43, and admission to the ICU if

  4. Living arrangements and suicidal ideation among the Korean older adults.

    Science.gov (United States)

    Kim, Jibum; Lee, Yun-Suk; Lee, Jinkook

    2016-12-01

    This study examines how living arrangements are associated with suicidal ideation for older adults in South Korea, which has the highest suicide rate among OECD countries, and a particularly high suicide rate for older persons. Analyzing a sample of 5795 women and 3758 men aged 65 and older from a nationwide representative cross-sectional data-set, we examined how many older adults think about suicide over a one-year period, why they think about suicide, and whether living arrangements are associated with suicidal ideation. About 1 out of 12 respondents in our sample reported suicidal ideation. While women and men did not differ in the prevalence of suicidal ideation, women attributed their suicidal feelings to health problems, while men attributed theirs to economic difficulties. Logistic regression results indicated that living arrangements are associated with suicidal ideation for men but not women. Older men living with a spouse were less likely to have suicidal ideation than older men with other living arrangements (i.e., living alone, living with children without spouse, living with spouse, and others). Our results highlight the importance of living arrangements to older men's suicidal ideation. We discuss gender differences in the implications of living arrangements to suicidal ideation within the context of Confucian culture.

  5. Treatment decisions for older adults with advanced chronic kidney disease.

    Science.gov (United States)

    Rosansky, Steven J; Schell, Jane; Shega, Joseph; Scherer, Jennifer; Jacobs, Laurie; Couchoud, Cecile; Crews, Deidra; McNabney, Matthew

    2017-06-19

    Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR start dialysis, initiate treatment "early", at an estimated glomerulofiltration rate (eGFR) >10 ml/min/1.73 m 2 and many initiate dialysis in hospital, often in association with an episode of acute renal failure. In the US older adults start dialysis at a mean e GFR of 12.6 ml/min/1.73 m 2 and 20.6% die within six months of dialysis initiation. In both the acute in hospital and outpatient settings, many older adults appear to be initiating dialysis for non-specific, non-life threatening symptoms and clinical contexts. Observational data suggests that dialysis does not provide a survival benefit for older adults with poor mobility and high levels of comorbidity. To optimize the care of this population, early and repeat shared decision making conversations by health care providers, patients, and their families should consider the risks, burdens, and benefits of dialysis versus conservative management, as well as the patient specific symptoms and clinical situations that could justify dialysis initiation. The potential advantages and disadvantages of dialysis therapy should be considered in conjunction with each patient's unique goals and priorities.In conclusion, when considering the morbidity and quality of life impact associated with dialysis, many older adults may prefer to delay dialysis until there is a definitive indication or may opt for conservative management without dialysis. This approach can incorporate all CKD treatments other than dialysis, provide psychosocial and spiritual support and active symptom management and may also incorporate a palliative care approach with less medical monitoring of lab parameters and more focus on the use of drug therapies directed to relief of a patient's symptoms.

  6. Hospitalization and aesthetic health in older adults.

    Science.gov (United States)

    Moss, Hilary; Donnellan, Claire; O'Neill, Desmond

    2015-02-01

    To assess the impact of hospitalization on arts engagement among older people; and to assess perceptions of whether hospitals are aesthetically deprived environments. A Survey of Aesthetic and Cultural Health was developed to explore the role of aesthetics before, during and after hospital. Study participants were n = 150 hospital in-patients aged >65. Descriptive and inferential statistics were used to analyze the data. Attendance at arts events was an important part of life for this sample and a large drop off was noted in continuation of these activities in the year post-hospital stay. Physical health issues were the main causes but also loss of confidence and transport issues. Film, dance, and music were the most popular arts for this sample prior to hospital stay. Noise pollution caused by other patients, lack of control over TV/radio, and access to receptive arts in hospital (reading and listening to music) were important issues for patients in hospital. This study identifies a trend for decreasing exposure to arts beginning with a hospital stay and concludes that older people may need encouragement to resume engagement in arts following a hospital stay. There is relatively limited evidence regarding the nature of, and potential benefit from, aesthetics in healthcare and limited studies with rigorous methodology, and further research is needed to understand the aesthetic preferences of older people in hospital. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  7. Singapore Healthy Older People Everyday (HOPE) Study: Prevalence of Frailty and Associated Factors in Older Adults.

    Science.gov (United States)

    Merchant, Reshma A; Chen, Matthew Zhixuan; Tan, Linda Wei Lin; Lim, Moses YiDong; Ho, Han Kwee; van Dam, Rob M

    2017-08-01

    In the context of a rapidly ageing population, Singapore is anticipating a rise in multimorbidity, disability, and dependency, which are driven by physical frailty. Healthy Older People Everyday (HOPE) is an epidemiologic population-based study on community-dwelling older adults aged 65 years and older in Singapore. To investigate the prevalence of frail and prefrail states and their association with polypharmacy, multimorbidity, cognitive and functional status, and perceived health status among community-dwelling older adults in Singapore. Participants for HOPE were older adults aged 65 years and older recruited from a cohort study on the northwest region of Singapore. Analysis was performed on data collected from a combination of interviewer-administered questionnaires (including FRAIL scale, EQ-5D, Mini Mental State Examination, Barthel index, and Lawton IADL scale), clinical assessments, and physical measurements (including hand grip strength and Timed-Up-and-Go [TUG] test). A total of 1051 older adults (mean age 71.2 years) completed the study. More than half (57.2%) were female. The prevalence of frailty and prefrailty was 6.2% and 37%, respectively. Frailty was associated with older age, female gender, Indian (instead of Chinese) ethnicity, multimorbidity, polypharmacy, cognitive and functional impairment, weaker hand grip strength, longer TUG times, and poor perceived health status. Those with underlying cognitive impairment and frailty were at greater risk of adverse health outcome. Frailty is a complex health state with multiple domains and dimensions. In our study in a multiethnic Asian population, we identified nonmodifiable factors and modifiable risk factors (multimorbidity, polypharmacy, cognitive and functional impairment) that were associated with frailty. Interventions will have to be multipronged and will require a collaborated effort in order to effect change and improve the health span in rapidly ageing populations. Copyright © 2017 AMDA

  8. Sexual Behavior of Older Adults Living with HIV in Uganda.

    Science.gov (United States)

    Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet

    2016-02-01

    Sexual behavior among older adults with HIV in Sub-Saharan Africa has been understudied despite the burgeoning of this population. We examined sexual behavior among older adults living with HIV in Uganda. Participants were eligible for the study if they were 50 years of age or older and living with HIV. Quantitative data were collected through face-to-face interviews, including demographic characteristics, health, sexual behavior and function, and mental health. Of respondents, 42 were men and 59 women. More than one-quarter of these HIV-positive older adults were sexually active. A greater proportion of older HIV-positive men reported being sexually active compared to women (54 vs. 15%). Among those who are sexually active, a majority never use condoms. Sixty-one percent of men regarded sex as at least somewhat important (42%), while few women shared this opinion (20%). Multivariate logistic regression analyses revealed that odds of sexual activity in the past year were significantly increased by the availability of a partner (married/cohabitating), better physical functioning, and male gender. As more adults live longer with HIV, it is critical to understand their sexual behavior and related psychosocial variables in order to improve prevention efforts.

  9. Physiological and psychological effects of gardening activity in older adults.

    Science.gov (United States)

    Hassan, Ahmad; Qibing, Chen; Tao, Jiang

    2018-04-06

    Gardening has long been one of most enjoyable pastimes among older adults. Whether gardening activities contribute to the well-being of older adults is a major question. Therefore, the aim of the present study was to clarify the psychophysiological relaxing effects of gardening activities on older adults living in modern institutional care. The study participants were 40 older women aged 79.5 ± 8.09 years (mean ± SD). A cross-over study design was used to investigate the physiological and psychological responses to environments with and without plants. Physiological evaluation was carried out using blood pressure and electroencephalography, and psychological evaluation was carried out using the State-Trait Anxiety Inventory and Semantic Differential method. Blood pressure was significantly lower, and changes in brainwaves were observed. Psychological responses showed that participants were more "comfortable and relaxed" after the plant task than after the control task. In addition, total anxiety levels were significantly lower after carrying out the plant task than after the control task. Our research suggests that gardening activities might enhance physiological and psychological relaxation in older adults. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  10. Effect of Footwear on Joint Pain and Function in Older Adults With Lower Extremity Osteoarthritis.

    Science.gov (United States)

    Wagner, Amy; Luna, Sarah

    Lower extremity osteoarthritis (OA) is a common condition among older adults; given the risks of surgical and pharmaceutical interventions, conservative, lower-cost management options such as footwear warrant further investigation. This systematic review investigated the effects of footwear, including shoe inserts, in reducing lower extremity joint pain and improving gait, mobility, and quality of life in older adults with OA. The CINAHL, SPORTDiscus, PubMed, RECAL, and Web of Knowledge databases were searched for publications from January 1990 to September 2014, using the terms "footwear," "shoes," "gait," "pain," and "older adult." Participants who were 50 years or older and those who had OA in at least one lower extremity joint narrowed the results. Outcomes of interest included measures of pain, comfort, function, gait, or quality of life. Exclusion criteria applied to participants with rheumatoid arthritis, amputation, diabetes, multiple sclerosis, use of modified footwear or custom orthotics, purely biomechanical studies, and outcomes of balance or falls only. Single-case studies, qualitative narrative descriptions, and expert opinions were also excluded. The initial search resulted in a total of 417 citations. Eleven articles met inclusion criteria. Two randomized controlled trials and 3 quasiexperimental studies reported lateral wedge insoles may have at least some pain-relieving effects and improved functional mobility in older adults at 4 weeks to 2 years' follow-up, particularly when used with subtalar and ankle strapping. Three randomized controlled trials with large sample sizes reported that lateral wedges provided no knee pain relief compared with flat insoles. Hardness of shoe soles did not significantly affect joint comfort in the foot in a quasiexperimental study. A quasiexperimental designed study investigating shock-absorbing insoles showed reduction in knee joint pain with 1 month of wear. Finally, a cross-sectional prognostic study indicated

  11. Subjective wellbeing among adults with diabetes : Results from Diabetes MILES—Australia

    NARCIS (Netherlands)

    Holmes-truscott, Elizabeth; Browne, Jessica L.; Pouwer, F.; Speight, Jane; Cummins, Robert A.

    2016-01-01

    This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which

  12. Factors Affecting Cognitive Function in Older Adults: A Turkish Sample

    OpenAIRE

    Akdag, Beyza; Telci, Emine Aslan; Cavlak, Ugur

    2013-01-01

    Background: The purpose of this study was to determine the influential factors of cognitive function in older adults. Methods: In this study, 377 older adults (mean age: 74.71 ± 6.15 years) were examined. The Hodkinson Abbreviated Mental Test (HAMT) was used to describe cognitive function of the individuals. The Centers for Disease Control (CDC) Health-Related Quality of Life (HRQOL-4) survey tool was used to measure the quality of life. Possible influential factors of cognitive function w...

  13. Older adults' engagement with a video game training program.

    Science.gov (United States)

    Belchior, Patrícia; Marsiske, Michael; Sisco, Shannon; Yam, Anna; Mann, William

    2012-12-19

    The current study investigated older adults' level of engagement with a video game training program. Engagement was measured using the concept of Flow (Csikszentmihalyi, 1975). Forty-five older adults were randomized to receive practice with an action game ( Medal of Honor ), a puzzle-like game ( Tetris ), or a gold-standard Useful Field of View (UFOV) training program. Both Medal of Honor and Tetris participants reported significantly higher Flow ratings at the conclusion, relative to the onset of training. Participants are more engaged in games that can be adjusted to their skill levels and that provide incremental levels of difficulty. This finding was consistent with the Flow theory (Csikszentmihalyi, 1975).

  14. Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai'i, December 2006-December 2010.

    Science.gov (United States)

    Guo, Mary W; Ahn, Hyeong Jun; Juarez, Deborah T; Miyamura, Jill; Sentell, Tetine L

    2015-08-06

    The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai'i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older. We considered all hospitalizations of older (>65 years) Japanese, Chinese, Native Hawaiians, Filipinos, and whites living in Hawai'i with Medicare as the primary insurer from December 2006 through December 2010 (n = 127,079). We used International Classification of Diseases - 9th Revision (ICD-9) codes to identify D-RPHs as defined by the Agency for Healthcare Research and Quality. Length of stays and deaths during hospitalization were compared for Asian American and Pacific Islander versus whites in multivariable regression models, adjusting for age, sex, location of residence (Oahu, y/n), and comorbidity. Among the group studied, 1,700 hospitalizations of 1,424 patients were D-RPHs. Native Hawaiians were significantly more likely to die during a D-RPH (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.42-10.87) than whites. Filipinos had a significantly shorter length of stay (relative risk [RR], 0.77; 95% CI, 0.62-0.95) for D-RPH than whites. Among Native Hawaiians with a D-RPH, 59% were in the youngest age group (65-75 y) whereas only 6.3% were in the oldest (≥85 y). By contrast, 23.2% of Japanese were in the youngest age group, and 32.2% were in the oldest. This statewide study found significant differences in the clinical characteristics and outcomes of D-RPHs for Asian American and Pacific Islanders in Hawai'i. Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups. Focused interventions targeting Native Hawaiians are needed to avoid these outcomes.

  15. Predictors of suicide ideation among older adults with bipolar disorder.

    Science.gov (United States)

    O'Rourke, Norm; Heisel, Marnin J; Canham, Sarah L; Sixsmith, Andrew

    2017-01-01

    Bipolar disorder (BD) carries the greatest risk of death by suicide of all psychiatric conditions as 25%-50% of those with BD will make one or more suicide attempt, and about 15% will intentionally end their lives. Among young adults with BD, substance misuse, medication non-adherence, age at onset, and comorbid psychiatric conditions each predict self-harm. It is currently unclear if these same factors or others predict suicide ideation among older adults with BD. We recruited a global sample of 220 older adults with BD over 19 days using socio-demographically targeted, social media advertising and online data collection (Mean = 58.50, SD = 5.42; range 50 to 81 years). Path analyses allowed us to identify direct and indirect predictors of suicide ideation among older adults with BD. Cognitive failures (perception, memory, and motor function), depressive symptoms, alcohol misuse, and dissatisfaction with life as direct predictors of suicide ideation; duration of BD symptoms and medication non-adherence emerged as indirect predictors. Of note, the significant impact of sleep on suicide ideation is indirect via depressive symptoms, cognitive failures, medication non-adherence and life dissatisfaction. As with young adults with BD, alcohol misuse and medication non-adherence emerged as significant predictors of suicide ideation. In addition, cognitive failures directly and indirectly predict suicide ideation in this sample of older adults with BD. Population aging and treatment efficacy are leading to ever growing numbers of older adults with BD. Both direct and indirect predictors of suicide ideation need to be considered in future BD research and treatment planning.

  16. The Link between Dietary Protein Intake, Skeletal Muscle Function and Health in Older Adults

    Directory of Open Access Journals (Sweden)

    Jamie I. Baum

    2015-07-01

    Full Text Available Skeletal muscle mass and function are progressively lost with age, a condition referred to as sarcopenia. By the age of 60, many older adults begin to be affected by muscle loss. There is a link between decreased muscle mass and strength and adverse health outcomes such as obesity, diabetes and cardiovascular disease. Data suggest that increasing dietary protein intake at meals may counterbalance muscle loss in older individuals due to the increased availability of amino acids, which stimulate muscle protein synthesis by activating the mammalian target of rapamycin (mTORC1. Increased muscle protein synthesis can lead to increased muscle mass, strength and function over time. This review aims to address the current recommended dietary allowance (RDA for protein and whether or not this value meets the needs for older adults based upon current scientific evidence. The current RDA for protein is 0.8 g/kg body weight/day. However, literature suggests that consuming protein in amounts greater than the RDA can improve muscle mass, strength and function in older adults.

  17. Social relevance enhances memory for impressions in older adults.

    Science.gov (United States)

    Cassidy, Brittany S; Gutchess, Angela H

    2012-01-01

    Previous research has demonstrated that older adults have difficulty retrieving contextual material over items alone. Recent research suggests this deficit can be reduced by adding emotional context, allowing for the possibility that memory for social impressions may show less age-related decline than memory for other types of contextual information. Two studies investigated how orienting to social or self-relevant aspects of information contributed to the learning and retrieval of impressions in young and older adults. Participants encoded impressions of others in conditions varying in the use of self-reference (Experiment 1) and interpersonal meaningfulness (Experiment 2), and completed memory tasks requiring the retrieval of specific traits. For both experiments, age groups remembered similar numbers of impressions. In Experiment 1 using more self-relevant encoding contexts increased memory for impressions over orienting to stimuli in a non-social way, regardless of age. In Experiment 2 older adults had enhanced memory for impressions presented in an interpersonally meaningful relative to a personally irrelevant way, whereas young adults were unaffected by this manipulation. The results provide evidence that increasing social relevance ameliorates age differences in memory for impressions, and enhances older adults' ability to successfully retrieve contextual information.

  18. 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.

  19. Gender Differences in Hypertension Control Among Older Korean Adults: Korean Social Life, Health, and Aging Project

    Directory of Open Access Journals (Sweden)

    Sang Hui Chu

    2015-01-01

    Full Text Available Objectives: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients’ attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. Methods: This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Results: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one’s blood pressure level (odds ratio [OR], 2.86; p=0.003 and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011 might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013. Conclusions: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

  20. Self-rated driving and driving safety in older adults.

    Science.gov (United States)

    Ross, Lesley A; Dodson, Joan E; Edwards, Jerri D; Ackerman, Michelle L; Ball, Karlene

    2012-09-01

    Many U.S. states rely on older adults to self-regulate their driving and determine when driving is no longer a safe option. However, the relationship of older adults' self-rated driving in terms of actual driving competency outcomes is unclear. The current study investigates self-rated driving in terms of (1) systematic differences between older adults with high (good/excellent) versus low (poor/fair/average) self-ratings, and (2) the predictive nature of self-rated driving to adverse driving outcomes in older adults (n=350; mean age 73.9, SD=5.25, range 65-91). Adverse driving outcomes included self-reported incidences of (1) being pulled over by the police, (2) receiving a citation, (3) receiving a recommendation to cease or limit driving, (4) crashes, and (5) state-reported crashes. Results found that older drivers with low self-ratings reported more medical conditions, less driving frequency, and had been given more suggestions to stop/limit their driving; there were no other significant differences between low and high self-raters. Logistic regression revealed older drivers were more likely to have a state-reported crash and receive a suggestion to stop or limit driving. Men were more likely to report all adverse driving outcomes except for receiving a suggestion to stop or limit driving. Regarding self-rated driving, older adults with high ratings were 66% less likely (OR=0.34, 95% CI=0.14-0.85) to have received suggestions to limit or stop driving after accounting for demographics, health and driving frequency. Self-ratings were not predictive of other driving outcomes (being pulled over by the police, receiving a citation, self-reported crashes, or state-reported crashes, ps>0.05). Most older drivers (85.14%) rated themselves as either good or excellent drivers regardless of their actual previous citation or crash rates. Self-rated driving is likely not related to actual driving proficiency as indicated by previous crash involvement in older adults

  1. Analysis of epidemiological indices of type 2 diabetes mellitus in the adult population of Moscow

    Directory of Open Access Journals (Sweden)

    Marina Fedorovna Kalashnikova

    2014-07-01

    Full Text Available Diabetes mellitus is a disease that presents a global medical problem. It is necessary to implement an in-depth analysis of the epidemiological situation of type 2 diabetes mellitus for planning and organizing specialized medical help to patients with type 2 diabetes mellitus. Aim. To rate the basic epidemiological indices of type 2 diabetes mellitus in actual clinical practice using the informational database of national registry of diabetic patients. Materials and methods. Epidemiological analyses were performed in two administrative districts of Moscow. From 1999 to 2011 48978 adult patients with type 2 diabetes mellitus who were aged 18 years and older were registered. We used methods of clinical, analytical and statistical epidemiology with elements of descriptive research. Results. The prevalence rate of type 2 diabetes mellitus was 1590 per hundred thousand, most patients were in the 60?64 and 70?74 age groups, and approximately 80% of patients were older than 55 years. The morbidity rate of type 2 diabetes mellitus was 138,72 per hundred thousand and was found to be higher in women at 1,89. The mortality rate of adult patients with diabetes mellitus was 0,83, mostly in men of all ages. Cardiovascular diseases accounted for most of the registered cases of deaths (34,4%. The average life expectancy appeared to be 75,24?0,45 years, although women lived 6 years longer than men. The average duration of the disease was 10,04?0,34 years. A total of 0,4% of patients underwent hospital treatment and the average length of treatment was 17?18 days. The total number of days of disablement was an average of 307,33?30,13 days (80% of patients were older than 55 years. In the study group, a mean grade of НbА1c

  2. Metformin in adults with type 1 diabetes

    DEFF Research Database (Denmark)

    Petrie, John R; Chaturvedi, Nish; Ford, Ian

    2017-01-01

    AIMS: Cardiovascular (CV) disease is a major cause of reduced life expectancy in type 1 diabetes (T1D). Intensive insulin therapy prevents CV complications but is constrained by hypoglycaemia and weight gain. Adjunct metformin reduces insulin dose requirement and stabilizes weight...... but there are no data on its cardiovascular effects. We have therefore initiated an international double-blind, randomized, placebo-controlled trial (REMOVAL: REducing with MetfOrmin Vascular Adverse Lesions in type 1 diabetes) to examine whether metformin reduces progression of atherosclerosis in adults with T1D....... Individuals ≥40 years of age with T1D for ≥5 years are eligible if they have ≥3 of 10 specified CV risk factors. The enrolment target is 500 participants in 17 international centres. MATERIALS AND METHODS: After 12 weeks of single-blind placebo-controlled run-in, participants with ≥ 70% adherence...

  3. Orchestrating care: nursing practice with hospitalised older adults.

    Science.gov (United States)

    Dahlke, Sherry Ann; Phinney, Alison; Hall, Wendy Ann; Rodney, Patricia; Baumbusch, Jennifer

    2015-12-01

    The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375 hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults. © 2014 John Wiley & Sons Ltd.

  4. Developmental trajectory of time perspective: From children to older adults.

    Science.gov (United States)

    Chen, Tao; Liu, Lu-Lu; Cui, Ji-Fang; Chen, Xing-Jie; Wang, Ya

    2016-12-01

    Time perspective is a fundamental dimension of the psychological time construct, with a pervasive and powerful influence on human behavior. However, the developmental trajectory of time perspective across a human lifespan remains unclear. The current study aimed to portray the developmental trajectory of all dimensions of time perspectives from children to older adults in a large sample. A total of 1,901 individuals (aged 9-84 years) completed measures of time perspective. They were then divided into five age groups: children, teenagers, young adults, middle-aged adults, and older adults. Results suggested that each time perspective showed a unique developmental pattern across the lifespan. Moreover, perceived economic situation and education were related to some dimensions of time perspective. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

  5. Salivary flow and xerostomia in older patients with type 2 diabetes mellitus

    OpenAIRE

    Lima, Danilo Lopes Ferreira; Carneiro, Sandro Dias Rocha Mendes; Barbosa, Fladia Taciana de Sousa; Saintrain, Maria Vieira de Lima; Moizan, Jean Andr? Herv?; Doucet, Jean

    2017-01-01

    Objectives To assess salivary flow in older patients with type 2 diabetes mellitus (DM2) and its association with xerostomia. Methods Cross-sectional clinical study conducted with older patients diagnosed with type 2 diabetes for at least one year receiving treatment at the Integrated Center for Diabetes and Hypertension of Cear? (CIHD) in the city of Fortaleza, Cear?, Northeastern Brazil. Oral clinical examination was carried out to assess the decayed, missing and filled teeth index (DMFT). ...

  6. Depressive symptoms in institutionalized older adults

    Directory of Open Access Journals (Sweden)

    Lívia Maria Santiago

    2014-04-01

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

  7. Risk Factors for Hip Fracture in Japanese Older Adults

    Directory of Open Access Journals (Sweden)

    Takashi Yamashita

    2012-09-01

    Full Text Available Risk factors for hip fracture in Japanese older populations are understudied compared with Western countries arguably due to the relatively lower prevalence rates in Japan. Nationally representative data from the Nihon University Japanese Longitudinal Study of Aging were analyzed using logistic regression to examine possible risk factors of hip fractures, separately for older women (n = 2,859 and older men (n = 2,108. Results showed that older Japanese women with difficulty bending their knees (OR = 1.9, with diabetes (OR = 1.7 times, and/or with more activity of daily living limitations (OR = 1.1 had higher risks of hip fracture. Older Japanese men with difficulty bending their knees (OR = 2.6, who use more external prescription drugs (OR = 1.9, and with cancer (OR = 2.0 times had higher risks of hip fracture. Further considerations of gender- and culture-specific factors along with the identified risk factors may provide insights into future intervention programs for hip fracture in Japanese older populations.

  8. Balance training reduces falls risk in older individuals with type 2 diabetes.

    Science.gov (United States)

    Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

    2010-04-01

    This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

  9. Functional abilities in older adults with mild cognitive impairment.

    Science.gov (United States)

    Burton, Catherine L; Strauss, Esther; Bunce, David; Hunter, Michael A; Hultsch, David F

    2009-01-01

    A classification scheme and general set of criteria for diagnosing mild cognitive impairment (MCI) were recently proposed by a multidisciplinary group of experts who met at an international symposium on MCI. One of the proposed criteria included preserved basic activities of daily living and minimal impairment in complex instrumental activities of daily living (IADLs). To investigate whether older adults with MCI classified according to the subtypes identified by the Working Group (i.e. amnestic, single non-memory domain, and multiple domain with or without a memory component) differed from cognitively intact older adults on a variety of measures indexing IADLs and to examine how well measures of IADL predict concurrent MCI status. Two hundred and fifty community-dwelling older adults, ranging in age from 66 to 92, completed self-report measures of IADLs (Lawton and Brody IADL Scale, Scales of Independent Behaviour-Revised--SIB-R) and a measure of everyday problem solving indexing IADLs (Everyday Problems Test--EPT). Ratings of participants' IADL functioning were also obtained from informants (e.g. spouse, adult child and friend). Older adults with multiple-domain MCI demonstrated poorer IADL functioning than older adults with no cognitive impairment on the EPT and the SIB-R (both self- and informant-report versions). The multiple-domain MCI participants also demonstrated poorer IADLs than MCI participants with impairments in a single cognitive domain on the self-reported SIB-R and EPT. The single-domain MCI groups demonstrated poorer IADLs than older adults without cognitive impairment on the informant-reported SIB-R and EPT. No significant group differences were found on the Lawton and Brody IADL Scale. Using the EPT and SIB-R as predictors in a multinomial regression analysis, MCI group status was reliably predicted, but the classification rate was poor. Individuals with MCI demonstrated poorer IADL functioning compared to cognitively intact older adults

  10. Health benefits of Tai Chi for older patients with type 2 diabetes: The “Move It for Diabetes Study” – A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tracey Tsang

    2007-10-01

    Full Text Available Tracey Tsang1, Rhonda Orr1, Paul Lam2, Elizabeth J Comino3, Maria Fiatarone Singh11School of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia; 2School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia; 3The University of NSW Research Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, AustraliaAbstract: Older adults with type 2 diabetes have mobility impairment and reduced fitness. This study aimed to test the efficacy of the “Tai Chi for Diabetes” form, developed to address health-related problems in diabetes, including mobility and physical function. Thirty-eight older adults with stable type 2 diabetes were randomized to Tai Chi or sham exercise, twice a week for 16 weeks. Outcomes included gait, balance, musculoskeletal and cardiovascular fitness, self-reported activity and quality of life. Static and dynamic balance index (−5.8 ± 14.2; p = 0.03 and maximal gait speed (6.2 ± 11.6%; p = 0.005 improved over time, with no significant group effects. There were no changes in other measures. Non-specific effects of exercise testing and/or study participation such as outcome expectation, socialization, the Hawthorne effect, or unmeasured changes in health status or compliance with medical treatment may underlie the modest improvements in gait and balance observed in this sham-exercise-controlled trial. This Tai Chi form, although developed specifically for diabetes, may not have been of sufficient intensity, frequency, or duration to effect positive changes in many aspects of physiology or health status relevant to older people with diabetes.Keywords: Tai Chi, Type 2 diabetes, physical function

  11. Stereotype Threat Lowers Older Adults' Self-Reported Hearing Abilities.

    Science.gov (United States)

    Barber, Sarah J; Lee, Soohyoung Rain

    2015-01-01

    Although stereotype threat is a well-documented phenomenon, previous studies examining it in older adults have almost exclusively focused on objective cognitive outcomes. Considerably less attention has been paid to the impact of stereotype threat on older adults' subjective assessments of their own abilities or to the impact of stereotype threat in noncognitive domains. Older adults are stereotyped as having experienced not only cognitive declines, but physical declines as well. The current study tested the prediction that stereotype threat can negatively influence older adults' subjective hearing abilities. To test this, 115 adults (mean age 50.03 years, range 41-67) read either a positive or negative description about how aging affects hearing. All participants then answered a questionnaire in which they assessed their own hearing abilities. The impact of stereotype threat on self-reported hearing was moderated by chronological age. Participants in their 40s and early 50s were unaffected by the stereotype threat manipulation. In contrast, participants in their late 50s and 60s rated their hearing as being subjectively worse when under stereotype threat. The current study provides a clear demonstration that stereotype threat negatively impacts older adults' subjective assessments of their own abilities. It is also the first study to demonstrate an effect of stereotype threat within the domain of hearing. These results have important implications for researchers investigating age-related hearing decline. Stereotype threat can lead to overestimation of the prevalence of age-related hearing decline. It can also serve as a confounding variable when examining the psychosocial correlates of hearing loss. Because of this, researchers studying age-related hearing loss should aim to provide a stereotype threat-free testing environment and also include assessments of stereotype threat within their studies. © 2015 S. Karger AG, Basel.

  12. Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans.

    Science.gov (United States)

    Rivera-Hernandez, Maricruz

    2014-07-01

    Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. Published by Elsevier Ireland Ltd.

  13. Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans☆

    Science.gov (United States)

    Rivera-Hernandez, Maricruz

    2016-01-01

    Aims Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Methods Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. Results People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Conclusion Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. PMID:24846446

  14. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults

    DEFF Research Database (Denmark)

    Larsen, Nadja; Vogensen, Finn Kvist; van der Berg, Franciscus Winfried J

    2010-01-01

    . Methods and Findings The study included 36 male adults with a broad range of age and body-mass indices (BMIs), among which 18 subjects were diagnosed with diabetes type 2. The fecal bacterial composition was investigated by real-time quantitative PCR (qPCR) and in a subgroup of subjects (N = 20) by tag...... = 0.04). Conclusions The results of this study indicate that type 2 diabetes in humans is associated with compositional changes in intestinal microbiota. The level of glucose tolerance should be considered when linking microbiota with metabolic diseases such as obesity and developing strategies......Background Recent evidence suggests that there is a link between metabolic diseases and bacterial populations in the gut. The aim of this study was to assess the differences between the composition of the intestinal microbiota in humans with type 2 diabetes and non-diabetic persons as control...

  15. Determinants of uncontrolled hypertension in adult type 2 diabetes mellitus: an analysis of the Malaysian diabetes registry 2009

    Directory of Open Access Journals (Sweden)

    Chew Boon How

    2012-05-01

    Full Text Available Abstract Background Uncontrolled blood pressure (BP is a significant contributor of morbidity and even mortality in type 2 diabetes (T2D patients. This study was done to determine the significant determinants of uncontrolled blood pressure in T2D patients in Malaysia. Methods Between 1st January 2009 to 31st December 2009, data from 70 889 patients with Type 2 diabetes was obtained from the Adult Diabetes Control and Management Registry for analysis; 303 centers participated in the study. Their demographic characteristics, the nature of their diabetes, their state of hypertension, treatment modalities, risk factors, and complications are described. Based on their most recent BP values, subjects were divided into controlled BP and uncontrolled BP and their clinical determinants compared. Independent determinants were identified using multivariate logistic regression. Results The mean age of patients at diagnosis of diabetes was 52.3 ± 11.1 years old. Most were women (59.0 % and of Malay ethnicity (61.9 %. The mean duration of diabetes was 5.9 ± 5.6 years. A total of 57.4 % were hypertensive. Of the 56 503 blood pressure (BP measured, 13 280 (23.5 % patients had BP two anti-hypertensive agents. Health clinics without doctor, older age (≥ 50 years old, shorter duration of diabetes ( Conclusions Major independent determinants of uncontrolled BP in our group of T2D patients were Malay ethnicity, older age, recent diagnosis of diabetes, overweight and follow-up at health clinics without a doctor and possibly the improper use of anti hypertensive agent. More effort, education and resources, especially in the primary health care centres are needed to improve hypertensive care among our patients with diabetes.

  16. Ageist attitudes block young adults' ability for compassion toward incapacitated older adults.

    Science.gov (United States)

    Bergman, Yoav S; Bodner, Ehud

    2015-09-01

    Upon encountering older adults, individuals display varying degrees of prosocial attitudes and behaviors. While some display compassion and empathy, others draw away and wish to maintain their distance from them. The current study examined if and how ageist attitudes influence the association between the sight of physical incapacity in older age and compassionate reactions toward them. We predicted that ageist attitudes would interfere with the ability to respond to them with compassion. Young adults (N = 149, ages 19-29) were randomly distributed into two experimental conditions, each viewing a short video portraying different aspects of older adult physicality; one group viewed older adults displaying incapacitated behavior, and the other viewed fit behavior. Participants subsequently filled out scales assessing aging anxieties, and ageist and compassionate attitudes. Ageism was associated with reduced compassion toward the figures. Moreover, viewing incapacitated older adults led to increased concern toward them and perceived efficacy in helping them. However, significant interactions proved that higher scores of ageism in response to the videos led to increased need for distance and reduced efficacy toward incapacitated adults, an effect not observed among subjects with lower ageism scores. Ageism seems to be a factor which disengages individuals from older adults displaying fragility, leading them to disregard social norms which dictate compassion. The results are discussed from the framework of terror management theory, as increased mortality salience and death-related thoughts could have led to the activation of negative attitudes which, in turn, reduce compassion.

  17. Daily Physical Activity and Cognitive Function Variability in Older Adults.

    Science.gov (United States)

    Phillips, Christine B; Edwards, Jerri D; Andel, Ross; Kilpatrick, Marcus

    2016-04-01

    Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants' daily or average PA over the study period. Effect size estimates indicated that PA explained 0-24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults' ability to perform cognitively complex activities within the context of daily living.

  18. Mealtime Interactions and Life Satisfaction Among Older Adults in Shanghai.

    Science.gov (United States)

    Ye, Minzhi; Chen, Lin; Kahana, Eva

    2017-06-01

    We examined the association between older adults' mealtime interactions at senior centers in Shanghai and their life satisfaction. Competing hypotheses, derived from socioemotional selectivity theory and activity theory, were tested. Data were obtained from the 2011 Shanghai senior center service utilization survey ( N = 320). Relationships between respondents' mealtime interactions and life satisfaction were tested using multilevel regression modeling. After adjusting for demographics, interactions with tablemates (companionship, self-disclosure, and instrumental support) were positively associated with respondents' life satisfaction. These associations varied by senior centers. However, the number of tablemates was not significantly associated with respondents' life satisfaction. Findings support the activity-theory-based hypothesis that mealtime interactions are related to older adults' life satisfaction independent of the number of tablemates. This study illuminates the value of social interactions in the context of community dining programs for the rapidly increasing older population in urban China.

  19. Factors associated with cane use among community dwelling older adults.

    Science.gov (United States)

    Aminzadeh, F; Edwards, N

    2000-01-01

    Guided by the Theory of Planned Behavior (TPB), this study examined factors associated with cane use among community dwelling older adults. Data were collected in a cross-sectional survey of a convenience sample of 106 community residing older adults in Ottawa, Canada. Using a stepwise discriminant analysis, subjective norms, attitudes, and age surfaced as the key variables associated with cane use in this sample. The discriminant function accounted for 67% of the variance in cane use and correctly classified 91% of cases (Wilks's lambda = 0.33, lambda2 = 110.12, df = 3, p cane use behaviors of older persons and have important implications for the design of theory-based fall prevention interventions to enhance the acceptance and effective use of mobility aids.

  20. Chinese older adults' Internet use for health information.

    Science.gov (United States)

    Wong, Carmen K M; Yeung, Dannii Y; Ho, Henry C Y; Tse, Kin-Po; Lam, Chun-Yiu

    2014-04-01

    Technological advancement benefits Internet users with the convenience of social connection and information search. This study aimed at investigating the predictors of Internet use to search for online health information among Chinese older adults. The Technology Acceptance Model (TAM) was applied to examine the predictiveness of perceived ease of use, perceived usefulness, and attitudes toward Internet use on behavioral intention to search for health information online. Ninety-eight Chinese older adults were recruited from an academic institute for older people and community centers. Frequency of Internet use and physical and psychological health were also assessed. Results showed that perceived ease of use and attitudes significantly predicted behavioral intention of Internet use. The potential influences of traditional Chinese values and beliefs in health were also discussed.

  1. Perceived Accessibility to Services and Sites Among Israeli Older Adults.

    Science.gov (United States)

    Vitman-Schorr, Adi; Ayalon, Liat; Khalaila, Rabia

    2017-07-01

    To explore the direct and indirect effects of settlement type (rural-kibbutz vs. urban mid-size cities) on perceived accessibility by sociospatial factors: (a) connection to the living area, (b) familiarity with the living area, (c) social participation, and (d) perceived safety of the living area. A convenience sample of 279 older adults aged 65 and older was interviewed. Using bootstrapping, we tested the strength and significance of the conditional indirect effects of four simultaneous mediators of the relationship between settlement type and perceived accessibility. The relationship between settlement type and perceived accessibility was mediated by social participation and perceived safety of the living area. Policy makers should pay attention to the enhancement of sociospatial dimensions to improve the perceived accessibility of older adults.

  2. Media Representations of Older Adults from 2000-2015

    DEFF Research Database (Denmark)

    Iversen, Sara Mosberg; Wilinska, Monika

    to the representation of older adults. The review encompasses 192 research articles found in the databases Academic Search Premiere, Communication Source, SOCindex and Scopus. The criteria for inclusion were that the articles should be in English, published between 2000-2015 in a scholarly, peer-reviewed journal...

  3. Usability and Acceptability of Balance Exergames in Older Adults

    DEFF Research Database (Denmark)

    Nawaz, Ather; Skjæret, Nina; Lægdheim Helbostad, Jorunn

    2016-01-01

    Serious games (exergames) have the potential to be effective for postural balance and increasing muscle strength. Several games have been developed to increase physical fitness and balance among older adults. However, it is unclear to which degree usability and acceptability of exergames for olde...

  4. Social media use of older adults: a mini-review.

    Science.gov (United States)

    Leist, Anja K

    2013-01-01

    Maintaining social relationships has been defined as a core element of aging well. With a considerable amount of older adults living alone, social media provides the possibility to engage in meaningful social contact, e.g. by joining online social networks and online discussion forums. The review encompasses current knowledge of prerequisites in social media use of older adults such as functional capacity, information and communications technology-related knowledge, and favorable attitudes towards social media. Then, the potential of social media use for clinical practice and possible negative consequences are outlined. Literature on social media use from a gerontological perspective was reviewed in July and August 2012. Online communities are suitable for providing and receiving social support when confronted with a difficult life situation, regardless of geographical location or time. From a practitioner's perspective, social media can be used to advance health-related knowledge such as information on prevention, diagnosis, and treatment of specific conditions and disorders. Further positive consequences have been shown to be overcoming loneliness, relieving stress, and raising feelings of control and self-efficacy. Possible negative consequences could be misuse of personal data as well as the distribution and uncritical adoption of potentially harmful information via online communities. The potential of social media in clinical practice is reflected in a wide range of intervention possibilities for older adults. However, with the rise of social media, new threats emerge for older adults as well. Copyright © 2013 S. Karger AG, Basel.

  5. Behavioral correlates of anxiety in well-functioning older adults.

    Science.gov (United States)

    Losada, Andrés; Márquez-González, María; Pachana, Nancy A; Wetherell, Julie L; Fernández-Fernández, Virginia; Nogales-González, Celia; Ruiz-Díaz, Miguel

    2015-07-01

    Research on the behavioral correlates of anxiety in older adults is sparse. The aim of this study was to explore the association of anxiety with behavioral patterns defined by health, activity, emotional and social variables. A convenience sample of 395 older adults completed measures of health, activity, emotions, social variables and experiential avoidance. Cross-sectional data were analysed using cluster analysis. Five clusters were identified: active healthy, healthy, active vulnerable, lonely inactive and frail lonely. Participants in the active healthy and healthy clusters showed the highest scores on health variables (vitality and physical function), and adaptive scores on the rest of variables. They also reported the lowest scores on anxiety and included the lowest number of cases with clinically significant anxiety levels. Active vulnerable showed high scores on social support, leisure activities and capitalization on them but low scores in vitality and physical functioning. Participants in the lonely inactive cluster reported the highest mean score in experiential avoidance and high scores on boredom and loneliness, and low scores on social support, leisure activities capitalizing on pleasant activities and health variables. Frail lonely represent a particularly vulnerable profile of participants, similar to that of lonely inactive, but with significantly lower scores on health variables and higher scores on boredom and hours watching TV. Anxiety in older adults is not only linked to poor health, but also to dysfunctional social behavior, loneliness, boredom and experiential avoidance. Maladaptive profiles of older adults with regard to these variables have been identified.

  6. What Motivates Older Adults to Improve Diet and Exercise Patterns?

    Science.gov (United States)

    Bardach, Shoshana H; Schoenberg, Nancy E; Howell, Britteny M

    2016-02-01

    Dietary intake and physical activity are lifestyle behaviors that are learned, developed, and practiced throughout an individual's lifetime. These lifestyle behaviors have a profound role on health and quality of life--with late-life changes still resulting in notable improvements. Despite well documented benefits of behavior change, such changes are extremely challenging. The purpose of this study is to better understand from the perspective of older adults themselves, the factors that may influence their likelihood of making lifestyle changes. Participants were recruited two primary care clinics. 104 older adults ranging in age from 65 to 95 were included. Participants were interviewed about their motivations and plans to change diet and physical activity behaviors following a routine primary care visit. All interviews were transcribed and transcripts were analyzed using a line-by-line coding approach. Older adults reported that their likelihood of making a lifestyle change related to perceptions of old age, personal motivation, and perceived confidence in the ability to make effective changes. These findings suggest the importance of creating more positive images of old age and tailoring health promotion efforts to older adults' motivations and confidence in their ability to make behavior changes.

  7. Differentiating true and false schematic memories in older adults.

    Science.gov (United States)

    Webb, Christina E; Dennis, Nancy A

    2018-02-06

    While schemas aid memory for schematically related information, the gist induced by the schema can also lead to high rates of false memories, especially in older adults. The neural mechanisms that support and differentiate true and false memories in aging are not well understood. The current study sought to clarify this, using a novel scene paradigm to investigate the role of schemas on true and false memories in older adults. Healthy older adults encoded schematic scenes (e.g., bathroom). At retrieval, participants were tested on their memory for both schematic and non-schematic targets and lures while fMRI data was collected. Results indicate that true memories were supported by the typical retrieval network, and activity in this network was greater for true than false memories. Schema specific retrieval was supported by mPFC, extending this common finding to aging. While no region differentiated false memories compared to correct rejections, results showed that individual differences in false memory rates were associated with variability in neural activity. The findings underscore the importance of elucidating the neural basis of cognition within older adults, as well as the specific contribution of individual differences to the neural basis of memory errors in aging. © 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.

  8. Motivations and Benefits of the Travel Experiences of Older Adults

    Science.gov (United States)

    Ahn, Young-Joo; Janke, Megan C.

    2011-01-01

    The motivations and benefits of educational travel among individuals aged 55 years old and over were examined in this study. A total of 136 older adults enrolled in Elderhostel programs participated in this study and reported their perceived benefits and motivations for engaging in educational travel experiences. Correlation analyses were used to…

  9. Positivity Effect Specific to Older Adults with Subclinical Memory Impairment

    Science.gov (United States)

    Leal, Stephanie L.; Noche, Jessica A.; Murray, Elizabeth A.; Yassa, Michael A.

    2016-01-01

    Numerous studies have suggested that older adults preferentially remember positive information ("positivity effect"), however others have reported mixed results. One potential source of conflict is that aging is not a unitary phenomenon and individual differences exist. We modified a standard neuropsychological test to vary emotional…

  10. Metabolites associated with circulating interleukin-6 in older adults

    Science.gov (United States)

    Background: Circulating levels of the pro-inflammatory cytokine interleukin-6 (IL-6) levels are elevated in older adults, but mechanisms are unclear. In the current study, we used an untargeted metabolomic approach to develop an improved understanding about mechanisms related to circulating IL-6 in ...

  11. Technology: Education and Training Needs of Older Adults

    Science.gov (United States)

    Huber, Lesa; Watson, Carol

    2014-01-01

    The impact of the global aging of the population on social, economic, political, and health care institutions is unequaled. Parallel to this, evolving developments in technology promise opportunities for sales and product development to support positive aging. Older adults are excited to utilize technologies that they perceive as practical.…

  12. Handgrip force steadiness in young and older adults

    DEFF Research Database (Denmark)

    Blomkvist, Andreas W; Eika, Fredrik; de Bruin, Eling D

    2018-01-01

    ) was investigated in a test-retest design with seven days between sessions. Ten young and thirty older adults were recruited and handgrip steadiness was tested at 5%, 10% and 25% of maximum voluntary contraction (MVC) using Nintendo Wii Balance Board (WBB). Coefficients of variation were calculated from the mean...

  13. Anthropometric characteristics and nutritional status of older adults ...

    African Journals Online (AJOL)

    2011-08-27

    Aug 27, 2011 ... Keywords: older adults, anthropometric measurements, nutritional status, Lake Victoria Basin ... of good nutritional status are critical to health and functioning,15 and ... Conclusion: The findings suggest energy depletion and loss of muscle mass, ... Arm span was used to estimate height for individuals who.

  14. Elevator and Escalator Safety Education for Older Adults.

    Science.gov (United States)

    Hanks, Roma Stovall

    1996-01-01

    In eight focus groups in five cities, older adults identified their concerns about safety on elevators and escalators, often related to misunderstanding of the equipment. Their preferences for delivery of safety information included video/television, pamphlets, discussions, and posters. Educational interventions and modifications for disabilities…

  15. Burden of four vaccine preventable diseases in older adults

    NARCIS (Netherlands)

    Kristensen, Maartje; van Lier, Alies; Eilers, Renske; McDonald, Scott A.; Opstelten, Wim; van der Maas, Nicoline; van der Hoek, Wim; Kretzschmar, Mirjam E.; Nielen, Mark M.; de Melker, Hester E.

    2016-01-01

    Background: Implementation of additional targeted vaccinations to prevent infectious diseases in the older adults is under discussion in different countries. When considering the added value of such preventive measures, insight into the current disease burden will assist in prioritization. The aim

  16. Formal caregivers of older adults: reflection about their practice

    Directory of Open Access Journals (Sweden)

    Marina Picazzio Perez Batista

    2014-10-01

    Full Text Available OBJECTIVE To understand the job function of caregivers of older adults and contribute to the debate on the consolidation of this professional practice. METHODOLOGICAL PROCEDURES This is a descriptive, qualitative, and exploratory study. Four focal group sessions were performed in 2011 with 11 elderly companions, formal caregivers of older adults in the Programa Acompanhante de Idosos (Program for Caregivers of Older Adults, Sao Paulo, SP, Southeastern Brazil. These sessions, guided by a semi-structured script, were audio-recorded and fully transcribed. Data were analyzed using the Content Analysis technique, Thematic Modality. RESULTS In view of considering the caregivers of older adults as a new category of workers, it was difficult to define their duties. The elderly companions themselves as well as the care receivers, their families, and the professionals that comprised the team were unclear about their duties. The professional practice of these formal caregivers has been built on the basis of constant discussions and negotiations among them and other team members in Programa Acompanhante de Idosos during daily work. This was achieved via a recognition process of their job functions and by setting apart other workers’ exclusive responsibilities. CONCLUSIONS The delimitation of specific job functions for elderly companions is currently one of the greatest challenges faced by these workers to develop and consolidate their professional role as well as improve Programa Acompanhante de Idosos.

  17. Older Adults: Community College Students of the 1990s.

    Science.gov (United States)

    Craig, Ford M.

    1990-01-01

    Provides a literature review on community college services to older adults, focusing on studies of this population's needs (e.g., personal business and financial information, employment needs, physical fitness training, and maintaining self-esteem and a sense of the purpose and meaning in life) and courses and services that colleges offer. (DMM)

  18. Undernutrition and associated factors in a Portuguese older adult community

    Directory of Open Access Journals (Sweden)

    Ana Luísa Moreira dos Santos

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged >75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged >75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6; being institutionalized (OR=12.6; 95%CI=1.7-90.5; or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1 were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged >75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care.

  19. Understanding Arthritis Promoting Healthy Lifestyles for Older Adults

    Science.gov (United States)

    Tremethick, Mary Jane; Hogan, Patricia I.; Coleman, Barb; Adams, Kady

    2010-01-01

    One of the goals of "Healthy People 2010" is to decrease the incidence of limitation in physical activity due to arthritis. Physical education, recreation, and dance professionals can play an important role in meeting this objective by addressing barriers to physical activity and exercise in older adults with arthritis, and by successfully…

  20. The Burden of ADHD in Older Adults: A Qualitative Study

    NARCIS (Netherlands)

    Michielsen, M.; de Kruif, J. Th C.M.; Comijs, H. C.; van Mierlo, S.; Semeijn, E. J.; Beekman, A. T.F.; Deeg, D. J.H.; Kooij, J. J.S.

    Objective: To explore how ADHD may have affected the lives of older adults who meet the diagnostic criteria of ADHD, but are unaware of their diagnosis. Our second aim was to examine whether the reported symptoms change over the life span. Method: A qualitative study was conducted. Seventeen Dutch

  1. The Burden of ADHD in Older Adults : A Qualitative Study

    NARCIS (Netherlands)

    Michielsen, M; de Kruif, J Th C M; Comijs, H C; van Mierlo, S; Semeijn, E J; Beekman, A T F; Deeg, D J H; Kooij, J J S

    2015-01-01

    OBJECTIVE: To explore how ADHD may have affected the lives of older adults who meet the diagnostic criteria of ADHD, but are unaware of their diagnosis. Our second aim was to examine whether the reported symptoms change over the life span. METHOD: A qualitative study was conducted. Seventeen Dutch

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

    NARCIS (Netherlands)

    Jansen, F.M.; Prins, R.G.; Etman, A.; Ploeg, H.P. van der; Vries, S.I. de; Lenthe, F.J. van; Pierik, F.H.

    2015-01-01

    Introduction Physical activity (PA) is important for healthy ageing. Better insight into objectively measured PA levels in older adults is needed, since most previous studies employed self-report measures for PA assessment, which are associated with overestimation of PA. Aim This study aimed to

  3. Destination Memory for Emotional Information in Older Adults

    NARCIS (Netherlands)

    El Haj, M.; Fasotti, L.; Allain, P.

    2015-01-01

    Background/Study Context: Destination memory, remembering the destination of the information that one tells, shows significant age-related decline. In the present paper, the authors sought to determine whether destination memory can be improved in older adults using emotional stimuli. This aim was

  4. Differential Diagnosis in Older Adults: Dementia, Depression, and Delirium.

    Science.gov (United States)

    Gintner, Gary G.

    1995-01-01

    Examines three common disorders, dementia, depression, and delirium, which can be particularly difficult to diagnose in older adults. Presents three aspects that are helpful in making a decision: age-related differences, medical issues that need to be ruled out, and assessment methods particularly useful in the diagnostic process. (JPS)

  5. An Optimal Delivery Format for Presentations Targeting Older Adults.

    Science.gov (United States)

    Austin-Wells, Vonnette; Zimmerman, Teena; McDougall, Graham J., Jr.

    2003-01-01

    African-American, Hispanic, and white older adults (n=34) attended three information sessions presented via flipcharts, transparencies, and PowerPoint (one format per session). In focus groups, participants rated accessibility, novelty, and efficiency. They overwhelmingly preferred PowerPoint on all dimensions. (SK)

  6. Lay Meanings of Health among Rural Older Adults in Appalachia

    Science.gov (United States)

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

    2011-01-01

    Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define…

  7. Digital Gaming Perspectives of Older Adults: Content vs. Interaction

    Science.gov (United States)

    Marston, Hannah R.

    2013-01-01

    There were two objectives to this study: (a) to establish flow and (2) to establish whether computer game interaction or content was important to the older adult, using the Nintendo Wii and the Sony PlayStation 2 consoles. An earlier study had identified the sports genre as a preference, and three games (golf, tennis, and boxing) were selected…

  8. Cognitive Behavioral Therapy for Insomnia in Older Adults

    Science.gov (United States)

    Belanger, Lynda; LeBlanc, Melanie; Morin, Charles M.

    2012-01-01

    Insomnia is associated with significant morbidity and is often a persistent problem, particularly in older adults. It is important to attend to this complaint and not assume that it will remit spontaneously. In many cases, unfortunately, insomnia remains unrecognized and untreated, often because it is presumed that insomnia is an inevitable…

  9. Ecological Relevance Determines Task Priority in Older Adults' Multitasking.

    Science.gov (United States)

    Doumas, Michail; Krampe, Ralf Th

    2015-05-01

    Multitasking is a challenging aspect of human behavior, especially if the concurrently performed tasks are different in nature. Several studies demonstrated pronounced performance decrements (dual-task costs) in older adults for combinations of cognitive and motor tasks. However, patterns of costs among component tasks differed across studies and reasons for participants' resource allocation strategies remained elusive. We investigated young and older adults' multitasking of a working memory task and two sensorimotor tasks, one with low (finger force control) and one with high ecological relevance (postural control). The tasks were performed in single-, dual-, and triple-task contexts. Working memory accuracy was reduced in dual-task contexts with either sensorimotor task and deteriorated further under triple-task conditions. Postural and force performance deteriorated with age and task difficulty in dual-task contexts. However, in the triple-task context with its maximum resource demands, older adults prioritized postural control over both force control and memory. Our results identify ecological relevance as the key factor in older adults' multitasking. © The Author 2013. 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.

  10. Operant Conditioning in Older Adults with Alzheimer's Disease

    Science.gov (United States)

    Spira, Adam P.; Edelstein, Barry A.

    2007-01-01

    Behavioral interventions based on operant principles are commonly attempted to manage agitation in older adults with dementia. The extent to which operant conditioning can occur in persons with particular dementias, however, is unclear. The present study involved use of a button-pressing task to evaluate the sensitivity of the responding of older…

  11. Behavior-Analytic Research on Dementia in Older Adults

    Science.gov (United States)

    Trahan, Maranda A.; Kahng, SungWoo; Fisher, Alyssa B.; Hausman, Nicole L.

    2011-01-01

    It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the "Journal of Applied Behavior Analysis" ("JABA") on behavioral gerontology (Iwata, 1986), there continues to be a paucity of…

  12. Characteristics of Older Adults and the Aging: Some Comments.

    Science.gov (United States)

    Kowalski, Cash J.; Cangemi, Joseph P.

    1978-01-01

    Asserting that both humanistic and manpower considerations dictate that we address the aging process, this article describes the characteristics of older adults and illustrates the way in which they may be allowed to remain productive. Maslow's "Need Hierarchy" and Thorndike's "Theory of Developmental Tasks" are applied to the…

  13. Cognitive Benefits of Online Social Networking for Healthy Older Adults.

    Science.gov (United States)

    Myhre, Janelle W; Mehl, Matthias R; Glisky, Elizabeth L

    2017-09-01

    Research suggests that older adults who remain socially active and cognitively engaged have better cognitive function than those who are isolated and disengaged. This study examined the efficacy of learning and using an online social networking website, Facebook.com, as an intervention to maintain or enhance cognitive function in older adults. Forty-one older adults were assigned to learn and use Facebook (n = 14) or an online diary website (active control, n = 13) for 8 weeks or placed on a waitlist (n = 14). Outcome measures included neuropsychological tests of executive functions, memory, and processing speed and self-report questionnaires about social engagement. The Facebook group showed a significant increase in a composite measure of updating, an executive function factor associated with complex working memory tasks, compared to no significant change in the control groups. Other measures of cognitive function and social support showed no differential improvement in the Facebook group. Learning and using an online social networking site may provide specific benefits for complex working memory in a group of healthy older adults. This may reflect the particular cognitive demands associated with online social networking and/or the benefits of social engagement more generally. © 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.

  14. Visual Object Pattern Separation Varies in Older Adults

    Science.gov (United States)

    Holden, Heather M.; Toner, Chelsea; Pirogovsky, Eva; Kirwan, C. Brock; Gilbert, Paul E.

    2013-01-01

    Young and nondemented older adults completed a visual object continuous recognition memory task in which some stimuli (lures) were similar but not identical to previously presented objects. The lures were hypothesized to result in increased interference and increased pattern separation demand. To examine variability in object pattern separation…

  15. Overweight duration in older adults and cancer risk

    DEFF Research Database (Denmark)

    Arnold, Melina; Freisling, Heinz; Stolzenberg-Solomon, Rachael

    2016-01-01

    Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing...

  16. Keeping It Safe: Aging in Place among Rural Older Adults

    Science.gov (United States)

    Peek, Gina G.; Bishop, Alex J.

    2016-01-01

    The purpose of the study addressed in this article was to identify ways to reduce risk and improve safe aging in place among rural older adults. Resident and Extension faculty and county educators visited study participants at home to assess functional capacity and the home environment. Extension professionals may be uniquely positioned to provide…

  17. The Application of a Generativity Model for Older Adults

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    Ehlman, Katie; Ligon, Mary

    2012-01-01

    Generativity is a concept first introduced by Erik Erikson as a part of his psychosocial theory which outlines eight stages of development in the human life. Generativity versus stagnation is the main developmental concern of middle adulthood; however, generativity is also recognized as an important theme in the lives of older adults. Building on…

  18. Motivational Interviewing to Affect Behavioral Change in Older Adults

    Science.gov (United States)

    Cummings, Sherry M.; Cooper, R. Lyle; Cassie, Kim McClure

    2009-01-01

    This article reviews and assesses the existing research literature on the efficacy of motivational interviewing (MI) to promote lifestyle changes and improve functioning among older adults confronting serious health challenges. A comprehensive literature review was conducted of intervention studies that tested the use of MI to achieve behavioral…

  19. Prejudice Reduction in University Programs for Older Adults

    Science.gov (United States)

    Castillo, Jose-Luis Alvarez; Camara, Carmen Palmero; Eguizabal, Alfredo Jimenez

    2011-01-01

    The present paper, drawing from the perspective of social cognition, examines and evaluates an intervention based on social-cognitive perspective-taking on the reduction of stereotyping and prejudice in older adults. Data were collected in a sample of Spanish participants with a mean age of 63.2 years. The intervention, aimed at reducing prejudice…

  20. Curling for Confidence: Psychophysical Benefits of Curling for Older Adults.

    Science.gov (United States)

    Stone, Rachael C; Rakhamilova, Zina; Gage, William H; Baker, Joseph

    2018-04-01

    While physical activity is increasingly promoted for older adults, there is a paucity of sport promotion, which has distinct benefits from exercise and remains stereotypically associated with younger age. Curling is a moderately intense and safe sport that continues to gain popularity; however, no research has investigated psychophysical benefits of curling for older adults. The present study compares high-experience (20+ years; n = 63) and low-experience (<20 years; n = 53) curlers (aged 60+ years) with older adult noncurlers (n = 44) on measures of daily functionality, balance confidence, and perceptions of the aging process. While no significant differences were found between high- and low-experience curlers, any level of experience reported significantly better functionality, physical confidence, and aging attitudes compared to noncurlers (p ≤ .05). Although further research is necessary, the results suggest that any level of curling experience can enhance older adult psychophysical well-being, and warrants consideration for physical activity promotion and falls prevention programs.

  1. Differences in risk aversion between young and older adults

    Directory of Open Access Journals (Sweden)

    Albert SM

    2012-02-01

    Full Text Available Steven M Albert1, John Duffy21Department of Behavioral and Community Health Sciences, 2Department of Economics, University of Pittsburgh, Pittsburgh, PA, USAAbstract: Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than the younger (P < 0.05 and had a higher discount rate (15.6%–21.0% versus 10.3%–15.5%, P < 0.01, indicating lower expected utility from future income. Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision making across the lifespan.Keywords: aging, decision making, risk, time preference, behavioral economics

  2. Treatment of Depression and Suicide in Older Adults

    Science.gov (United States)

    Bhar, Sunil S.; Brown, Gregory K.

    2012-01-01

    This article describes a cognitive behavior therapy (CBT) intervention for suicide prevention in older adults. Although many studies have found that CBT interventions are efficacious for reducing depressive symptoms in the elderly, researchers have yet to evaluate the efficacy of such interventions for preventing suicide or reducing suicide risk…

  3. Older adult opinions of "advance driving directives".

    Science.gov (United States)

    Betz, Marian E; Lowenstein, Steven R; Schwartz, Robert

    2013-01-01

    Discussions about driving cessation are difficult. "Advance driving directives" (ADDs), like advance directives for end-of-life care, would allow drivers to designate someone to help make driving decisions for them in the future. It is not known if older drivers support the concept of ADDs. Cross-sectional study of a convenience sample of English-speaking drivers (55+ years) at 2 independent living facilities and 2 community centers who completed anonymous surveys. Of 168 participants, 80% were female; the median age was 76.5 years (range = 56-93 years). Most (74%) drove daily or almost daily, and 7% reported a crash in the past year. Few had spoken with someone about driving safety (5%) or their wishes when driving skills decline (21%). Of the few who had discussed this topic, 83% had spoken with a family member; only 17% had spoken with a health care provider. However, participants were open to driving discussions, and 54% said they would be willing to complete an ADD if recommended. Of these, 79% said it was "likely" or "very likely" they would comply with the directive in the future. Most (73%) supported mandatory, age-based retesting; the median recommended testing age suggested was 80 years. More participants thought the driver (71%), a family member (61%), or a physician (59%) should determine license revocation for an unsafe driver, rather than the department of motor vehicles (32%). Many older drivers may be open to discussing their driving plans with physicians and family members. ADDs may facilitate these discussions in the present and help define driving-related wishes in the future.

  4. Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.

    Science.gov (United States)

    Goenka, N; Turner, B; Vora, J

    2011-12-01

    The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  5. Multifactorial intervention for diabetes control among older users of insulin

    Directory of Open Access Journals (Sweden)

    Rafael Vaz Machry

    2018-05-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day. Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22% and 8.54% (SE = 0.24%, p < 0.001 and 8.09% (SE = 0.21%, p < 0.001 at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up. Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes.

  6. Multifactorial intervention for diabetes control among older users of insulin

    Science.gov (United States)

    Machry, Rafael Vaz; Pedroso, Henrique Umpierre; Vasconcellos, Luthiele Silva; Nunes, Rafaela Ramos; Evaldt, Cibelle de Abreu; Yunes, Eduardo Bardou; Rodrigues, Ticiana da Costa

    2018-01-01

    ABSTRACT OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day). Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22%) and 8.54% (SE = 0.24%, p < 0.001) and 8.09% (SE = 0.21%, p < 0.001) at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up). Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes. PMID:29791677

  7. Eye care utilization by older adults in low, middle, and high income countries

    Directory of Open Access Journals (Sweden)

    Vela Claudia

    2012-04-01

    Full Text Available Abstract Background The risk of visual impairment increases dramatically with age and therefore older adults should have their eyes examined at least every 1 to 2 years. Using a world-wide, population-based dataset, we sought to determine the frequency that older people had their eyes examined. We also examined factors associated with having a recent eye exam. Methods The World Health Surveys were conducted in 70 countries throughout the world in 2002-2003 using a random, multi-stage, stratified, cluster sampling design. Participants 60 years and older from 52 countries (n = 35,839 were asked "When was the last time you had your eyes examined by a medical professional?". The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank website. Prevalence estimates were adjusted to account for the complex sample design. Results Overall, only 18% (95% CI 17, 19 of older adults had an eye exam in the last year. The rate of an eye exam in the last year in low, lower middle, upper middle, and high income countries was 10%, 24%, 22%, and 37% respectively. Factors associated with having an eye exam in the last year included older age, female gender, more education, urban residence, greater wealth, worse self-reported health, having diabetes, and wearing glasses or contact lenses (p Conclusions Given that older adults often suffer from age-related but treatable conditions, they should be seen on a regular basis to prevent visual impairment and its disabling consequences.

  8. Diurnal Patterns and Correlates of Older Adults' Sedentary Behavior.

    Directory of Open Access Journals (Sweden)

    Jelle Van Cauwenberg

    Full Text Available Insights into the diurnal patterns of sedentary behavior and the identification of subgroups that are at increased risk for engaging in high levels of sedentary behavior are needed to inform potential interventions for reducing older adults' sedentary time. Therefore, we examined the diurnal patterns and sociodemographic correlates of older adults' sedentary behavior(s.Stratified cluster sampling was used to recruit 508 non-institutionalized Belgian older adults (≥ 65 years. Morning, afternoon, evening and total sedentary time was assessed objectively using accelerometers. Specific sedentary behaviors, total sitting time and sociodemographic attributes were assessed using an interviewer-administered questionnaire.Participants self-reported a median of 475 (Q1-Q3 = 383-599 minutes/day of total sitting time and they accumulated a mean of 580 ± 98 minutes/day of accelerometer-derived sedentary time. Sedentary time was lowest during the morning and highest during the evening. Older participants were as sedentary as younger participants during the evening, but they were more sedentary during daytime. Compared to married participants, widowers were more sedentary during daytime. Younger participants (< 75 years, men and the higher educated were more likely to engage in (high levels of sitting while driving a car and using the computer. Those with tertiary education viewed 29% and 22% minutes/day less television compared to those with primary or secondary education, respectively. Older participants accumulated 35 sedentary minutes/day more than did younger participants and men accumulated 32 sedentary minutes/day more than did women.These findings highlight diurnal variations and potential opportunities to tailor approaches to reducing sedentary time for subgroups of the older adult population.

  9. Prevalence and biochemical risk factors of diabetic peripheral neuropathy with or without neuropathic pain in Taiwanese adults with type 2 diabetes mellitus.

    Science.gov (United States)

    Pai, Yen-Wei; Lin, Ching-Heng; Lee, I-Te; Chang, Ming-Hong

    To investigate the prevalence and risk factors for diabetic peripheral neuropathy with or without neuropathic pain in Taiwanese. A cross-sectional, hospital-based observational study was conducted. We enrolled 2837 adults with type 2 diabetes mellitus. Diabetic peripheral neuropathy with or without pain were diagnosed using 2 validated screening tools, namely the Michigan Neuropathy Screening Instrument and Douleur Neuropathique 4 questionnaire. In our sample, 2233 participants had no neuropathy, 476 had diabetic peripheral neuropathy without pain, and 128 had diabetic peripheral neuropathy with neuropathic pain, representing an overall diabetic peripheral neuropathy prevalence of 21.3%, and the prevalence of neuropathic pain in diabetic peripheral neuropathy was 21.2%. Multivariate analysis revealed that older age (Pperipheral neuropathy, whereas older age (Pperipheral neuropathy with neuropathic pain. During clinical visits involving biochemical studies, the risk for diabetic peripheral neuropathy with neuropathic pain should be considered for people with older age, elevated glycated haemoglobin, low high-density lipoprotein cholesterol and overt proteinuria, with particular attention given to increased levels of albuminuria while concerning neuropathic pain. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  10. Listening to Older Adult Parents of Adult Children with Mental Illness

    Science.gov (United States)

    Smith, Judith R.

    2012-01-01

    This article uses qualitative research and narrative analysis to examine the experience of women age 55 and older who are parents caring for adult children with mental illness. Knowledge about the conflicts of older parents with dependent children is underdeveloped. In this study, analysis of women's stories about parenting in later life reveal…

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

    Science.gov (United States)

    Phelan, A; Fealy, G; Downes, C

    Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

    Science.gov (United States)

    Heisel, Marnin J.; Talbot, Nancy L.; King, Deborah A.; Tu, Xin M.; Duberstein, Paul R.

    2014-01-01

    Objective To pilot a psychological intervention adapted for older adults at-risk for suicide. Design A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Setting Outpatient mental healthcare provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Participants Seventeen English-speaking adults 60 years or older, at- risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. Intervention A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at-risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Measurements Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation), and secondary study outcomes (depressive symptom severity; social adjustment and support; psychological well-being), and psychotherapy process measures. Results Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Conclusions Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at-risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. PMID:24840611

  13. Adapting interpersonal psychotherapy for older adults at risk for suicide.

    Science.gov (United States)

    Heisel, Marnin J; Talbot, Nancy L; King, Deborah A; Tu, Xin M; Duberstein, Paul R

    2015-01-01

    To pilot a psychological intervention adapted for older adults at risk for suicide. A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Outpatient mental health care provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Seventeen English-speaking adults 60 years or older, at risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation) and secondary study outcomes (depressive symptom severity, social adjustment and support, psychological well-being), and psychotherapy process measures. Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Psychological effects of exercise on community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Tada A

    2018-02-01

    Full Text Available Akio Tada Faculty of Health Science, Hyogo University, Kakogawa, Hyogo, Japan Background: In recent years, there have been an increasing number of older adults who suffer from mental disorders globally.Objective: The objective of this study was to examine the effect of an intervention that consisted of an exercise program to improve the mental health of community-dwelling older adults.Participants and methods: The recruited participants of this study were community-dwelling older adults aged ≥60 years who participated in a comprehensive health promotion program in Kakogawa, Japan. Participants in the intervention group received an exercise program that was developed for older adults using Thera-Band. To measure participants’ mental health status, a Japanese version of the short form of the Profile of Mood States (POMS-SF was used. Stress markers were measured, such as salivary cortisol, alpha-amylase, and sIgA levels. All participants provided salivary samples and completed psychological questionnaires at baseline and 6-month follow-up.Results: No significant differences were observed between the intervention and control groups with respect to POMS-SF score and salivary biomarker profile at baseline. After the intervention, the intervention group showed a significant decrease in the POMS-SF “fatigue” score and cortisol level. No significant changes were observed in the control group.Conclusion: Simultaneous changes in feelings of fatigue and cortisol levels were observed among subjects who had received the intervention of regular exercise. Further research is needed to investigate the effectiveness of exercise intervention in improving mental health among older adults. Keywords: intervention, exercise, psychological status, stress, cortisol

  15. Restraint Use in Older Adults Receiving Home Care.

    Science.gov (United States)

    Scheepmans, Kristien; Dierckx de Casterlé, Bernadette; Paquay, Louis; Van Gansbeke, Hendrik; Milisen, Koen

    2017-08-01

    To determine the prevalence, types, frequency, and duration of restraint use in older adults receiving home nursing care and to determine factors involved in the decision-making process for restraint use and application. Cross-sectional survey of restraint use in older adults receiving home care completed by primary care nurses. Homes of older adults receiving care from a home nursing organization in Belgium. Randomized sample of older adults receiving home care (N = 6,397; mean age 80.6; 66.8% female). For each participant, nurses completed an investigator-constructed and -validated questionnaire collecting information demographic, clinical, and behavioral characteristics and aspects of restraint use. A broad definition of restraint was used that includes a range of restrictive actions. Restraints were used in 24.7% of the participants, mostly on a daily basis (85%) and often for a long period (54.5%, 24 h/d). The most common reason for restraint use was safety (50.2%). Other reasons were that the individual wanted to remain at home longer, which necessitated the use of restraints (18.2%) and to provide respite for the informal caregiver (8.6%). The latter played an important role in the decision and application process. The physician was less involved in the process. In 64.5% of cases, there was no evaluation after restraint use was initiated. Use of restraints is common in older adults receiving home care nursing in Belgium. These results contribute to a better understanding of the complexity of use of restraints in home care, a situation that may be even more complex than in nursing homes and acute hospital settings. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  16. Self-reported cognitive inconsistency in older adults.

    Science.gov (United States)

    Vanderhill, Susan; Hultsch, David F; Hunter, Michael A; Strauss, Esther

    2010-01-01

    Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70-91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.

  17. Emotional memory for musical excerpts in young and older adults

    Science.gov (United States)

    Alonso, Irene; Dellacherie, Delphine; Samson, Séverine

    2015-01-01

    The emotions evoked by music can enhance recognition of excerpts. It has been suggested that memory is better for high than for low arousing music (Eschrich et al., 2005; Samson et al., 2009), but it remains unclear whether positively (Eschrich et al., 2008) or negatively valenced music (Aubé et al., 2013; Vieillard and Gilet, 2013) may be better recognized. Moreover, we still know very little about the influence of age on emotional memory for music. To address these issues, we tested emotional memory for music in young and older adults using musical excerpts varying in terms of arousal and valence. Participants completed immediate and 24 h delayed recognition tests. We predicted highly arousing excerpts to be better recognized by both groups in immediate recognition. We hypothesized that arousal may compensate consolidation deficits in aging, thus showing more prominent benefit of high over low arousing stimuli in older than younger adults on delayed recognition. We also hypothesized worst retention of negative excerpts for the older group, resulting in a recognition benefit for positive over negative excerpts specific to older adults. Our results suggest that although older adults had worse recognition than young adults overall, effects of emotion on memory do not seem to be modified by aging. Results on immediate recognition suggest that recognition of low arousing excerpts can be affected by valence, with better memory for positive relative to negative low arousing music. However, 24 h delayed recognition results demonstrate effects of emotion on memory consolidation regardless of age, with a recognition benefit for high arousal and for negatively valenced music. The present study highlights the role of emotion on memory consolidation. Findings are examined in light of the literature on emotional memory for music and for other stimuli. We finally discuss the implication of the present results for potential music interventions in aging and dementia. PMID

  18. Conceptualizations of frailty in relation to older adults.

    Science.gov (United States)

    Markle-Reid, Maureen; Browne, Gina

    2003-10-01

    The aim of this article is to discuss the concept of frailty and its adequacy in identifying and describing older adults as frail. Despite the dramatic increase in use of the term 'frailty' over the past two decades, there is a lack of consensus in the literature about its meaning and use, and no clear conceptual guidelines for identifying and describing older adults as frail. Differences in theoretical perspectives will influence policy decisions regarding eligibility for, and allocation of, scarce health care resources among older adults. The article presents a literature review and synthesis of definitions and conceptual models of frailty in relation to older adults. The first part of the paper is a summary of the synonyms, antonyms and definitions of the term frailty. The second part is a critical evaluation of conceptual models of frailty. Six conceptual models are analysed on the basis of four main categories of assumptions about: (1) the nature of scientific knowledge; (2) the level of analysis; (3) the ageing process; (4) the stability of frailty. The implications of these are discussed in relation to clinical practice, policy and research. The review gives guidelines for a new theoretical approach to the concept of frailty in older adults: (1) it must be a multidimensional concept that considers the complex interplay of physical, psychological, social and environmental factors; (2) the concept must not be age-related, suggesting a negative and stereotypical view of ageing; (3) the concept must take into account an individual's context and incorporate subjective perceptions; (4) the concept must take into account the contribution of both individual and environmental factors.

  19. Emotional memory for musical excerpts in young and older adults.

    Science.gov (United States)

    Alonso, Irene; Dellacherie, Delphine; Samson, Séverine

    2015-01-01

    The emotions evoked by music can enhance recognition of excerpts. It has been suggested that memory is better for high than for low arousing music (Eschrich et al., 2005; Samson et al., 2009), but it remains unclear whether positively (Eschrich et al., 2008) or negatively valenced music (Aubé et al., 2013; Vieillard and Gilet, 2013) may be better recognized. Moreover, we still know very little about the influence of age on emotional memory for music. To address these issues, we tested emotional memory for music in young and older adults using musical excerpts varying in terms of arousal and valence. Participants completed immediate and 24 h delayed recognition tests. We predicted highly arousing excerpts to be better recognized by both groups in immediate recognition. We hypothesized that arousal may compensate consolidation deficits in aging, thus showing more prominent benefit of high over low arousing stimuli in older than younger adults on delayed recognition. We also hypothesized worst retention of negative excerpts for the older group, resulting in a recognition benefit for positive over negative excerpts specific to older adults. Our results suggest that although older adults had worse recognition than young adults overall, effects of emotion on memory do not seem to be modified by aging. Results on immediate recognition suggest that recognition of low arousing excerpts can be affected by valence, with better memory for positive relative to negative low arousing music. However, 24 h delayed recognition results demonstrate effects of emotion on memory consolidation regardless of age, with a recognition benefit for high arousal and for negatively valenced music. The present study highlights the role of emotion on memory consolidation. Findings are examined in light of the literature on emotional memory for music and for other stimuli. We finally discuss the implication of the present results for potential music interventions in aging and dementia.

  20. The Precarity of Older Adults Living Alone With Cognitive Impairment.

    Science.gov (United States)

    Portacolone, Elena; Rubinstein, Robert L; Covinsky, Kenneth E; Halpern, Jodi; Johnson, Julene K

    2018-01-24

    To examine the lived experience of older adults living alone with cognitive impairment to better understand their needs and concerns. Based on our previous work suggesting that older adults living alone often experience a sense of precarity, we were interested in exploring this construct in older adults living alone with a diagnosis of cognitive impairment. The notion of precarity points to the uncertainty deriving from coping with cumulative pressures while trying to preserve a sense of independence. This is a qualitative study of 12 adults aged 65 and older living alone with cognitive impairment. Six participants had a diagnosis of Alzheimer's disease; 6 had a diagnosis of mild cognitive impairment. Participants' lived experiences were elicited through 40 ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Qualitative analysis of transcripts revealed three themes. Theme 1 described the distress stemming from the uncertainty of having cognitive impairment that has an unpredictable course. Theme 2 drew attention to the tendency of participants to feel responsible for managing their cognitive impairment. Theme 3 described the pressures stemming from the lack of appropriate services to support independent living for persons with cognitive impairment. These 3 themes all pointed to facets of precarity. Findings also suggest the dearth of programs to support older adults living alone with cognitive impairment and the need to develop novel programs and interventions. © 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.