The Influence of Emotional Material on Encoding and Retrieving Intentions: An ERP Study in Younger and Older Adults

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Alexandra Hering

2018-02-01

Full Text Available Prospective memory is a cognitive process that comprises the encoding and maintenance of an intention until the appropriate moment of its retrieval. It is of highly relevance for an independent everyday life, especially in older adults; however, there is ample evidence that prospective memory declines with increasing age. Because most studies have used neutral stimuli, it is still an open question how emotional factors influence age-related differences in prospective remembering. The aim of the study was to investigate the influence of emotional material on prospective memory encoding, monitoring, maintaining, and retrieval in younger and older adults using behavioral and electrophysiological measures. We tested 24 younger adults (M = 26.4 years and 20 older adults (M = 68.1 years using a picture one-back task as ongoing activity with an embedded prospective memory instruction. The experimental task consisted of three sessions. In each session, participants had to encode series of images that represented the prospective memory cues for the consecutive block. The images were either of pleasant, unpleasant, or neutral valence. The pictures used in the ongoing task were likewise of pleasant, unpleasant, or neutral valence. Event-related potentials (ERPs were recorded to assess the neural correlates of intention encoding, maintenance, and self-initiated retrieval. We did not find age differences between younger and older adults on the behavioral level. However, the ERP results revealed an interesting pattern that suggested for both age groups elevated attentional processing of emotional cues during encoding indicated by an elevated LPP for the emotional cues. Additionally, younger adults showed increased activity for unpleasant cues. During the maintenance phase, both age groups engaged in strategic monitoring especially for pleasant cues, which led to enhanced sustained positivity. During retrieval, older adults showed increased activity of ERP

Metacognition for strategy selection during arithmetic problem-solving in young and older adults.

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Geurten, Marie; Lemaire, Patrick

2018-04-19

We examined participants' strategy choices and metacognitive judgments during arithmetic problem-solving. Metacognitive judgments were collected either prospectively or retrospectively. We tested whether metacognitive judgments are related to strategy choices on the current problems and on the immediately following problems, and age-related differences in relations between metacognition and strategy choices. Data showed that both young and older adults were able to make accurate retrospective, but not prospective, judgments. Moreover, the accuracy of retrospective judgments was comparable in young and older adults when participants had to select and execute the better strategy. Metacognitive accuracy was even higher in older adults when participants had to only select the better strategy. Finally, low-confidence judgments on current items were more frequently followed by better strategy selection on immediately succeeding items than high-confidence judgments in both young and older adults. Implications of these findings to further our understanding of age-related differences and similarities in adults' metacognitive monitoring and metacognitive regulation for strategy selection in the context of arithmetic problem solving are discussed.

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 ...

Post-Traumatic Stress Disorder among Older Adults Experiencing Motor Vehicle Collision: A Multicenter Prospective Cohort Study.

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Platts-Mills, Timothy F; Nebolisa, Bo C; Flannigan, Sean A; Richmond, Natalie L; Domeier, Robert M; Swor, Robert A; Hendry, Phyllis L; Peak, David A; Rathlev, Niels K; Jones, Jeffrey S; Lee, David C; Jones, Christopher W; McLean, Samuel A

2017-09-01

To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among older adults evaluated in the emergency department (ED) following motor vehicle collision (MVC). Prospective multicenter longitudinal study (2011-2015). 9 EDs across the United States. Adults aged 65 years and older who presented to an ED after MVC without severe injuries. PTSD symptoms were assessed 6 months after the ED visit using the Impact of Event Scale-Revised. Of 223 patients, clinically significant PTSD symptoms at 6 months were observed in 21% (95% CI 16%-26%). PTSD symptoms were more common in patients who did not have a college degree, had depressive symptoms prior to the MVC, perceived the MVC as life-threatening, had severe ED pain, and expected their physical or emotional recovery time to be greater than 30 days. Three factors (ED pain severity [0-10 scale], perceived life-threatening MVC [0-10 scale], and pre-MVC depressive symptoms [yes to either of two questions]), predicted 6-month PTSD symptoms with an area under the curve of 0.76. Compared to patients without PTSD symptoms, those with PTSD symptoms were at higher risk for persistent pain (72% versus 30%), functional decline (67% versus 42%), and new disability (49% versus 18%). Among older adults treated in the ED following MVC, clinically significant PTSD symptoms at 6 months were present in 21% of patients and were associated with adverse health outcomes. Increased risk for PTSD development can be identified with moderate accuracy using information readily available in the ED. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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] ...

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 ...

Physical Activity and Heart Rate Variability in Older Adults: The Cardiovascular Health Study

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Soares-Miranda, Luisa; Sattelmair, Jacob; Chaves, Paulo; Duncan, Glen; Siscovick, David S; Stein, Phyllis K; Mozaffarian, Dariush

2014-01-01

Background Cardiac mortality and electrophysiologic dysfunction both increase with age. Heart rate variability (HRV) provides indices of autonomic function and electrophysiology that are associated with cardiac risk. How habitual physical activity (PA) among older adults prospectively relates to HRV, including nonlinear indices of erratic sinus patterns, is not established. We hypothesized that increasing levels of both total leisure-time activity and walking would be prospectively associated with more favorable time-domain, frequency-domain, and nonlinear HRV measures in older adults. Methods and Results We evaluated serial longitudinal measures of both PA and 24-hour Holter HRV over 5 years among 985 older US adults in the community-based Cardiovascular Health Study. After multivariable adjustment, greater total leisure-time activity, walking distance, and walking pace were each prospectively associated with specific, more favorable HRV indices, including higher 24-hour standard-deviation-of-all-normal-to-normal-intervals (SDNN, p-trend=0.009, 0.02, 0.06, respectively) and ultra-low-frequency-power (p-trend=0.02, 0.008, 0.16, respectively). Greater walking pace was also associated with higher short-term-fractal-scaling-exponent (p-trend=0.003) and lower Poincare ratio (p-trend=0.02), markers of less erratic sinus patterns. Conclusions Greater total leisure-time activity, as well as walking alone, were prospectively associated with more favorable and specific indices of autonomic function in older adults, including several suggestive of more normal circadian fluctuations and less erratic sinoatrial firing. Our results suggest potential mechanisms that might contribute to lower cardiovascular mortality with habitual PA later in life. PMID:24799513

The Moderating Role of Executive Functioning in Older Adults' Responses to a Reminder of Mortality

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Maxfield, Molly; Pyszczynski, Tom; Greenberg, Jeff; Pepin, Renee; Davis, Hasker P.

2011-01-01

In previous research, older adults responded to mortality salience (MS) with increased tolerance, whereas younger persons responded with increased punitiveness. One possible explanation for this is that many older adults adapt to challenges of later life, such as the prospect of mortality, by becoming more flexible. Recent studies suggest that positively-oriented adaptation is more likely for older adults with high levels of executive functioning. We thus hypothesized that the better an older adult's executive functioning, the more likely MS would result in increased tolerance. Older and younger adults were randomly assigned to MS or control conditions, and then evaluated moral transgressors. As in previous research, younger adults were more punitive following reminders of mortality; executive functioning did not affect their responses. Among older adults, high functioning individuals responded to MS with increased tolerance rather than intolerance, whereas those low in functioning became more punitive. PMID:21728445

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

Obesity Prevention in Older Adults.

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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.

Cognitive and neural plasticity in older adults' prospective memory following training with the Virtual Week computer game.

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Rose, Nathan S; Rendell, Peter G; Hering, Alexandra; Kliegel, Matthias; Bidelman, Gavin M; Craik, Fergus I M

2015-01-01

Prospective memory (PM) - the ability to remember and successfully execute our intentions and planned activities - is critical for functional independence and declines with age, yet few studies have attempted to train PM in older adults. We developed a PM training program using the Virtual Week computer game. Trained participants played the game in 12, 1-h sessions over 1 month. Measures of neuropsychological functions, lab-based PM, event-related potentials (ERPs) during performance on a lab-based PM task, instrumental activities of daily living, and real-world PM were assessed before and after training. Performance was compared to both no-contact and active (music training) control groups. PM on the Virtual Week game dramatically improved following training relative to controls, suggesting PM plasticity is preserved in older adults. Relative to control participants, training did not produce reliable transfer to laboratory-based tasks, but was associated with a reduction of an ERP component (sustained negativity over occipito-parietal cortex) associated with processing PM cues, indicative of more automatic PM retrieval. Most importantly, training produced far transfer to real-world outcomes including improvements in performance on real-world PM and activities of daily living. Real-world gains were not observed in either control group. Our findings demonstrate that short-term training with the Virtual Week game produces cognitive and neural plasticity that may result in real-world benefits to supporting functional independence in older adulthood.

Emergency Department Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

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Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J.

2016-01-01

Background The rise in emergency department (ED) utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to positively impact the care of older adults. Symptoms have been associated with ED utilization, however, it remains unclear if symptoms are the primary reason for ED utilization. Purpose Describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department. Examine the differences in self-reported symptoms among those who utilized the emergency department, and those who did not. Procedures A prospective longitudinal design was used. The sample included 403 community-dwelling older adults 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Main Findings Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance, and fair/poor well-being were significantly associated with ED utilization. Conclusions Several symptoms were common among this cohort of older adults. However, there were no significant differences in the types of symptoms reported by older adults who utilized the emergency department compared to those who did not use the emergency department. Based on these findings, symptoms among community-dwelling older adults may not be the primary reason for ED utilization. PMID:28131350

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

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Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

Prospective associations of social isolation and loneliness with poor sleep quality in older adults.

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Yu, Bin; Steptoe, Andrew; Niu, Kaijun; Ku, Po-Wen; Chen, Li-Jung

2018-03-01

There is evidence for negative associations between social isolation and loneliness and sleep quality in older adults. However, it is unclear to what extent these two factors independently affect sleep quality. This study examined the simultaneous associations of social isolation and loneliness with sleep quality in a longitudinal study of older adults. Data were analyzed from the Social Environment and Biomarkers of Aging Study in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66.14, SD 7.26). Poisson regression models were conducted to examine the association of social isolation and/or loneliness with sleep quality at follow-up after adjusting for multiple confounding variables. Univariate analysis showed that sleep quality was inversely associated with both social isolation and loneliness. After demographic, health, cognitive factors, and depressive symptoms were controlled in multivariable analysis, social isolation at the baseline still predicted poor sleep quality 6 years later (incident rate ratio, IRR 1.14; 95% CI 1.04-1.24; p social isolation on the sleep quality of older adults, but indicate that this effect is independent of loneliness. Social isolation and loneliness seem to have distinct pathways in affecting the sleep quality of older adults.

Subjective memory complaints, cognitive performance, and psychological factors in healthy older adults.

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Steinberg, Susanne I; Negash, Selamawit; Sammel, Mary D; Bogner, Hillary; Harel, Brian T; Livney, Melissa G; McCoubrey, Hannah; Wolk, David A; Kling, Mitchel A; Arnold, Steven E

2013-12-01

To determine whether subjective memory complaints (SMCs) are associated with performance on objective cognitive measures and psychological factors in healthy, community-dwelling older adults. The cohort was composed of adults, 65 years and older with no clinical evidence of cognitive impairment (n = 125). Participants were administered: CogState computerized neurocognitive battery, Prospective Retrospective Memory Questionnaire, personality and meaning-in-life measures. SMCs were associated with poorer performance on measures of executive function (p = 0.001). SMCs were also associated with impaired delayed recall (p = 0.006) but this did not remain significant after statistical adjustment for multiple comparisons. SMCs were inversely associated with conscientiousness (p = 0.004) and directly associated with neuroticism (p cognitive changes and are associated with personality traits and meaning-in-life in healthy, older adults.

Effective communication with older adults.

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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.

Four-Week Strategy-Based Training to Enhance Prospective Memory in Older Adults: Targeting Intention Retention Is More Beneficial than Targeting Intention Formation.

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Ihle, Andreas; Albiński, Rafal; Gurynowicz, Kamila; Kliegel, Matthias

2018-01-01

So far, training of prospective memory (PM) focused on very short instances (single sessions) and targeted the intention-formation phase only. We aimed to compare the effectiveness of 2 different 4-week strategy-based PM training types, namely imagery training (targeting the encoding of the PM intention in the intention-formation phase) versus rehearsal training (targeting the maintenance of the PM intention in the intention-retention phase) in older adults. We used a 4-week training protocol (8 sessions in total, 2 sessions per week). From the 44 participants, 21 were randomly assigned to the imagery training (vividly imagining a mental picture to memorize the connection between the PM cue words and related actions during intention formation) and 23 to the rehearsal training (rehearsing the PM cue words during intention retention). The criterion PM task was assessed before and after the training. Comparing the effectiveness of both training types, we found a significant time by training type interaction on PM accuracy in terms of PM cue detection, F(1, 42) = 6.07, p = 0.018, η2p = 0.13. Subsequent analyses revealed that the rehearsal training was more effective in enhancing PM accuracy in terms of PM cue detection than the imagery training. Strategy-based PM training in older adults targeting the maintenance of the PM intention in the intention-retention phase may be more effective in enhancing PM accuracy in terms of PM cue detection than the strategy targeting the encoding of the PM intention in the intention-formation phase. This suggests that for successful prospective remembering, older adults may need more support to keep the PM cues active in memory while working on the ongoing task than to initially encode the PM intention. © 2018 S. Karger AG, Basel.

Drinking Level Versus Drinking Pattern and Cigarette Smoking Among Older Adults.

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Holahan, Charles J; Brennan, Penny L; Schutte, Kathleen K; Holahan, Carole K; Hixon, J Gregory; Moos, Rudolf H

2018-04-01

There is a lack of research on the role of alcohol consumption in cigarette smoking among older adults, and the few studies on alcohol use and smoking with older adults have failed to distinguish between average level and pattern of drinking as predictors of smoking. The main purpose of this study was to examine the independent contributions of average level versus pattern of drinking as predictors of cigarette smoking among older adults. A subsidiary purpose was to examine the link between continued smoking and mortality among older smokers. We investigated average level and pattern of drinking as predictors of current smoking among 1,151 older adults at baseline and of continued smoking and mortality among the subset of 276 baseline smokers tracked across 20 years. We used multiple linear and logistic regression analyses and, to test mediation, bias-corrected bootstrap confidence intervals. A high level of average drinking and a pattern of episodic heavy drinking were concurrently associated with smoking at baseline. However, only episodic heavy drinking was prospectively linked to continued smoking among baseline smokers. Continued smoking among baseline smokers increased the odds of 20-year mortality and provided an indirect pathway through which heavy episodic drinking related to mortality. Smokers who misuse alcohol are a challenging population for smoking cessation efforts. Older adults who concurrently misuse alcohol and smoke cigarettes provide a unique target for public health interventions. Copyright © 2018 by the Research Society on Alcoholism.

Dehydration in the Older Adult.

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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.

Age effects in emotional prospective memory: cue valence differentially affects the prospective and retrospective component.

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Schnitzspahn, Katharina M; Horn, Sebastian S; Bayen, Ute J; Kliegel, Matthias

2012-06-01

While first studies suggested that emotional task material may enhance prospective memory performance in young and older adults, the extent and mechanisms of this effect are under debate. The authors explored possible differential effects of cue valence on the prospective and retrospective component of prospective memory in young and older adults. Forty-five young and 41 older adults performed a prospective memory task in which emotional valence of the prospective memory cue was manipulated (positive, negative, neutral). The multinomial model of event-based prospective memory was used to analyze effects of valence and age on the two prospective memory components separately. Results revealed an interaction indicating that age differences were smaller in both emotional valence conditions. For older adults positive cues improved the prospective component, while negative cues improved the retrospective component. No main effect of valence was found for younger adults on an overt accuracy measure, but model-based analyses showed that the retrospective component was enhanced in the positive compared with the negative cue condition. The study extends the literature in demonstrating that processes underlying emotional effects on prospective memory may differ depending on valence and age. PsycINFO Database Record (c) 2012 APA, all rights reserved

Prognostic effects of delirium motor subtypes in hospitalized older adults: A prospective cohort study.

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Avelino-Silva, Thiago Junqueira; Campora, Flavia; Curiati, Jose Antonio Esper; Jacob-Filho, Wilson

2018-01-01

To investigate the association between delirium motor subtypes and hospital mortality and 12-month mortality in hospitalized older adults. Prospective cohort study conducted from 2009 to 2015. Geriatric ward of a university hospital in Sao Paulo, Brazil. We included 1,409 consecutive admissions of acutely ill patients aged 60 years and over. We excluded admissions for end-of-life care, with missing data on the main variables, length of stay shorter than 48 hours, or when consent to participate was not given. Delirium was detected using the Confusion Assessment Method and categorized in hypoactive, hyperactive, or mixed delirium. Primary outcomes were time to death in the hospital, and time to death in 12 months (for the discharged sample). Comprehensive geriatric assessment was performed at admission and included socio-demographic, clinical, functional, cognitive, and laboratory variables. Further clinical data were documented upon death or discharge. Multivariate analyses used Cox proportional hazards models adjusted for possible confounders. We included 1,409 admissions, with a mean age of 80 years. The proportion of in-hospital deaths was 19%, with a cumulative mortality of 38% in 12 months. Delirium occurred in 47% of the admissions. Hypoactive delirium was the predominant motor subtype (53%), followed by mixed delirium (30%) and hyperactive delirium (17%). Hospital mortality rates were respectively 33%, 34% and 15%. We verified that hypoactive and mixed delirium were independently associated with hospital mortality, with respective hazard ratios of 2.43 (95%CI = 1.64-3.59) and 2.31 (95%CI = 1.53-3.50). Delirium motor subtypes were not independently predictive of 12-month mortality. One in three acutely ill hospitalized older adults who suffered hypoactive or mixed delirium died in the hospital. Clinicians should be aware that hypoactive symptoms of delirium, whether shown exclusively or in alternation with hyperactive symptoms, are indicative of a worse

Prospective association between added sugars and frailty in older adults.

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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.

Stiffness control of balance during dual task and prospective falls in older adults: the MOBILIZE Boston Study.

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Kang, Hyun Gu; Quach, Lien; Li, Wenjun; Lipsitz, Lewis A

2013-09-01

Outdoor fallers differ from indoor fallers substantially in demographics, lifestyle, health condition and physical function. Biomechanical predictors of outdoor falls have not been well characterized. Current validated measures of postural deficits, which describe only the overall postural behavior, are predictive of indoor falls but not outdoor falls. We hypothesized that a model-based description of postural muscle tone and reflexes, particularly during dual tasking, would predict outdoor falls. We tested whether postural stiffness and damping from an inverted pendulum model were predictive of future indoor and outdoor falls among older adults from the MOBILIZE Boston Study. The center of pressure data during standing were obtained from 717 participants aged 77.9±5.3 years. Participants stood barefoot with eyes open for 30s per trial, in two sets of five standing trials. One set included a serial subtractions task. Postural stiffness and damping values were determined from the postural sway data. After the postural measurements, falls were monitored prospectively using a monthly mail-in calendar over 6-36 months. Associations of postural measures with fall rates were determined using negative binomial regressions. After covariate adjustments, postural stiffness (p=0.02-0.05) and damping (p=0.007-0.1) were associated with lower outdoor falls risk, but not with indoor falls. Results were invariant by direction (anteroposterior versus mediolateral) or by condition (quiet standing versus dual task). Outdoor fall risk may be tied to postural control more so than indoor falls. Dual tasking is likely related to fall risk among older and sicker older adults, but not those relatively healthy. Copyright © 2013 Elsevier B.V. All rights reserved.

Identifying reliable predictors of protein-energy malnutrition in hospitalized frail older adults. A prospective longitudinal study.

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Sanson, Gianfranco; Bertocchi, Luca; Dal Bo, Eugenia; Di Pasquale, Carmen Luisa; Zanetti, Michela

2018-03-07

Decreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identify patients for malnutrition at hospital admission and effectively monitoring their food intake. The primary aim was to identify reliable predictive indicators of reduced food intake at hospital admission. The secondary aims were to assess the adequacy of daily energy and protein intake and the impact of nutrient intake on patient outcomes. Prospective observational longitudinal study. Internal Medicine Ward of an Academic Teaching University Hospital. Acute older adults who were malnourished or at risk of malnutrition (Nutritional Risk Score-2002 ≥ 3, middle-upper arm circumference energy and protein intake was monitored during the first 5 days of hospital stay by a photographic method and compared to the daily energy and protein requirement calculated by specific equations. Data on anthropometry, inflammation/malnutrition laboratory data and body composition (phase angle calculated using bioelectrical impedance analysis) were collected. Eighty-one subjects (age 81.5 ± 11.5 years) were enrolled. Mean energy intake was 669.0 ± 573.9 kcal/day, and mean protein intake was 30.7 ± 25.8 g/day. Over 60% of patients ingested ≤50% of their calculated energy and protein requirements: these patients were older (p = 0.026), had a lower middle-upper arm circumference (p = 0.022) and total arm area (p = 0.038), a higher C-reactive protein/albumin ratio and Instant Nutritional Assessment score (p protein/albumin ratio, and impaired self-feeding at admission were independently associated with critically reduced energy and protein intake. Middle

Health Outcomes of Obtaining Housing Among Older Homeless Adults

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Miao, Yinghui; Mitchell, Susan L.; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L.; Grande, Laura J.; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A.

2015-01-01

Objectives. We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. Methods. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. Results. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Conclusions. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless. PMID:25973822

Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

Directory of Open Access Journals (Sweden)

Anat Mirelman

Full Text Available Recent findings suggest that executive function (EF plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk.We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR. After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021, the attention index (RR: .84; CI: .75-.94, p = .002 and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027 were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p<0.02.These findings demonstrate that among community-living older adults, the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

Falls in institutions for older adults: characterization of fall occurrences and associated risk factors

Directory of Open Access Journals (Sweden)

Cristina Rosa Soares Lavareda Baixinho

2015-12-01

Full Text Available Falls are the main accident for older adults, with consequences on functionality. Older adults impose restrictions or have restrictions imposed on their activities for fear of new falls. This prospective longitudinal study was conducted with 104 institutionalized older adults during six months with the following goals: to determine the prevalence of falls, to characterize the falls according to place, time, resulting injuries, supervision of the older adult, action performed at the time of the fall, and to relate the occurrence of the fall to the risk of falling, medical diagnoses, number of medications in use, type of medication, degree of dependency, age, and gender. The prevalence of falls was 37.5%, and they happened mostly in the bedroom, while walking after getting up from the bed. Those under risk in the Morse Fall Scale (p=0.034 and on sedatives (p=0.007 face a higher prevalence of falls. This study enables the possibility of making suggestions for practice, training and investigation.

Non-native Speech Learning in Older Adults.

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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.

Weight change and all-cause mortality in older adults: A meta-analysis

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This meta-analysis of observational cohort studies examined the association between weight change (weight loss, weight gain, and weight fluctuation) and all-cause mortality among older adults. We used PubMed (MEDLINE), Web of Science, and Cochrane Library to identify prospective studies published in...

Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review.

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Fernando, Eresha; Fraser, Michelle; Hendriksen, Jane; Kim, Corey H; Muir-Hunter, Susan W

2017-01-01

Purpose: People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood. A review is needed to determine a fall risk profile for this population. The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia. Methods: Articles published between January 1988 and October 2014 in EMBASE, PubMed, PsycINFO, and CINAHL were searched. Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment, prospective cohort design, detailed fall definition, falls as the primary outcome, and multi-variable regression analysis. Two authors independently reviewed and extracted data on study characteristics, quality assessment, and outcomes. Adjusted risk estimates were extracted from the articles. Results: A total of 17 studies met the inclusion criteria. Risk factors were categorized into demographic, balance, gait, vision, functional status, medications, psychosocial, severity of dementia, and other. Risk factors varied with living setting and were not consistent across all studies within a setting. Conclusion: Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors, some shared with older adults in general and others unique to the disease. Risk factors vary between community- and institution-dwelling samples of adults with dementia or cognitive impairment.

Older adults' personal routine at time of hospitalization.

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Zisberg, Anna; Gur-Yaish, Nurit

This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

Is bilingualism associated with a lower risk of dementia in community-living older adults? Cross-sectional and prospective analyses.

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Yeung, Caleb M; St John, Philip D; Menec, Verena; Tyas, Suzanne L

2014-01-01

The aim of this study was to determine whether bilingualism is associated with dementia in cross-sectional or prospective analyses of older adults. In 1991, 1616 community-living older adults were assessed and were followed 5 years later. Measures included age, sex, education, subjective memory loss (SML), and the modified Mini-mental State Examination (3MS). Dementia was determined by clinical examination in those who scored below the cut point on the 3MS. Language status was categorized based upon self-report into 3 groups: English as a first language (monolingual English, bilingual English) and English as a Second Language (ESL). The ESL category had lower education, lower 3MS scores, more SML, and were more likely to be diagnosed with cognitive impairment, no dementia at both time 1 and time 2 compared with those speaking English as a first language. There was no association between being bilingual (ESL and bilingual English vs. monolingual) and having dementia at time 1 in bivariate or multivariate analyses. In those who were cognitively intact at time 1, there was no association between being bilingual and having dementia at time 2 in bivariate or multivariate analyses. We did not find any association between speaking >1 language and dementia.

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.

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van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

2017-10-01

Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. Cross-sectional analysis of data from a longitudinal prospective study. Health, aging, and body composition study performed in the USA. 2,597 community-dwelling adults aged 70-79. A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Pain management in older adults.

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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.

Older Adults and Gambling: A Review

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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…

AIDS and the Older Adult.

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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.…

Physical activity and cognitive function among older adults in China: A systematic review

Directory of Open Access Journals (Sweden)

Jiaojiao Lü

2016-09-01

Conclusion: This systematic review provides initial evidence that PA may benefit cognition in older Chinese adults. Further studies of individuals with cognitive impairments and prospective and RCT studies having high scientific rigor are needed to corroborate the findings reported in this review.

Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.

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Geraedts, Hilde A E; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

2014-06-07

With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC. Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact. The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application of innovative technology in home

Family Caregiver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults With Cancer.

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Geddie, Patricia I; Wochna Loerzel, Victoria; Norris, Anne E

2016-07-01

To explore factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions for older adults with cancer.
. A prospective longitudinal design and a retrospective chart review.
. Adult oncology outpatient infusion centers and inpatient units at Orlando Regional Medical Center in Florida.
. A convenience sample of 129 dyads of older adults with cancer and their family caregivers. 
. Family caregiver demographic and side effect knowledge data were collected prospectively during interviews with family caregivers using a newly developed tool, the Nurse Assessment of Family Caregiver Knowledge and Action Tool. Patient demographic and clinical data were obtained through a retrospective chart review. Descriptive statistics and logistic regression analyses were used to evaluate data and examine relationships among variables.
. Patient illness characteristics; impaired function; side effects, such as infection, fever, vomiting, and diarrhea; family caregiver knowledge; and unplanned hospital admissions.
. Unplanned hospital admissions were more likely to occur when older adults had impaired function and side effects, such as infection, fever, vomiting, and diarrhea. Impaired function and family caregiver knowledge did not moderate the effects of these side effects on unplanned hospital admissions. 
. Findings suggest that the presence of impaired function and side effects, such as infection, fever, vomiting, and diarrhea, predict unplanned hospital admissions in older adults with cancer during the active treatment phase. Side effects may or may not be related to chemotherapy and may be related to preexisting comorbidities. 
. Nurses can conduct targeted assessments to identify older adults and their family caregivers who will need additional follow-up and support during the cancer treatment trajectory. Information gained from these assessments will assist nurses to provide practical and

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

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Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

2018-01-01

BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.

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.

Predicting older adults' maintenance in exercise participation using an integrated social psychological model

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Stiggelbout, M.; Hopman-Rock, M.; Crone, M.; Lechner, L.; Mechelen, W. van

2006-01-01

Little is known about the predictors of maintenance in organized exercise programmes. The aim of this study was to investigate the behavioral predictors of maintenance of exercise participation in older adults, using an integrated social psychological model. To this end, we carried out a prospective

Nutrition Education Brings Behavior and Knowledge Change in Limited-Resource Older Adults

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McClelland, Jacquelyn W.; Jayaratne, K.S.U.; Bird, Carolyn L.

2013-01-01

A prospective, controlled, randomized, crossover design was used to examine a nutrition education curriculum's effects on knowledge and behavior of 463 limited-resource older adults in 13 counties. Counties were randomized to begin with the treatment or control curriculum and then the remaining curriculum. Participants completed a pre-test…

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

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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.

Asthma Is More Severe in Older Adults

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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

Adult Age Differences in Dual Information Processes: Implications for the Role of Affective and Deliberative Processes in Older Adults' Decision Making.

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Peters, Ellen; Hess, Thomas M; Västfjäll, Daniel; Auman, Corinne

2007-03-01

Age differences in affective/experiential and deliberative processes have important theoretical implications for judgment and decision theory and important pragmatic implications for older-adult decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age. However, age-related adaptive processes, including motivated selectivity in the use of deliberative capacity, an increased focus on emotional goals, and greater experience, predict better or worse decisions for older adults depending on the situation. The aim of the current review is to examine adult age differences in affective and deliberative information processes in order to understand their potential impact on judgments and decisions. We review evidence for the role of these dual processes in judgment and decision making and then review two representative life-span perspectives (based on aging-related changes to cognitive or motivational processes) on the interplay between these processes. We present relevant predictions for older-adult decisions and make note of contradictions and gaps that currently exist in the literature. Finally, we review the sparse evidence about age differences in decision making and how theories and findings regarding dual processes could be applied to decision theory and decision aiding. In particular, we focus on prospect theory (Kahneman & Tversky, 1979) and how prospect theory and theories regarding age differences in information processing can inform one another. © 2007 Association for Psychological Science.

Sociality and intergenerational transfer of older adults' nostalgia.

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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.

Weather, day length and physical activity in older adults: Cross-sectional results from the European Prospective Investigation into Cancer and Nutrition (EPIC Norfolk Cohort.

Directory of Open Access Journals (Sweden)

Yu-Tzu Wu

Full Text Available A wide range of environmental factors have been related to active ageing, but few studies have explored the impact of weather and day length on physical activity in older adults. We investigate the cross-sectional association between weather conditions, day length and activity in older adults using a population-based cohort in England, the European Prospective Investigation into Cancer and Nutrition (EPIC Norfolk study.Physical activity was measured objectively over 7 days using an accelerometer and this was used to calculate daily total physical activity (counts per minute, daily minutes of sedentary behaviour and light, moderate and vigorous physical activity (LMVPA. Day length and two types of weather conditions, precipitation and temperature, were obtained from a local weather station. The association between these variables and physical activity was examined by multilevel first-order autoregressive modelling.After adjusting for individual factors, short day length and poor weather conditions, including high precipitation and low temperatures, were associated with up to 10% lower average physical activity (p<0.01 and 8 minutes less time spent in LMVPA but 15 minutes more sedentary time, compared to the best conditions.Day length and weather conditions appear to be an important factor related to active ageing. Future work should focus on developing potential interventions to reduce their impact on physical activity behaviours in older adults.

Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

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Mirelman, Anat; Herman, Talia; Brozgol, Marina; Dorfman, Moran; Sprecher, Elliot; Schweiger, Avraham; Giladi, Nir; Hausdorff, Jeffrey M

2012-01-01

Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021), the attention index (RR: .84; CI: .75-.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (pfalls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

Hypnosis for pain management in the older adult.

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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.

Suicide in older adults: current perspectives

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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

Changing Medical Students' Attitudes toward Older Adults

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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…

Physiological Parameters Database for Older Adults

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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...

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

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Singer, Jefferson; Rexhaj, Blerim; Baddeley, Jenna

2007-11-01

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

Catastrophic events and older adults.

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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

Macronutrients Intake and Incident Frailty in Older Adults: A Prospective Cohort Study.

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Sandoval-Insausti, Helena; Pérez-Tasigchana, Raúl F; López-García, Esther; García-Esquinas, Esther; Rodríguez-Artalejo, Fernando; Guallar-Castillón, Pilar

2016-10-01

Only a few studies have assessed the association between protein intake and frailty incidence and have obtained inconsistent results. This study examined the association of protein and other macronutrient intake with the risk of frailty in older adults. A prospective cohort of 1,822 community-dwelling individuals aged 60 and older was recruited in 2008-2010 and followed-up through 2012. At baseline, food consumption was assessed with a validated, computerized face-to-face diet history. In 2012, individuals were contacted again to ascertain incident frailty, defined as the presence of at least three of the five Fried criteria: low physical activity, slowness, unintentional weight loss, muscle weakness, and exhaustion. Analyses were performed using logistic regression and adjusted for the main confounders, including total energy intake. During a mean follow-up of 3.5 years, 132 persons with incident frailty were identified. The odds ratios (95% confidence interval) of frailty across increasing quartiles of total protein were 1.00, 0.55 (0.32-0.93), 0.45 (0.26-0.78), and 0.41 (0.23-0.72); p trend: .001. The corresponding figures for animal protein intake were 1.00, 0.68 (0.40-1.17), 0.56 (0.32-0.97), and 0.48 (0.26-0.87), p trend: .011. And for intake of monounsaturated fatty acids (MUFAs), the results were 1.00, 0.66 (0.37-1.20), 0.54 (0.28-1.02), and 0.50 (0.26-0.96); p trend: .038. No association was found between intake of vegetable protein, saturated fats, long-chain ω-3 fatty acids, α-linolenic acid, linoleic acid, simple sugars, or polysaccharides and the risk of frailty. Intake of total protein, animal protein, and MUFAs was inversely associated with incident frailty. Promoting the intake of these nutrients might reduce frailty. © 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.

Clinical Interviewing with Older Adults

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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…

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

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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.

Perceptions of exercise screening among older adults.

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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.

Suicide in older adults: current perspectives

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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

Physical activity during hospitalization: Activities and preferences of adults versus older adults.

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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.

Attitudes of neurology specialists toward older adults.

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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.

Resilience in Rural Community-Dwelling Older Adults

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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…

Dispositional Optimism and Incidence of Cognitive Impairment in Older Adults.

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Gawronski, Katerina A B; Kim, Eric S; Langa, Kenneth M; Kubzansky, Laura D

2016-09-01

Higher levels of optimism have been linked with positive health behaviors, biological processes, and health conditions that are potentially protective against cognitive impairment in older adults. However, the association between optimism and cognitive impairment has not been directly investigated. We examined whether optimism is associated with incident cognitive impairment in older adults. Data are from the Health and Retirement Study. Optimism was measured by using the Life Orientation Test-R and cognitive impairment with a modified version of the Telephone Interview for Cognitive Status derived from the Mini-Mental State Examination. Using multiple logistic regression models, we prospectively assessed whether optimism was associated with incident cognitive impairment in 4624 adults 65 years and older during a 4-year period. Among participants, 312 women and 190 men developed cognitive impairment during the 4-year follow-up. Higher optimism was associated with decreased risk of incident cognitive impairment. When adjusted for sociodemographic factors, each standard deviation increase in optimism was associated with reduced odds (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.61-0.81) of becoming cognitively impaired. A dose-response relationship was observed. Compared with those with the lowest levels of optimism, people with moderate levels had somewhat reduced odds of cognitive impairment (OR = 0.78, 95% CI = 0.59-1.03), whereas people with the highest levels had the lowest odds of cognitive impairment (OR = 0.52, 95% CI = 0.36-0.74). These associations remained after adjusting for health behaviors, biological factors, and psychological covariates that could either confound the association of interest or serve on the pathway. Optimism was prospectively associated with a reduced likelihood of becoming cognitively impaired. If these results are replicated, the data suggest that potentially modifiable aspects of positive psychological functioning such

Multiple Types of Memory and Everyday Functional Assessment in Older Adults

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Beaver, Jenna

2017-01-01

Abstract Objective Current proxy measures for assessing everyday functioning (e.g., questionnaires, performance-based measures, and direct observation) show discrepancies in their rating of functional status. The present study investigated the relationship between multiple proxy measures of functional status and content memory (i.e., memory for information), temporal order memory, and prospective memory in an older adult sample. Method A total of 197 community-dwelling older adults who did (n = 45) or did not meet (n = 152) criteria for mild cognitive impairment (MCI), completed six different assessments of functional status (two questionnaires, two performance-based tasks, and two direct observation tasks) as well as experimental measures of content memory, prospective memory, and temporal order memory. Results After controlling for demographics and content memory, the temporal order and prospective memory measures explained a significant amount of variance in all proxy functional status measures. When all variables were entered into the regression analyses, content memory and prospective memory were found to be significant predictors of all measures of functional status, whereas temporal order memory was a significant predictor for the questionnaire and direct observation measures, but not performance-based measures. Conclusion The results suggest that direct observation and questionnaire measures may be able to capture components of everyday functioning that require context and temporal sequencing abilities, such as multi-tasking, that are not as well captured in many current laboratory performance-based measures of functional status. Future research should aim to inform the development and use of maximally effective and valid proxy measures of functional ability. PMID:28334170

Gout in Older Adults: The Atherosclerosis Risk in Communities Study

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Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N.; Coresh, Josef

2016-01-01

Background: It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. Methods: We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population–based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. Results: The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63–6.63) increased gout risk in older age. Conclusions: These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. PMID:26714568

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

Physical Frailty Is Associated with Longitudinal Decline in Global Cognitive Function in Non-Demented Older Adults: A Prospective Study.

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Chen, S; Honda, T; Narazaki, K; Chen, T; Kishimoto, H; Haeuchi, Y; Kumagai, S

2018-01-01

To assess the relationship between physical frailty and subsequent decline in global cognitive function in the non-demented elderly. A prospective population-based study in a west Japanese suburban town, with two-year follow-up. Community-dwellers aged 65 and older without placement in long-term care, and not having a history of dementia, Parkinson's disease and depression at baseline, who participated in the cohort of the Sasaguri Genkimon Study and underwent follow-up assessments two years later (N = 1,045). Global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Physical frailty was identified according to the following five components: weight loss, low grip strength, exhaustion, slow gait speed and low physical activities. Linear regression models were used to examine associations between baseline frailty status and the MoCA scores at follow-up. Logistic regression models were used to estimate the risk of cognitive decline (defined as at least two points decrease of MoCA score) according to baseline frailty status. Seven hundred and eight non-demented older adults were included in the final analyses (mean age: 72.6 ± 5.5 years, male 40.3%); 5.8% were frail, and 40.8% were prefrail at baseline. One hundred and fifty nine (22.5%) participants experienced cognitive decline over two years. After adjustment for baseline MoCA scores and all confounders, being frail at baseline was significantly associated with a decline of 1.48 points (95% confidence interval [CI], -2.37 to -0.59) in MoCA scores, as compared with non-frailty. Frail persons were over two times more likely to experience cognitive decline (adjusted odds ratio 2.28; 95% CI, 1.02 to 5.08), compared to non-frail persons. Physical frailty is associated with longitudinal decline in global cognitive function in the non-demented older adults over a period of two years. Physically frail older community-dwellers should be closely monitored for cognitive decline that can be

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

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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

Coping and health in older adults.

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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.

Effectiveness of coordination exercise in improving cognitive function in older adults: a prospective study

Directory of Open Access Journals (Sweden)

Kwok TCY

2011-09-01

Full Text Available Timothy CY Kwok1,2, KC Lam2, PS Wong2, WW Chau2, Kenneth SL Yuen2,3, KT Ting2, Elite WK Chung2, Jessie CY Li2, Florence KY Ho2,41Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 2Jockey Club Centre for Positive Ageing, 3Laboratory of Neuropsychology, Department of Psychology, The University of Hong Kong, 4Jockey Club CADENZA Hub, Hong Kong SARBackground: Studies on the effect of a low intensity coordination exercise on the elderly with limited mobility are sparse. This prospective study attempted to compare the effectiveness of a customized coordination exercise and a strength exercise in improving the cognitive functioning and physical mobility on the elderly.Methods: Participants from two centers for the elderly were allocated to practice either an 8-week coordination training (CT program or an 8-week towel exercise (TE program. The Chinese Mini-Mental State Examination and Chinese Dementia Rating Scale (CDRS were used to measure cognitive functioning of participants, and Timed Up-and-Go test for physical mobility. These assessments were administered before and after the program.Results: Paired t-tests showed that the CDRS scores of the CT group improved significantly from 114.8 at pre-test to 119.3 after training (P = 0.045. The CDRS scores of the TE group also improved from 114.9 at pre-test to 116.9 after training.Conclusion: Findings from this prospective study demonstrated that low-intensity level mind-body exercise could be beneficial to the cognitive functioning of older adults.Keywords: coordination exercise, cognitive function, elderly, Chinese

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

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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.

Volunteering is prospectively associated with health care use among older adults.

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Kim, Eric S; Konrath, Sara H

2016-01-01

Although observational and experimental studies have shown that volunteering is linked with better mental health, physical health, and health behaviors, no studies have examined whether volunteering is associated with patterns of health care use. The purpose of this study was to prospectively examine whether volunteering was associated with a greater use of preventive health care services, but fewer doctor visits and nights spent in the hospital. Participants (n = 7168) were drawn from the 2006 wave of the Health and Retirement Study, a nationally representative panel study of American adults over the age of 51, and tracked for one wave (2 years). Logistic regression and generalized linear models were used for analyses. In analyses that adjusted for sociodemographic factors and baseline health, volunteers were 30% more likely to receive flu shots (OR = 1.30, 95% CI = 1.16-1.47), 47% more likely to receive cholesterol tests (OR = 1.47, 95% CI = 1.24-1.74); female volunteers were 53% more likely to receive mammograms/x-rays (OR = 1.53, 95% CI = 1.28-1.83) and 21% more likely to receive Pap smears (OR = 1.21, 95% CI = 1.03-1.41); male volunteers were 59% more likely to receive prostate exams (OR = 1.59, 95% CI = 1.29-1.95). In a model that adjusted for sociodemographic factors, volunteers spent 38% fewer nights in the hospital (RR = 0.62, 95% CI = 0.52-0.76), however volunteering was not associated with frequency of doctor visits (RR = 0.94, 95% CI = 0.87-1.02). The association between volunteering and number of nights spent in the hospital was minimally affected after adjusting for potential confounding (baseline health) and explanatory variables (health behaviors, social integration, stress, positive psychological factors, personality). This is the first known study to examine the association between volunteering and health care use. If future studies replicate these findings, the results may be used to inform the development of new

The role of chiropractic care in older adults

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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.

Older Adults' Acceptance of Information Technology

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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…

Emergency Department and Older Adult Motor Vehicle Collisions

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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.

Multiple Types of Memory and Everyday Functional Assessment in Older Adults.

Science.gov (United States)

Beaver, Jenna; Schmitter-Edgecombe, Maureen

2017-06-01

Current proxy measures for assessing everyday functioning (e.g., questionnaires, performance-based measures, and direct observation) show discrepancies in their rating of functional status. The present study investigated the relationship between multiple proxy measures of functional status and content memory (i.e., memory for information), temporal order memory, and prospective memory in an older adult sample. A total of 197 community-dwelling older adults who did (n = 45) or did not meet (n = 152) criteria for mild cognitive impairment (MCI), completed six different assessments of functional status (two questionnaires, two performance-based tasks, and two direct observation tasks) as well as experimental measures of content memory, prospective memory, and temporal order memory. After controlling for demographics and content memory, the temporal order and prospective memory measures explained a significant amount of variance in all proxy functional status measures. When all variables were entered into the regression analyses, content memory and prospective memory were found to be significant predictors of all measures of functional status, whereas temporal order memory was a significant predictor for the questionnaire and direct observation measures, but not performance-based measures. The results suggest that direct observation and questionnaire measures may be able to capture components of everyday functioning that require context and temporal sequencing abilities, such as multi-tasking, that are not as well captured in many current laboratory performance-based measures of functional status. Future research should aim to inform the development and use of maximally effective and valid proxy measures of functional ability. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of a Forgiveness Intervention for Older Adults

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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…

Gout in Older Adults: The Atherosclerosis Risk in Communities Study.

Science.gov (United States)

Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N; Coresh, Josef; McAdams-DeMarco, Mara A

2016-04-01

It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population-based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63-6.63) increased gout risk in older age. These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. © 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.

Improving associative memory in older adults with unitization.

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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.

Neighbourhood greenspace is associated with a slower decline in physical activity in older adults: A prospective cohort study

Directory of Open Access Journals (Sweden)

Alice M. Dalton

2016-12-01

Full Text Available Maintaining physical activity in later life is important for maintaining health and function. Activity outdoors, such as walking, jogging and cycling, may provide an accessible, sociable and practical solution, but maintaining outdoor mobility may be a challenge in later life. Providing green environments which are supportive of physical activity may facilitate this, yet research into how greenspace could be best used is inconclusive. This study evaluates the role of greenspace in protecting against decline in physical activity over time in older adults.Data from the European Prospective Investigation of Cancer Norfolk, UK, cohort 1993–2009 (N=15,672 was used. Linear regression modelling was used to examine the association between exposure to greenspace in the home neighbourhood and change in overall, recreational and outdoor physical activity measured in terms of metabolic equivalent cost (MET in hours/week. Mediation analysis was conducted to assess if dog walking explained the relationship between greenspace and physical activity change. Models were adjusted for known and hypothesised confounders.People living in greener neighbourhoods experienced less of a decline in physical activity than those living in less green areas. Comparing change for those living in the greenest versus least green quartiles, participants showed a difference in overall physical activity of 4.21 MET hours/week (trend P=0.001, adjusted for baseline physical activity, age, sex, BMI, social class and marital status. This difference was 4.03 MET hours/week for recreational physical activity (trend P<0.001 and 1.28 MET hours/week for outdoor physical activity (trend P=0.007. Dog walking partially mediated the association between greenspace and physical activity change, by 22.6% for overall, 28.1% for recreational and 50.0% for outdoor physical activity (all P<0.001.Greenspace in the home neighbourhood may be protective against decline in physical activity among older

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

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.

Prospective study of falls and risk factors for falls in adults with advanced cancer.

LENUS (Irish Health Repository)

Stone, Carol A

2012-06-10

Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

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

How retellings shape younger and older adults' memories.

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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.

Interference from previous distraction disrupts older adults' memory.

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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.

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

Changing Students' Stereotypes of Older Adults

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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…

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...

Implementing reverse mentoring to address social isolation among older adults.

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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.

Exploring Life Satisfaction Among Older Adults in Dakar.

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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.

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...

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.

Dietary Patterns and Cardiovascular Disease–Related Risks in Chinese Older Adults

Directory of Open Access Journals (Sweden)

Jing eSun

2013-11-01

Full Text Available AbstractStudies of Western populations demonstrate a relationship between dietary patterns and cardiovascular-related risk factors. Simiar research regarding Chinese populations is limited. This study explored the dietary patterns of Chinese older adults and their association with cardiovascular-related risk factors, including hypertension, obesity and metabolic syndrome. Data were collected using a 34-item Chinese food frequency questionnaire from 750 randomly selected older adults aged 50–88 who participated in the study in 2012. Factor analysis revealed four dietary patterns: a ‘traditional food pattern’, consisting of vegetable, fruit, rice, pork and fish; a ‘fast and processed food pattern’ consisting of fast or processed food products, sugar and confectionery; a ‘soybean, grain and flour food pattern’; and a ‘dairy, animal liver and other animal food pattern’. These patterns explained 17.48%, 9.52%, 5.51% and 4.80% of the variances in food intake, respectively. This study suggests that specific dietary patterns are evident in Chinese older adults. Moderate intake of ‘traditional Chinese food’ is associated with decreased blood pressure and cholesterol level. A dietary pattern rich in soybeans, grains, potatoes and flour is associated with reduced metabolic factors including reduced triglycerides, fasting glucose, waist circumference, and waist–hip ratio, and a high level of dairy, animal liver and other animal intake food pattern is associated with increased level of Body Mass Index. In conclusion, this study revealed identifiable dietary patterns among Chinese older adults that are significantly related to blood pressure and metabolic biomarkers. Further study using prospective cohort or intervention study should be used to confirm the association between dietary patterns and blood pressure and metabolic factors.

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

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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.

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.

Perceptions of emotion and age among younger, midlife, and older adults.

Science.gov (United States)

Santorelli, Gennarina D; Ready, Rebecca E; Mather, Molly A

2018-03-01

Older adults report greater emotional well-being than younger persons, yet negative stereotypes about aging are pervasive. Little is known about age group perceptions of emotion in adulthood, particularly for familiar persons. Thus, this project determined perceptions of general affect in familiar younger and older adults. In two studies, participants (Study 1, younger adult n = 123, older adult n = 43; Study 2, younger adult n = 34, midlife adult n = 41, older adult n = 16) provided self-report data about their affect in general, as well as reported on the affect of a familiar younger person (aged 18--34) and a familiar older person (aged 65 or older). Emotion scales assessed high- and low-arousal positive and negative affect. Results suggest a less favorable perception of emotion experiences of older adults compared to younger adults. Specifically, participants of all age groups rated older adults as having lower positive emotions and higher negative emotions than is found in self-report data. Perceptions of emotion in older adulthood reflect stereotypes of negative functioning. Older adult participants were not immune to holding negative views about older adults. Negative perceptions about emotion experiences in later life may be detrimental to the physical and mental health of older adults.

ShopComm: Community-Supported Online Shopping for Older Adults.

Science.gov (United States)

Gorkovenko, Katerina; Tigwell, Garreth W; Norrie, Christopher S; Waite, Miriam; Herron, Daniel

2017-01-01

The United Kingdom has an ageing population whose members experience significant life transitions as they grow older, for example, losing mobility due to deteriorating health. For these adults, digital technology has the potential to sustain their independence and improve their quality of life. However older adults can be reluctant to use digital solutions. In this paper, we review a local charity providing a grocery shopping service for older adults who are unable to go themselves. We explore how older adults perceive the benefits and drawbacks of both physical and digital shopping. Using these insights, we designed ShopComm to enable and support older adults with mobility impairments to shop online.

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.

Cancer: Unique to Older Adults

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... 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 ...

Underdiagnosis of Influenza Virus Infection in Hospitalized Older Adults.

Science.gov (United States)

Hartman, Lauren; Zhu, Yuwei; Edwards, Kathryn M; Griffin, Marie R; Talbot, H Keipp

2018-03-01

To describe factors associated with provider-ordered influenza testing in hospitalized older adults. Information on participant demographics, symptoms, and provider-ordered influenza testing were collected by questionnaire and chart review. We conducted prospective laboratory-based surveillance using reverse-transcriptase polymerase chain reaction (RT-PCR), the criterion standard for diagnosis of influenza, to determine how participant characteristics and provider-ordered testing affected accurate influenza diagnosis. One academic and three community hospitals in Davidson County, Tennessee. Adults aged 18 and older with acute respiratory illness or nonlocalizing fever (N=1,422). We compared characteristics of participants with and without provider-ordered testing for influenza using the Wilcoxon test and Pearson chi-square test. Multivariable logistic regression models were used to identify factors predictive of provider-ordered influenza testing. Twenty-eight percent (399/1,422) of participants had provider-ordered influenza testing. Participants who were tested were younger than those not tested (58 ± 18 vs 66 ± 15, p<.001) and more likely to have influenza-like illness (ILI) (71% vs 49%, p<.001). ILI decreased with increasing age (aged 18-49, 63%; aged 50-64, 60%; aged ≥65, 48%). ILI and younger age were independent predictors of provider-ordered testing. Of the 136 participants with influenza confirmed using RT-PCR, ILI was the only significant predictor of provider-ordered testing (adjusted odds ratio=3.43, 95% confidence interval=1.22-9.70). Adults aged 65 and older hospitalized with fever or respiratory symptoms during influenza season are less likely to undergo a provider-ordered influenza test than younger adults. Some, but not all, of this disparity is due to a lower likelihood of ILI. Further strategies are needed to increase clinician awareness and testing in this vulnerable group. © 2018, Copyright the Authors Journal compilation © 2018

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.

Effects of different amounts of exercise on preventing depressive symptoms in community-dwelling older adults: a prospective cohort study in Taiwan.

Science.gov (United States)

Chang, Yu-Chen; Lu, Mei-Chun; Hu, I-Han; Wu, Wan-Chi Ida; Hu, Susan C

2017-05-02

To compare the effects of four different amounts of exercise for preventing depressive symptoms in community-dwelling older adults. Prospective cohort study. A nationally representative sample in Taiwan. Four waves of the survey 'Taiwan Longitudinal Study on Aging (TLSA)' from 1996 to 2007 were analysed. A total of 2673 older adults aged 65 years and over were recruited. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Four different types/amounts of exercise were examined including: (1) 3 times/week, 15 min/time; (2) 3 times/week, 30 min/time; (3) 6 times/week, 15 min/time; and (4) 6 times/week, 30 min/time. All exercise types were required to have at least moderate intensity. The impacts of different amounts of exercise on depressive symptoms were analysed using generalised linear mixed models. More than one-fifth of the elder individuals under consideration had depressive symptoms (CESD ≥10). About 38.6% of older adults met the lowest criteria for exercise type 1, and fewer (28.0%) met the highest criteria for type 4. Only exercise type 4 in the current survey was initially related to lower depressive symptoms (OR=0.8, 95% CI 0.66 to 0.95). However, after considering the interaction between time and changes in exercise patterns, the results showed that all persistent exercise models, even if a very low amount (3 times/week, 15 min/time), had significantly preventive effects on depressive symptoms (OR=0.56~0.67). Consistent exercise with at least 15 min per time, three times a week of moderate intensity is significantly associated with lower risk of depressive symptoms. This low amount of exercise may be easier to promote at the community and population level than other alternatives. Registry number 104040 of the Institutional Ethics Committee of Chia-Yi Christian Hospital. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

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.

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.

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.

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

Directory of Open Access Journals (Sweden)

Wu YH

2015-01-01

Full Text Available Ya-Huei Wu,1,2 Souad Damnée,1,2 Hélène Kerhervé,1,2 Caitlin Ware,1,3 Anne-Sophie Rigaud1,2 1Department of Clinical Gerontology, Broca Hospital, Assistance Publique-Hôpitaux de Paris, 2Research Team 4468, Paris Descartes University, 3Centre de Recherche en Psychanalyse, Médicine et la Société, Paris Diderot University, Paris, France Purpose: 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.Patients and methods: 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.Results: 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”.Discussions and conclusion: This project encouraging older adults to be informed about

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.

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.

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.

Ageist attitudes block young adults' ability for compassion toward incapacitated older adults.

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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.

The Effects of Multisensory Balance Training on Postural Control in Older Adults

OpenAIRE

Farnoosh Shams; Afsoun Hassani Mehraban; Ghorban Taghizadeh

2011-01-01

Objectives: It has been found that older adults fall or sway significantly more than younger ones under sensory conflict conditions. Considering the prospects of future increases in the elderly population size of Iran and the lack of proper postural control and the high costs of its probable consequences, this study investigated the effects of multi balance training on postural control. Methods & Materials: In this semi-experimental study, 34 elderly women participated in two training and...

Online Attention Training for Older Adults.

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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.

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...

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....

The Effects of Spatial Enclosure on Social Interaction Between Older Adults With Dementia and Young Children.

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Cerruti, Minyoung S; Shepley, Mardelle M

2016-04-01

To examine the impact of spatial enclosures on social interaction between older adults with early stage dementia and young children. Intergenerational interaction through meaningful activities can promote positive affects and behaviors of children and older adults. The development of social interaction is closely related to the physical environment in association with personal competence of older adults with dementia and young children. However, minimal attention has been given to the role of physical environment in influencing intergenerational interaction. A quasi-experiment examined the functional relationship between the amount of spatial enclosure and the types of social behaviors of older adults with dementia and young children. Semi-structured interviews, aided by a photographic simulation, were developed to explore the participants' perceptions of and experiences with the different degrees of spatial enclosure. Findings showed that the semienclosed spatial plan impacted both prosocial and antisocial behaviors of older adults with dementia in their interactions with young children. This apparent discrepancy was associated with two conflicting perceptions: a sense of openness and the lack of control due to distraction created by the loose visual boundary. There was no correlation between the elder-child neutral behaviors and the degrees of spatial enclosure. This study suggests that spaces with moderate openness without visual and acoustic distraction are the most desirable to promote prosocial behaviors of older adults with dementia and young children. Additionally, elder-child prosocial behaviors were likely facilitated by specific design features such as adequate personal space, the perception of openness, and possible spaces that provide both prospect and refuge in relation to spatial enclosure. © The Author(s) 2016.

Executive functioning in older adults with hoarding disorder.

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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.

The impact of physical performance and cognitive status on subsequent ADL disability in low-functioning older adults

NARCIS (Netherlands)

Kempen, GIJM; Ormel, J

Objectives. The purpose of this study was to examine the independent contributions of physical performance and cognitive status to subsequent levels of ADL disability in low-functioning non-institutionalized older adults. Methods. A prospective cohort study included 416 women and 141 men 57 years of

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...

Television viewing time as a risk factor for frailty and functional limitations in older adults: results from 2 European prospective cohorts.

Science.gov (United States)

García-Esquinas, Esther; Andrade, Elena; Martínez-Gómez, David; Caballero, Francisco Félix; López-García, Esther; Rodríguez-Artalejo, Fernando

2017-04-26

Sedentariness is an important risk factor for poor health. The main objective of this work was to examine the prospective association between television viewing time and indicators of physical function, mobility, agility, and frailty. Data came from two independent cohorts of community-dwelling older adults: the Seniors-ENRICA (n = 2392, 3.5 year follow-up), and the ELSA (n = 3989, 3.9 year follow-up). At baseline, television viewing and other sedentary behaviors were ascertained using interviewer-administered questionnaires. In the Seniors-ENRICA cohort overall physical function at baseline and follow-up was assessed using the physical component summary (PCS) of the SF-12 Health Survey. Measures for incident mobility and agility limitations in both cohorts were based on standardized questions, and incident frailty was measured with the Fried criteria. Analyses were adjusted for the main confounders, including physical activity at baseline. Results across cohorts were pooled using a random effects model. Lower (worse) scores in the PCS were observed among those in the highest (vs. the lowest) tertile of television viewing time (b-coefficient:-1.66; 95% confidence interval:-2.81,-0.52; p-trend = 0.01). Moreover, the pooled odds ratios (95% CIs) for mobility limitations for the second and third (vs. the lowest) tertile of television viewing were 1.00 (0.84, 1.20) and 1.17 (1.00, 1.38); p-trend = 0.12, respectively. The corresponding results for agility limitations were 1.18 (0.97, 1.44) and 1.25 (1.03, 1.51); p-trend = 0.02. Results for incident frailty were 1.10 (0.80, 1.51) and 1.47 (1.09, 1.97); p-trend = 0.03. No association between other types of sedentary behavior (time seated at the computer, while commuting, lying in the sun, listening to music/reading, internet use) and risk of functional limitations was found. Among older adults, longer television viewing time is prospectively associated with limitations in physical function

Perspectives on wellness self-monitoring tools for older adults.

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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.

Exploring Older Adults' Health Information Seeking Behaviors

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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…

Advances in Psychotherapy for Depressed Older Adults.

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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.

Wound Healing in Older Adults.

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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'.

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…

Five dimensions of wellness and predictors of cognitive health protection in community-dwelling older adults: a historical COLLAGE cohort study.

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Strout, Kelley A; Howard, Elizabeth P

2015-03-01

Wellness is associated with cognitive health protection; however, findings are limited because they only examine variable(s) within one dimension of wellness. This research examined the association between multiple dimensions of wellness and cognition among aging adults. The sample included 5,605 male and female community-dwelling adults 60 years and older. Four dimensions of wellness demonstrated a statistically significant higher mean difference in cognitively healthy older adults compared to cognitively impaired older adults, F(4, 5,595) = 47.57, p < .001. Emotional wellness demonstrated the strongest association with cognitive health, followed by physical and spiritual wellness, F(5, 5,372) = 50.35, p < .001. Future research is needed to examine the cognitive protective benefits of wellness using longitudinal, prospective designs that control for the potential temporal relationship between wellness and cognition. © The Author(s) 2014.

Frailty and type of death among older adults in China: prospective cohort study

Science.gov (United States)

Warner, David F; Yi, Zeng

2009-01-01

Objective To examine the association between frailty and type of death among the world’s largest oldest-old population in China. Design Prospective cohort study. Setting 2002 and 2005 waves of the Chinese longitudinal healthy longevity survey carried out in 22 provinces throughout China. Participants 13 717 older adults (aged ≥65). Main outcome measures Type of death, categorised as being bedridden for fewer than 30 days with or without suffering and being bedridden for 30 or more days with or without suffering. Results Multinomial analyses showed that higher levels of frailty significantly increased the relative risk ratios of mortality for all types of death. Of those with the highest levels of frailty, men were most likely to experience 30 or more bedridden days with suffering before death (relative risk ratio 8.70, 95% confidence interval 6.31 to 12.00) and women 30 or more bedridden days with no suffering (11.53, 17.84 to 16.96). Regardless of frailty, centenarians and nonagenarians were most likely to experience fewer than 30 bedridden days with no suffering, whereas those aged 65-79 and 80-89 were more likely to experience fewer than 30 bedridden days with suffering. Adjusting for compositional differences had little impact on the link between frailty and type of death for both sexes and age groups. Conclusions The association between frailty and type of death differs by sex and age. Health scholars and clinical practitioners should consider age and sex differences in frailty to develop more effective measures to reduce preventable suffering before death. PMID:19359289

Trends in substance use admissions among older adults.

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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

Framing matters: Effects of framing on older adults' exploratory decision-making.

Science.gov (United States)

Cooper, Jessica A; Blanco, Nathaniel J; Maddox, W Todd

2017-02-01

We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults' decision-making performance was preserved when maximizing gains, but it declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subject behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss minimization from Experiment 1 and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults' performance in exploratory decision-making is hindered when framed as loss minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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.

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.

Preventing Elder Abuse and Neglect in Older Adults

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... 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 ...

Predictors of short-term mortality, cognitive and physical decline in older adults in northwest Russia: a population-based prospective cohort study.

Science.gov (United States)

Turusheva, Anna; Frolova, Elena; Hegendoerfer, Eralda; Degryse, Jean-Marie

2017-08-01

The classical phenotype, accumulated deficit model and self-report approach of frailty were found not useful in older adults in northwest Russia. More research is needed to identify predictors of adverse outcomes in this population. The aim of this study is to identify predictors of mortality, autonomy and cognitive decline in a population that is characterized by a high cardiovascular morbidity and mortality rate. A population-based prospective cohort study of 611 community-dwelling individuals 65+. Anthropometry, medical history nutritional status were recorded. An evaluation of cognitive, physical and autonomy function, spirometry, and laboratory tests were performed. The total follow-up was 5 years. Multiple imputation, backward stepwise Cox regression analysis, C-statistic, risk reclassification analysis and the bootstrapping techniques were used to analyze the data. We found that the combination of increasing age, male sex, low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s and anemia was associated with mortality for people 65+. The substitution of anemia with anemia + high level of C-reactive protein (hCRP) and the addition of high brain natriuretic peptide (hBNP) levels improved the classification of older persons at risk for mortality. The combination of low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s, anemia with hCRP levels and hBNP identified older persons at a higher risk for mortality. These predictors may be used for the development of a prediction model to detect older people who are at risk for adverse health outcomes in northwest Russia.

Temporal characteristics of imagined and actual walking in frail older adults.

Science.gov (United States)

Nakano, Hideki; Murata, Shin; Shiraiwa, Kayoko; Iwase, Hiroaki; Kodama, Takayuki

2018-05-09

Mental chronometry, commonly used to evaluate motor imagery ability, measures the imagined time required for movements. Previous studies investigating mental chronometry of walking have investigated healthy older adults. However, mental chronometry in frail older adults has not yet been clarified. To investigate temporal characteristics of imagined and actual walking in frail older adults. We investigated the time required for imagined and actual walking along three walkways of different widths [width(s): 50, 25, 15 cm × length: 5 m] in 29 frail older adults and 20 young adults. Imagined walking was measured with mental chronometry. We observed significantly longer imagined and actual walking times along walkways of 50, 25, and 15 cm width in frail older adults compared with young adults. Moreover, temporal differences (absolute error) between imagined and actual walking were significantly greater in frail older adults than in young adults along walkways with a width of 25 and 15 cm. Furthermore, we observed significant differences in temporal differences (constant error) between frail older adults and young adults for walkways with a width of 25 and 15 cm. Frail older adults tended to underestimate actual walking time in imagined walking trials. Our results suggest that walkways of different widths may be a useful tool to evaluate age-related changes in imagined and actual walking in frail older adults.

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.

Consumption of fruit and vegetables and risk of frailty: a dose-response analysis of 3 prospective cohorts of community-dwelling older adults.

Science.gov (United States)

García-Esquinas, Esther; Rahi, Berna; Peres, Karine; Colpo, Marco; Dartigues, Jean-François; Bandinelli, Stefania; Feart, Catherine; Rodríguez-Artalejo, Fernando

2016-07-01

Consuming fruit and vegetables (FVs) may protect against frailty, but to our knowledge no study has yet assessed their prospective dose-response relation. We sought to examine the dose-response association between FV consumption and the risk of frailty in older adults. Data were taken from 3 independent cohorts of community-dwelling older adults: the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk Factors in Spain) cohort (n = 1872), Three-City (3C) Bordeaux cohort (n = 581), and integrated multidisciplinary approach cohort (n = 473). Baseline food consumption was assessed with a validated computerized diet history (Seniors-ENRICA) or with a food-frequency questionnaire (3C Bordeaux and AMI). In all cohorts, incident frailty was assessed with the use of the Fried criteria. Results across cohorts were pooled with the use of a random-effects model. During a mean 2.5-y follow-up, 300 incident frailty cases occurred. Fully adjusted models showed that the pooled ORs (95% CIs) of incident frailty comparing participants who consumed 1, 2, or ≥3 portions of fruit/d to those with no consumption were, respectively, 0.59 (0.27, 0.90), 0.58 (0.29, 0.86), and 0.48 (0.20, 0.75), with a P-trend of 0.04. The corresponding values for vegetables were 0.69 (0.42, 0.97), 0.56 (0.35, 0.77), and 0.52 (0.13, 0.92), with a P-trend consumption of fruit and risk of exhaustion, low physical activity, and slow walking speed, whereas the consumption of vegetables was associated with a decreased risk of exhaustion and unintentional weight loss. Among community-dwelling older adults, FV consumption was associated with a lower short-term risk of frailty in a dose-response manner, and the strongest association was obtained with 3 portions of fruit/d and 2 portions of vegetables/d. © 2016 American Society for Nutrition.

Automated technology to speed recognition of signs of illness in older adults.

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Rantz, Marilyn J; Skubic, Marjorie; Koopman, Richelle J; Alexander, Gregory L; Phillips, Lorraine; Musterman, Katy; Back, Jessica; Aud, Myra A; Galambos, Colleen; Guevara, Rainer Dane; Miller, Steven J

2012-04-01

Our team has developed a technological innovation that detects changes in health status that indicate impending acute illness or exacerbation of chronic illness before usual assessment methods or self-reports of illness. We successfully used this information in a 1-year prospective study to alert health care providers so they could readily assess the situation and initiate early treatment to improve functional independence. Intervention participants showed significant improvements (as compared with the control group) for the Short Physical Performance Battery gait speed score at Quarter 3 (p = 0.03), hand grip-left at Quarter 2 (p = 0.02), hand grip-right at Quarter 4 (p = 0.05), and the GAITRite functional ambulation profile score at Quarter 2 (p = 0.05). Technological methods such as these could be widely adopted in older adult housing, long-term care settings, and in private homes where older adults wish to remain independent for as long as possible. Copyright 2012, SLACK Incorporated.

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...

The Partners in Health scale for older adults: design and examination of its psychometric properties in a Dutch population of older adults.

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Veldman, Karin; Reijneveld, Sijmen A; Lahr, Maarten M H; Uittenbroek, Ronald J; Wynia, Klaske

2017-08-01

Self-management is an important asset in helping older adults remain independent and in control for as long as possible. There is no reliable and valid measurement instrument to evaluate self-management behaviour of older adults. This study aims to design a measurement instrument, that is the Partners in Health scale for older adults (PIH-OA), to assess self-management knowledge and behaviour of community-living older adults and to examine its psychometric properties in a Dutch context. The original PIH scale was translated into Dutch and adapted to the context of community-living older adults, resulting in the PIH-OA. Data for 1127 participants (mean age 81.7, SD=4.5) from the Embrace study were used to assess the psychometric properties. Data fitted a three-factor model, covering the constructs Knowledge, Management and Coping, with good internal consistencies (Cronbach's alphas ranging from .77 to .84). Known groups validity was confirmed: no differences were found between gender, age and marital status groups, and differences were found between the education level and health status groups. Discriminant validity was confirmed by weak correlations between PIH-OA scales and scales evaluating "Perceived integrated care" and "Activities of daily living (ADL)" (rknowledge and behaviour of older adults. This could help professionals provide tailored support to improve the well-being and independence of older adults. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Inefficient postural responses to unexpected slips during walking in older adults.

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Tang, P F; Woollacott, M H

1998-11-01

Slips account for a high percentage of falls and subsequent injuries in community-dwelling older adults but not in young adults. This phenomenon suggests that although active and healthy older adults preserve a mobility level comparable to that of young adults, these older adults may have difficulty generating efficient reactive postural responses when they slip. This study tested the hypothesis that active and healthy older adults use a less effective reactive balance strategy than young adults when experiencing an unexpected forward slip occurring at heel strike during walking. This less effective balance strategy would be manifested by slower and smaller postural responses, altered temporal and spatial organization of the postural responses, and greater upper trunk instability after the slip. Thirty-three young adults (age range=19-34 yrs, mean=25+/-4 yrs) and 32 community-dwelling older adults (age range=70-87 yrs, mean=74+/-14 yrs) participated. Subjects walked across a movable forceplate which simulated a forward slip at heel strike. Surface electromyography was recorded from bilateral leg, thigh, hip, and trunk muscles. Kinematic data were collected from the right (perturbed) side of the body. Although the predominant postural muscles and the activation sequence of these muscles were similar between the two age groups, the postural responses of older adults were of longer onset latencies, smaller magnitudes, and longer burst durations compared to young adults. Older adults also showed a longer coactivation duration for the ankle, knee, and trunk agonist/antagonist pairs on the perturbed side and for the knee agonist/antagonist pair on the nonperturbed side. Behaviorally, older adults became less stable after the slips. This was manifested by a higher incidence of being tripped (21 trials in older vs 5 trials in young adults) and a greater trunk hyperextension with respect to young adults. Large arm elevation was frequently used by older adults to assist in

Amyloid burden and incident depressive symptoms in cognitively normal older adults.

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Harrington, Karra D; Gould, Emma; Lim, Yen Ying; Ames, David; Pietrzak, Robert H; Rembach, Alan; Rainey-Smith, Stephanie; Martins, Ralph N; Salvado, Olivier; Villemagne, Victor L; Rowe, Christopher C; Masters, Colin L; Maruff, Paul

2017-04-01

Several studies have reported that non-demented older adults with clinical depression show changes in amyloid-β (Aβ) levels in blood, cerebrospinal fluid and on neuroimaging that are consistent with those observed in patients with Alzheimer's disease. These findings suggest that Aβ may be one of the mechanisms underlying the relation between the two conditions. We sought to determine the relation between elevated cerebral Aβ and the presence of depression across a 54-month prospective observation period. Cognitively normal older adults from the Australian Imaging Biomarkers and Lifestyle study who were not depressed and had undergone a positron emission tomography scan to classify them as either high Aβ (n = 81) or low Aβ (n = 278) participated. Depressive symptoms were assessed using the Geriatric Depression Scale - Short Form at 18-month intervals over 54 months. Whilst there was no difference in probable depression between groups at baseline, incidence was 4.5 (95% confidence interval [CI] 1.3-16.4) times greater within the high Aβ group (9%) than the low Aβ group (2%) by the 54-month assessment. Results of this study suggest that elevated Aβ levels are associated with a 4.5-fold increased likelihood of developing clinically significant depressive symptoms on follow-up in preclinical Alzheimer's disease. This underscores the importance of assessing, monitoring and treating depressive symptoms in older adults with elevated Aβ. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Low Blood Sodium in Older Adults: A Concern?

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... 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 ...

Association between delirium superimposed on dementia and mortality in hospitalized older adults: A prospective cohort study.

Directory of Open Access Journals (Sweden)

Thiago J Avelino-Silva

2017-03-01

Full Text Available Hospitalized older adults with preexisting dementia have increased risk of having delirium, but little is known regarding the effect of delirium superimposed on dementia (DSD on the outcomes of these patients. Our aim was to investigate the association between DSD and hospital mortality and 12-mo mortality in hospitalized older adults.This was a prospective cohort study completed in the geriatric ward of a university hospital in São Paulo, Brazil. We included 1,409 hospitalizations of acutely ill patients aged 60 y and over from January 2009 to June 2015. Main variables and measures included dementia and dementia severity (Informant Questionnaire on Cognitive Decline in the Elderly, Clinical Dementia Rating and delirium (Confusion Assessment Method. Primary outcomes were time to death in the hospital and time to death in 12 mo (for the discharged sample. Comprehensive geriatric assessment was performed at admission, and additional clinical data were documented upon death or discharge. Cases were categorized into four groups (no delirium or dementia, dementia alone, delirium alone, and DSD. The no delirium/dementia group was defined as the referent category for comparisons, and multivariate analyses were performed using Cox proportional hazards models adjusted for possible confounders (sociodemographic information, medical history and physical examination data, functional and nutritional status, polypharmacy, and laboratory covariates. Overall, 61% were women and 39% had dementia, with a mean age of 80 y. Dementia alone was observed in 13% of the cases, with delirium alone in 21% and DSD in 26% of the cases. In-hospital mortality was 8% for patients without delirium or dementia, 12% for patients with dementia alone, 29% for patients with delirium alone, and 32% for DSD patients (Pearson Chi-square = 112, p < 0.001. DSD and delirium alone were independently associated with in-hospital mortality, with respective hazard ratios (HRs of 2.14 (95% CI

Motivation to Learn among Older Adults in Taiwan

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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…

Sexuality in Nigerian older adults.

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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.

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

Independent older adults perspectives on oral health.

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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.

Quick Guide to Health Literacy and Older Adults

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... 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 ...

Potential for intensive volunteering to promote the health of older adults in fair health.

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Barron, Jeremy S; Tan, Erwin J; Yu, Qilu; Song, Meilin; McGill, Sylvia; Fried, Linda P

2009-07-01

Volunteer service opportunities for older adults may soon be expanded. Although volunteering is thought to provide health benefits for healthier older adults, it is not known whether older adults in less than very good health are suitable candidates for high-intensity volunteering and can derive health benefits. This manuscript presents a prospective analysis of 174 older adult volunteers serving in Experience Corps Baltimore, a high-intensity senior volunteer program in Baltimore, Maryland. Volunteers served > or =15 h per week, for a full school year, in elementary schools helping children with reading and other skills between 1999 and 2002. Volunteers were assessed with standardized questionnaires and performance-based testing including grip strength, walking speed, chair stand speed, and stair-climbing speed prior to school volunteering and at the end of the school year. Results were stratified by health status. Among 174 volunteers, 55% initially reported "good" and 12% "fair" or "poor" health status. At baseline, those in fair health reported higher frequencies of disease and disability than volunteers in excellent or very good health. After volunteering, a majority of volunteers in every baseline health status category described increased strength and energy. Those in fair health were significantly more likely to display improved stair-climbing speed than those in good or excellent/very good health (100.0% vs. 53.4% vs. 37.5%, p = 0.05), and many showed clinically significant increases in walking speed of >0.5 m/s. Satisfaction and retention rates were high for all health status groups. Clinicians should consider whether their patients in fair or good health, as well as those in better health, might benefit from high-intensity volunteer programs. Productive activity such as volunteering may be an effective community-based approach to health promotion for older adults.

Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder.

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Rolin, Stephanie A; Aschbrenner, Kelly A; Whiteman, Karen L; Scherer, Emily; Bartels, Stephen J

2017-09-01

The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. Three community mental health centers in New Hampshire and Massachusetts. Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization. Copyright © 2017

Using informatics to capture older adults' wellness.

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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

Older Adults Have Difficulty in Decoding Sarcasm

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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…

Healthcare-Associated Meningitis or Ventriculitis in Older Adults.

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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.

Snow and Rain Modify Neighbourhood Walkability for Older Adults.

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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.

Cohabitation among older adults: a national portrait.

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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.

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

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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.

Effects of a community disability prevention program for frail older adults at 48-month follow up.

Science.gov (United States)

Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutumimoto, Kota; Yoshida, Daisuke; Suzuki, Takao

2017-12-01

The present prospective study was carried out to determine whether participation in community-based intervention studies exerted a positive impact on disability prevention in older adults with physical frailty. A total of 514 community-dwelling older adults (aged ≥65 years) with physical frailty who had undergone baseline assessment and participated in community-based intervention studies (participants) or did not (non-participants) were included in the present study. Non-participants were selected through propensity score matching, to balance potential covariates at baseline. Disability incidence was followed up at 48 months as a main outcome. Demographic data (age, sex and medical history), global cognitive function, grip strength, walking speed, and blood test results including serum albumin and brain-derived neurotrophic factor at baseline were included as covariates. Disability incidence rates differed significantly between participants (11.3%) and non-participants (19.8%) of community-based intervention studies during the 48-month follow-up period (P = 0.007). Participation in community-based intervention studies (hazard ratio 0.55, 95% confidence interval 0.35-0.88) was significantly associated with the incidence of disability in older adults with physical frailty. Participation in community-based intervention studies could reduce the incidence of disability in older adults with physical frailty. Thus, strategies designed to increase the number of participants in community-based intervention programs should be considered in community-based approaches for the prevention of disability in older adults with physical frailty. Geriatr Gerontol Int 2017; 17: 2347-2353. © 2017 Japan Geriatrics Society.

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.

Stereotype threat can reduce older adults' memory errors.

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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.

Dental Care Utilization among North Carolina Rural Older Adults

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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

Differences of oral health conditions between adults and older adults: A census in a Southern Brazilian city.

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Boscato, Noeli; Schuch, Helena S; Grasel, Claudia E; Goettems, Marilia L

2016-09-01

To assess differences in the oral diseases/conditions between adults and older adults. A cross-sectional study was carried out with all adults and older adults in Luzerna, South Brazil (n = 569). Clinical data included use of and need for dental prostheses; number of decayed, missing and filled teeth; and temporomandibular disorder. Differences between adults and older adults were evaluated using χ(2) -tests. Associations between independent variables and the use of and need for dental prostheses were determined using Poisson regression analyses (P older adults. After adjustments, lower social class (P = 0.001) and unmarried status (P = 0.05) were associated with greater need for prosthetic rehabilitation. Women (P = 0.02), older individuals (P adults and older adults was observed. The frequency of use of and need for dental prostheses was higher for older adults, although they had reported lower frequency of temporomandibular disorder. Women, married and individuals of higher socioeconomic status showed better oral health conditions. Geriatr Gerontol Int 2016; 16: 1014-1020. © 2015 Japan Geriatrics Society.

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

Lifelong education for older adults in Malta: Current trends and future visions

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Formosa, Marvin

2012-04-01

With European demographic developments causing a decline of the available workforce in the foreseeable future and the unsustainability of dominant pay-as-you-go pension systems (where contributions from the current workforce sustain pensioners), governments need to come up with strategies to deal with this upcoming challenge and to adjust their policies. Based on a study carried out between September 2009 and May 2010, this article evaluates the policies guiding late-life education in Malta, as well as the local plethora of learning opportunities for older adult education, and participation rates. The Maltese government is committed to supporting the inclusion of older persons (aged 60+) in lifelong education policies and programmes, to the extent that local studies have uncovered a recent rise in the overall participation of older adults in formal, non-formal and informal areas of learning. While the present and future prospects for late-life education in Malta seem promising, a critical scrutiny of present ideologies and trends finds the field to be no more than seductive rhetoric. Though the coordination of late-life education in Malta does result in various social benefits to older learners and Maltese society in general, it also occurs within five intersecting lines of inequality - namely an economic rationale, elitism, gender bias, the urban-rural divide and third ageism. This article ends by proposing policy recommendations for the future of late-life education.

The secrets of highly active older adults.

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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.

Positive messaging promotes walking in older adults.

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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.

Hiring and screening practices of agencies supplying paid caregivers to older adults.

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Lindquist, Lee A; Cameron, Kenzie A; Messerges-Bernstein, Joanne; Friesema, Elisha; Zickuhr, Lisa; Baker, David W; Wolf, Michael

2012-07-01

To assess what screening practices agencies use in hiring caregivers and how caregiver competency is measured before assigning responsibilities in caring for older adults. One-to-one phone interviews in which interviewers posed as prospective clients seeking a caregiver for an older adult relative. Cross-sectional cohort of agencies supplying paid caregivers to older adults in Illinois, California, Florida, Colorado, Arizona, Wisconsin, and Indiana. Four hundred sixty-two home care agencies were contacted, of which 84 were no longer in service, 165 offered only nursing care, and 33 were excluded; 180 agencies completed interviews. Agencies were surveyed about their hiring methods, screening measures, training practices, skill competencies assessments, and supervision. Two coders qualitatively analyzed open-ended responses. To recruit caregivers, agencies primarily used print and Internet (e.g., Craigslist.com) advertising (n = 69, 39.2%) and word-of-mouth referrals (n = 49, 27.8%). In hiring, agencies required prior "life experiences" (n = 121, 68.8%) few of which (n = 33, 27.2%) were specific to caregiving. Screening measures included federal criminal background checks (n = 96, 55.8%) and drug testing (n = 56, 31.8%). Agencies stated that the paid caregiver could perform skills, such as medication reminding (n = 169, 96.0%). Skill competency was assessed according to caregiver self-report (n = 103, 58.5%), testing (n = 62, 35.2%), and client feedback (n = 62, 35.2%). General caregiver training length ranged from 0 to 7 days. Supervision ranged from none to weekly and included home visits, telephone calls, and caregivers visiting the central office. Using an agency to hire paid caregivers may give older adults and their families a false sense of security regarding the background and skill set of the caregiver. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Symptom burden predicts hospitalization independent of comorbidity in community-dwelling older adults.

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Salanitro, Amanda H; Hovater, Martha; Hearld, Kristine R; Roth, David L; Sawyer, Patricia; Locher, Julie L; Bodner, Eric; Brown, Cynthia J; Allman, Richard M; Ritchie, Christine S

2012-09-01

To determine whether cumulative symptom burden predicts hospitalization or emergency department (ED) visits in a cohort of older adults. Prospective, observational study with a baseline in-home assessment of symptom burden. Central Alabama. Nine hundred eighty community-dwelling adults aged 65 and older (mean 75.3 ± 6.7) recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban/rural residence. Symptom burden score (range 0-10). One point was given for each symptom reported: shortness of breath, tiredness or fatigue, problems with balance or dizziness, leg weakness, poor appetite, pain, stiffness, constipation, anxiety, and loss of interest in activities. Dependent variables were hospitalizations and ED visits, assessed every 6 months during the 8.5-year follow-up period. Using Cox proportional hazards models, time from the baseline in-home assessment to the first hospitalization and first hospitalization or ED visit was determined. During the 8.5-year follow-up period, 545 (55.6%) participants were hospitalized or had an ED visit. Participants with greater symptom burden had higher risk of hospitalization (hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.05-1.14) and hospitalization or ED visit (HR = 1.10, 95% CI = 1.06-1.14) than those with lower scores. Participants living in rural areas had significantly lower risk of hospitalization (HR = 0.83, 95% CI = 0.69-0.99) and hospitalization or ED visit (HR = 0.80, 95% CI = 0.70-0.95) than individuals in urban areas, independent of symptom burden and comorbidity. Greater symptom burden was associated with higher risk of hospitalization and ED visits in community-dwelling older adults. Healthcare providers treating older adults should consider symptom burden to be an additional risk factor for subsequent hospital utilization. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

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 ...

The Effects of Feedback on Memory Strategies of Younger and Older Adults.

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Zhang, Fan; Zhang, Xin; Luo, Meng; Geng, Haiyan

2016-01-01

Existing literature suggests that feedback could effectively reduce false memories in younger adults. However, it is unclear whether memory performance in older adults also might be affected by feedback. The current study tested the hypothesis that older adults can use immediate feedback to adjust their memory strategy, similar to younger adults, but after feedback is removed, older adults may not be able to maintain using the memory strategy. Older adults will display more false memories than younger adults due to a reduction in attentional resources. In Study 1, both younger and older adults adjusted gist processing and item-specific processing biases based on the feedback given (i.e., biased and objective feedback). In Study 2 after the feedback was removed, only younger adults with full attention were able to maintain the feedback-shaped memory strategy; whereas, both younger adults with divided attention and older adults had increased false memories after feedback was removed. The findings suggest that environmental support helps older adults as well as younger adults to adopt a memory strategy that demands high attentional resources, but when the support is removed, older adults can no longer maintain such a strategy.

The Association between Sleep Problems, Sleep Medication Use, and Falls in Community-Dwelling Older Adults: Results from the Health and Retirement Study 2010

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2016-01-01

Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on the risk of falls after controlling for covariates. Results. Among 9,843 community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the participants. Older adults who do have sleep problems and take sleep medications had a significant high risk of falls, compared to older adults who do not have sleep problems and do not take sleep medications. The other two groups also had significantly greater risk for falls. Conclusion. Sleep problems added to sleep medication use increase the risk of falls. Further prospective studies are needed to confirm these observed findings. PMID:27547452

The effect of a music therapy intergenerational program on children and older adults' intergenerational interactions, cross-age attitudes, and older adults' psychosocial well-being.

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Belgrave, Melita

2011-01-01

The purpose of this study was to examine the effect of participation in a music-based intergenerational music program on cross-age interactions and cross-age attitudes of elementary-age children and older adults, and older adults' psychosocial well-being. Twenty-one children in the 4th grade volunteered to participate in the experimental (n = 12) or control (n = 9) group. Twenty-six older adults from a retirement living facility also volunteered to participate in the experimental (n = 14) or control (n = 12) group. Ten 30-min music sessions occurred in which participants engaged in singing, structured conversation, moving to music, and instrument playing interventions. Data analysis of cross-age interactions revealed that the interventions "structured conversation" and "moving to music" were more effective in eliciting interaction behaviors than the interventions "singing" and "instrument playing." Standardized measures revealed that children's attitudes towards older adults improved, though not significantly so, after participation in the intergenerational program. Results of biweekly post-session questionnaires revealed a decrease in negative descriptions of older adults and an increase in positive descriptions of older adults--suggesting a more positive view towards aging. Results revealed that older adults' attitudes towards children improved significantly after their participation in the intergenerational program. While standardized measures revealed that older adults did not perceive a significant improvement in their psychosocial well-being, their bi-weekly post-session questionnaires showed they perceived increased feelings of usefulness and other personal benefits from the intergenerational interactions. Suggestions for future research, the utility of varied measurement instruments, and implications for practice are discussed.

Gaps in nutritional research among older adults with cancer

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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

Personality disorders in older adults : Emerging research issues

NARCIS (Netherlands)

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

2015-01-01

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

Personality disorders in older adults : emerging research issues

NARCIS (Netherlands)

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

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

Aging and the Socioeconomic Life of Older Adults in India

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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.

Perspectives on Wellness Self-Monitoring Tools for Older Adults

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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

Older adults learn less, but still reduce metabolic cost, during motor adaptation

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Huang, Helen J.

2013-01-01

The ability to learn new movements and dynamics is important for maintaining independence with advancing age. Age-related sensorimotor changes and increased muscle coactivation likely alter the trial-and-error-based process of adapting to new movement demands (motor adaptation). Here, we asked, to what extent is motor adaptation to novel dynamics maintained in older adults (≥65 yr)? We hypothesized that older adults would adapt to the novel dynamics less well than young adults. Because older adults often use muscle coactivation, we expected older adults to use greater muscle coactivation during motor adaptation than young adults. Nevertheless, we predicted that older adults would reduce muscle activity and metabolic cost with motor adaptation, similar to young adults. Seated older (n = 11, 73.8 ± 5.6 yr) and young (n = 15, 23.8 ± 4.7 yr) adults made targeted reaching movements while grasping a robotic arm. We measured their metabolic rate continuously via expired gas analysis. A force field was used to add novel dynamics. Older adults had greater movement deviations and compensated for just 65% of the novel dynamics compared with 84% in young adults. As expected, older adults used greater muscle coactivation than young adults. Last, older adults reduced muscle activity with motor adaptation and had consistent reductions in metabolic cost later during motor adaptation, similar to young adults. These results suggest that despite increased muscle coactivation, older adults can adapt to the novel dynamics, albeit less accurately. These results also suggest that reductions in metabolic cost may be a fundamental feature of motor adaptation. PMID:24133222

Introduction of a university-based counselling service for older adults.

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Bhar, Sunil S; Silver, Mark

2014-03-01

Despite the growing number of older adults in Australia, many do not access counselling, partly because of the lack of trained mental health professionals for older people. This paper describes an innovative solution for providing counselling services to older adults, and geropsychology training to postgraduate psychology students. A university-based counselling clinic for older adults was described – an outreach service for older adults living in the community or in residential aged care facilities in metropolitan Melbourne, Australia. Over its first 13 months, the clinic provided a total of 266 sessions of counselling to 57 clients (41 living in residential aged care), and involved six postgraduate students. This paper describes the potential benefits of the clinic for clients and students and the resources needed to support this model of service delivery. Thus, it provides a blueprint for other universities for developing similar services for older adults.

Financial Exploitation Is Associated With Structural and Functional Brain Differences in Healthy Older Adults.

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Spreng, R Nathan; Cassidy, Benjamin N; Darboh, Bri S; DuPre, Elizabeth; Lockrow, Amber W; Setton, Roni; Turner, Gary R

2017-10-01

Age-related brain changes leading to altered socioemotional functioning may increase vulnerability to financial exploitation. If confirmed, this would suggest a novel mechanism leading to heightened financial exploitation risk in older adults. Development of predictive neural markers could facilitate increased vigilance and prevention. In this preliminary study, we sought to identify structural and functional brain differences associated with financial exploitation in older adults. Financially exploited older adults (n = 13, 7 female) and a matched cohort of older adults who had been exposed to, but avoided, a potentially exploitative situation (n = 13, 7 female) were evaluated. Using magnetic resonance imaging, we examined cortical thickness and resting state functional connectivity. Behavioral data were collected using standardized cognitive assessments, self-report measures of mood and social functioning. The exploited group showed cortical thinning in anterior insula and posterior superior temporal cortices, regions associated with processing affective and social information, respectively. Functional connectivity encompassing these regions, within default and salience networks, was reduced, while between network connectivity was increased. Self-reported anger and hostility was higher for the exploited group. We observed financial exploitation associated with brain differences in regions involved in socioemotional functioning. These exploratory and preliminary findings suggest that alterations in brain regions implicated in socioemotional functioning may be a marker of financial exploitation risk. Large-scale, prospective studies are necessary to validate this neural mechanism, and develop predictive markers for use in clinical practice. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

Hypothyroidism: challenges when treating older adults.

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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.

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

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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.

Reverse correlating trustworthy faces in young and older adults

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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.

Older Adults' Memory for Verbally Presented Medical Information

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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…

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

Tooth loss associated with physical and cognitive decline in older adults.

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Tsakos, Georgios; Watt, Richard G; Rouxel, Patrick L; de Oliveira, Cesar; Demakakos, Panayotes

2015-01-01

To examine the effect of total tooth loss (edentulousness) on decline in physical and cognitive functioning over 10 years in older adults in England. Secondary data analysis. English Longitudinal Study of Ageing, a national prospective cohort study of community-dwelling people aged 50 and older. Individuals aged 60 and older (N = 3,166). Cognitive function (memory) was measured using a 10-word recall test. Physical function was assessed using gait speed (m/s). Generalized estimating equations were used to model associations between baseline edentulousness and six repeated measurements of gait speed and memory from 2002-03 to 2012-13. Models were sequentially adjusted for time, demographic characteristics, socioeconomic status, comorbidities, health behaviors, depressive symptoms, and anthropometric measurements and mutually adjusted for gait speed or memory. Edentulous participants recalled 0.88 fewer words and were 0.09 m/s slower than dentate participants after adjusting for time and demographics. Only the latter association remained significant after full adjustment, with edentulous participants being 0.02 m/s slower than dentate participants. In age-stratified analyses, baseline edentulousness was associated with both outcomes in fully adjusted models in participants aged 60 to 74 but not in those aged 75 and older. Supplementary analysis indicated significant associations between baseline edentulousness and 4-year change in gait speed and memory in participants aged 60 to 74; the former was fully explained in the fully adjusted model and the latter after adjusting for socioeconomic status. Total tooth loss was independently associated with physical and cognitive decline in older adults in England. Tooth loss is a potential early marker of decline in older age. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Older adults abuse in three Brazilian cities

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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.

Filipino older adults' beliefs about exercise activity.

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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.

How Arousal Affects Younger and Older Adults' Memory Binding

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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

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.

A concept analysis of dignity for older adults.

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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.

What Older Adults Need to Know about Retail Clinics

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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, ...

Sociodemographic, behavioural and health factors associated with changes in older adults' TV viewing over 2 years.

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Gardner, Benjamin; Iliffe, Steve; Fox, Kenneth R; Jefferis, Barbara J; Hamer, Mark

2014-08-15

Of all age groups, older adults spend the most time watching TV, which is one of the most common sedentary behaviours. Such sedentary activity in older adulthood is thought to risk deterioration of physical and mental functioning, health and wellbeing. Identifying the characteristics of older adults whose TV viewing increases over time may help to target sedentary behaviour reduction interventions to those in most urgent need. Yet, studies of the factors associated with TV viewing have predominantly been cross-sectional. This study used a prospective design to describe changes in TV viewing over a two-year follow-up period, and to model socio-demographic, behavioural and health factors associated with observed changes in viewing time. A two-year follow-up of 6,090 male and female older adults (mean age 64.9 ± 8.9 years) was conducted in the English Longitudinal Study of Ageing, a cohort of community dwelling older adults. TV viewing time was self-reported at baseline and at follow-up. The sample was categorised according to baseline TV viewing duration (TV viewing time between baseline and follow-up. Mean self-reported TV viewing time increased from 5.32 ± 4.08 hrs/d at baseline to 5.53 ± 4.19 hrs/d at follow-up (p TV viewing (23% of all participants by 60 minutes or more), 41% decreased their viewing, and 10% reported no change in viewing duration. Increases in TV viewing at follow-up were associated with lower socioeconomic status, presence of depressive symptoms, higher BMI, physical inactivity, and being a smoker at baseline. Findings call for the development of effective behaviour change interventions to counter increases in inactive TV viewing among older adults, and point to subgroups who may need to be prioritised for such interventions.

Compensatory Processing During Rule-Based Category Learning in Older Adults

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Bharani, Krishna L.; Paller, Ken A.; Reber, Paul J.; Weintraub, Sandra; Yanar, Jorge; Morrison, Robert G.

2016-01-01

Healthy older adults typically perform worse than younger adults at rule-based category learning, but better than patients with Alzheimer's or Parkinson's disease. To further investigate aging's effect on rule-based category learning, we monitored event-related potentials (ERPs) while younger and neuropsychologically typical older adults performed a visual category-learning task with a rule-based category structure and trial-by-trial feedback. Using these procedures, we previously identified ERPs sensitive to categorization strategy and accuracy in young participants. In addition, previous studies have demonstrated the importance of neural processing in the prefrontal cortex and the medial temporal lobe for this task. In this study, older adults showed lower accuracy and longer response times than younger adults, but there were two distinct subgroups of older adults. One subgroup showed near-chance performance throughout the procedure, never categorizing accurately. The other subgroup reached asymptotic accuracy that was equivalent to that in younger adults, although they categorized more slowly. These two subgroups were further distinguished via ERPs. Consistent with the compensation theory of cognitive aging, older adults who successfully learned showed larger frontal ERPs when compared with younger adults. Recruitment of prefrontal resources may have improved performance while slowing response times. Additionally, correlations of feedback-locked P300 amplitudes with category-learning accuracy differentiated successful younger and older adults. Overall, the results suggest that the ability to adapt one's behavior in response to feedback during learning varies across older individuals, and that the failure of some to adapt their behavior may reflect inadequate engagement of prefrontal cortex. PMID:26422522

Geriatric dermatology: optimising care in frail older adults

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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,

Acquired Inhibitors: A Special Case of Bleeding in Older Adults

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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.

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

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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...

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

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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.

Walking through doorways causes forgetting: Younger and older adults.

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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).

Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management.

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Parker, Samantha J; Jessel, Sonal; Richardson, Joshua E; Reid, M Cary

2013-05-06

Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults' attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management. We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes. Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%). This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, m

Count me in: response to sexual orientation measures among older adults.

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Fredriksen-Goldsen, Karen I; Kim, Hyun-Jun

2015-07-01

Health disparities exist among sexual minority older adults. Yet, health and aging surveys rarely include sexual orientation measures and when they do, they often exclude older adults from being asked about sexual orientation. This is the first population-based study to assess item nonresponse to sexual orientation measures by age and change over time. We compare response rates and examine time trends in response patterns using adjusted logistic regressions. Among adults aged 65 and older, the nonresponse rate on sexual orientation is lower than income. While older adults show higher nonresponse rates on sexual orientation than younger adults, the nonresponse rates have significantly decreased over time. By 2010, only 1.23% of older adults responded don't know/not sure, with 1.55% refusing to answer sexual orientation questions. Decisions to not ask sexual orientation among older adults must be reconsidered, given documented health disparities and rapidly changing social trends in the understanding of diverse sexualities. © The Author(s) 2014.

Improving nursing students' assessment of fall risk in community-dwelling older adults.

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Patton, Susan K

2016-12-09

Nationally, approximately one third of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence-based protocols by health care providers to identify older adults at risk of falling is limited, and rates of participation by older adults in prevention activities is low. Because of nursing's increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community-dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 undergraduate nursing students and 22 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult. After completing the clinical assignment, students completed a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. Results revealed an increase in knowledge and student self-reporting of efficacy of fall risk assessment skills for the older adult population. This study suggests that nursing students acquired the necessary knowledge and self-efficacy for assessing fall risk of older adults through the combination of an online learning module and participating in actual fall risk assessment of an older adult.

Undernutrition: who cares? Perspectives of dietitians and older adults on undernutrition

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Beelen, J.; Vasse, Emmelyne; Ziylan, C.; Janssen, N.; Roos, de N.M.; Groot, de C.P.G.M.

2017-01-01

Background: Many older adults are at risk of undernutrition. Dietitians play a key role in the management and treatment of undernutrition, but older adults have difficulties to comply with dietetic recommendations. This qualitative study investigated which barriers older adults experience in

Differences in Risk Aversion between Young and Older Adults.

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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.

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

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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.

A prospective investigation of neighborhood socioeconomic deprivation and physical activity and sedentary behavior in older adults.

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Xiao, Qian; Keadle, Sarah K; Berrigan, David; Matthews, Charles E

2018-06-01

Neighborhood conditions may have an important impact on physical activity and sedentary behaviors in the older population. Most previous studies in this area are cross-sectional and report mixed findings regarding the effects of neighborhood environment on different types of physical activity. Moreover, little is known about the prospective relationship between neighborhood environment and sedentary behaviors. Our analysis included 136,526 participants from the NIH-AARP Diet and Health Study (age 51-70). Neighborhood socioeconomic deprivation was measured with an index based on census variables and developed using principal component analysis. Physical activity and sedentary behaviors were measured both at baseline (1995-1996) and follow-up (2004-2006). Multiple regression analyses were conducted to examine the prospective relationship between neighborhood deprivation and exercise, non-exercise physical activity, and sedentary behaviors, adjusting for baseline physical activity and sedentary behaviors as well as potential confounders. We found that more severe neighborhood socioeconomic deprivation was prospectively associated with reduced time for exercise (β Q5 vs Q1 (95% confidence interval), hour, -0.85 (-0.95, -0.75)) but increased time spent in non-exercise physical activities (1.16 (0.97, 1.34)), such as household activities, outdoor chores, and walking for transportation. Moreover, people from more deprived neighborhoods were also more likely to engage in prolonged (≥5 h/day) TV viewing (Odds ratio Q5 vs Q1 (95% confidence interval), 1.21 (1.15, 1.27)). In conclusion, neighborhood socioeconomic deprivation is associated with physical activity and sedentary behavior in the older population. These associations may differ for different types of physical activities. Copyright © 2018 Elsevier Inc. All rights reserved.

Older Adults: What Every Paediatric Nurse Should Know

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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…

Older Adults' Motivation to Learn in Higher Education

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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…

Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

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Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

2014-01-01

Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

Physical activity-friendly neighbourhood among older adults from a medium size urban setting in Southern Europe.

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Ribeiro, Ana Isabel; Mitchell, Richard; Carvalho, Marília Sá; de Pina, Maria de Fátima

2013-11-01

In this cross-sectional study, we examined the relationship between socio-environmental characteristics of neighborhood of residence and the frequency of leisure-time physical activity (LTPA) among older adults from Porto (Portugal). Data from EpiPorto - a prospective adult cohort study from Porto (Portugal) - were used. Only adults aged ≥ 65 at baseline (1999-2003) were included (n=580). We used a Geographic Information System to objectively measure the neighborhood characteristics and Generalized Additive Models to estimate their effect on participation in LTPA (none vs. some reported) and frequency of LTPA (min/day). 62% of the participants reported no LTPA. Active elderly spent on average 38 (women) and 67 (men) minutes per day exercising. Neighborhood characteristics were unrelated to whether older people exercised or not. However, among active individuals, distance to the nearest destination (β=-0.154, p=0.016), in women, and distance to the nearest park, in men (-0.030, 0.050), were predictors of LTPA frequency. There was almost no association between neighborhood characteristics and whether older adults engaged in LTPA or not, but among those that did engage, neighborhood characteristics were associated with increased frequency of LTPA. The promotion of well distributed destinations and parks might improve physical activity levels among the elderly. © 2013.

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.

Overgeneral autobiographical memory and depression in older adults: a systematic review.

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Wilson, F C L; Gregory, J D

2018-05-01

Overgeneral autobiographical memory (OGM) is a well-researched phenomenon in working age adults with depression. However, the relevance and importance of OGM in older adult depression is not well established. The aim of this review was to synthesise existing literature on OGM and depressive symptoms in older adults under the framework of the Capture and Rumination, Functional Avoidance and Impaired Executive Control (CaR-FA-X) model. Literature searches were conducted using PsychINFO, PubMed and Web of Knowledge. Eighteen articles were reviewed. OGM is elevated in healthy older adults compared to adults of working age, and further elevated in older adults with depression. Evidence supports the role of impaired executive function as a mechanism for OGM in older adults with depression, but no studies measured other components of the CaR-FA-X model (i.e. functional avoidance and rumination). OGM is prevalent in older adults and more so for those with depression; however, there is no clear understanding of the underpinning mechanisms. It is recommended that future research looks at the role of functional avoidance and rumination, and at the use of memory specificity interventions being developed in the working age adult literature.

An examination of electronic health information privacy in older adults.

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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.

Self-reported cognitive inconsistency in older adults.

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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.

Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.

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Duan-Porter, Wei; Hastings, Susan Nicole; Neelon, Brian; Van Houtven, Courtney Harold

2017-01-11

Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for established "classic" biomedical risk factors. We also determined if an enhanced risk model with control beliefs improved identification of individuals with low vs. high mortality risk. We used nationally representative data from the Health and Retirement Study (2006-2012) for adults 50 years or older in 2006 (n = 7313) or 2008 (n = 6301). We assessed baseline perceived global control (measured as 2 dimensions-"constraints" and "mastery"), and health-specific control. We also obtained baseline data for 12 established biomedical risk factors of 4-year mortality: age, sex, 4 medical conditions (diabetes mellitus, cancer, lung disease and heart failure), body mass index less than 25 kg/m 2 , smoking, and 4 functional difficulties (with bathing, managing finances, walking several blocks and pushing or pulling heavy objects). Deaths within 4 years of follow-up were determined through interviews with respondents' family and the National Death Index. After accounting for classic biomedical risk factors, perceived constraints were significantly associated with higher mortality risk (third quartile scores odds ratio [OR] 1.37, 95% CI 1.03-1.81; fourth quartile scores OR 1.45, 95% CI, 1.09-1.92), while health-specific control was significantly associated with lower risk (OR 0.69-0.78 for scores above first quartile). Higher perceived mastery scores were not consistently associated with decreased risk. The enhanced model with control beliefs found an additional 3.5% of participants (n = 222) with low predicted risk of 4-year mortality (i.e., 4% or less); observed mortality for these individuals was 1.8% during follow-up. Compared with participants predicted to have low mortality risk only by the classic biomedical model

Feasibility of mobile mental wellness training for older adults.

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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.

Barriers to treatment for older adults seeking psychological therapy.

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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.

Casino gambling among older adults in North Dakota: a policy analysis.

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Bjelde, Kristine; Chromy, Barbara; Pankow, Debra

2008-12-01

This article examined social issues surrounding casino gambling among older adults both nationally and in the state of North Dakota. An exploratory review of gambling trends among older adults and an examination of policies to protect older gamblers revealed that older adults are targeted by the gaming industry as a lucrative market (Singh et al. J Retail Leisure Property 2007, 6(1):61-68). The authors used the national literature to frame their qualitative study, which explored gambling issues among older adults in North Dakota from the perspective of six counselors trained in gambling addiction who provide treatment services in the state. Findings indicated that relatively few policies existed at the state and national levels to protect older, more vulnerable adults who gamble. Further, the six casinos in North Dakota were viewed as very effective in marketing their casino gaming opportunities to older citizens by the gambling treatment providers interviewed. Additionally, barriers to gambling addiction treatment involved lack of available services and distance to receive services in this rural state. Based on the findings of this study, social policy changes which could lead to increased protection for older adult gamblers in the state were included.

Everyday memory errors in older adults.

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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.

Older Adults and Drinking | NIH MedlinePlus the Magazine

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... 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 ...

Reduced Syntactic Processing Efficiency in Older Adults During Sentence Comprehension

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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.

Malnutrition in Hospitalised Older Adults: A Multicentre Observational Study of Prevalence, Associations and Outcomes.

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O'Shea, E; Trawley, S; Manning, E; Barrett, A; Browne, V; Timmons, S

2017-01-01

Malnutrition is common in older adults and is associated with high costs and adverse outcomes. The prevalence, predictors and outcomes of malnutrition on admission to hospital are not clear for this population. Prospective Cohort Study. Six hospital sites (five public, one private). In total, 606 older adults aged 70+ were included. All elective and acute admissions to any speciality were eligible. Day-case admissions and those moribund on admission were excluded. Socio-demographic and clinical data, including nutritional status (Mini-Nutritional Assessment - short form), was collected within 36 hours of admission. Outcome data was collected prospectively on length of stay, in-hospital mortality and new institutionalisation. The mean age was 79.7; 51% were female; 29% were elective admissions; 67% were admitted to a medical specialty. Nutrition scores were available for 602/606; 37% had a 'normal' status, 45% were 'at-risk', and 18% were 'malnourished'. Malnutrition was more common in females, acute admissions, older patients and those who were widowed/ separated. Dementia, functional dependency, comorbidity and frailty independently predicted a) malnutrition and b) being at-risk of malnutrition, compared to normal status (p Malnutrition was associated with outcomes including an increased length of stay (p < .001), new institutionalisation (p =<0.001) and in-hospital mortality (p < .001). These findings support the prioritisation of nutritional screening in clinical practice and public health policy, for all patients ≥70 on admission to hospital, and in particular for people with dementia, increased functional dependency and/or multi-morbidity, and those who are frail.

The effects of emotion on younger and older adults' monitoring of learning.

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Tauber, Sarah K; Dunlosky, John; Urry, Heather L; Opitz, Philipp C

2017-09-01

Age-related differences in memory monitoring appear when people learn emotional words. Namely, younger adults' judgments of learning (JOLs) are higher for positive than neutral words, whereas older adults' JOLs do not discriminate between positive versus neutral words. In two experiments, we evaluated whether this age-related difference extends to learning positive versus neutral pictures. We also evaluated the contribution of two dimensions of emotion that may impact younger and older adults' JOLs: valence and arousal. Younger and older adults studied pictures that were positive or neutral and either high or low in arousal. Participants made immediate JOLs and completed memory tests. In both experiments, the magnitude of older adults' JOLs was influenced by emotion, and both younger and older adults demonstrated an emotional salience effect on JOLs. As important, the magnitude of participants' JOLs was influenced by valence, and not arousal. Emotional salience effects were also evident on participants' free recall, and older adults recalled as many pictures as did younger adults. Taken together, these data suggest that older adults do not have a monitoring deficit when learning positive (vs. neutral) pictures and that emotional salience effects on younger and older adults' JOLs are produced more by valence than by arousal.

Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults

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Aronow, Harriet Udin; Borenstein, Jeff; Haus, Flora; Braunstein, Glenn D.; Bolton, Linda Burnes

2014-01-01

Older patients are vulnerable to adverse hospital events related to frailty. SPICES, a common screening protocol to identify risk factors in older patients, alerts nurses to initiate care plans to reduce the probability of patient harm. However, there is little published validating the association between SPICES and measures of frailty and adverse outcomes. This paper used data from a prospective cohort study on frailty among 174 older adult inpatients to validate SPICES. Almost all patients met one or more SPICES criteria. The sum of SPICES was significantly correlated with age and other well-validated assessments for vulnerability, comorbid conditions, and depression. Individuals meeting two or more SPICES criteria had a risk of adverse hospital events three times greater than individuals with either no or one criterion. Results suggest that as a screening tool used within 24 hours of admission, SPICES is both valid and predictive of adverse events. PMID:24876954

Relationship between massage therapy usage and health outcomes in older adults.

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Munk, Niki; Zanjani, Faika

2011-04-01

Physical and emotional decline in older adults is a serious issue affecting not only quality of life but also susceptibility to injury. Non-pharmacological interventions addressing the needs of older adults are important for reducing medication burden and possible drug interactions. This study (N=144) examines the potential of massage therapy as such an intervention for older adults by comparing self-reported health outcome scores among adults 60 and older who have and have not utilized massage therapy in the past year. When controlling for age and cumulative morbidities, older adults who reported massage therapy usage in the past year had significantly better health outcome scores in the following domains: 1) emotional well-being, 2) limitations due to physical issues, and 3) limitations due to emotional issues. Because previous massage therapy research has not included or focused on older adults, studies examining massage therapy and emotional health, specifically among this population, are warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

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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.

Development of an Integrated Theory of Surgical Recovery in Older Adults.

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Ann DiMaria-Ghalili, Rose

2016-01-01

Experts argue the health care system is not prepared to meet the unique needs of older surgical patients, including how to provide the best care during the recovery phase. Nutrition plays a critical role in the recovery of surgical patients. Since older adults are at risk for malnutrition, examining the role of nutrition as a mediator for surgical recovery across the care continuum in older adults is critical. Presently there is a paucity of frameworks, models, and guidelines that integrate the role of nutrition on the trajectory of postoperative recovery in older surgical patients. The purpose of this article is to introduce the Integrated Theory of Surgical Recovery in Older Adults, an interdisciplinary middle-range theory, so that scholars, researchers, and clinicians can use this framework to promote recovery from surgery in older adults by considering the contribution of mediators of recovery (nutritional status, functional status, and frailty) unique to the older adults.

Older Adults' Comprehension of Transformational and Deactivation Negation

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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.…

Prevalence and correlates of binge drinking among older adults with multimorbidity.

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Han, Benjamin H; Moore, Alison A; Sherman, Scott E; Palamar, Joseph J

2018-06-01

Binge drinking among older adults has increased in the past decade. Binge drinking is associated with unintentional injuries, medical conditions, and lower health-related quality of life. No studies have characterized multimorbidity among older binge drinkers. We examined past 30-day binge alcohol use and lifetime medical conditions among adults age ≥50 from the National Survey on Drug Use and Health from 2005 to 2014. Self-reported lifetime prevalence of 13 medical conditions and medical multimorbidity (≥2 diseases) among binge drinkers were compared to non-binge drinkers. Multivariable logistic regression models were used to examine correlates of binge alcohol use among older adults with medical multimorbidity. Among adults aged ≥50, 14.4% reported past-month binge drinking. Estimated prevalence of medical multimorbidity was lower (21.4%) among binge drinkers than non-binge drinkers (28.3%; p older adults with multimorbidity, higher income (AOR = 1.44, p older adults in good health are apt to drink more than adults in poorer health. Current use of tobacco and substance use disorder were associated with an increased risk for binge drinking among older adults with multimorbidity. Binge drinking by older adults with multimorbidity may pose significant health risks especially with the concurrent use of other substances. Copyright © 2018 Elsevier B.V. All rights reserved.

Optimal management of ADHD in older adults

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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

The effects of the empowerment education program in older adults with total hip replacement surgery.

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Huang, Tzu-Ting; Sung, Chia-Chun; Wang, Woan-Shyuan; Wang, Bi-Hwa

2017-08-01

To measure the effectiveness of an education empowerment program on primary (self-efficacy and self-care competence) and secondary outcomes (Activities of Daily Life, mobility, depressive mood and quality of life) for older adults with total hip replacement surgery. Degenerative arthritis is a common and serious chronic illness that impacts the quality of life of older adults. As joints continue to degenerate and the hip damaged by arthritis, activities of daily life will be difficult to perform due to severe hip pain and joint stiffness. Therefore, hip replacement surgery should be considered and effective nursing care should be provided to improve the recovery of older adults. A prospective randomized control trial. A trial was conducted from September 2013 - May 2014 in two hospitals in northern Taiwan. 108 participants were random assigned to either the education empowerment group or in the comparison group. The researchers collected baseline data at admission and outcomes on the day of discharge, one month after and three months after the discharge. After the interventions, the education empowerment group participants demonstrated significantly higher self-care competence and self-efficacy and lower depressive inclinations compared with those in the comparison group. Participants in both groups significantly improved on activities of daily life, mobility and quality of life over the course of the interventions. This education empowerment intervention was very effective in enhancing participants' outcomes. Moreover, involving both older adults and their caregivers for the participation this program is recommended for a greater impact. © 2017 John Wiley & Sons Ltd.

Adult age differences in prospective memory in the laboratory: are they related to higher stress levels in the elderly?

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Ihle, Andreas; Kliegel, Matthias; Hering, Alexandra; Ballhausen, Nicola; Lagner, Prune; Benusch, Julia; Cichon, Anja; Zergiebel, Annekathrin; Oris, Michel; Schnitzspahn, Katharina M

2014-01-01

To explain age deficits found in laboratory-based prospective memory (PM) tasks, it has recently been suggested that the testing situation per se may be more stressful for older adults, thereby impairing their performance. To test this assumption, subjective and physiological stress levels were assessed at several times during the experiment in 33 younger and 29 older adults. In addition, half of participants were randomized in a condition where they completed a relaxation intervention before performing a time-based PM task. Results confirmed the age deficit in laboratory PM. Subjective and physiological stress levels showed no age difference and no detrimental association with PM. The intervention successfully reduced stress levels in both age groups but had no effect on PM or the age deficit. In conclusion, data suggest that age deficits usually observed in laboratory PM may not be due to higher stress levels in the older adults.

What accounts for rib fractures in older adults?

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Wuermser, Lisa-Ann; Achenbach, Sara J; Amin, Shreyasee; Khosla, Sundeep; Melton, L Joseph

2011-01-01

To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21-93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

What Accounts for Rib Fractures in Older Adults?

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Lisa-Ann Wuermser

2011-01-01

Full Text Available To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years, 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

What Accounts for Rib Fractures in Older Adults?

Science.gov (United States)

Wuermser, Lisa-Ann; Achenbach, Sara J.; Amin, Shreyasee; Khosla, Sundeep; Melton, L. Joseph

2011-01-01

To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes. PMID:22028986

Developing a Tool for Measuring the Decision-Making Competence of Older Adults

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Finucane, Melissa L.; Gullion, Christina M.

2010-01-01

The authors evaluated the reliability and validity of a tool for measuring older adults’ decision-making competence (DMC). Two-hundred-five younger adults (25-45 years), 208 young-older adults (65-74 years), and 198 old-older adults (75-97 years) made judgments and decisions related to health, finance, and nutrition. Reliable indices of comprehension, dimension weighting, and cognitive reflection were developed. Unlike previous research, the authors were able to compare old-older with young-older adults’ performance. As hypothesized, old-older adults performed more poorly than young-older adults; both groups of older adults performed more poorly than younger adults. Hierarchical regression analyses showed that a large amount of variance in decision performance across age groups (including mean trends) could be accounted for by social variables, health measures, basic cognitive skills, attitudinal measures, and numeracy. Structural equation modeling revealed significant pathways from three exogenous latent factors (crystallized intelligence, other cognitive abilities, and age) to the endogenous DMC latent factor. Further research is needed to validate the meaning of performance on these tasks for real-life decision making. PMID:20545413

Coming of Age: Considerations in the Prescription of Exercise for Older Adults.

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Zaleski, Amanda L; Taylor, Beth A; Panza, Gregory A; Wu, Yin; Pescatello, Linda S; Thompson, Paul D; Fernandez, Antonio B

2016-01-01

Older adults represent the fastest-growing age demographic of the population. Physiological changes associated with primary aging and concurrent chronic disease adversely impact functional capacity, health outcomes, and quality of life. For these reasons, there is a national emphasis for healthcare providers to improve the health, function, and quality of life of older adults to preserve independent living and psychological well-being. The benefits of regular physical activity or exercise with regard to aging and disease are indisputable, yet many clinicians do not prescribe exercise to older adults. This reluctance may be attributable to a lack of knowledge regarding appropriate exercise prescription for older adults in light of the potential risks and benefits of various doses and types of exercise. In addition, clinicians and patients may have concerns about potential health considerations relevant to older adults such as comprehensive pre-exercise screening and exercise-drug interactions. In light of this, the following review presents (1) guidelines for exercise prescription in older adults and modification of these guidelines for patients with the most common age-associated comorbidities; (2) recommendations for pre-exercise screening prior to initiating an exercise program in older adults; (3) considerations for older adults on one or more medications; and (4) common barriers to adopting and maintaining exercise in an older population. Our goal is to provide a framework that clinicians can follow when prescribing exercise in older adults while considering the unique characteristics and concerns present in this population.

Depressive symptoms among adolescents and older adults in Mexico City.

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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.

The Mental Health of Older LGBT Adults.

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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.

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

NARCIS (Netherlands)

Muntinga, Maaike E; Hoogendijk, Emiel O; van Leeuwen, Karen M; van Hout, Hein P J; Twisk, Jos W R; van der Horst, Henriette E; Nijpels, Giel; Jansen, Aaltje P D

2012-01-01

BACKGROUND: Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care

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

NARCIS (Netherlands)

Muntinga, M.E.; Hoogendijk, E.O.; van Leeuwen, K.M.; van Hout, H.P.J.; Twisk, J.W.R.; van der Horst, H.E.; Nijpels, G.; Jansen, A.P.D.

2012-01-01

Background: Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care

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

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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.

Self-reference enhances relational memory in young and older adults.

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Hou, Mingzhu; Grilli, Matthew D; Glisky, Elizabeth L

2017-11-27

The present study investigated the influence of self-reference on two kinds of relational memory, internal source memory and associative memory, in young and older adults. Participants encoded object-location word pairs using the strategies of imagination and sentence generation, either with reference to themselves or to a famous other (i.e., George Clooney or Oprah Winfrey). Both young and older adults showed memory benefits in the self-reference conditions compared to other-reference conditions on both tests, and the self-referential effects in older adults were not limited by low memory or executive functioning. These results suggest that self-reference can benefit relational memory in older adults relatively independently of basic memory and executive functions.

Functional abilities in older adults with mild cognitive impairment.

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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

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...

Orchestrating care: nursing practice with hospitalised older adults.

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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.

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults

NARCIS (Netherlands)

van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

2017-01-01

BACKGROUND/OBJECTIVES: Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling

Understanding Older Adults' Perceptions of Internet Use: An Exploratory Factor Analysis

Science.gov (United States)

Zheng, Robert; Spears, Jeffrey; Luptak, Marilyn; Wilby, Frances

2015-01-01

The current study examined factors related to older adults' perceptions of Internet use. Three hundred ninety five older adults participated in the study. The factor analysis revealed four factors perceived by older adults as critical to their Internet use: social connection, self-efficacy, the need to seek financial information, and the need to…

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…

Stride dynamics, gait variability and prospective falls risk in active community dwelling older women.

Science.gov (United States)

Paterson, Kade; Hill, Keith; Lythgo, Noel

2011-02-01

Measures of walking instability such as stride dynamics and gait variability have been shown to identify future fallers in older adult populations with gait limitations or mobility disorders. This study investigated whether measures of walking instability can predict future fallers (over a prospective 12 month period) in a group of healthy and active older women. Ninety-seven healthy active women aged between 55 and 90 years walked for 7 min around a continuous walking circuit. Gait data recorded by a GAITRite(®) walkway and foot-mounted accelerometers were used to calculate measures of stride dynamics and gait variability. The participant's physical function and balance were assessed. Fall incidence was monitored over the following 12 months. Inter-limb differences (p≤0.04) in stride dynamics were found for fallers (one or more falls) aged over 70 years, and multiple fallers (two or more falls) aged over 55 years, but not in non-fallers or a combined group of single and non-fallers. No group differences were found in the measures of physical function, balance or gait, including variability. Additionally, no gait variable predicted falls. Reduced coordination of inter-limb dynamics was found in active healthy older fallers and multiple fallers despite no difference in other measures of intrinsic falls risk. Evaluating inter-limb dynamics may be a clinically sensitive technique to detect early gait instability and falls risk in high functioning older adults, prior to change in other measures of physical function, balance and gait. Copyright © 2010 Elsevier B.V. All rights reserved.

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.

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.

Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

Science.gov (United States)

Burks, Collin E; Jones, Christopher W; Braz, Valerie A; Swor, Robert A; Richmond, Natalie L; Hwang, Kay S; Hollowell, Allison G; Weaver, Mark A; Platts-Mills, Timothy F

2017-08-01

Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury. To identify modifiable risk factors associated with malnutrition in older patients. Prospective cross-sectional multicenter study. 3 EDs in the South, Northeast, and Midwest. Non-critically ill, English-speaking adults aged ≥65 years. Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor. In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%). Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Relationship of metabolic and endocrine parameters to brain glucose metabolism in older adults: do cognitively-normal older adults have a particular metabolic phenotype?

Science.gov (United States)

Nugent, S; Castellano, C A; Bocti, C; Dionne, I; Fulop, T; Cunnane, S C

2016-02-01

Our primary objective in this study was to quantify whole brain and regional cerebral metabolic rates of glucose (CMRg) in young and older adults in order to determine age-normalized reference CMRg values for healthy older adults with normal cognition for age. Our secondary objectives were to--(i) report a broader range of metabolic and endocrine parameters including body fat composition that could form the basis for the concept of a 'metabolic phenotype' in cognitively normal, older adults, and (ii) to assess whether medications commonly used to control blood lipids, blood pressure or thyroxine affect CMRg values in older adults. Cognition assessed by a battery of tests was normal for age and education in both groups. Compared to the young group (25 years old; n = 34), the older group (72 years old; n = 41) had ~14% lower CMRg (μmol/100 g/min) specifically in the frontal cortex, and 18% lower CMRg in the caudate. Lower grey matter volume and cortical thickness was widespread in the older group. These differences in CMRg, grey matter volume and cortical thickness were present in the absence of any known evidence for prodromal Alzheimer's disease (AD). Percent total body fat was positively correlated with CMRg in many brain regions but only in the older group. Before and after controlling for body fat, HOMA2-IR was significantly positively correlated to CMRg in several brain regions in the older group. These data show that compared to a healthy younger adult, the metabolic phenotype of a cognitively-normal 72 year old person includes similar plasma glucose, insulin, cholesterol, triglycerides and TSH, higher hemoglobin A1c and percent body fat, lower CMRg in the superior frontal cortex and caudate, but the same CMRg in the hippocampus and white matter. Age-normalization of cognitive test results is standard practice and we would suggest that regional CMRg in cognitively healthy older adults should also be age-normalized.

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.

Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.

Science.gov (United States)

Arias, Sarah A; Boudreaux, Edwin D; Segal, Daniel L; Miller, Ivan; Camargo, Carlos A; Betz, Marian E

2017-10-01

We described characteristics and treatment received for older (≥60 years) vs younger (adult emergency department (ED) patients with suicide risk. Retrospective chart review. An ED with universal screening for suicide risk. Eligible charts included a random sample of adults (≥18 years) who screened positive for suicidal ideation (SI) in past 2 weeks and/or a suicide attempt (SA) within the past 6 months. Visit dates were from May 2014 to September 2016. A total of 800 charts were reviewed, with oversampling of older adults. Of the 200 older adults sampled, fewer older adults compared to younger adults (n = 600) had a chief complaint involving psychiatric behavior (53% vs 70%) or self-harm behavior (26% vs 36%). Although a higher number of older adults (93%) had documentation of current SI compared to younger adults (79%), fewer older adults (17%) reported SA in the past 2 weeks compared to younger adults (23%). Of those with a positive suicide screen who were discharged home, less than half of older adults received a mental health evaluation during their visit (42%, 95% CI 34-52) compared to 66% (95% CI 61-70) of younger adults who met the same criteria. Similarly, fewer older, than younger, adult patients with current SI/SA received referral resources (34%; 95% CI 26-43; vs 60%; 95% CI 55-65). Significantly fewer suicidal older adult patients who were discharged home received a mental health evaluation when compared to similar younger adults. These findings highlight an important area for improvement in the treatment of older adults at risk for suicide. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Diabetes: Unique to Older Adults

Science.gov (United States)

... 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 ...

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

Science.gov (United States)

Verweij, Lisanne Marlieke; Wehrens, Rik; Oldenhof, Lieke; Bal, Roland; Francke, Anneke L

2018-05-02

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 for care for older people was implemented (2008-2016) in the Netherlands. Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived. A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach. Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals

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

Science.gov (United States)

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

2016-12-01

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

Negative Prospective Memory in Alzheimer's Disease: "Do Not Perform That Action".

Science.gov (United States)

El Haj, Mohamad; Coello, Yann; Kapogiannis, Dimitrios; Gallouj, Karim; Antoine, Pascal

2018-01-01

Relatively to "standard" prospective memory, i.e., remembering to perform a future action, little is known about negative prospective memory, i.e., remembering not to perform a future action. This study investigated the latter ability in Alzheimer's disease (AD). AD participants and healthy older adults were asked to click on the keyboard or not to click on it when a cue word was encountered. Results showed more omissions (i.e., forgetting to click the keyboard when the instruction was to do so) in AD participants than in healthy older adults, suggesting a prospective memory deficit. Interestingly, more commissions (i.e., clicking the keyboard when the instruction was not to do so) were also observed in AD participants than in healthy older adults. Similar levels of commissions and omissions were observed in AD participants and in healthy older adults. Also, commissions and omissions were correlated with performance on an inhibition assessment task. Our findings reveal that AD is characterized by not only difficulty in the retrieval of recent information, but also difficulty to inhibit no-longer appropriate stimulus-response associations previously learned, suggesting a specific deficit of negative prospective memory in AD.

Older Adults Can Suppress Unwanted Memories When Given an Appropriate Strategy

Science.gov (United States)

2015-01-01

Memory suppression refers to the ability to exclude distracting memories from conscious awareness, and this ability can be assessed with the think/no-think paradigm. Recent research with older adults has provided evidence suggesting both intact and deficient memory suppression. The present studies seek to understand the conditions contributing to older adults’ ability to suppress memories voluntarily. We report 2 experiments indicating that the specificity of the think/no-think task instructions contributes to older adults’ suppression success: When older adults receive open-ended instructions that require them to develop a retrieval suppression strategy on their own, they show diminished memory suppression compared with younger adults. Conversely, when older adults receive focused instructions directing them to a strategy thought to better isolate inhibitory control, they show suppression-induced forgetting similar to that exhibited by younger adults. Younger adults demonstrate memory suppression regardless of the specificity of the instructions given, suggesting that the ability to select a successful suppression strategy spontaneously may be compromised in older adults. If so, this deficit may be associated with diminished control over unwanted memories in naturalistic settings if impeded strategy development reduces the successful deployment of inhibitory control. PMID:25602491

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.

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

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.

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…

Examining the effects of an experiential interprofessional education activity with older adults.

Science.gov (United States)

Conti, Gerry; Bowers, Cassandra; O'Connell, Mary Beth; Bruer, Stephen; Bugdalski-Stutrud, Carol; Smith, Geralynn; Bickes, Joan; Mendez, Jennifer

2016-01-01

The need for experienced healthcare professionals to work with older adults is great, yet educational training is limited. In this interprofessional education (IPE) study, 861 students from five professions made 293 visits in the homes or preferred community settings of 208 older adults. Surveys with quantitative and open-text feedback assessed attitudes towards older adults, IPE team functioning, and the value of home visits. Survey results showed strongly positive attitudes towards ageing and older adults. Students from all professions expressed surprise and admiration for the active lives led by these healthier older adults, lives clearly in contrast to stereotypes of ageing. They further acknowledged the value of collaborative team functioning in meeting older adult needs, learned more about the roles and responsibilities of other professions, and identified strengths of the home as a site for care. Students positively valued the experience as part of their professional training, with 82% of all students stating they would welcome additional IPE opportunities. Results suggest that an experiential IPE activity can positively shape student attitudes towards older adults, IPE, and interprofessional collaboration.

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...

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, ...

Sleep benefits consolidation of visuo-motor adaptation learning in older adults.

Science.gov (United States)

Mantua, Janna; Baran, Bengi; Spencer, Rebecca M C

2016-02-01

Sleep is beneficial for performance across a range of memory tasks in young adults, but whether memories are similarly consolidated in older adults is less clear. Performance benefits have been observed following sleep in older adults for declarative learning tasks, but this benefit may be reduced for non-declarative, motor skill learning tasks. To date, studies of sleep-dependent consolidation of motor learning in older adults are limited to motor sequence tasks. To examine whether reduced sleep-dependent consolidation in older adults is generalizable to other forms of motor skill learning, we examined performance changes over intervals of sleep and wake in young (n = 62) and older adults (n = 61) using a mirror-tracing task, which assesses visuo-motor adaptation learning. Participants learned the task either in the morning or in evening, and performance was assessed following a 12-h interval containing overnight sleep or daytime wake. Contrary to our prediction, both young adults and older adults exhibited sleep-dependent gains in visuo-motor adaptation. There was a correlation between performance improvement over sleep and percent of the night in non-REM stage 2 sleep. These results indicate that motor skill consolidation remains intact with increasing age although this relationship may be limited to specific forms of motor skill learning.

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.

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)

Factors influencing life satisfaction of Korean older adults living with family.

Science.gov (United States)

Sok, Sohyune R

2010-03-01

The purpose of this study was to identify the factors influencing life satisfaction of Korean older adults living with family. Participants included 267 adults age 65 and older who met eligibility criteria. Analyses showed that the prediction model of the life satisfaction of older adults who are living with their family was significant (F=24.429, ppocket money (beta=0.060), and age (beta=0.040). It is possible that older adults' life satisfaction increases when they are provided with nursing interventions and are able to effectively manage their health. Nursing interventions must strive to improve their self-esteem and address their depression.

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

Do older adults with chronic low back pain differ from younger adults in regards to baseline characteristics and prognosis?

DEFF Research Database (Denmark)

Manogharan, S; Kongsted, A; Ferreira, M L

2017-01-01

BACKGROUND: Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP....... Patients older than 65 were classified as older adults and compared to middle aged (45-65 years old) and younger adults (17-44 years old) for 10 baseline characteristics. Pain intensity and disability were collected at 6 and 12 month follow-ups and compared between age groups. RESULTS: A total of 14......,479 participants were included in the study. Of these 3087 (21%) patients were older adults, 6071 (42%) were middle aged and 5321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain...

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.

Delayed plastic responses to anodal tDCS in older adults

Directory of Open Access Journals (Sweden)

Hakuei eFujiyama

2014-06-01

Full Text Available Despite the abundance of research reporting the neurophysiological and behavioral effects of transcranial direct current stimulation (tDCS in healthy young adults and clinical populations, the extent of potential neuroplastic changes induced by tDCS in healthy older adults is not well understood. The present study compared the extent and time course of anodal tDCS-induced plastic changes in primary motor cortex (M1 in young and older adults. Furthermore, as it has been suggested that neuroplasiticity and associated learning depends on the brain-derived neurotrophic factor (BDNF gene polymorphisms, we also assessed the impact of BDNF polymorphism on these effects. Corticospinal excitability was examined using transcranial magnetic stimulation before and following (0, 10, 20, 30 min anodal tDCS (30 min, 1 mA or sham in young and older adults. While the overall extent of increases in corticospinal excitability induced by anodal tDCS did not vary reliably between young and older adults, older adults exhibited a delayed response; the largest increase in corticospinal excitability occurred 30 min following stimulation for older adults, but immediately post-stimulation for the young group. BDNF genotype did not result in significant differences in the observed excitability increases for either age group. The present study suggests that tDCS-induced plastic changes are delayed as a result of healthy aging, but that the overall efficacy of the plasticity mechanism remains unaffected.

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.

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

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.

Comparison for younger and older adults: Stimulus temporal asynchrony modulates audiovisual integration.

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Ren, Yanna; Ren, Yanling; Yang, Weiping; Tang, Xiaoyu; Wu, Fengxia; Wu, Qiong; Takahashi, Satoshi; Ejima, Yoshimichi; Wu, Jinglong

2018-02-01

Recent research has shown that the magnitudes of responses to multisensory information are highly dependent on the stimulus structure. The temporal proximity of multiple signal inputs is a critical determinant for cross-modal integration. Here, we investigated the influence that temporal asynchrony has on audiovisual integration in both younger and older adults using event-related potentials (ERP). Our results showed that in the simultaneous audiovisual condition, except for the earliest integration (80-110ms), which occurred in the occipital region for older adults was absent for younger adults, early integration was similar for the younger and older groups. Additionally, late integration was delayed in older adults (280-300ms) compared to younger adults (210-240ms). In audition‑leading vision conditions, the earliest integration (80-110ms) was absent in younger adults but did occur in older adults. Additionally, after increasing the temporal disparity from 50ms to 100ms, late integration was delayed in both younger (from 230 to 290ms to 280-300ms) and older (from 210 to 240ms to 280-300ms) adults. In the audition-lagging vision conditions, integration only occurred in the A100V condition for younger adults and in the A50V condition for older adults. The current results suggested that the audiovisual temporal integration pattern differed between the audition‑leading and audition-lagging vision conditions and further revealed the varying effect of temporal asynchrony on audiovisual integration in younger and older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Heat Stress in Older Adults

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... 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 ...

Postural adaptations to repeated optic flow stimulation in older adults

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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

Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia.

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Kaup, Allison R; Byers, Amy L; Falvey, Cherie; Simonsick, Eleanor M; Satterfield, Suzanne; Ayonayon, Hilsa N; Smagula, Stephen F; Rubin, Susan M; Yaffe, Kristine

2016-05-01

Depression has been identified as a risk factor for dementia. However, most studies have measured depressive symptoms at only one time point, and older adults may show different patterns of depressive symptoms over time. To investigate the association between trajectories of depressive symptoms and risk of dementia in older adults. This was a prospective cohort investigation of black and white community-dwelling older adults in the Health, Aging, and Body Composition study. Participants were enrolled between May 1997 and June 1998 and followed up through 2001-2002. The dates of this analysis were September 2014 to December 2015. The setting was community research centers in Memphis, Tennessee, and Pittsburgh, Pennsylvania. Trajectories of depressive symptoms were assessed from baseline to year 5. Symptoms were measured with the Center for Epidemiologic Studies Depression Scale Short Form, and trajectories were calculated using latent class growth curve analysis. Incident dementia through year 11, determined by dementia medication use, hospital records, or significant cognitive decline (≥1.5 SD race-specific decline on the Modified Mini-Mental State Examination). We examined the association between depressive symptom trajectories and dementia incidence using Cox proportional hazards regression models adjusted for demographics, health factors that differed between groups, and cognition during the depressive symptom assessment period (baseline to year 5). The analytic cohort included 2488 black and white older adults with repeated depressive symptom assessments from baseline to year 5 who were free of dementia throughout that period. Their mean (SD) age at baseline was 74.0 (2.8) years, and 53.1% (n = 1322) were female. The following 3 depressive symptom trajectories were identified: consistently minimal symptoms (62.0% [n = 1542] of participants), moderate and increasing symptoms (32.2% [n = 801] of participants), and high and increasing symptoms (5

Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study.

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van der Meulen, Erik; Zijlstra, G A Rixt; Ambergen, Ton; Kempen, Gertrudis I J M

2014-12-01

To determine the effect of fall-related concerns on physical, mental, and social function. Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial). Two municipalities in the south of the Netherlands. Community-dwelling older adults (N = 260). Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline. At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months. Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Audio-Visual and Meaningful Semantic Context Enhancements in Older and Younger Adults.

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Kirsten E Smayda

Full Text Available Speech perception is critical to everyday life. Oftentimes noise can degrade a speech signal; however, because of the cues available to the listener, such as visual and semantic cues, noise rarely prevents conversations from continuing. The interaction of visual and semantic cues in aiding speech perception has been studied in young adults, but the extent to which these two cues interact for older adults has not been studied. To investigate the effect of visual and semantic cues on speech perception in older and younger adults, we recruited forty-five young adults (ages 18-35 and thirty-three older adults (ages 60-90 to participate in a speech perception task. Participants were presented with semantically meaningful and anomalous sentences in audio-only and audio-visual conditions. We hypothesized that young adults would outperform older adults across SNRs, modalities, and semantic contexts. In addition, we hypothesized that both young and older adults would receive a greater benefit from a semantically meaningful context in the audio-visual relative to audio-only modality. We predicted that young adults would receive greater visual benefit in semantically meaningful contexts relative to anomalous contexts. However, we predicted that older adults could receive a greater visual benefit in either semantically meaningful or anomalous contexts. Results suggested that in the most supportive context, that is, semantically meaningful sentences presented in the audiovisual modality, older adults performed similarly to young adults. In addition, both groups received the same amount of visual and meaningful benefit. Lastly, across groups, a semantically meaningful context provided more benefit in the audio-visual modality relative to the audio-only modality, and the presence of visual cues provided more benefit in semantically meaningful contexts relative to anomalous contexts. These results suggest that older adults can perceive speech as well as younger

Overview of persistent pain in older adults.

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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.

Dare to Dream: New Venture Incubator for Older Adults

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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…

Temporal discounting rates and their relation to exercise behavior in older adults.

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Tate, Linda M; Tsai, Pao-Feng; Landes, Reid D; Rettiganti, Mallikarjuna; Lefler, Leanne L

2015-12-01

As our nation's population ages, the rates of chronic illness and disability are expected to increase significantly. Despite the knowledge that exercise may prevent chronic disease and promote health among older adults, many still are inactive. Factors related to exercise behaviors have been explored in recent years. However, temporal discounting is a motivational concept that has not been explored in regard to exercise in older adults. Temporal discounting is a decision making process by which an individual chooses a smaller more immediate reward over a larger delayed reward. The aim of this study was to determine if temporal discounting rates vary between exercising and non-exercising older adults. This study used cross-sectional survey of 137 older adults living in the community. Older adults were recruited from 11 rural Arkansas churches. The Kirby delay-discounting Monetary Choice Questionnaire was used to collect discounting rates and then bivariate analysis was performed to compare temporal discounting rate between the exercisers and non-exercisers. Finally, multivariate analysis was used to compare discounting rate controlling for other covariates. The results indicated that exercising older adults display lower temporal discounting rates than non-exercising older adults. After controlling for education, exercisers still have lower temporal discounting rates than non-exercisers (phealth conditions relate to lack of exercise especially in older adults. This research suggests that if we can find appropriate incentives for discounting individuals, some type of immediate reward, then potentially we can design programs to engage and retain older adults in exercise. Copyright © 2015 Elsevier Inc. All rights reserved.

Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults.

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Yamada, Minoru; Arai, Hidenori

2017-05-15

Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62-0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.

Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults.

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Zhong, Yaqin; Wang, Jian; Nicholas, Stephen

2017-09-02

Gender difference and life-course socioeconomic inequalities in functional disability may exist among older adults. However, the association is less well understood among Chinese older population. The objective is to provide empirical evidences on this issue by exploring the association between gender, childhood and adult socioeconomic inequalities in functional disability. Data from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS) was utilized. Functional disability was assessed by the activities of daily living (ADL) and instrumental activities of daily living (IADL). Childhood socioeconomic status (SES) was measured by birthplace, father's education and occupation. Adult SES was measured in terms of education and household income. Multivariate logistic regressions were conducted to assess the association between gender, childhood and adult SES and functional disability. Based on a sample of 18,448 older adults aged 45 years old and above, our results showed that the prevalence of ADL and IADL disability was higher among women than men, but gender difference disappeared after adult SES and adult health were controlled. Harsh conditions during childhood were associated with functional disability but in multivariate analyses only father's education was associated with IADL disability (OR for no education = 1.198; 95% CI = 1.062-1.353). Current SES such as higher education and good economic situation are protective factors of functional disability. Childhood and adult SES were both related to functional disability among older adults. Our findings highlight the need for policies and programs aimed at decreasing social inequalities during childhood and early adulthood, which could reduce socioeconomic inequalities in functional disability in later life.

Managing Status Epilepticus in the Older Adult

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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

Entity versus incremental theories predict older adults' memory performance.

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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.

Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

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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.

Hip Fractures among Older Adults

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... 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 ...

Late-life and life history predictors of older adults' high-risk alcohol consumption and drinking problems.

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Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

2010-04-01

This prospective, longitudinal study focused on late-life and life history predictors of high-risk alcohol consumption and drinking problems during a 20-year interval as adults matured from age 55-65 to 75-85. A sample of older community residents (N=719) who had consumed alcohol in the past year or shortly before was surveyed at baseline and 10 and 20 years later. At each contact point, participants completed an inventory that assessed their alcohol consumption, drinking problems, and personal and life context factors. Participants also provided information about their life history of drinking and help-seeking. Older adults who, at baseline, had more friends who approved of drinking, relied on substances for tension reduction, and had more financial resources were more likely to engage in high-risk alcohol consumption and to incur drinking problems at 10- and 20-year follow-ups. With respect to life history factors, drinking problems by age 50 were associated with a higher likelihood of late-life high-risk alcohol consumption and drinking problems; having tried to cut down on drinking and participation in Alcoholics Anonymous were associated with a lower likelihood of high-risk consumption and problems. Specific late-life and life history factors can identify older adults likely to engage in excessive alcohol consumption 10 and 20 years later. Targeted screening that considers current alcohol consumption and life context, and history of drinking problems and help-seeking, could help identify older adults at higher risk for excessive or problematic drinking. Published by Elsevier Ireland Ltd.

Emergency Department Visits by Older Adults for Motor Vehicle Collisions

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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

Self-rated driving and driving safety in older adults.

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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

Understanding and Reducing Disability in Older Adults Following Critical Illness

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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

Urban and rural factors associated with life satisfaction among older Chinese adults.

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Li, Chengbo; Chi, Iris; Zhang, Xu; Cheng, Zhaowen; Zhang, Lei; Chen, Gong

2015-01-01

This study compared urban and rural factors associated with life satisfaction among older adults in mainland China. Study data were extracted at random from 10% of the Sample Survey on Aged Population in urban/rural China in 2006 for 1980 participants aged 60 and older, including 997 from urban cities and 983 from rural villages. In this study, 54.6% of urban older adults and 44.1% of rural older adults reported satisfaction with their lives. Binary logistic regression analysis showed that financial strain, depressive symptoms, filial piety, and accessibility of health services were significantly associated with life satisfaction for both urban and rural participants, but age and financial exchange with children were only associated with life satisfaction among urban older adults. Findings are consistent with some previous studies that indicated the importance of financial strain, depressive symptoms, filial piety, and accessibility of health services to life satisfaction among the older adults in both urban and rural areas. This study also demonstrated the importance of age and family financial exchange to the life satisfaction of urban older adults.

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

The Nature of Subjective Cognitive Complaints of Older Adults

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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…

Observational Learning among Older Adults Living in Nursing Homes

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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…

Investigating the Bidirectional Associations of Adiposity with Sleep Duration in Older Adults: The English Longitudinal Study of Ageing (ELSA).

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Garfield, Victoria; Llewellyn, Clare H; Steptoe, Andrew; Kumari, Meena

2017-01-09

Cross-sectional analyses of adiposity and sleep duration in younger adults suggest that increased adiposity is associated with shorter sleep. Prospective studies have yielded mixed findings, and the direction of this association in older adults is unclear. We examined the cross-sectional and potential bi-directional, prospective associations between adiposity and sleep duration (covariates included demographics, health behaviours, and health problems) in 5,015 respondents from the English Longitudinal Study of Ageing (ELSA), at baseline and follow-up. Following adjustment for covariates, we observed no significant cross-sectional relationship between body mass index (BMI) and sleep duration [(unstandardized) B = -0.28 minutes, (95% Confidence Intervals (CI) = -0.012; 0.002), p = 0.190], or waist circumference (WC) and sleep duration [(unstandardized) B = -0.10 minutes, (95% CI = -0.004; 0.001), p = 0.270]. Prospectively, both baseline BMI [B = -0.42 minutes, (95% CI = -0.013; -0.002), p = 0.013] and WC [B = -0.18 minutes, (95% CI = -0.005; -0.000), p = 0.016] were associated with decreased sleep duration at follow-up, independently of covariates. There was, however, no association between baseline sleep duration and change in BMI or WC (p > 0.05). In older adults, our findings suggested that greater adiposity is associated with decreases in sleep duration over time; however the effect was very small.

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

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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)....

Feasibility study of an attention training application for older adults.

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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

The Silence of Our Science: Nursing Research on LGBT Older Adult Health.

Science.gov (United States)

Cloyes, Kristin G

2016-01-01

Lesbian, gay, bisexual, and transgender (LGBT) older adults have been largely invisible within health and aging services research, despite being disproportionately burdened by poor health and aging outcomes. The current study examines the prevalence of LGBT aging and older adult health-related studies in the 2010-2014 nursing literature, and how this topic is being addressed. Systematic CINAHL and PubMed searches were conducted and compared to (a) quantify the prevalence of LGBT older adult-related scholarship in nursing research; (b) document the appearance of relevant publications in top nursing journals; (c) identify the focus of articles with a substantive focus on LGBT older adult health or aging; and (d) compare the prevalence of LGBT older adult-related literature in nursing, gerontology, medicine, and social work. Findings indicate that research explicitly including LGBT older adults is lacking across the health sciences, particularly in nursing (where it has been largely absent). Implications for nursing research, practice, and education are discussed. Copyright 2016, SLACK Incorporated.

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

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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.

Differences in foot kinematics between young and older adults during walking.

Science.gov (United States)

Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

2014-02-01

Our understanding of age-related changes to foot function during walking has mainly been based on plantar pressure measurements, with little information on differences in foot kinematics between young and older adults. The purpose of this study was to investigate the differences in foot kinematics between young and older adults during walking using a multi-segment foot model. Joint kinematics of the foot and ankle for 20 young (mean age 23.2 years, standard deviation (SD) 3.0) and 20 older adults (mean age 73.2 years, SD 5.1) were quantified during walking with a 12 camera Vicon motion analysis system using a five segment kinematic model. Differences in kinematics were compared between older adults and young adults (preferred and slow walking speeds) using Student's t-tests or if indicated, Mann-Whitney U tests. Effect sizes (Cohen's d) for the differences were also computed. The older adults had a less plantarflexed calcaneus at toe-off (-9.6° vs. -16.1°, d = 1.0, p = range of motion (ROM) of the midfoot (11.9° vs. 14.8°, d = 1.3, p = young adults. Walking speed did not influence these differences, as they remained present when groups walked at comparable speeds. The findings of this study indicate that independent of walking speed, older adults exhibit significant differences in foot kinematics compared to younger adults, characterised by less propulsion and reduced mobility of multiple foot segments. Copyright © 2013 Elsevier B.V. All rights reserved.

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

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Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A

2015-01-01

Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

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

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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.

Social relevance enhances memory for impressions in older adults.

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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.

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.

High Blood Pressure: Unique to Older Adults

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... 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 ...

Self-initiated object-location memory in young and older adults.

Science.gov (United States)

Berger-Mandelbaum, Anat; Magen, Hagit

2017-11-20

The present study explored self-initiated object-location memory in ecological contexts, as aspect of memory that is largely absent from the research literature. Young and older adults memorized objects-location associations they selected themselves or object-location associations provided to them, and elaborated on the strategy they used when selecting the locations themselves. Retrieval took place 30 min and 1 month after encoding. The results showed an age-related decline in self-initiated and provided object-location memory. Older adults benefited from self-initiation more than young adults when tested after 30 min, while the benefit was equal when tested after 1 month. Furthermore, elaboration enhanced memory only in older adults, and only after 30 min. Both age groups used deep encoding strategies on the majority of the trials, but their percentage was lower in older adults. Overall, the study demonstrated the processes involved in self-initiated object-location memory, which is an essential part of everyday functioning.

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...

Stimulus-independent semantic bias misdirects word recognition in older adults.

Science.gov (United States)

Rogers, Chad S; Wingfield, Arthur

2015-07-01

Older adults' normally adaptive use of semantic context to aid in word recognition can have a negative consequence of causing misrecognitions, especially when the word actually spoken sounds similar to a word that more closely fits the context. Word-pairs were presented to young and older adults, with the second word of the pair masked by multi-talker babble varying in signal-to-noise ratio. Results confirmed older adults' greater tendency to misidentify words based on their semantic context compared to the young adults, and to do so with a higher level of confidence. This age difference was unaffected by differences in the relative level of acoustic masking.

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.

Physical Activity Predicts Higher Physical Function in Older Adults: The Osteoarthritis Initiative.

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Batsis, John A; Germain, Cassandra M; Vásquez, Elizabeth; Zbehlik, Alicia J; Bartels, Stephen J

2016-01-01

Physical activity reduces mobility impairments in elders. We examined the association of physical activity on risk of subjective and objective physical function in adults with and at risk for osteoarthritis (OA). Adults aged ≥ 60 years from the longitudinal Osteoarthritis Initiative, a prospective observational study of knee OA, were classified by sex-specific quartiles of Physical Activity Score for the Elderly scores. Using linear mixed models, we assessed 6-year data on self-reported health, gait speed, Late-Life Function and Disability Index (LLFDI) and chair stand. Of 2252 subjects, mean age ranged from 66 to 70 years. Within each quartile, physical component (PCS) of the Short Form-12 and gait speed decreased from baseline to follow-up in both sexes (all P physical activity is associated with maintained physical function and is mediated by muscle strength, highlighting the importance of encouraging physical activity in older adults with and at risk for OA.

Trunk repositioning errors are increased in balance-impaired older adults.

Science.gov (United States)

Goldberg, Allon; Hernandez, Manuel Enrique; Alexander, Neil B

2005-10-01

Controlling the flexing trunk is critical in recovering from a loss of balance and avoiding a fall. To investigate the relationship between trunk control and balance in older adults, we measured trunk repositioning accuracy in young and balance-impaired and unimpaired older adults. Young adults (N = 8, mean age 24.3 years) and two groups of community-dwelling older adults defined by unipedal stance time (UST)-a balance-unimpaired group (UST > 30 seconds, N = 7, mean age 73.9 years) and a balance-impaired group (UST tested in standing trunk control ability by reproducing a approximately 30 degrees trunk flexion angle under three visual-surface conditions: eyes opened and closed on the floor, and eyes opened on foam. Errors in reproducing the angle were defined as trunk repositioning errors (TREs). Clinical measures related to balance, trunk extensor strength, and self-reported disability were obtained. TREs were significantly greater in the balance-impaired group than in the other groups, even when controlling for trunk extensor strength and body mass. In older adults, there were significant correlations between TREs and three clinical measures of balance and fall risk, UST and maximum step length (-0.65 to -0.75), and Timed Up & Go score (0.55), and between TREs and age (0.63-0.76). In each group TREs were similar under the three visual-surface conditions. Test-retest reliability for TREs was good to excellent (intraclass correlation coefficients > or =0.74). Older balance-impaired adults have larger TREs, and thus poorer trunk control, than do balance-unimpaired older individuals. TREs are reliable and valid measures of underlying balance impairment in older adults, and may eventually prove to be useful in predicting the ability to recover from losses of balance and to avoid falls.

Plasticity in older adults' theory of mind performance: the impact of motivation.

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Zhang, Xin; Lecce, Serena; Ceccato, Irene; Cavallini, Elena; Zhang, Linfang; Chen, Tianyong

2017-09-08

Recently, motivation has been found to attenuate the age-related decline in Theory of Mind (ToM) performance (i.e. faux pas recognition). However, whether or not this effect could be generalized to other ToM tasks is still unknown. In the present study, we investigated whether and how motivation could enhance older adults' performance and reduce age differences in ToM tasks (Faux Pas vs. Animation task) that differ in familiarity. Following a previous paradigm, 171 Chinese adults (87 younger adults and 84 older adults) were recruited, and we experimentally manipulated the level of perceived closeness between participants and the experimenter before administering the ToM tasks in order to enhance participants' motivation. Results showed that, for the Faux Pas task, we replicated previous findings such that older adults under the enhanced motivation conditions performed equally well as younger adults. Conversely, for the Animation task, younger adults outperformed older adults, regardless of motivation. These results indicate that motivation can enhance older adults' performance in ToM tasks, however, this beneficial effect cannot be generalized across ToM tasks.

Are HIV-Infected Older Adults Aging Differently?

Science.gov (United States)

Karpiak, Stephen E; Havlik, Richard

With increasing success in treating HIV, infected persons are living longer, and a new challenge has emerged - the need to understand how HIV-infected adults are aging. What are the similarities with typical aging and what are the unique aspects that may have resulted from HIV infection, interacting with characteristic life style factors and other comorbid conditions? Are specific diseases and conditions (comorbidities), typically seen as part of the aging process, occurring at accelerated rates or with higher frequency (accentuated) in HIV-infected adults? At this juncture, conclusions should be tentative. Certainly, biological processes that correlate with aging occur earlier in the older adult HIV population. Clinical manifestations of these biological processes are age-associated illnesses occurring in greater numbers (multimorbidity), but they are not accelerated. Specifically cardiovascular disease, certain cancers, and renal disease are more common with other comorbidities less certain. Management of this elevated risk for developing multimorbidity is a major concern for patients and their health care teams. The medical system must respond to the evolving needs of this aging and growing older adult population who will dominate the epidemic. Adopting a more holistic approach to their health care management is needed to achieve optimal health and well-being in the HIV-infected older adult. Geriatric care principles best embody this approach. © 2017 S. Karger AG, Basel.

Sarcopenia Is Associated With Physical and Mental Components of Health-Related Quality of Life in Older Adults.

Science.gov (United States)

Manrique-Espinoza, Betty; Salinas-Rodríguez, Aarón; Rosas-Carrasco, Oscar; Gutiérrez-Robledo, Luis Miguel; Avila-Funes, José Alberto

2017-07-01

To estimate the association between sarcopenia and the health-related quality of life (HRQoL) among community-dwelling older adults. Cross-sectional analysis of a prospective cohort. The Rural Frailty Study, a prospective study on the prevalence of frailty in rural settings in Mexico, with baseline and follow-up measurements conducted in 2009 and 2013, respectively. Five hundred forty-three men and women older than 70 years. Information regarding demographic characteristics, comorbidities, mental status, dependency in activities of daily living, frailty, HRQoL, and other characteristics was obtained. Objective measurements of muscle strength and physical performance were grip strength using a manual hydraulic dynamometer and walking speed; measure of low muscle was by a calf circumference. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria. Physical and mental components of the HRQoL were measured through the Medical Outcomes Study Health Survey Questionnaire 36-Item Short Form. Prevalence of sarcopenia was 20.6% for severe and 15.8% for moderate. After adjusting for sociodemographic and health characteristics, severe sarcopenia was significantly and inversely associated with both the physical (β = -5.39; P = .010) and the mental components (β = -3.69; P = .057) of HRQoL when compared with pre- and nonsarcopenic individuals. Our results on the association between sarcopenia and HRQoL suggest that the latter declines in the presence of severe sarcopenia in older adults. This finding highlights the relevance of the early detection of sarcopenia in older individuals, and even that its detection must be a part of routine diagnosis procedures. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Neighborhood Environment and Self-Rated Health Among Urban Older Adults

Directory of Open Access Journals (Sweden)

Arlesia Mathis PhD

2015-09-01

Full Text Available Objective: This study examines associations between neighborhood environment and self-rated health (SRH among urban older adults. Method: We selected 217 individuals aged 65+ living in a de-industrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and SRH was analyzed using regression models. Neighborhood variables included social support and participation, perceived racism, and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Results: Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH ( p = .01. Additional analyses revealed Black seniors are 7% less likely to participate in social activities ( p = .005 and 4% more likely to report experiencing racism ( p < .001. Discussion: More than 80% of older adults live in urban areas. By 2030, older adults will account for 20% of the U.S. population. Given the increasing numbers of older adults living in urban neighborhoods, studies such as this one are important. Mitigating environmental influences in the neighborhood that are associated with poor SRH may allow urban older adults to maintain health and reduce disability.

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...

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.

Comparison of access, outcomes and experiences of older adults and working age adults in psychological therapy.

Science.gov (United States)

Chaplin, Robert; Farquharson, Lorna; Clapp, Melissa; Crawford, Mike

2015-02-01

This study aimed to evaluate the access, experiences and outcomes of older adults receiving psychological therapies in comparison with adults of working age Primary and secondary care providers of psychological therapy services participated in the National Audit of Psychological Therapies. The main standards of access, experience and outcomes were measured by retrospective case records audits of people who completed therapy and a service user questionnaire. Outcomes were measured pre-treatment and post-treatment on the PHQ-9 and GAD-7. A total of 220 services across 97 organisations took part, 137 (62%) in primary care. Service user questionnaires were received from 14 425 (20%) respondents. A total of 122 740 records were audited, of whom 7794 (6.4%) were older adults. They were under represented as 13% of the sample would have been expected to be over 65 years according to age adjusted psychiatric morbidity figures. People over 75 years had the third expected referral rate. Significantly, more older adults than working age adults completed therapy (59.6% vs 48.6%) and were assessed as having 'recovered' post-treatment (58.5% vs 45.5%). Older adults were more satisfied with waiting times and numbers of sessions, but there were no differences in self-reported experience of therapy. Although older adults are less likely to gain access to psychological therapies, they appear to have better outcomes than working age adults. Further work is needed to improve access for older people. Copyright © 2014 John Wiley & Sons, Ltd.

"Old Oxen Cannot Plow": Stereotype Themes of Older Adults in Turkish Folklore.

Science.gov (United States)

Marcus, Justin; Sabuncu, Neslihan

2016-12-01

Although much research has established the nature of attitudes and stereotypes toward older adults, there are conflicting explanations for the root cause of ageism, including the sociocultural view and interpersonal views, that age bias against older adults is uniquely a product of modernity and occurs through social interactions, and the evolutionary view and intraindividual views, that age bias against older adults is rooted in our naturally occurring and individually held fear of death. We make initial investigations into resolving this conflict, by analyzing literature from a society predating the Industrial Revolution, the society of Ottoman Turks. Using Grounded Theory, we analyzed 1,555 Turkish fairy tales of the most well-known older adult in Turkish folklore, Nasreddin Hoca, for stereotype themes of older adults. Using the same method, we then analyzed 22,000+ Turkish sayings and proverbs for the same themes. Results indicated older adults to be viewed both positively and negatively. Positive stereotypes included wisdom, warmth, deserving of respect, and retirement. Negative stereotypes included incompetence, inadaptability, and frailty/nearing of death. Older females were viewed more negatively relative to older males. Results indicated views of older adults to parallel those found in contemporary research. Results have implications for the design of interventions to reduce ageism and on the cross-cultural generalizability of age-based stereotypes. © 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.

Older adults in jail: high rates and early onset of geriatric conditions.

Science.gov (United States)

Greene, Meredith; Ahalt, Cyrus; Stijacic-Cenzer, Irena; Metzger, Lia; Williams, Brie

2018-02-17

The number of older adults in the criminal justice system is rapidly increasing. While this population is thought to experience an early onset of aging-related health conditions ("accelerated aging"), studies have not directly compared rates of geriatric conditions in this population to those found in the general population. The aims of this study were to compare the burden of geriatric conditions among older adults in jail to rates found in an age-matched nationally representative sample of community dwelling older adults. This cross sectional study compared 238 older jail inmates age 55 or older to 6871 older adults in the national Health and Retirement Study (HRS). We used an age-adjusted analysis, accounting for the difference in age distributions between the two groups, to compare sociodemographics, chronic conditions, and geriatric conditions (functional, sensory, and mobility impairment). A second age-adjusted analysis compared those in jail to HRS participants in the lowest quintile of wealth. All geriatric conditions were significantly more common in jail-based participants than in HRS participants overall and HRS participants in the lowest quintile of net worth. Jail-based participants (average age of 59) experienced four out of six geriatric conditions at rates similar to those found in HRS participants age 75 or older. Geriatric conditions are prevalent in older adults in jail at significantly younger ages than non-incarcerated older adults suggesting that geriatric assessment and geriatric-focused care are needed for older adults cycling through jail in their 50s and that correctional clinicians require knowledge about geriatric assessment and care.

CircleRides: developing an older adult transportation application and evaluating feedback.

Science.gov (United States)

Heinz, Melinda; Kelly, Norene

2015-05-01

The purpose of the current study was to assess perceptions of CircleRides, a paper prototype of a service website designed to meet older adult transportation needs. Researchers used purposive sampling to conduct two focus groups comprised of older adults to obtain feedback on the CircleRides prototype at the beginning of its iterative design process. One focus group was conducted in a continuing care retirement community (n = 13) and the other in an independent living community for older adults (n = 11). The study assessed perceptions of the CircleRides prototype as well as self-reported older adult transportation preferences and needs. Three themes emerged from the data: (a) trust and concern, (b) socialization, and (c) flexibility and options. Researchers found that participants are interested in transportation options; however, concern exists about trusting a new system or prototype that has not established a reputation. Findings from the current study offer lessons learned for future iterations and for creating transportation prototypes for older adults. Copyright 2015, SLACK Incorporated.

Social Workers' Attitudes toward Older Adults: A Review of the Literature

Science.gov (United States)

Wang, Donna; Chonody, Jill

2013-01-01

Ageist attitudes toward older adults have been recognized as barriers to recruiting and training competent social workers. This article provides a systematic review of the literature that focused on social workers' and social work students' attitudes toward older adults and working with older adults. The authors sought empirical studies…

Hypermnesia: a further examination of age differences between young and older adults.

Science.gov (United States)

Otani, Hajime; Kato, Koichi; Von Glahn, Nicholas R; Nelson, Meghann E; Widner, Robert L; Goernert, Phillip N

2008-05-01

Previous studies that examined age differences in hypermnesia reported inconsistent results. The present experiment investigated whether the different study materials in these studies were responsible for the inconsistency. In particular, the present experiment examined whether the use of a video, as opposed to words and pictures, would eliminate previously reported age differences in hypermnesia. Fifteen college students and 15 older adults viewed a 3-minute video clip followed by two free-recall tests. The results indicated that older adults, as a whole, did not show hypermnesia. However, when older adults were divided into low and high memory groups based on test 1 performance, the high memory group showed hypermnesia whereas the low memory group did not show hypermnesia. The older adults in the low memory group were significantly older than the older adults in the high memory group - indicating that hypermnesia is inversely related to age in older adults. Reminiscence did not show an age-related difference in either the low or high memory group whereas inter-test forgetting did show an age difference in the low memory group. As expected, older adults showed greater inter-test forgetting than young adults in the low memory group. Findings from the present experiment suggest that video produces a pattern of results that is similar to the patterns obtained when words and pictures are used as study material. Thus, it appears that the nature of study material is not the source of inconsistency across the previous studies.