WorldWideScience

Sample records for older persons skeletal

  1. Identification and treatment of older persons with sarcopenia.

    Science.gov (United States)

    Lauretani, Fulvio; Bautmans, Ivan; De Vita, Francesca; Nardelli, Anna; Ceda, Gian Paolo; Maggio, Marcello

    2014-12-01

    In the last decades, sarcopenia in older persons has been operationalized by the assessment of lean body mass, muscle strength and/or physical performance. Several definitions of sarcopenia, using different parameters and cut-offs, have been proposed. However, which is the best definition to describe and to assess this condition is still matter of debate. Hand grip strength has been suggested as better predictor of incident mobility impairment and mortality, than skeletal muscle mass. In the light of the current knowledge, we sought to propose an operative approach for identifying and treating sarcopenic older persons according to main categories of sarcopenia: the age-related or primary sarcopenia and disease-related or secondary sarcopenia. We suggest that a quantitative assessment of grip strength alone might be sufficient to identify patients with primary sarcopenia. When chronic diseases accompany the ageing process, the combined assessment of muscle strength plus a balance test could be more appropriate. The identification of tests and pathological relevant cut-offs that facilitates the entry of sarcopenia into the clinical practice, could step forward researchers and physicians. This could be important for planning multidisciplinary models to maximize the maintenance of locomotive abilities especially in older persons affected by chronic diseases such as Parkinson's disease.

  2. Malnutrition in older persons: underestimated, underdiagnosed and ...

    African Journals Online (AJOL)

    implemented a social protection system to improve access to food and provide for living ... non-resilience with limited reserve capacity in major organ systems”12 and is ... to eat, an approach that is often all that is required.16,19,20. Older persons ... should be the first mandatory step to identify malnutrition when following the ...

  3. Aberrant mitochondrial homeostasis in the skeletal muscle of sedentary older adults

    National Research Council Canada - National Science Library

    Safdar, Adeel; Hamadeh, Mazen J; Kaczor, Jan J; Raha, Sandeep; Debeer, Justin; Tarnopolsky, Mark A

    2010-01-01

    .... What remains less clear is whether the decline in skeletal muscle mitochondrial oxidative capacity is purely a function of the aging process or if the sedentary lifestyle of older adult subjects...

  4. Aberrant mitochondrial homeostasis in the skeletal muscle of sedentary older adults.

    Directory of Open Access Journals (Sweden)

    Adeel Safdar

    Full Text Available The role of mitochondrial dysfunction and oxidative stress has been extensively characterized in the aetiology of sarcopenia (aging-associated loss of muscle mass and muscle wasting as a result of muscle disuse. What remains less clear is whether the decline in skeletal muscle mitochondrial oxidative capacity is purely a function of the aging process or if the sedentary lifestyle of older adult subjects has confounded previous reports. The objective of the present study was to investigate if a recreationally active lifestyle in older adults can conserve skeletal muscle strength and functionality, chronic systemic inflammation, mitochondrial biogenesis and oxidative capacity, and cellular antioxidant capacity. To that end, muscle biopsies were taken from the vastus lateralis of young and age-matched recreationally active older and sedentary older men and women (N = 10/group; female symbol = male symbol. We show that a physically active lifestyle is associated with the partial compensatory preservation of mitochondrial biogenesis, and cellular oxidative and antioxidant capacity in skeletal muscle of older adults. Conversely a sedentary lifestyle, associated with osteoarthritis-mediated physical inactivity, is associated with reduced mitochondrial function, dysregulation of cellular redox status and chronic systemic inflammation that renders the skeletal muscle intracellular environment prone to reactive oxygen species-mediated toxicity. We propose that an active lifestyle is an important determinant of quality of life and molecular progression of aging in skeletal muscle of the elderly, and is a viable therapy for attenuating and/or reversing skeletal muscle strength declines and mitochondrial abnormalities associated with aging.

  5. 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 tre

  6. 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 tre

  7. Knowledge of colorectal cancer among older persons.

    Science.gov (United States)

    Weinrich, S P; Weinrich, M C; Boyd, M D; Johnson, E; Frank-Stromborg, M

    1992-10-01

    Cancer screening is a national health priority, especially for colorectal cancer, the second leading cause of death due to cancer in the United States. The researchers measured colorectal cancer knowledge among 211 older Americans. A quasiexperimental pretest-posttest two-by-two factorial design was used to test the effect of knowledge on participation in fecal occult blood screening. The American Cancer Society's colorectal cancer educational slide-tape presentation served as the basis for all of the educational programs. Hemoccult II kits were distributed at no cost to the participants. Descriptive statistics, chi 2, and logistic regressions were used to analyze data. One-half of the participants had incomes below the poverty level. Almost one-half the subjects in the study sample stated that they had not received any information about colorectal cancer within the past year. Caucasians had more knowledge of colorectal cancer than African Americans [F(1, 78) = 7.92, p < 0.01] and persons with higher income had more knowledge than persons with less income [F(2, 76) = 3.01, p = 0.05]. Subjects showed significant increases in colorectal cancer knowledge 6 days after the colorectal cancer education program [t(79) = 2.59, p = 0.01] and this increased knowledge was a predictor of participation in free fecal occult blood screening [chi 2(1, n = 164) = 5.34, p = 0.02].

  8. [Should subclinical hypothyroidism in older persons be treated?

    NARCIS (Netherlands)

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

    2012-01-01

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

  9. Bibliotherapy: An Interactive Process in Counseling Older Persons.

    Science.gov (United States)

    Hynes, Arleen M.; Wedl, Lois C.

    1990-01-01

    Describes bibliotherapeutic process and techniques that mental health counselors can use to effect intellectual, emotional, social, and spiritual growth in older persons. Envisions new opportunities for work with older persons who are chemically dependent, victims of abuse, or Alzheimer patients. Proposes research tool that observes participant's…

  10. Older Persons' Reasoning about Responsibility for Health: Variations and Predictions

    Science.gov (United States)

    Kjellstrom, Sofia; Ross, Sara Nora

    2011-01-01

    With many Western societies structured for adults to live longer and take responsibility for their health, it is valuable to investigate how older persons reason about this demand. Using mixed methods, this pilot studied how older persons reason about responsibility for health and their responsibility as a patient. Interviews with a small Swedish…

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

    Science.gov (United States)

    Clark, Robert L.; Anker, Richard

    1990-01-01

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

  12. Older Persons' Reasoning about Responsibility for Health: Variations and Predictions

    Science.gov (United States)

    Kjellstrom, Sofia; Ross, Sara Nora

    2011-01-01

    With many Western societies structured for adults to live longer and take responsibility for their health, it is valuable to investigate how older persons reason about this demand. Using mixed methods, this pilot studied how older persons reason about responsibility for health and their responsibility as a patient. Interviews with a small Swedish…

  13. Skeletal muscle TLR4 and TACE are associated with body fat percentage in older adults.

    Science.gov (United States)

    Timmerman, Kyle L; Connors, Ian D; Deal, Michael A; Mott, Rachael E

    2016-04-01

    Elevated skeletal muscle expression of toll-like receptor 4 (TLR4) has been linked to increased inflammation in clinical populations. TNFα converting enzyme (TACE), which cleaves membrane-bound TNFα (mTNFα) to its soluble (sTNFα) and more bioactive form, has been linked to chronic disease. In contrast, higher physical activity level is associated with decreased chronic disease risk and inflammation. The purpose of the present study was to examine the relationship between physical activity and skeletal muscle TLR4, TACE, and TNFα in older adults. In 26 older adults (age = 68 ± 4 years, body mass index = 26 ± 3 kg·m(-2)), self-reported physical activity (kcal·week(-1)), estimated maximal oxygen consumption, and body composition (air plethysmography) were measured. TLR4, TACE, mTNFα, and sTNFα were measured in skeletal muscle biopsies (vastus lateralis) using western blot analyses. Pearson product-moment correlations were run between variables. Significance was set at p muscle TACE was directly associated with sTNFα (r = 0.53, p fat was directly associated with skeletal muscle TLR4 (r = 0.52, p fat was directly associated with TLR4 and TACE expression in skeletal muscle of older adults. These findings suggest that elevated skeletal muscle expression of TLR4 and TACE may contribute to the augmented inflammation and chronic disease risk observed with increased adiposity.

  14. Specialist prescribing of psychotropic drugs to older persons in Sweden - a register-based study of 188 024 older persons

    Directory of Open Access Journals (Sweden)

    Martinsson Gunilla

    2012-11-01

    Full Text Available Abstract Background The situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (≥65 in Sweden, focused on the medical specialties of the prescribing physicians. Methods Data concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42 were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs, other specialists, and physicians without specialist education. Results GPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men. Conclusions This study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons’ disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were

  15. DSM-5-classificatie van persoonlijkheidsstoornissen bij ouderen [DSM-5 classification of personality disorders in older persons

    OpenAIRE

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

    2014-01-01

    BACKGROUND: Although it is generally agreed that personality disorders are an important topic in old-age psychiatry, DSM-5 has paid relatively little attention to older persons affected with this severe mental disorder. AIM: To look closely and carefully at several aspects of the way in which DSM-5 defines personality disorders relating to older persons. METHOD: We make a critical evaluation of the description of personality disorders given in DSM-5. RESULTS: First of all, we question whether...

  16. In search of meaning: A reminiscence program for older persons

    NARCIS (Netherlands)

    Westerhof, G.J.; Bohlmeijer, E.T.; Valenkamp, M.W.

    2004-01-01

    A pilot evaluation is reported of a reminiscence program aimed at increasing personal meaning. Fifty-seven older persons completed both a sentence completion questionnaire measuring personal meaning and a depression scale administered before and after the program. In comparison to a group from a rep

  17. Genetic and metabolic effects on skeletal muscle AMPK in young and older twins

    DEFF Research Database (Denmark)

    Mortensen, Brynjulf; Poulsen, Pernille; Wegner, Lise

    2009-01-01

    and environmental mechanisms involved in the regulation of AMPK expression and activity and to examine the association between AMPK protein levels and activity on one hand, and glucose and fat metabolism on the other hand. We investigated skeletal muscle biopsies from 100 young and 82 older mono- and dizygotic non......The protein complex AMP-activated protein kinase (AMPK) is believed to play an important role in the regulation of skeletal muscle glucose and lipid metabolism. Defects in the AMPK system might therefore be an important factor in the pathogenesis of type 2 diabetes. We aimed to identify genetic...... indicated that skeletal muscle AMPK mRNA and protein expression as well as activity were regulated by sex, age, obesity, and aerobic capacity. Comparison of intraclass correlations on AMPK measures from mono- and dizygotic twins suggested that skeletal muscle AMPK expression was under minor genetic...

  18. An Exploration of Personality Traits in Older Adult Amateur Musicians

    Science.gov (United States)

    Coffman, Don D.

    2007-01-01

    The primary research question for the study was, "Will older adult amateur musicians' personality profiles reflect the traits found in professional musicians?" Participants (N = 58, ages 52 to 79) recruited from a New Horizons Institute "band camp" for older adult amateur musicians completed a musical background questionnaire and the Cattell…

  19. Older persons' use of the European Court of Human Rights.

    Science.gov (United States)

    Spanier, Benny; Doron, Israel; Milman-Sivan, Faina

    2013-12-01

    One of the most significant human rights tribunals in Europe is the European Court of Human Rights (ECtHR). Up to day, no study has attempted to explore the cases brought before the ECtHR that discuss and rule on issues concerning the rights of older persons. To descriptively analyze the ECtHR cases that deal with older persons and elder rights issues. Quantitative and descriptive analysis of 226 randomly selected publicly-open ECtHR cases dealing with elder-rights between the years 2000-2010. On average, 11.9 % of the ECtHR case load included rulings that concern older persons' rights. In the majority of the cases (91 %, 205 judgments), the ECtHR found a violation of at least one human right concerning older persons. Despite the fact that rights of older persons do not appear as such in the European Convention on Human Rights, older persons do find their way to the ECtHR.

  20. Perspectives on use of personal alarms by older fallers

    Directory of Open Access Journals (Sweden)

    Kylie Johnston

    2010-08-01

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

  1. Sarcopenia Is Associated With Lower Skeletal Muscle Capillarization and Exercise Capacity in Older Adults.

    Science.gov (United States)

    Prior, Steven J; Ryan, Alice S; Blumenthal, Jacob B; Watson, Jonathan M; Katzel, Leslie I; Goldberg, Andrew P

    2016-08-01

    Skeletal muscle capillary rarefaction limits the transcapillary transport of nutrients and oxygen to muscle and may contribute to sarcopenia and functional impairment in older adults. We tested the hypothesis that skeletal muscle capillarization and exercise capacity (VO2max) are lower in sarcopenic than in nonsarcopenic older adults and that the degree of sarcopenia is related to lower skeletal muscle capillarization. Body composition, VO2max, and vastus lateralis capillarization were determined in 76 middle-aged and older men and women (age = 61±1 years, body mass index [BMI] = 30.7±0.5kg/m(2) [mean ± SEM]). Participants were classified as sarcopenic if appendicular lean mass divided by BMI (ALMBMI) was less than 0.789 for men or less than 0.512 for women. Sarcopenic subjects (ALMBMI = 0.65±0.04, n = 16) had 20% lower capillary-to-fiber ratio, as well as 13% and 15% lower VO2max expressed as mL/kg/min or L/min, respectively, compared with sex-, race-, and age-matched participants without sarcopenia (ALMBMI = 0.81±0.05, n = 16; p sarcopenia and reduced exercise capacity in older adults by limiting diffusion of substrates, oxygen, hormones, and nutrients. Strategies to prevent the aging-related decline in skeletal muscle capillarization may help to prevent or slow the progression of sarcopenia and its associated functional declines in generally healthy older adults. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

  2. Osteoarthritis and falls in the older person.

    Science.gov (United States)

    Ng, Chin Teck; Tan, Maw Pin

    2013-09-01

    Osteoarthritis and falls are common conditions affecting older individuals which are associated with disability and escalating health expenditure. It has been widely assumed that osteoarthritis is an established risk factor for falls in older people. The relationship between osteoarthritis and falls has, quite surprisingly, not been adequately elucidated, and published reports have been conflicting. Our review of the existing literature has found limited evidence supporting the current assumption that the presence of osteoarthritis is associated with increased risk of falls with suggestions that osteoarthritis may actually be protective against falls related fractures. In addition, joint arthroplasty appears to increase the risk of falls in individuals with osteoarthritis.

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

    Directory of Open Access Journals (Sweden)

    Md. Nuruzzaman Haque

    2016-01-01

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

  4. How older persons explain why they became victims of abuse

    DEFF Research Database (Denmark)

    Mysyuk, Yuliya; Westendorp, Rudi Gerardus Johannes; Lindenberg, Jolanda

    2016-01-01

    position of older persons. Effects of abuse included negative feelings, physical and psychological distress, a change of personal norms and values, changed perspectives on money and low self-efficacy. These differential effects depended upon the types of abuse experienced and the relationship...

  5. Older Adolescent's Perceptions of Personal Internet Use

    Science.gov (United States)

    Koff, Rosalind N.; Moreno, Megan A.

    2013-01-01

    Internet use is widespread among the older adolescent population. Given the pervasiveness and frequency of internet use, concerns have been raised regarding the impact of excess internet use on adolescent health. In order to understand the impact of internet use on health, we must have accurate and reliable measures of internet use. This study…

  6. Erythropoietin Does Not Enhance Skeletal Muscle Protein Synthesis Following Exercise in Young and Older Adults

    Science.gov (United States)

    Lamon, Séverine; Zacharewicz, Evelyn; Arentson-Lantz, Emily; Gatta, Paul A. Della; Ghobrial, Lobna; Gerlinger-Romero, Frederico; Garnham, Andrew; Paddon-Jones, Douglas; Russell, Aaron P.

    2016-01-01

    Purpose: Erythropoietin (EPO) is a renal cytokine that is primarily involved in hematopoiesis while also playing a role in non-hematopoietic tissues expressing the EPO-receptor (EPOR). The EPOR is present in human skeletal muscle. In mouse skeletal muscle, EPO stimulation can activate the AKT serine/threonine kinase 1 (AKT) signaling pathway, the main positive regulator of muscle protein synthesis. We hypothesized that a single intravenous EPO injection combined with acute resistance exercise would have a synergistic effect on skeletal muscle protein synthesis via activation of the AKT pathway. Methods: Ten young (24.2 ± 0.9 years) and 10 older (66.6 ± 1.1 years) healthy subjects received a primed, constant infusion of [ring-13C6] L-phenylalanine and a single injection of 10,000 IU epoetin-beta or placebo in a double-blind randomized, cross-over design. 2 h after the injection, the subjects completed an acute bout of leg extension resistance exercise to stimulate skeletal muscle protein synthesis. Results: Significant interaction effects in the phosphorylation levels of the members of the AKT signaling pathway indicated a differential activation of protein synthesis signaling in older subjects when compared to young subjects. However, EPO offered no synergistic effect on vastus lateralis mixed muscle protein synthesis rate in young or older subjects. Conclusions: Despite its ability to activate the AKT pathway in skeletal muscle, an acute EPO injection had no additive or synergistic effect on the exercise-induced activation of muscle protein synthesis or muscle protein synthesis signaling pathways. PMID:27458387

  7. Cardiovascular risk estimation in older persons

    DEFF Research Database (Denmark)

    Cooney, Marie Therese; Selmer, Randi; Lindman, Anja

    2016-01-01

    model and were included in the SCORE O.P. model were: age, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, smoking status and diabetes. SCORE O.P. showed good discrimination; area under receiver operator characteristic curve (AUROC) 0.74 (95% confidence interval: 0......AIMS: Estimation of cardiovascular disease risk, using SCORE (Systematic COronary Risk Evaluation) is recommended by European guidelines on cardiovascular disease prevention. Risk estimation is inaccurate in older people. We hypothesized that this may be due to the assumption, inherent in current...... risk estimation systems, that risk factors function similarly in all age groups. We aimed to derive and validate a risk estimation function, SCORE O.P., solely from data from individuals aged 65 years and older. METHODS AND RESULTS: 20,704 men and 20,121 women, aged 65 and over and without pre...

  8. Resistance training for activity limitations in older adults with skeletal muscle function deficits: a systematic review

    Directory of Open Access Journals (Sweden)

    Papa EV

    2017-06-01

    Full Text Available Evan V Papa,1 Xiaoyang Dong,2 Mahdi Hassan1 1Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China; 2Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA Abstract: Human aging results in a variety of changes to skeletal muscle. Sarcopenia is the age-associated loss of muscle mass and is one of the main contributors to musculoskeletal impairments in the elderly. Previous research has demonstrated that resistance training can attenuate skeletal muscle function deficits in older adults, however few articles have focused on the effects of resistance training on functional mobility. The purpose of this systematic review was to 1 present the current state of literature regarding the effects of resistance training on functional mobility outcomes for older adults with skeletal muscle function deficits and 2 provide clinicians with practical guidelines that can be used with seniors during resistance training, or to encourage exercise. We set forth evidence that resistance training can attenuate age-related changes in functional mobility, including improvements in gait speed, static and dynamic balance, and fall risk reduction. Older adults should be encouraged to participate in progressive resistance training activities, and should be admonished to move along a continuum of exercise from immobility, toward the recommended daily amounts of activity. Keywords: aging, strength training, sarcopenia, mobility, balance

  9. Treatment of hypertension in older persons: what is the evidence?

    Science.gov (United States)

    Morley, John E

    2014-05-01

    Evidence for treatment of hypertension in older people is limited to placebo-controlled studies that reduced blood pressure in persons over 60 years who had systolic blood pressure >160 mmHg. Generally, physicians measure blood pressure poorly, failing to look for white coat or masked hypertension, orthostasis, postprandial hypotension, or pseudohypertension. There is evidence that if 24-hour ambulatory blood pressures were obtained, the treatment goal should be substantially lower. Sleep apnea, pain, nocturnal hypoglycemia, drugs, excess aldosterone production, and pheochromocytoma should all be considered as causes of hypertension in older persons. Evidence supports a low-dose diuretic or an angiotensin converting enzyme inhibitor as appropriate first-line therapies in older persons.

  10. Hospitalisations due to falls in older persons.

    LENUS (Irish Health Repository)

    Carey, D

    2005-06-01

    This paper describes hospitalisations due to falls among people aged 65 years and over resident in the Eastern Region of Ireland. Of the 2,029 hospitalisations recorded for 2002, 78% were female and 68% were aged 75 years and over. Fractures accounted for 1,697 or 84% of cases with nearly half of them (841) sustained to the hip. Females were more likely to have a limb fracture whereas males were more likely to have a head injury. The total inpatient costs of the 2,029 hospitalisations were estimated at 10.6 million euros. Hip fractures were the costliest injuries as they accounted for 7.4 million euros (70%) of inpatient costs. There are also substantial additional costs implications for hip fractures as they constituted the majority (56%) of cases transferred to nursing\\/convalescent homes or long-stay health facilities. In keeping with an ageing population, the problem of injuries in older people is likely to increase over time and as falls are the dominant cause of those injuries, all acute and long-stay health facilities need to develop and implement fall prevention strategies for older people.

  11. The Impact of Cuban Economic Reform on Older Persons.

    Science.gov (United States)

    Strug, David L

    2017-03-01

    This paper discusses the economic reforms initiated by Cuban President Raúl Castro in 2008 and its effect on the country's fast-growing, vulnerable population of older persons 60+ years of age. Cubans are living longer and the country has a very low birthrate. These two factors combined have reduced the proportion of the population in the work force. This adversely affects the economy. Population aging is a major reason why the government has introduced structural reforms and reduced social spending, which have weakened the welfare state on which older persons depend. Many older persons have become critical of the reforms over time. Policy makers need to address the impact the reforms are having on older Cubans and consider them as active participants in economic reform. Data for this paper come from qualitative, case study research carried out in Havana between the years 2008-15 and from a review of the literature on aging and economic reforms in Cuba. Two case studies illustrate the impact of the economic reforms on older persons.

  12. Promoting independence at mealtimes for older persons with severe dementia

    Directory of Open Access Journals (Sweden)

    Liv Helene Jensen

    2016-11-01

    Full Text Available Background: Maintaining independence in activities of daily living, including when eating meals, may be challenging for persons with dementia. To uphold person-centred care there is a need for knowledge of how to facilitate mealtimes in such circumstances. Aims: To develop knowledge of how nurses promote independence at mealtimes for persons with severe dementia, and to explore their practice from a person-centred perspective. Methods: A collaborative action research project was conducted over two years in a Norwegian hospital for older persons with mental health challenges and severe dementia. The nurses conducted observations at mealtimes and presented narratives as a basis for group reflections, care planning and individualised adjustments. In the qualitative analysis, commonalities and differences in meal situations were explored and a constructed narrative was designed to identify the nurses’ actions and attitudes. Results: Person-centred practice and different levels of simplification in the planning and facilitation of meals for older persons with severe dementia seemed to help uphold their independence and dignity. This was achieved by careful observations during meals, when the nurses took the role of hostesses. Promoting independence for persons with severe dementia requires ongoing commitment, with practical reflection among the nurses and evaluation in everyday practice. Conclusions and implications for practice: Facilitation of meals for older persons with severe dementia using a person-centred approach seems to increase the nurses’ attention to people’s independence and dignity Sharing narratives from meal observations in reflective dialogues promotes the nurses’ competence in planning meals with different levels of simplification Building in systematic attentive observations and sharing narratives in everyday practice may be an important step in practice development Critical dialogue seems to strengthen awareness of person

  13. Skeletal muscle strength in older adults. Angiotensin-converting enzyme (ACE genotype affects: an UPDATE

    Directory of Open Access Journals (Sweden)

    ANA PEREIRA

    2011-06-01

    Full Text Available Problem Statement : Previous studies have associated angiotensin-converting enzyme (ACE with variability inthe skeletal muscle baseline strength, though conclusions have been inconsistent across investigations.Approach: The purpose of this study was to review the most important studies that have been exanimate thepossible association between ACE genotype and skeletal muscle baseline strength in elite male and femaleathletes involved in elderly populations. This research is needed because the possibility that the DD genotypemay be associated with a greater proportion of fast twitch fibers could explain the influence of the ACE D alleleupon strength/ power, particularly at high velocities, but this evidence remains equivocal in older people becausemore studies are necessary.Results: Thus, according to scientific evidence, changes in muscle strength with exercise training in olderindividuals may be dependent on ACE I/D genotype. Of note, the results provide a novel insight that thesegenetic variations may interact to determine muscle mass in older women specially. The determination of thispredisposition in this population, highlighting the interest of study, for the prophylactic attitude on the factorsand causes of aging (sarcopenia, osteoporosis, risk of falls, reduction of functional physical go through thisanalysis.Conclusions/Recommendations: In this work, the state of the art related to the influence of the ACE genotypeon skeletal muscle strength was presented and some important relations were reported

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  15. A Comparison of Intellectual and Behavioral Functioning in Older Persons.

    Science.gov (United States)

    Smith, Michael C.; Kramer, Nanette A.

    In order to ascertain the extent to which older persons' levels of behavioral functioning parallel their levels of intellectual functioning, 42 female patients, aged 61-99, of an outpatient comprehensive care geriatric clinic, completed the Wechsler Adult Intelligence Scale (WAIS), the Instrumental Activities of Daily Living Scale (IADL), the…

  16. A Comparison of Intellectual and Behavioral Functioning in Older Persons.

    Science.gov (United States)

    Smith, Michael C.; Kramer, Nanette A.

    In order to ascertain the extent to which older persons' levels of behavioral functioning parallel their levels of intellectual functioning, 42 female patients, aged 61-99, of an outpatient comprehensive care geriatric clinic, completed the Wechsler Adult Intelligence Scale (WAIS), the Instrumental Activities of Daily Living Scale (IADL), the…

  17. DSM-5-classificatie van persoonlijkheidsstoornissen bij ouderen [DSM-5 classification of personality disorders in older persons

    NARCIS (Netherlands)

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

    2014-01-01

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

  18. DSM-5-classificatie van persoonlijkheidsstoornissen bij ouderen [DSM-5 classification of personality disorders in older persons

    NARCIS (Netherlands)

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

    2014-01-01

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

  19. Bone Turnover Does Not Reflect Skeletal Aging in Older Hispanic Men with Type 2 Diabetes

    Science.gov (United States)

    Rianon, N.; McCormick, J.; Ambrose, C.; Smith, S. M.; Fisher-Hoch, S.

    2016-01-01

    The paradox of fragility fracture in the presence of non-osteoporotic bone mineral density in older patients with type 2 diabetes mellitus (DM2) makes it difficult to clinically predict fracture in this vulnerable group. Serum osteocalcin (OC), a marker of bone turnover, increases with normal skeletal aging indicating risk of fracture. However, OC has been reported to be lower in patients with DM2. An inverse association between higher glycated hemoglobin levels (HbA1c) and lower serum OC in older DM2 patients triggered discussions encouraging further investigation. A key question to be answered is whether changes in glucose metabolism is responsible for bone metabolic changes, ultimately leading to increased risk of fragility fractures in DM2 patients. While these studies were conducted among Caucasian and Asian populations, this has not been studied in Hispanic populations who suffer from a higher prevalence of DM2. The Cameron County Hispanic Cohort (CCHC) in Texas is a homogeneous Hispanic cohort known to have high prevalence of DM2 (30%). Our preliminary data from this cohort reported OC levels lower than the suggested threshold for fragility fracture in post-menopausal women. We further investigated whether bone turnover in older CCHC adults with DM2 show a normal pattern of skeletal aging. Samples and data were obtained from a nested cohort of 68 (21 men and 47 women) Hispanic older adults (=50 years) who had a diagnosis of DM2. Given high prevalence of uncontrolled DM2 in this cohort, we divided population into two groups: i) poor DM2 control with HbA1c level =8 (48% men and 38% women) and ii) good DM2 control with HbA1c level <8). A crosssectional analysis documented associations between serum OC and age adjusted HbA1c levels. There was no direct association between age and OC concentrations in our study. Higher HbA1c was associated with lower serum OC in men (odds ratio -6.5, 95% confidence interval -12.7 to - 0.3, p < 0.04). No significant associations

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

    Directory of Open Access Journals (Sweden)

    Sulistyowati Tuminah Darjoko

    2016-05-01

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

  1. The Link between Dietary Protein Intake, Skeletal Muscle Function and Health in Older Adults

    Directory of Open Access Journals (Sweden)

    Jamie I. Baum

    2015-07-01

    Full Text Available Skeletal muscle mass and function are progressively lost with age, a condition referred to as sarcopenia. By the age of 60, many older adults begin to be affected by muscle loss. There is a link between decreased muscle mass and strength and adverse health outcomes such as obesity, diabetes and cardiovascular disease. Data suggest that increasing dietary protein intake at meals may counterbalance muscle loss in older individuals due to the increased availability of amino acids, which stimulate muscle protein synthesis by activating the mammalian target of rapamycin (mTORC1. Increased muscle protein synthesis can lead to increased muscle mass, strength and function over time. This review aims to address the current recommended dietary allowance (RDA for protein and whether or not this value meets the needs for older adults based upon current scientific evidence. The current RDA for protein is 0.8 g/kg body weight/day. However, literature suggests that consuming protein in amounts greater than the RDA can improve muscle mass, strength and function in older adults.

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

    OpenAIRE

    Md. Nuruzzaman Haque

    2016-01-01

    Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male...

  3. Family support and loneliness among older persons in multiethnic Malaysia.

    Science.gov (United States)

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

    2014-01-01

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

  4. Rehabilitation of Older Persons Disabled by Cancer, Stroke, and Heart Disease.

    Science.gov (United States)

    Finnerty-Fried, Pamela; And Others

    1986-01-01

    Rehabilitation of older persons disabled by cancer, stroke, or heart disease is discussed. Aspects of each disability are described, and the importance of timely and appropriate intervention with older persons is emphasized. Barriers generally faced by older disabled persons are briefly outlined. (Author)

  5. Skeletal Muscle Mitochondrial Energetics Are Associated With Maximal Aerobic Capacity and Walking Speed in Older Adults

    Science.gov (United States)

    2013-01-01

    Background. Lower ambulatory performance with aging may be related to a reduced oxidative capacity within skeletal muscle. This study examined the associations between skeletal muscle mitochondrial capacity and efficiency with walking performance in a group of older adults. Methods. Thirty-seven older adults (mean age 78 years; 21 men and 16 women) completed an aerobic capacity (VO2 peak) test and measurement of preferred walking speed over 400 m. Maximal coupled (State 3; St3) mitochondrial respiration was determined by high-resolution respirometry in saponin-permeabilized myofibers obtained from percutanous biopsies of vastus lateralis (n = 22). Maximal phosphorylation capacity (ATPmax) of vastus lateralis was determined in vivo by 31P magnetic resonance spectroscopy (n = 30). Quadriceps contractile volume was determined by magnetic resonance imaging. Mitochondrial efficiency (max ATP production/max O2 consumption) was characterized using ATPmax per St3 respiration (ATPmax/St3). Results. In vitro St3 respiration was significantly correlated with in vivo ATPmax (r 2 = .47, p = .004). Total oxidative capacity of the quadriceps (St3*quadriceps contractile volume) was a determinant of VO2 peak (r 2 = .33, p = .006). ATPmax (r 2 = .158, p = .03) and VO2 peak (r 2 = .475, p VO2 peak in a multiple linear regression model improved the prediction of preferred walking speed (r 2 = .647, p < .0001), suggesting that mitochondrial efficiency is an important determinant for preferred walking speed. Conclusions. Lower mitochondrial capacity and efficiency were both associated with slower walking speed within a group of older participants with a wide range of function. In addition to aerobic capacity, lower mitochondrial capacity and efficiency likely play roles in slowing gait speed with age. PMID:23051977

  6. Personal Meaning Orientations and Psychosocial Adaptation in Older Adults

    Directory of Open Access Journals (Sweden)

    Gary T. Reker

    2011-04-01

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

  7. Approaching neurological diseases to reduce mobility limitations in older persons.

    Science.gov (United States)

    Lauretani, Fulvio; Ceda, Gian Paolo; Pelliccioni, Pio; Ruffini, Livia; Nardelli, Anna; Cherubini, Antonio; Maggio, Marcello

    2014-01-01

    The rapidly increasing elderly population poses a major challenge for future health-care systems. Neurological diseases in older persons are particularly common and coexist with other clinical conditions. This is not surprising given that, for example, even patients with Alzheimer Disease (AD) could have relevant extrapyramidal signs at the moment of the diagnosis with motor signs having more negative prognostic value. Longitudinal studies conducted on Parkinson Disease (PD) showed that, after 20 years, dementia is not only present in almost all survivors but is also the main factor influencing nursing home admission. Recently, it has been reported the importance of Comprehensive Geriatric Assessment (CGA: comprehensive evaluation of cognition, depressive symptoms, mobility and functional assessment) as a tool reducing morbidity in frail older patients admitted to any acute hospital unit. The CGA should be considered as a technological device, for physicians who take care of older persons affected by overlapping neurological diseases. CGA is an extraordinary and cost effective instrument even in patients with advanced neurological diseases where allows to collect valuable information for an effective plan of management.

  8. Protein Considerations for Optimising Skeletal Muscle Mass in Healthy Young and Older Adults

    Directory of Open Access Journals (Sweden)

    Oliver C. Witard

    2016-03-01

    Full Text Available Skeletal muscle is critical for human health. Protein feeding, alongside resistance exercise, is a potent stimulus for muscle protein synthesis (MPS and is a key factor that regulates skeletal muscle mass (SMM. The main purpose of this narrative review was to evaluate the latest evidence for optimising the amino acid or protein source, dose, timing, pattern and macronutrient coingestion for increasing or preserving SMM in healthy young and healthy older adults. We used a systematic search strategy of PubMed and Web of Science to retrieve all articles related to this review objective. In summary, our findings support the notion that protein guidelines for increasing or preserving SMM are more complex than simply recommending a total daily amount of protein. Instead, multifactorial interactions between protein source, dose, timing, pattern and macronutrient coingestion, alongside exercise, influence the stimulation of MPS, and thus should be considered in the context of protein recommendations for regulating SMM. To conclude, on the basis of currently available scientific literature, protein recommendations for optimising SMM should be tailored to the population or context of interest, with consideration given to age and resting/post resistance exercise conditions.

  9. Struggling for existence-Life situation experiences of older persons with mental disorders.

    Science.gov (United States)

    Martinsson, Gunilla; Fagerberg, Ingegerd; Lindholm, Christina; Wiklund-Gustin, Lena

    2012-01-01

    Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons' experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. "Struggling for existence" emerged as a main theme in the older persons' narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care.

  10. Normativity under change: Older persons with implantable cardioverter defibrillator.

    Science.gov (United States)

    Svanholm, Jette Rolf; Nielsen, Jens Cosedis; Mortensen, Peter Thomas; Christensen, Charlotte Fuglesang; Birkelund, Regner

    2016-05-01

    In modern society, death has become 'forbidden' fed by the medical technology to conquer death. The technological paradigm is challenged by a social-liberal political ideology in postmodern Western societies. The question raised in this study was as follows: Which arguments, attitudes, values and paradoxes between modern and postmodern tendencies concerning treatment and care of older persons with an implantable cardioverter defibrillator appear in the literature? The aim of this study was to describe and interpret how the field of tension concerning older persons with an implantable cardioverter defibrillator - especially end-of-life issues - has been expressed in the literature throughout the last decade. Paul Ricoeur's reflexive interpretive approach was used to extract the meaningful content of the literature involving qualitative, quantitative and normative literature. Analysis and interpretation involved naive reading, structural analysis and critical interpretation. The investigation complied with the principles outlined in the Declaration of Helsinki. The unifying theme was 'Normativity under change'. The sub-themes were 'Death has become legitimate', 'The technological imperative is challenged' and 'Patients and healthcare professionals need to talk about end-of-life issues'. There seems to be a considerable distance between the normative approach of how practice ought to be and findings in empirical studies. Modern as well as postmodern attitudes and perceptions illustrate contradictory tendencies regarding deactivation of the implantable cardioverter defibrillator and replacement of the implantable cardioverter defibrillator in older persons nearing the end of life. The tendencies challenge each other in a struggle to gain position. On the other hand, they can also complement each other because professionalism and health professional expertise cannot stand alone when the patient's life is at stake but must be unfolded in an alliance with the patient who

  11. Sensory functioning and personality development among older adults.

    Science.gov (United States)

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

    2017-03-01

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

  12. Anteroposterior jaw position in persons with skeletal class I

    Directory of Open Access Journals (Sweden)

    Vučinić Predrag

    2004-01-01

    Full Text Available Introduction Many authors point out that there are great differences in anthropometric studies due to racial, ethnic and population morphological characteristics. Facial type is a decisive factor when planning and setting objectives, as well as when choosing the mode of orthodontic treatment. The aim of this study was to determine the morphological characteristics of antero-posterior position of maxilla and mandible and determine the most prevalent facial type in children living in Vojvodina. Material and methods Sixty cephalograms of both males and females, with skeletal class I and harmonious facial profile, were digitized and the following skeletal measurements were calculated: SNA, SNB and ANB angles. For comparative analysis, characteristics of craniofacial complex of the tested population were compared to Bolton standards from the Broadbent-Bolton longitudinal growth study. Results A statistically significant difference of both maxillary and mandibular prognathism were present when compared to Bolton standards. This indicates more retrognathic viscerocranial structures, and more posteriorly divergent profiles (SNA=81.7o; SNB=78.23o. Conclusion Differences identified in craniofacial parameters in relation to Bolton standards show that one should carefully consider the risk of altering facial esthetics of patients from Vojvodina with extraction treatment. Whenever possible, give priority to early non-extraction treatment, in order to reach the best possible end-result within the given facial type, preserving facial esthetics.

  13. How Older Persons Are Portrayed in Television Advertising: Implications for Educators.

    Science.gov (United States)

    Hiemstra, Roger; And Others

    1983-01-01

    Examined 136 recent television ads to analyze the treatment of older persons. Results showed a significant absence of the elderly in television commercials. Suggests that educators must become assertive in helping both the older person and advertisers portray older people more positively and realistically. (JAC)

  14. Personality traits and personality disorders in older women: an explorative study between normal development and psychopathology.

    Science.gov (United States)

    Henriques-Calado, Joana; Duarte-Silva, Maria Eugénia; Keong, Ana Marta; Sacoto, Carlota; Junqueira, Diana

    2014-01-01

    The relationships between Axis II personality disorders (DSM-IV) and the Five-Factor Model (FFM) were explored in older women. The sample consists of 90 participants (M = 72.29 years, SD = 7.10) who were administered the NEO-Five-Factor Inventory and the Personality Diagnostic Questionnaire. The highest prevalence of A and C clusters and obsessive-compulsive personality disorder was observed. Also, elevated neuroticism and decreased agreeableness and openness appear as valuable traits in the description of psychopathology. The study of maladaptive personality functioning within an aging population can be described with the same traits that underlie normal personality functioning, extending the range of psychopathology to a dimensional approach.

  15. Therapeutic interaction with an older personality disordered patient.

    Science.gov (United States)

    Josephs, Lawrence; Sanders, Avihay; Gorman, Bernard S

    2014-06-01

    This study reflects an assessment of the relationship between change in defensive functioning and change in the therapeutic interaction during an eight-year treatment episode of an older personality disordered woman. The patient, Ms. Q, possessed schizoid, avoidant, and depressive personality disorders as well as major depression as assessed by the Millon Clinical Multiaxial Inventory-III (MCMI-III). At the end of the treatment episode, Ms. Q still possessed an avoidant personality disorder and significant depressive personality traits but no longer possessed clinically significant schizoid traits or major depression. Ms. Q made significant positive change in her adaptive defensive functioning as assessed by the Defense Mechanism Rating Scale (DMRS). Through time-series analysis it was discovered that positive change in adaptive defenses was predicted by increases in a specific type of therapeutic interaction as assessed by the Psychotherapy Q Sort (PQS). In this therapeutic interaction the therapist in a didactic and advice-giving manner highlighted the patient's role in a problem in a clear and coherent way that could be perceived as tactless. Time-series analysis revealed a reciprocal relationship in which positive changes in adaptive defenses predicted further increases in that particular quality of therapeutic interaction.

  16. Immunoglobulin G subclasses in older persons with Down syndrome.

    Science.gov (United States)

    Mehta, P D; Dalton, A J; Mehta, S P; Percy, M E; Sersen, E A; Wisniewski, H M

    1993-07-01

    IgG subclasses were measured in sera from 33 persons with Down syndrome (DS) (mean age 55 +/- 7 years) and 33 age- and sex-matched control individuals using a mouse monoclonal antibody based sandwich enzyme linked immunosorbent assay. Significantly higher levels of IgG1 and IgG3 and lower levels of IgG2 and IgG4 subclasses were found in the DS group compared to the control individuals. The higher levels of IgG1 and IgG3 subclasses found in DS persons were consistent with those seen in patients with autoimmune diseases and chronic viral infections; the lower levels of IgG2 and IgG4 subclasses were consistent with those seen in patients with recurrent infections. Our findings are similar to those reported in children with DS. We speculate that the subclass levels may have little or no relationship to the development of brain lesions typical of Alzheimer disease in older persons with DS. There were no significant differences between the levels of IgG subclasses of persons with DS showing signs of dementia of the Alzheimer type compared to those without such manifestations.

  17. Multimorbidity and survival in older persons with colorectal cancer.

    Science.gov (United States)

    Gross, Cary P; Guo, Zhenchao; McAvay, Gail J; Allore, Heather G; Young, Mary; Tinetti, Mary E

    2006-12-01

    To ascertain the effect of common chronic conditions on mortality in older persons with colorectal cancer. Retrospective cohort study. Population-based cancer registry. Patients in the Surveillance Epidemiology and End Results-Medicare linked database who were aged 67 and older and had a primary diagnosis of Stage 1 to 3 colorectal cancer during 1993 through 1999. Chronic conditions were identified using claims data, and vital status was determined from the Medicare enrollment files. After estimating the adjusted hazard ratios for mortality associated with each condition using a Cox model, the population attributable risk (PAR) was calculated for the full sample and by age subgroup. The study sample consisted of 29,733 patients, 88% of whom were white and 55% were female. Approximately 9% of deaths were attributable to congestive heart failure (CHF; PAR = 9.4%, 95% confidence interval (CI) = 8.4-10.5%), more than 5% were attributable to chronic obstructive pulmonary disease (COPD; PAR = 5.3%, 95% CI = 4.7-6.6%), and nearly 4% were attributable to diabetes mellitus (PAR = 3.9%, 95% CI = 3.1-4.8%). The PAR associated with CHF increased with age, from 6.3% (95% CI = 4.4-8.8%) in patients aged 67 to 70 to 14.5% (95% CI = 12.0-17.5%) in patients aged 81 to 85. Multiple conditions were common. More than half of the patients who had CHF also had diabetes mellitus or COPD. The PAR associated with CHF alone (4.29%, 95% CI = 3.68-4.94%) was similar to the PAR for CHF in combination with diabetes mellitus (3.08, 95% CI = 2.60-3.61%) or COPD (3.93, 95% CI = 3.41-4.54%). A substantial proportion of deaths in older persons with colorectal cancer can be attributed to CHF, diabetes mellitus, and COPD. Multimorbidity is common and exerts a substantial effect on colorectal cancer survival.

  18. Struggling for existence—Life situation experiences of older persons with mental disorders

    Science.gov (United States)

    Fagerberg, Ingegerd; Lindholm, Christina; Wiklund-Gustin, Lena

    2012-01-01

    Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. “Struggling for existence” emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care. PMID:22693537

  19. Determinants of thoughts of death or suicide in depressed older persons

    NARCIS (Netherlands)

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

    2013-01-01

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

  20. Determinants of thoughts of death or suicide in depressed older persons

    NARCIS (Netherlands)

    Bogers, I.C.; Zuidersma, M.; Boshuisen, M.L.; Comijs, H.C.; Oude Voshaar, R.C.

    2013-01-01

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

  1. Determinants of thoughts of death or suicide in depressed older persons

    NARCIS (Netherlands)

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

    2013-01-01

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

  2. Presence and correlates of apathy in non-demented depressed and non-depressed older persons

    Directory of Open Access Journals (Sweden)

    Isis Groeneweg-Koolhoven

    2015-06-01

    Full Text Available Background and Objectives: Apathy is a behavioral syndrome that often co-occurs with depression. Nonetheless, the etiology of apathy and depression may be different. We hypothesized that apathy occurs more often in depressed compared to non-depressed older persons; and that independent correlates for apathy will be different in depressed and non-depressed older persons. Methods: In this cross-sectional study of Netherlands Study of Depression in Older Persons (NESDO, a total of 350 depressed older persons according to the Composite International Diagnostic Interview (CIDI and 126 non-depressed older persons, aged at least 60 years were recruited in several Medical Centres and general practices. In both depressed and non-depressed older persons, those with and without apathy as assessed with the Apathy Scale (score ≥ 14 were compared with regard to socio-demographic, clinical, and biological characteristics. Results: Apathy was present in 75% of the depressed and 25% of the non- depressed older persons. Independent correlates of apathy in both depressed and non-depressed older persons were male gender and less education. Furthermore, in depressed older persons, higher scores on the Inventory of Depressive Symptomatology (IDS and, in non-depressed older persons, a higher C-reactive protein (CRP level correlated independently with apathy. Conclusions: Apathy occurred frequently among both depressed and non-depressed older persons. Among depressed older persons, apathy appeared to be a symptom of more serious depression, whereas among non-depressed persons apathy was associated with increased CRP being a marker for immune activation, suggesting a different aetiology for apathy in its own right.

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

    DEFF Research Database (Denmark)

    Kollerup, Mette Geil; Angel, Sanne

    2015-01-01

    age and frailty implies impressive and expressive challenges, the nursing assessment of basic needs requires well developed nursing skills to create a facilitating setting that involves the frail older person. The nurse elicits patiently the older person's voice, and listens empathically to piece...... if they are suffering from chronic diseases and complex functional impairments. A starting point for an exploration of this complexity is the identification of frail older persons' basic needs Aim: To explore the challenges in nursing assessment of basic needs when the older persons' frailty also implies impressive......Background: Despite research on caring for older persons' basic needs, a number of hospital admissions occur which had been preventable, given the proper attention to caring for the basic needs. Literature show that caring for the basic needs of frail older persons can be complicated...

  4. Pharmacological treatment of neuropathic pain in older persons

    Directory of Open Access Journals (Sweden)

    Clair Haslam

    2008-03-01

    Full Text Available Clair Haslam1, Turo Nurmikko21The Walton Centre for Neurology and Neurosurgery, Liverpool, England, UK; 2The Pain Research Institute, Division of Neurological Science, University of Liverpool, Liverpool, England, UKAbstract: Interest and research into the mechanisms and treatment of neuropathic pain have increased during recent years, but current treatment is still far from satisfactory (Dworkin et al 2003; Attal et al 2006. The European Federation of Neurological Societies (EFNS Task Force recently published guidelines for the pharmacological treatment of neuropathic pain (Attal et al 2006. However, no particular consideration is given as to how the recommendations are applicable to the elderly population. This paper will review the guidelines in relation to this population and evaluate the existing evidence relating to the use of these drugs in older persons.Keywords: neuropathic pain, elderly, anticonvulsants, antidepressants, opioids, tramadol, lidocaine patch/plaster, capsaicin

  5. TREATMENT OF CANCER IN THE OLDER AGED PERSON

    Directory of Open Access Journals (Sweden)

    Lodovico Balducci

    2010-05-01

    Full Text Available

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

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

     

     

  6. Risk Factors for Restricting Back Pain in Older Persons

    Science.gov (United States)

    Makris, Una E.; Fraenkel, Liana; Han, Ling; Leo-Summers, Linda; Gill, Thomas M.

    2013-01-01

    Objectives To identify risk factors for back pain leading to restricted activity (restricting back pain) in older persons. Design Prospective cohort study. Setting Greater New Haven, Connecticut. Participants 731 men and women aged 70 years or older, who were community-living and non-disabled in essential activities of daily living at baseline. Measurements Candidate risk factors were ascertained every 18 months for 108 months during comprehensive home-based assessments. Restricting back pain was assessed during monthly telephone interviews for up to 126 months. Incident episodes of: (1) short-term (one episode lasting one month) restricting back pain; and (2) persistent (one episode lasting two or more months) or recurrent (two or more episodes of any duration) restricting back pain were determined during each 18-month interval. The associations between the candidate risk factors and short-term and persistent/recurrent restricting back pain, respectively, were evaluated using a multivariable Cox model. Results The cumulative incidence was 21.3% (95% confidence interval (CI) 19.6%, 23.1%) for short-term restricting back pain and 20.6% (CI 18.6%, 22.9%) for persistent/recurrent restricting back pain over a median follow-up of 109 months. In a recurrent event multivariable analysis, female sex (HR 1.30; 1.07, 1.58), weak grip strength (HR 1.24; 1.01,1.52), and hip weakness (HR 1.19; 1.07,1.32) were independently associated with an increased likelihood of having short-term restricting back pain, while female sex (HR 1.48; CI 1.13,1.94), depressive symptoms (HR 1.57; 1.23, 2.00), 2 or more chronic conditions (HR 1.38; 1.08, 1.77), and arthritis (HR1.66; 1.31, 2.09) were independently associated with persistent/recurrent restricting back pain. Conclusion In this prospective study, several factors were independently associated with restricting back pain, including some that may be modifiable and therefore potential targets for interventions to reduce this common and

  7. Antipsychotic prescription and mortality in hospitalized older persons.

    Science.gov (United States)

    Chiesa, Deborah; Marengoni, Alessandra; Nobili, Alessandro; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Djade, Codjo D; Corrao, Salvatore; Salerno, Francesco; Marcucci, Maura; Romanelli, Giuseppe; Mannucci, Pier Mannuccio

    2017-06-06

    Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score ≥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score <5 (indicative of normal cognition). In-hospital mortality was slightly higher in patients prescribed antipsychotic drugs (14.3% vs 9.4%; P = 0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. We found that the prescription of antipsychotic

  8. Dance performance as a method of intervention as experienced by older persons with dementia.

    Science.gov (United States)

    Ravelin, Teija; Isola, Arja; Kylmä, Jari

    2013-03-01

    Previous studies have shown that dance can bring out the strength and resources of persons with dementia. To describe for later evaluation how older persons with dementia experience dance performances in a nursing home. Four dance performances, based on the recollections the older persons had of different seasons, were arranged in one nursing home. Qualitative descriptive study, with 13 older persons with dementia, four family members, seven nurses and three practical nurse students. Data were collected and analysed using methodological triangulation. Older persons identified dance performance activity as a process. They had a positive attitude towards the dance performance and performers, and they had experiences of different elements of the dance performance. The older persons forgot their ailments during the performances, and the performances evoked various emotions and awoke memories. Some of them had negative experiences of dancing and dance performances. The older persons experienced a common bond with other spectators. Watching a dance performance is an active process for older persons with dementia. Reminiscence about the dance performance gives the older person an opportunity to deal with the experiences evoked by the performance. © 2011 Blackwell Publishing Ltd.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tinda Rabie

    2015-06-01

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

  12. Personal Strength and Finding Meaning in Conjugally Bereaved Older Adults: A Four-Year Prospective Analysis

    Science.gov (United States)

    Kim, Su Hyun; Kjervik, Diane; Belyea, Michael; Choi, Eun Sook

    2011-01-01

    This study was performed to identify the patterns and mechanisms of the development of personal strength of bereaved older adults over a 4-year period after spousal death. The findings showed that while bereaved older adults, on average, experienced a moderate level of personal strength at 6 months post-spousal death with a slight increase over a…

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

    Science.gov (United States)

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

    2015-01-01

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

  14. Comprehensive geriatric assessment : recognition of identified geriatric conditions by community-dwelling older persons

    NARCIS (Netherlands)

    van Rijn, Marjon; Suijker, Jacqueline J; Bol, Wietske; Hoff, Eva; Ter Riet, Gerben; de Rooij, Sophia E; Moll van Charante, Eric P; Buurman, Bianca M

    2016-01-01

    OBJECTIVES: to study (i) the prevalence of geriatric conditions in community-dwelling older persons at increased risk of functional decline and (ii) the extent to which older persons recognise comprehensive geriatric assessment (CGA)-identified conditions as relevant problems. METHODS: trained regis

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

    NARCIS (Netherlands)

    G.M.E.E. Peeters (Geeske); N.M. van Schoor (Natasja); S. Pluijm (Saskia); D.J.H. Deeg (Dorly); P. Lips (Paul)

    2010-01-01

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

  16. COMMON ISSUES IN AGEING - WHAT OLDER PERSONS ARE SAYING?

    Directory of Open Access Journals (Sweden)

    Anand P

    2016-02-01

    Full Text Available CONTEXT The number of senior citizens is increasing worldwide. In India 8% of population is above 60 years as per census 2011. The peculiarity of growth of senior citizen in India is that first the population is ageing and then country is developing, unlike western countries where countries developed first and then number of senior citizen increased. This phenomenon has huge impact on planning for the needs of growing number of senior citizen. The United Nations declared the theme for international year of older people 2013. "The future we want: what older persons are saying". This is an attempt by policy makers to know what elders wish to convey. AIM This study aimed to know the basic problems concerned to social, family and health aspects of senior citizen. MATERIAL AND METHODS One hundred and thirty-three literate senior citizens participated and duly filled the questionnaire provided to them. They expressed their views and the same is presented through this study. RESULTS The senior literate senior citizen, majority of males in age group of 70-75years have conveyed that there are hidden problems and also good things happening with them. Most of them are happy with their life so far, they have accomplished their responsibilities in better way, and have a pension to take care of financial needs, want to lead a healthy life and wish to donate organs after death. Few feel that there is need for old age homes, very few are subject to abuse and many felt that their decisions should be honoured in the house hold matters. CONCLUSION This study expresses the original views of the literate senior citizen regarding their problems related to social, health and family matters. The results bring out the real scenario of life of senior citizen so for the policy makers

  17. Potentiation of cGMP signaling increases oxygen delivery and oxidative metabolism in contracting skeletal muscle of older but not young humans

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Piil, Peter Bergmann; Egelund, Jon;

    2015-01-01

    regulation remain unresolved. Cyclic guanosine monophosphate (cGMP) is one of the main second messengers that mediate smooth muscle vasodilation and alterations in cGMP signaling could, therefore, be one mechanism by which skeletal muscle perfusion is impaired with advancing age. The current study aimed...... to evaluate the effect of inhibiting the main enzyme involved in cGMP degradation, phosphodiesterase 5 (PDE5), on blood flow and O2 delivery in contracting skeletal muscle of young and older humans. A group of young (23 ± 1 years) and a group of older (72 ± 2 years) male human subjects performed submaximal...... in the older subjects correlated with the increase in leg O2 uptake (r (2) = 0.843). These findings suggest an insufficient O2 delivery to the contracting skeletal muscle of aged individuals and that reduced cGMP availability is a novel mechanism underlying impaired skeletal muscle perfusion with advancing age....

  18. Views and experiences of Malaysian older persons about falls and their prevention-A qualitative study.

    Science.gov (United States)

    Loganathan, Annaletchumy; Ng, Chirk Jenn; Low, Wah Yun

    2016-05-06

    Few studies on falls interventions have been conducted in South East Asia. Despite its population ageing rapidly, the acceptability of interventions among the older population in this region remains variable. This study aims to explore views and experiences regarding falls and their prevention among older persons at high risk of falls. Sixteen individuals aged 60 years and over with at least one fall in the preceding 12 months were recruited from our Primary Care clinics. A qualitative study using semi-structured interviews among individuals and focus-groups was conducted. Thematic analyses were conducted on transcriptions of audio-taped interviews using the WeftQDA software. The interviews ceased when data saturation was achieved. The three themes included older persons' views on falls, help-seeking behaviour and views on falls interventions. Many older persons interviewed did not perceive falls as a serious problem, some reported a stigma surrounding falls, while others felt they had not sustained more serious injuries due to God's grace. Older persons sought traditional medicine and other alternative treatments for pain relief and other fall-related symptoms. Accessibility of healthcare facilities often prevented older persons from receiving physiotherapy or eye tests. The delivery of complex interventions for a multifactorial condition such as falls in the older persons in our setting is inhibited by various cultural barriers, falls perceptions as well as logistic difficulties. Efforts to establish a multi-disciplinary intervention among our older population will need to include strategies to overcome these issues.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

    Patterson, Karen; Newman, Claire; Doona, Katherine

    2016-09-01

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

  1. A Primer on Personal Money Management for Midlife and Older Women. Revised.

    Science.gov (United States)

    Fullner, Wanda

    This booklet, which is intended to acquaint midlife and older women with the basic principles of personal money management, presents action steps, tips, and sample forms for planning and organizing personal finances. The booklet is organized into 10 sections that deal with the following aspects of personal money management: determining financial…

  2. Can echocardiographic findings predict falls in older persons?

    NARCIS (Netherlands)

    N. van der Velde (Nathalie); B.H.Ch. Stricker (Bruno); J.R.T.C. Roelandt (Jos); F.J. ten Cate (Folkert); T.J.M. van der Cammen (Tischa)

    2007-01-01

    textabstractBackground. The European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers. Method and

  3. Personal networks and mortality risk in older adults: A twenty-year longitudinal study

    NARCIS (Netherlands)

    Ellwardt, L.; Tilburg, van T.G.; Aartsen, M.J.; Wittek, R.; Steverink, N.

    2015-01-01

    Background: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investig

  4. Personal Networks and Mortality Risk in Older Adults : A Twenty-Year Longitudinal Study

    NARCIS (Netherlands)

    Ellwardt, Lea; van Tilburg, Theo; Aartsen, Marja; Wittek, Rafael; Steverink, Nardi

    2015-01-01

    Background Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investiga

  5. Personal networks and mortality risk in older adults : A twenty-year longitudinal study

    NARCIS (Netherlands)

    Ellwardt, Lea; Tilburg, Theo G. van; Aartsen, Marja; Wittek, Rafael; Steverink, Nardi

    2015-01-01

    Background: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investig

  6. Personal networks and mortality risk in older adults : A twenty-year longitudinal study

    NARCIS (Netherlands)

    Ellwardt, Lea; Tilburg, Theo G. van; Aartsen, Marja; Wittek, Rafael; Steverink, Nardi

    2015-01-01

    Background: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investig

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

    Science.gov (United States)

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

    2017-08-16

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

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

    Science.gov (United States)

    Waldbrook, Natalie

    2015-03-01

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

  9. Personal autonomy for older people living in residential care: an overview.

    Science.gov (United States)

    Rodgers, Vivien; Neville, Stephen

    2007-07-01

    Autonomy has significance for everyone, including those in long-term residential care. This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how an individual's autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.

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

    Directory of Open Access Journals (Sweden)

    Laura Mählmann

    2016-03-01

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

  11. Critical Analysis of Government vs. Commercial Advertising Discourse on Older Persons in Spain

    OpenAIRE

    de-Andrés-del Campo, Susana; de-Lima-Maestro, Rosa

    2014-01-01

    The elderly population has increased considerably in recent years and it is estimated that by 2050 32% of the Spanish population will be older persons. This group is underrepresented in the media and does not attract much research interest. To put this right, we present an analysis of the representation of older persons in advertisements appearing in magazines aimed directly or indirectly at seniors in Spain. A content analysis estimated the frequency of appearance of the images and words tha...

  12. Effect of PDE5 inhibition on the modulation of sympathetic α-adrenergic vasoconstriction in contracting skeletal muscle of young and older recreationally active humans

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Piil, Peter Bergmann; Egelund, Jon;

    2015-01-01

    Aging is associated with an altered regulation of blood flow to contracting skeletal muscle; however, the precise mechanisms remain unclear. We recently demonstrated that inhibition of cGMP-binding phosphodiesterase 5 (PDE5) increased blood flow to contracting skeletal muscle of older but not young......- and α2-adrenergic receptors. The level of the sympatholytic compound ATP was measured in venous plasma by use of the microdialysis technique. Sildenafil increased (P

  13. Family Support and Loneliness among Older Persons in Multiethnic Malaysia

    OpenAIRE

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

    2014-01-01

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

  14. Family Support and Loneliness among Older Persons in Multiethnic Malaysia

    Directory of Open Access Journals (Sweden)

    Jane Kimm Lii Teh

    2014-01-01

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

  15. Diverse Family Structures and the Care of Older Persons.

    Science.gov (United States)

    Roberto, Karen A; Blieszner, Rosemary

    2015-09-01

    Demographic and social trends lead to a variety of micro-level and internal structural contexts that influence caregiving in families with older members. The results of macro-level changes have received little focused attention in the aging literature, where much of the caregiving research has addressed issues within the context of traditional family structure. Yet the conventional nuclear family model is increasingly uncommon as new, pluralistic models of family life are emerging in contemporary society. The majority of elder care is provided by relatives, albeit with varying patterns of involvement and responsibility across family structures. Both conventional and pluralistic families face challenges in meeting the care needs of their oldest members, leaving some older adults at risk of having unmet needs. Additional research on family risk and resilience related to the care of older relatives is warranted, particularly with respect to pluralistic models of family life.

  16. Depression in homebound older adults: problem-solving therapy and personal and social resourcefulness.

    Science.gov (United States)

    Choi, Namkee G; Marti, C Nathan; Bruce, Martha L; Hegel, Mark T

    2013-09-01

    The goal of problem-solving therapy is to teach patients systematic coping skills. For many homebound older adults, coping skills must also include both personal and social (help-seeking) resourcefulness. This study aimed to examine the relationship between perceived resourcefulness and depressive symptoms at postintervention and potential mediating effect of the resourcefulness among 121 low-income homebound older adults who participated in a pilot randomized controlled trial testing feasibility and preliminary efficacy of telehealth-PST. Resourcefulness Scale for Older Adults was used to measure personal and social resourcefulness. Only personal resourcefulness scores were significantly associated with depression outcomes at postintervention, and neither resourcefulness scores were significantly associated with group assignment. Analysis found no mediation effect of resourcefulness. The findings call for further research on potential mediators for the potentially effective depression treatment that could be sustained in the real world for low-income homebound older adults who have limited access to psychotherapy as a treatment modality.

  17. Personal relevance modulates the positivity bias in recall of emotional pictures in older adults.

    Science.gov (United States)

    Tomaszczyk, Jennifer C; Fernandes, Myra A; MacLeod, Colin M

    2008-02-01

    Some studies have suggested that older adults remember more positive than negative valence information, relative to younger adults, whereas other studies have reported no such difference. We tested whether differences in encoding instructions and in personal relevance could account for these inconsistencies. Younger and older adults were instructed either to passively view positive, negative, and neutral pictures or to actively categorize them by valence. On a subsequent incidental recall test, older adults recalled equal numbers of positive and negative pictures, whereas younger adults recalled negative pictures best. There was no effect of encoding instructions. Crucially, when the pictures were grouped into high and low personal relevance, a positivity bias emerged in older adults only for low-relevance pictures, suggesting that the personal relevance of pictures may be the factor underlying cross-study differences.

  18. Being altruistically egoistic—Nursing aides’ experiences of caring for older persons with mental disorders

    Directory of Open Access Journals (Sweden)

    Christina Lindholm

    2011-10-01

    Full Text Available Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given.

  19. Being altruistically egoistic—Nursing aides’ experiences of caring for older persons with mental disorders

    Science.gov (United States)

    Wiklund-Gustin, Lena; Lindholm, Christina; Fagerberg, Ingegerd

    2011-01-01

    Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given. PMID:22007261

  20. Physical fitness related to age and physical activity in older persons

    NARCIS (Netherlands)

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

    1998-01-01

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

  1. Lymphocyte count and mortality risk in older persons. The Leiden 85-Plus Study

    NARCIS (Netherlands)

    Izaks, GJ; Remarque, EJ; Becker, SV; Westendorp, RGJ

    2003-01-01

    OBJECTIVES: To investigate whether a low peripheral blood lymphocyte count is associated with increased mortality risk in older persons and to determine whether this association could be ascribed to ill health. DESIGN: A cohort study with a total follow-up period of 1,602 person years. SETTING: Leid

  2. Physical fitness related to age and physical activity in older persons

    NARCIS (Netherlands)

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

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

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

    Science.gov (United States)

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

    2012-01-01

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

  4. Tackling the increasing problem of malnutrition in older persons

    NARCIS (Netherlands)

    Visser, Marjolein; Volkert, D.; Corish, C.; Geisler, C.; Groot, de C.P.G.M.; Cruz-Jentoft, A.J.; Lohrmann, C.; O'Connor, E.M.; Schindler, K.; Schueren, van der D.E.

    2017-01-01

    In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative (JPI) A

  5. Measuring psychosocial variables that predict older persons' oral health behaviour.

    Science.gov (United States)

    Kiyak, H A

    1996-12-01

    The importance of recognising psychosocial characteristics of older people that influence their oral health behaviours and the potential success of dental procedures is discussed. Three variables and instruments developed and tested by the author and colleagues are presented. A measure of perceived importance of oral health behaviours has been found to be a significant predictor of dental service utilization in three studies. Self-efficacy regarding oral health has been found to be lower than self-efficacy regarding general health and medication use among older adults, especially among non-Western ethnic minorities. The significance of self-efficacy for predicting changes in caries and periodontal disease is described. Finally, a measure of expectations regarding specific dental procedures has been used with older people undergoing implant therapy. Studies with this instrument reveal that patients have concerns about the procedure far different than those focused on by dental providers. All three instruments can be used in clinical practice as a means of understanding patients' values, perceived oral health abilities, and expectations from dental care. These instruments can enhance dentist-patient rapport and improve the chances of successful dental outcomes for older patients.

  6. Older Adolescent's Perceptions of Personal Internet Use

    Science.gov (United States)

    Koff, Rosalind N.; Moreno, Megan A.

    2013-01-01

    Internet use is widespread among the older adolescent population. Given the pervasiveness and frequency of internet use, concerns have been raised regarding the impact of excess internet use on adolescent health. In order to understand the impact of internet use on health, we must have accurate and reliable measures of internet use. This study…

  7. Skeletal muscle myofilament adaptations to aging, disease and disuse and their effects on whole muscle performance in older adult humans

    Directory of Open Access Journals (Sweden)

    Mark Stuart Miller

    2014-09-01

    Full Text Available Skeletal muscle contractile function declines with aging, disease and disuse. In vivo muscle contractile function depends on a variety of factors, but force, contractile velocity and power generating capacity ultimately derive from the summed contribution of single muscle fibers. The contractile performance of these fibers are, in turn, dependent upon the isoform and function of myofilament proteins they express, with myosin protein expression and its mechanical and kinetic characteristics playing a predominant role. Alterations in myofilament protein biology, therefore, may contribute to the development of functional limitations and disability in these conditions. Recent studies suggest that these conditions are associated with altered single fiber performance due to decreased expression of myofilament proteins and/or changes in myosin-actin cross-bridge interactions. Furthermore, cellular and myofilament-level adaptations are related to diminished whole muscle and whole body performance. Notably, the effect of these various conditions on myofilament and single fiber function tends to be larger in older women compared to older men, which may partially contribute to their higher rates of disability. To maintain functionality and provide the most appropriate and effective countermeasures to aging, disease and disuse in both sexes, a more thorough understanding is needed of the contribution of myofilament adaptations to functional disability in older men and women and their contribution to tissue level function and mobility impairment.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  9. Modifiable impairments predict progressive disability among older persons.

    Science.gov (United States)

    Tinetti, Mary E; Allore, Heather; Araujo, Katy L B; Seeman, Teresa

    2005-04-01

    Our purpose was to determine the extent to which a predetermined set of modifiable impairments predicted progression of disability. We conducted a 3-year follow-up of two community-based cohorts of older adults. The impairment areas included lower extremity, upper extremity, hearing, vision, and affect. Home management and social or productive activities were the domains of function investigated. All five impairments were of at least borderline significance in predicting decline in both functional domains in both cohorts with the exception of hearing for home management activities. The five impairments together explained from 17% to 23% of the decline seen in the functional outcomes (partial R(2)s 0.17 to 0.23). Five prevalent and potentially modifiable impairments explained much of the progressive disability experienced. Given the priority that older patients place on function as a health outcome, these impairments should be routinely assessed and modified.

  10. Verbal expressive personality testing with older adults: 25+ years later.

    Science.gov (United States)

    Panek, Paul E; Jenkins, Sharon Rae; Hayslip, Bert; Moske, Amanda Kay

    2013-01-01

    This review builds on those conducted over 25 years ago by Panek and Hayslip in examining the literature dealing with the use of verbal expressive techniques with older adults. Such findings based on the Rorschach Ink Blot Test, Holtzman Inkblot Technique, Hand Test, Sentence Completion methods, and the Thematic Apperception Test and kindred thematic apperceptive techniques are presented and evaluated regarding the evidence for age differences, differential diagnosis, extraneous individual differences in performance, and adequacy of normative data. Although available evidence appears to warrant the continued use of verbal expressive techniques with older adults, more adequately designed studies are necessary to fully support the potential of these assessment tools for decision making with this population: assisting in diagnosis, recommending the appropriateness of various living arrangements, facilitating supportive care choices, and aiding in treatment planning.

  11. Can echocardiographic findings predict falls in older persons?

    Directory of Open Access Journals (Sweden)

    Nathalie van der Velde

    Full Text Available BACKGROUND: The European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers. METHOD AND FINDINGS: In order to determine the association between echocardiographic abnormalities and falls in older adults, we performed a prospective cohort study, in which 215 new consecutive referrals (age 77.4, SD 6.0 of a geriatric outpatient clinic of a Dutch university hospital were included. During the previous year, 139 had experienced a fall. At baseline, all patients underwent routine two-dimensional and Doppler echocardiography. Falls were recorded during a three-month follow-up. Multivariate adjustment for confounders was performed with a Cox proportional hazards model. 55 patients (26% fell at least once during follow-up. The adjusted hazard ratio of a fall during follow-up was 1.35 (95% CI, 1.08-1.71 for pulmonary hypertension, 1.66 (95% CI, 1.01 to 2.89 for mitral regurgitation, 2.41 (95% CI, 1.32 to 4.37 for tricuspid regurgitation and 1.76 (95% CI, 1.03 to 3.01 for pulmonary regurgitation. For aortic regurgitation the risk of a fall was also increased, but non-significantly (hazard ratio, 1.57 [95% CI, 0.85 to 2.92]. Trend analysis of the severity of the different regurgitations showed a significant relationship for mitral, tricuspid and pulmonary valve regurgitation and pulmonary hypertension. CONCLUSIONS: Echo (Doppler cardiography can be useful in order to identify risk indicators for falling. Presence of pulmonary hypertension or regurgitation of mitral, tricuspid or pulmonary valves was associated with a higher fall risk. Our study indicates that the diagnostic work-up for falls in older adults might be improved by adding an echo (Doppler cardiogram in selected groups.

  12. Instruments to stimulate activation of older persons on labor market

    Directory of Open Access Journals (Sweden)

    Klaudia Lucius

    2015-03-01

    Full Text Available The topic of ageing society and its influence on shaping economy is one of the priorities in political discussions nowadays.  The trend of increasing population of 50+ years old people is visible in most of the highly developed European countries. This situation induces countries with changing demographical structure to implement solutions that will extend the job activity of people in the immobile age. The best example is Germany, where the introduction of structural reforms in the labor market employment in the 55+ group increased in 10 years by 20%.  Effective management of the community of older people is necessary to keep the balance in economy. Many examples of good case practices from chosen European countries point an important role of education in this process. Education is a tool that aims to support older people in functioning on the job market and increase employers’ awareness of changes and solutions that need to be implemented in their companies. Customized forms of employment are another instrument of increasing job activity of older people. They let employers adjust the time, place of work, job description and form of payment according to the employer’s and employee’s preferences. Though, the most significant instrument is reduction of unemployment benefits for people who are qualified to take job activity. In this case one of the solutions is applying temporary benefits that stimulate active job hunting. The mentioned activities, to ensure their efficiency, should be supported by adequate law regulations.

  13. Potentiation of cGMP signaling increases oxygen delivery and oxidative metabolism in contracting skeletal muscle of older but not young humans

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Piil, Peter Bergmann; Egelund, Jon

    2015-01-01

    to evaluate the effect of inhibiting the main enzyme involved in cGMP degradation, phosphodiesterase 5 (PDE5), on blood flow and O2 delivery in contracting skeletal muscle of young and older humans. A group of young (23 ± 1 years) and a group of older (72 ± 2 years) male human subjects performed submaximal......Aging is associated with progressive loss of cardiovascular and skeletal muscle function. The impairment in physical capacity with advancing age could be related to an insufficient peripheral O2 delivery to the exercising muscles. Furthermore, the mechanisms underlying an impaired blood flow...... regulation remain unresolved. Cyclic guanosine monophosphate (cGMP) is one of the main second messengers that mediate smooth muscle vasodilation and alterations in cGMP signaling could, therefore, be one mechanism by which skeletal muscle perfusion is impaired with advancing age. The current study aimed...

  14. Skeletal muscle sodium glucose co-transporters in older adults with type 2 diabetes undergoing resistance training

    Directory of Open Access Journals (Sweden)

    Francisco Castaneda, Jennifer E. Layne, Carmen Castaneda

    2006-01-01

    Full Text Available We examined the expression of the sodium-dependent glucose co-transporter system (hSGLT3 in skeletal muscle of Hispanic older adults with type 2 diabetes. Subjects (65±8 yr were randomized to resistance training (3x/wk, n=13 or standard of care (controls, n=5 for 16 weeks. Skeletal muscle hSGLT3 and GLUT4 mRNA transcript levels were determined by real time RT-PCR. hSGLT3 transcripts increased by a factor of ten following resistance training compared to control subjects (0.10, P=0.03. There were no differences in GLUT4 mRNA expression levels between groups. Protein expression levels of these transporters were confirmed by immunohistochemistry and Western blotting. hSGLT3 after resistance exercise was found not to be co-localized with the nicotinic acetylcholine receptor. The change in hSGLT3 transcript levels in the vastus lateralis muscle was positively correlated with glucose uptake, as measured by the change in muscle glycogen stores (r=0.53, P=0.02; and with exercise intensity, as measured by the change in muscle strength (r=0.73, P=0.001. Group assignment was be the only independent predictor of hSGLT3 transcript levels, explaining 68% of its variability (P=0.01. Our data show that hSGLT3, but not GLTU4, expression was enhanced in skeletal muscle after 16 weeks of resistance training. This finding suggests that hSGLT3, an insulin-independent glucose transporter, is activated with exercise and it may play a significant role in glycemic control with muscle contraction. The hSGLT3 exact mechanism is not well understood and requires further investigation. However its functional significance regarding a reduction of glucose toxicity and improvement of insulin resistance is the subject of ongoing research.

  15. Depression in Homebound Older Adults: Problem-Solving Therapy and Personal and Social Resourcefulness

    OpenAIRE

    Choi, Namkee G.; Marti, C. Nathan; Bruce, Martha L.; Hegel, Mark T.

    2013-01-01

    The goal of problem-solving therapy is to teach patients systematic coping skills. For many homebound older adults, coping skills must also include both personal and social (help-seeking) resourcefulness. This study aimed to examine the relationship between perceived resourcefulness and depressive symptoms at postintervention and potential mediating effect of the resourcefulness among 121 low-income homebound older adults who participated in a pilot randomized controlled trial testing feasibi...

  16. Personal factors predictive of health-related lifestyles of community-dwelling older adults.

    Science.gov (United States)

    Peralta-Catipon, Terry; Hwang, Jengliang Eric

    2011-01-01

    We explored personal factors that can predict health-related lifestyles of community-dwelling older adults. A convenience sample of 253 older adults was recruited to complete the Health Enhancement Lifestyle Profile (HELP), a comprehensive measure of health-promoting behaviors. Data were analyzed through univariate correlational/comparative statistics followed by stepwise multiple regression analysis to determine significant predictor variables for different aspects of health-related lifestyle. Personal health conditions, including the number of chronic diseases or impairments and self-rated health, were two strong predictors for the HELP (R2 = .571, p Leisure). When developing individualized plans for older adults in community settings, occupational therapists should consider the clients' strengths and vulnerabilities potentially derived from personal health factors and demographic attributes to yield more effective lifestyle interventions.

  17. Spirituality and health in older Thai persons in the United States.

    Science.gov (United States)

    Pincharoen, Sumon; Congdon, JoAnn G

    2003-02-01

    Health and spiritual phenomena are viewed differently depending on the cultural perspective. This study describes spirituality as perceived and experienced by older Thai persons. Specific aims were to describe how spirituality helped older Thai persons maintain their health and to describe what they valued most as they aged. A qualitative, descriptive study informed by ethnographic methods was utilized. The sample included 9 older Thai persons from an urban U.S. community. Data were generated using ethnographic interviews and participant observation. Data analysis incorporated coding, categorizing, and theme development. Rigor was guided by Lincoln and Guba. Five major themes emerged from the data: Connecting with spiritual resources provided comfort and peace, finding harmony through a healthy mind and body, living a valuable life, valuing tranquil relationships with family and friends, and experiencing meaning and confidence in death. For these Thai participants, health and spirituality coexisted and were linked to all of life.

  18. Health care for older persons in Colombia: a country profile.

    Science.gov (United States)

    Gómez, Fernando; Curcio, Carmen-Lucía; Duque, Gustavo

    2009-09-01

    Colombia is a country of approximately 42 million inhabitants, with some 2.5 million being aged 65 and older. Currently, life expectancy in Colombia is 72.3. By 2025, the population life expectancy at birth will be 77.6 for women and 69.8 for men. The quality of care that people receive as they age in Colombia varies according to where they live. Individuals living in the highly urbanized areas of Colombia receive high-quality care, whereas elderly subjects living in rural areas and in the southern and northern regions are exposed to unemployment, low income, inequity of access to health care, drug trafficking, and armed conflict. In spite of these problems, characteristics of aging of older people in terms of functionality and healthcare access are similar to those of people living in developing countries around the world. This article reviews the particular characteristics of the elderly population in Colombia, especially the significant changes that have happened in recent years, when social instability and conflict have determined that health resources be redirected to other budget priorities such as defense and security.

  19. A Learning Model for Updating Older Technical and Professional Persons.

    Science.gov (United States)

    Dubin, Samuel S.

    Technical and professional persons are especially threatened by the potentiality of becoming outdated in their skills and their knowledge. It is not enough for workers in these fields to maintain the competence acquired in the years of formal education. Their information bank is anything but static; the norm is perpetual change. Psychologists,…

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

    Science.gov (United States)

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

    2017-03-01

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

  1. Draw a Young and an Older Person: Schoolchildren's Images of Older People

    Science.gov (United States)

    Villar, Feliciano; Faba, Josep

    2012-01-01

    The goal of this study was to explore stereotypes of older people as expressed in drawings by a sample of primary school children. Sixty children from fourth to sixth grades (30 boys and 30 girls aged 9 to 12 years) were asked to draw a young man, a young woman, an old man, and an old woman. The drawings were content analyzed. Children in our…

  2. Dual-energy X-ray absorptiometry is a valid tool for assessing skeletal muscle mass in older women.

    Science.gov (United States)

    Chen, Zhao; Wang, ZiMian; Lohman, Timothy; Heymsfield, Steven B; Outwater, Eric; Nicholas, Jennifer S; Bassford, Tamsen; LaCroix, Andrea; Sherrill, Duane; Punyanitya, Mark; Wu, Guanglin; Going, Scott

    2007-12-01

    Assessing skeletal muscle mass (SMM) is critical in studying and detecting sarcopenia. Direct measurements by MRI or computerized tomography are expensive or high in radiation exposure. Dual-energy X-ray absorptiometry (DXA) is promising for body composition assessments, but the validity of DXA for predicting SMM in the elderly is still under investigation. The objective of this study was to assess the relationship between DXA-derived measurements of lean soft tissue mass (LSTM) and SMM in older women. Study participants were postmenopausal women (n = 101) recruited in southern Arizona. Total and regional body composition was measured using MRI and DXA (QDR4500w). The participants' mean age was 70.7 +/- 6.4 y and their mean BMI was 27.4 +/- 5.1 kg/m2. DXA-derived LSTM was highly correlated with MRI-derived SMM for the whole body (r = 0.94; P LSTM assessments for the leg region but not for the total body. In conclusion, although the relationships between DXA measures and MRI-derived SMM vary by region of interest, the overall prediction of SMM by DXA is excellent. We conclude that DXA is a reliable method for cross-sectional assessments of SMM in older women.

  3. Skeletal muscle power: a critical determinant of physical functioning in older adults

    Science.gov (United States)

    Muscle power declines earlier and more precipitously with advancing age compared to muscle strength. Peak muscle power has also emerged as an important predictor of functional limitations in older adults. Our current working hypothesis is focused on examining lower extremity muscle power as a more d...

  4. Schema therapy for personality disorders in older adults: a multiple-baseline study.

    Science.gov (United States)

    Videler, Arjan C; van Alphen, Sebastiaan P J; van Royen, Rita J J; van der Feltz-Cornelis, Christina M; Rossi, Gina; Arntz, Arnoud

    2017-04-21

    No studies have been conducted yet into the effectiveness of treatment of personality disorders in later life. This study is a first test of the effectiveness of schema therapy for personality disorders in older adults. Multiple-baseline design with eight cluster C personality disorder patients, with a mean age of   69. After a baseline phase with random length, schema therapy was given during the first year, followed by follow-up sessions during six months. Participants weekly rated the credibility of dysfunctional core beliefs. Symptomatic distress, early maladaptive schemas, quality of life and target complaints were assessed every six months and personality disorder diagnosis was assessed before baseline and after follow-up. Data were analyzed with mixed regression analyses. Results revealed significant linear trends during treatment phases, but not during baseline and follow-up. The scores during follow-up remained stable and were significantly lower compared to baseline, with high effect sizes. Seven participants remitted from their personality disorder diagnosis. Schema therapy appears an effective treatment for cluster C personality disorders in older adults. This finding is highly innovative as this is the first study exploring the effectiveness of psychotherapy, in this case schema therapy, for personality disorders in older adults.

  5. The Netherlands study of depression in older persons (NESDO; a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Comijs Hannie C

    2011-12-01

    Full Text Available Abstract Background To study late-life depression and its unfavourable course and co morbidities in The Netherlands. Methods We designed the Netherlands Study of Depression in Older Persons (NESDO, a multi-site naturalistic prospective cohort study which makes it possible to examine the determinants, the course and the consequences of depressive disorders in older persons over a period of six years, and to compare these with those of depression earlier in adulthood. Results From 2007 until 2010, the NESDO consortium has recruited 510 depressed and non depressed older persons (≥ 60 years at 5 locations throughout the Netherlands. Depressed persons were recruited from both mental health care institutes and general practices in order to include persons with late-life depression in various developmental and severity stages. Non-depressed persons were recruited from general practices. The baseline assessment included written questionnaires, interviews, a medical examination, cognitive tests and collection of blood and saliva samples. Information was gathered about mental health outcomes and demographic, psychosocial, biological, cognitive and genetic determinants. The baseline NESDO sample consists of 378 depressed (according to DSM-IV criteria and 132 non-depressed persons aged 60 through 93 years. 95% had a major depression and 26.5% had dysthymia. Mean age of onset of the depressive disorder was around 49 year. For 33.1% of the depressed persons it was their first episode. 41.0% of the depressed persons had a co morbid anxiety disorder. Follow up assessments are currently going on with 6 monthly written questionnaires and face-to-face interviews after 2 and 6 years. Conclusions The NESDO sample offers the opportunity to study the neurobiological, psychosocial and physical determinants of depression and its long-term course in older persons. Since largely similar measures were used as in the Netherlands Study of Depression and Anxiety (NESDA; age

  6. The 24-h distribution of falls and person-hours of physical activity in the home are strongly associated among community-dwelling older persons

    NARCIS (Netherlands)

    Wijlhuizen, G.J.; Chorus, A.M.J.; Hopman-Rock, M.

    2008-01-01

    Objectives: Most research on falls among older persons focuses on health-related factors that affect the ability to maintain balance. The objective of the study is to determine the association between physical activity and occurrence of falls among community-dwelling older persons. Methods: The dist

  7. Providing health care for older persons in Singapore.

    Science.gov (United States)

    Teo, Peggy; Chan, Angelique; Straughan, Paulin

    2003-06-01

    Health care social policy in Singapore has passed the burden of care to the individual and the family on the rationale that it would enable the state to contain the costs of long-term care by channelling some of its funds to community services and to providing essential health services to all Singaporeans and not just the older group. While a wide array of services has come into existence, there is a lack of integration between the available resources and needs of the individual/family and what has been availed at the community and state levels. Part of the problem lies in the stringent criteria to which the state allows subsidies to be used; the lack of understanding with regard to the profile of users of services; and the case manager approach in offering services. Mapping health care has proven more difficult than anticipated because ageing is a diverse experience, varying by gender, race, income, religion and intergenerational relationships. A social policy does not apply to a 'universal citizen' and services that exist in the public sphere should not exist as merely commodified services which require a great deal of institutional processing.

  8. Openness and conscientiousness predict 34-week patterns of Interleukin-6 in older persons.

    Science.gov (United States)

    Chapman, Benjamin P; van Wijngaarden, Edwin; Seplaki, Christopher L; Talbot, Nancy; Duberstein, Paul; Moynihan, Jan

    2011-05-01

    Studies have indicated that personality may be associated with inflammatory markers such as Interleukin (IL)-6. One pathway between personality and IL-6 may be health behaviors and conditions resulting in inflammation, while an alternate pathway involves activation of stress-response systems. In a clinical trial sample of 200 older adults, we examined associations between personality traits at baseline and three measures of IL-6 spanning 34 weeks of follow-up. Results indicate that IL-6 remained very stable over time, and that higher Conscientiousness and Openness were associated with lower IL-6 across the entire 34 week period. Goal striving was the active subcomponent of Conscientiousness, while aesthetic interests was the active subcomponent of Openness in IL-6 associations. Common health behaviors and chronic illness accounted for only a portion of these effects, suggesting that other behavioral and/or physiological processes may also predispose some persons to inflammation. Personality phenotype may provide useful prognostic information for inflammation. Older adults lower in Conscientiousness and Openness constitute a target population for anti-inflammatory interventions. Openness and Conscientiousness predicts 32-week patterns of Interleukin-6 in older persons.

  9. Potential role of vitamin D in prevention of skeletal and extraskeletal diseases in older people

    Directory of Open Access Journals (Sweden)

    Andrea Montagnani

    2015-11-01

    Full Text Available Vitamin D and calcium are essential for bone health. An adequate calcium-phosphorus product determines a high quality mineralization long lifetime. In older people, both calcium and vitamin D levels may be lower causing osteomalacia and/or osteoporosis with a higher risk of fracture. Epidemiological data have clearly associated serum vitamin D lower levels (deficiency with bone fracture in older people, however, not univocal data exist in regard to a beneficial effect of vitamin D supplementation in general population. Although not systematic, the present review aims to make a narrative synthesis of the most recent published data on vitamin D effect not only on bone, classical target associated with vitamin D studies, but namely on extraskeletal diseases. In fact, recently, there has been an increasing interest on this latter issue with surprising findings. Vitamin D, and in particular its deficiency, seems to have a role in pathophysiological pathways in several diseases involving cardiovascular, central nervous system and neoplastic process. On the other hand, vitamin D supplementation may modify the outcome of a wide range of illnesses. Up to date the data are conflicting mainly because of difficulty to establish a consensus on the threshold of vitamin D deficit. The US Institute of Medicine recommends to distinguish a level of insufficiency [defined as 30-50 nmol/L or 16-25 ng/mL of 25(OHD] and another of deficiency identified by 25(OHD levels lower than 30 nmol/L (or <16 ng/mL. This latter level is considered a minimum level necessary in older adults to minimize the risk of falls, fracture and probably to have some effects of vitamin D supplementation in extraskeletal diseases. Although there are no absolute certainties in such issue, the most recent data suggest that vitamin D deficiency, and its supplementation, may play an important role in a wide range of diseases other than in bone metabolic diseases in older but not in general

  10. Risk of upper limb complaints due to computer use in older persons: a randomized study

    Directory of Open Access Journals (Sweden)

    Jolles Jelle

    2007-08-01

    Full Text Available Abstract Background We studied whether the twelve-month use of a standard computer would induce complaints of upper limb pain or functional limitations in older novice computer users. Methods Participants between 64 and 76 of age were randomly assigned to an Intervention group (n = 62, whose members received a personal computer and fast Internet access at their homes, or a No Intervention control group (n = 61, whose members refrained from computer use during the twelve month study period. Results Difference scores between baseline and twelve months assessments on both complaint (SFS and functional health scales (SF-36 did not differ between groups (all p > .05. Conclusion Prolonged, self-paced use of a standard computer interface does not put older persons at a risk of upper limb complaints or reduce functional health in older adults.

  11. Psychometric properties of the extended Care Dependency Scale for older persons in Egypt

    NARCIS (Netherlands)

    Boggatz, Thomas; Farid, Tamer; Mohammedin, Ahmed; Dijkstra, Ate; Lohrmann, Christa; Dassen, Theo

    2009-01-01

    Aim. The aim of this study was to determine the validity and reliability of the modified Arabic Care Dependency Scale for self-assessment of older persons in Egypt and to compare these self-assessments to proxy assessments by care givers and family members. Background. The Care Dependency Scale is a

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  13. Psychometric properties of the extended Care Dependency Scale for older persons in Egypt

    NARCIS (Netherlands)

    Boggatz, Thomas; Farid, Tamer; Mohammedin, Ahmed; Dijkstra, Ate; Lohrmann, Christa; Dassen, Theo

    2009-01-01

    Aim. The aim of this study was to determine the validity and reliability of the modified Arabic Care Dependency Scale for self-assessment of older persons in Egypt and to compare these self-assessments to proxy assessments by care givers and family members. Background. The Care Dependency Scale is

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

    Science.gov (United States)

    Doron, Israel; Apter, Itai

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nor Azizah Ishak

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    1999-01-01

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

  17. Effective nursing leadership of older persons in the community - a systematic review.

    Science.gov (United States)

    Holm, Anne Lise; Severinsson, Elisabeth

    2014-03-01

    The aim of this systematic review was to increase the knowledge of developing effective nursing leadership and management in order to improve the outcomes of older persons in the community. There is a need for increased knowledge of nursing leadership and management in order to improve the outcomes of older persons in the community. A review of the literature published in different databases between January 2000 and May 2012 was conducted. Eleven articles met the inclusion criteria and were evaluated by means of thematic content analysis. Six themes were identified: Ability to change the attitudes towards older persons; Building trust; Ensuring efficacy in management decisions; Lack of knowledge about how to overcome relational challenges; Health system collaboration to achieve goals and visions; and Staff members' experiences of the meaning of and possibility to influence their work, all of which are of importance for effective nursing leadership and management in the care of older persons. Advanced nursing knowledge is necessary in order to improve the work and vision involved in nursing leadership and management. Findings indicate that relational and organisational abilities are necessary components of effective nursing leadership and management. © 2013 John Wiley & Sons Ltd.

  18. Older Persons' Perceptions of the Frequency and Meaning of Elderspeak from Family, Friends, and Service Workers

    Science.gov (United States)

    O'Connor, Brian P.; St. Pierre, Edouard S.

    2004-01-01

    Older persons (N = 159) were surveyed for their impressions of and experiences with elderspeak from friends, same-age family members, younger family members, familiar service workers, and unfamiliar service workers. Two dimensions, "warmth" and "superiority," emerged in the judgments of elderspeak from all five speaker types. Respondents perceived…

  19. Observation of Hand Movements by Older Persons with Dementia : Effects on Cognition

    NARCIS (Netherlands)

    Eggermont, Laura H. P.; Swaab, Dick F.; Hol, Elly M.; Scherder, Erik J. A.

    2009-01-01

    Background/Aim: Hand movement observation activates mirror neurons, located in brain areas that are vulnerable to Alzheimer's disease. We examined the effects of hand movement observation on cognition in older persons with dementia. Methods: Nursing home residents with dementia (n = 44) watched eith

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  1. Digital Technology and Caregiver Training for Older Persons: Cognitive and Affective Perspectives

    Science.gov (United States)

    Zheng, Robert; Hicken, Bret L.; Hill, Robert D.; Luptak, Marilyn; Daniel, Candice M.; Grant, Marren; Rupper, Randall

    2016-01-01

    This research project included two studies that investigated (a) differences between technology use in tech-knowledgeable and less tech-knowledgeable older persons, (b) cognitive and affective variables and their association with the application of technology, and (c) the implications of these variables on the design of remote-delivered caregiver…

  2. Effectiveness of Sweden's Contact Family/Person Program for Older Children

    Science.gov (United States)

    Brännström, Lars; Vinnerljung, Bo; Hjern, Anders

    2015-01-01

    Objectives: To estimate the impacts of Sweden's Contact Family/Person Program (CFPP) for older children on participants' long-term outcomes related to mental health problems, illicit drug use, public welfare receipt, placement in out-of-home care, educational achievement, and offending. Method: We analyzed longitudinal register data on…

  3. Getting Older, Getting Better? Personal Strivings and Psychological Maturity across the Life Span.

    Science.gov (United States)

    Sheldon, Kennon M.; Kasser, Tim

    2001-01-01

    Examined psychological maturity based on personal strivings in 108 adults ages 17 to 82 years. Results supported hypotheses that older people would list more strivings concerning generativity and ego integrity and fewer strivings concerning identity and intimacy, and that maturity and age would be positively associated with subjective well-being.…

  4. Hypothalamic-pituitary-adrenal axis activity in older persons with and without a depressive disorder

    NARCIS (Netherlands)

    Rhebergen, D.; Korten, N. C. M.; Penninx, B. W. J. H.; Stek, M. L.; van der Mast, R. C.; Voshaar, R. Oude; Comijs, H. C.

    2015-01-01

    Background: Altered functioning of the hypothalamic-pituitary-adrenal axis (HPA-axis) has been associated with depression, but findings have been inconsistent. Among older depressed persons, both hyperactivity and hypo-activity of the HPA-axis were demonstrated. However, most studies were population

  5. Provision of High-Quality Orientation and Mobility Services to Older Persons with Visual Impairments.

    Science.gov (United States)

    Hill, M.-M.

    1991-01-01

    The provision of high quality orientation and mobility (O&M) services to older persons with visual impairments requires consideration of problems in attitudes, client characteristics, financial resources, inservice training, and the availability of age-appropriate assessment instruments. This paper discusses research on O&M interventions and…

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

    NARCIS (Netherlands)

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

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

  7. Drug-induced falls in older persons: is there a role for therapeutic drug monitoring?

    NARCIS (Netherlands)

    K.A. Hartholt (Klaas); M.L. Becker (Matthijs); T.J.M. van der Cammen (Tischa)

    2015-01-01

    textabstractBackground: Falls are the leading cause of injuries among older persons. Because of ageing societies worldwide, falls are expected to become a prominent public health problem. The usage of several types of drugs has been associated with an increased fall and fracture risk. In order to re

  8. Sensori-motor function in older persons with diabetes.

    Science.gov (United States)

    Lord, S R; Caplan, G A; Colagiuri, R; Colagiuri, S; Ward, J A

    1993-01-01

    Twenty-five persons with diabetes (aged 55-83 years) who were living independently in the community, and 40 age- and sex-matched non-diabetic controls were assessed for tactile sensitivity, vibration sense, proprioception, quadriceps strength and body sway. In both men and women, those with diabetes performed significantly worse in tests of body sway on firm and compliant surfaces compared with the control subjects after controlling for weight and body mass index. The female diabetic subjects also performed significantly worse in tests of peripheral sensation and strength compared with controls. Age-related declines in sensori-motor function were greater in the diabetic group (r = 0.55-0.75) than in the controls (r vibration sense were significantly correlated with sway on a compliant (foam rubber) surface with the eyes open (partial r = 0.52, p problems with stability and related sensori-motor factors which may place them at increased risk of falls.

  9. 78 FR 40311 - 30-Day Notice of Proposed Information Collection: Implementation of the Housing for Older Persons...

    Science.gov (United States)

    2013-07-03

    ... Older Persons Act of 1995 (HOPA) AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice... Information Collection: Implementation of the Housing for Older Persons Act of 1995 (HOPA). OMB Approval... , prohibits discrimination in the sale, rental, occupancy, advertising, insuring, or financing of...

  10. 16 CFR Figure 5 to Part 1203 - Location of Tesr Lines for Helmets Intended for Persons Ages 1 and Older

    Science.gov (United States)

    2010-01-01

    ... for Persons Ages 1 and Older 5 Figure 5 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 5 Figure 5 to Part 1203—Location of Tesr Lines for Helmets Intended for Persons Ages 1 and Older...

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

    Science.gov (United States)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  14. Older persons' narrations on falls and falling—stories of courage and endurance.

    Science.gov (United States)

    Clancy, Anne; Balteskard, Bjørg; Perander, Bente; Mahler, Marianne

    2015-01-01

    Fall related injuries in nursing homes have a major impact on the quality of life in later adulthood and there is a dearth of studies on falling and fall prevention from the older person's perspective. The aim of the study was to identify how older persons perceive falling, fall prevention, and fall accidents. Six in-depth interviews were carried out and a hermeneutic phenomenological method was used to describe and interpret the older persons' accounts. Interpretations of Levinasian and Heidegarian philosophy related to dwelling and mobility helped cultivate important insights. Symbolic and physical environments are important for the participants' well-being. The older persons in the study did not wish to dwell on the subject of falling and spoke of past and present coping strategies and the importance of staying on their feet. The women spoke about endurance in their daily lives. The men's narrations were more dramatic; they became animated when they spoke of their active past lives. As the scope of the study is small, these gender differences require further investigation. However, their stories give specific knowledge about the individual and their symbolic environmental circumstances and universal knowledge about the importance of integrating cultural environmental knowledge in health promotion and care work. Traditional fall prevention interventions are often risk oriented and based on generalized knowledge applied to particular cases. The findings indicate a need for contextual life-world knowledge and an understanding of fall prevention as a piece in a larger puzzle within a broader framework of culture, health, and well-being. Showing an interest in the older persons' stories can help safeguard their integrity and promote their well-being. This can ignite a spark that kindles their desire to participate in meaningful exercises and activities.

  15. Risk factors for acute care hospital readmission in older persons in Western countries

    DEFF Research Database (Denmark)

    Pedersen, Mona Kyndi; Meyer, Gabriele; Uhrenfeldt, Lisbeth

    2017-01-01

    summary and metasynthesis of the quantitative findings was conducted. RESULTS: Based on a review of nine studies from ten Western countries, we found several significant risk factors pertaining to readmission to an acute care hospital within one month of discharge in persons aged 65 years and over....... To allow health professionals to focus more intensively on patients at risk of readmission, there is a need to identify the characteristics of those patients. OBJECTIVES: To identify and synthesize the best available evidence on risk factors for acute care hospital readmission within one month of discharge...... in older persons in Western countries. INCLUSION CRITERIA TYPES OF PARTICIPANTS: Participants were older persons from Western countries, hospitalized and discharged home or to residential care facilities. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: The factors of interest considered generic factors...

  16. Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition.

    Science.gov (United States)

    Miner, Brienne; Tinetti, Mary E; Van Ness, Peter H; Han, Ling; Leo-Summers, Linda; Newman, Anne B; Lee, Patty J; Vaz Fragoso, Carlos A

    2016-10-01

    To evaluate the associations between a broad array of cardiorespiratory and noncardiorespiratory impairments and dyspnea in older persons. Cross-sectional. Cardiovascular Health Study. Community-dwelling persons (N = 4,413; mean age 72.6, 57.1% female, 4.5% African American, 27.2% score ≥16; aOR = 2.02, 95% CI = 1.26-3.23), and obesity (BMI ≥30; aOR = 2.07, 95% CI = 1.67-2.55). Impairments with modest but still statistically significant associations with moderate to severe dyspnea included respiratory muscle weakness, diastolic cardiac dysfunction, grip weakness, anxiety symptoms, and use of cardiovascular and psychoactive medications (aORs = 1.31-1.71). In community-dwelling older persons, several cardiorespiratory and noncardiorespiratory impairments were significantly associated with moderate to severe dyspnea, akin to a multifactorial geriatric health condition. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

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

    Science.gov (United States)

    Band-Winterstein, Tova

    2015-04-01

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

  18. Development, feasibility and performance of a health risk appraisal questionnaire for older persons

    Directory of Open Access Journals (Sweden)

    Egger Matthias

    2007-01-01

    Full Text Available Abstract Background Health risk appraisal is a promising method for health promotion and prevention in older persons. The Health Risk Appraisal for the Elderly (HRA-E developed in the U.S. has unique features but has not been tested outside the United States. Methods Based on the original HRA-E, we developed a scientifically updated and regionally adapted multilingual Health Risk Appraisal for Older Persons (HRA-O instrument consisting of a self-administered questionnaire and software-generated feed-back reports. We evaluated the practicability and performance of the questionnaire in non-disabled community-dwelling older persons in London (U.K. (N = 1090, Hamburg (Germany (N = 804, and Solothurn (Switzerland (N = 748 in a sub-sample of an international randomised controlled study. Results Over eighty percent of invited older persons returned the self-administered HRA-O questionnaire. Fair or poor self-perceived health status and older age were correlated with higher rates of non-return of the questionnaire. Older participants and those with lower educational levels reported more difficulty in completing the HRA-O questionnaire as compared to younger and higher educated persons. However, even among older participants and those with low educational level, more than 80% rated the questionnaire as easy to complete. Prevalence rates of risks for functional decline or problems were between 2% and 91% for the 19 HRA-O domains. Participants' intention to change health behaviour suggested that for some risk factors participants were in a pre-contemplation phase, having no short- or medium-term plans for change. Many participants perceived their health behaviour or preventative care uptake as optimal, despite indications of deficits according to the HRA-O based evaluation. Conclusion The HRA-O questionnaire was highly accepted by a broad range of community-dwelling non-disabled persons. It identified a high number of risks and problems, and provided

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

    Science.gov (United States)

    Kusumastuti, Sasmita; van Fenema, Esther; Polman-van Stratum, Eugenie C F; Achterberg, Wilco; Lindenberg, Jolanda; Westendorp, Rudi G J

    2017-01-01

    Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude. To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image. Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives) and the Attitudes toward Old People (AOP; 34 positions) questionnaires. Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC) in the academic year 2012-2013 participated. Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores. Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p students considering over 75 years as being old increased from 17.2% to 31.2% (p student's gender and previous contact experience. Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Perceptions of Heat-Susceptibility in Older Persons: Barriers to Adaptation

    Directory of Open Access Journals (Sweden)

    Alison Kitson

    2011-12-01

    Full Text Available The increase in the frequency of very hot weather that is a predicted consequence of climate change poses an emerging threat to public health. Extreme heat can be harmful to the health of older persons who are known to be amongst the most vulnerable in the community. This study aimed to investigate factors influencing the ability of older persons to adapt to hot conditions, and barriers to adaptation. A qualitative study was conducted in Adelaide, Australia, involving focus groups and interviews with stakeholders including key personnel involved in aged care, community services, government sectors, emergency services and policy making. Findings revealed a broad range of factors that underpin the heat-susceptibility of the aged. These were categorized into four broad themes relating to: physiology and an age-related decline in health; socioeconomic factors, particularly those influencing air conditioning use; psychological issues including fears and anxieties about extreme heat; and adaptive strategies that could be identified as both enablers and barriers. As a consequence, the ability and willingness to undertake behavior change during heatwaves can therefore be affected in older persons. Additionally, understanding the control panels on modern air conditioners can present challenges for the aged. Improving heat-health knowledge and addressing the social and economic concerns of the older population will assist in minimizing heat-related morbidity and mortality in a warming climate.

  2. Resistance Training Enhances Skeletal Muscle Innervation Without Modifying the Number of Satellite Cells or their Myofiber Association in Obese Older Adults.

    Science.gov (United States)

    Messi, María Laura; Li, Tao; Wang, Zhong-Min; Marsh, Anthony P; Nicklas, Barbara; Delbono, Osvaldo

    2016-10-01

    Studies in humans and animal models provide compelling evidence for age-related skeletal muscle denervation, which may contribute to muscle fiber atrophy and loss. Skeletal muscle denervation seems relentless; however, long-term, high-intensity physical activity appears to promote muscle reinnervation. Whether 5-month resistance training (RT) enhances skeletal muscle innervation in obese older adults is unknown. This study found that neural cell-adhesion molecule, NCAM+ muscle area decreased with RT and was inversely correlated with muscle strength. NCAM1 and RUNX1 gene transcripts significantly decreased with the intervention. Type I and type II fiber grouping in the vastus lateralis did not change significantly but increases in leg press and knee extensor strength inversely correlated with type I, but not with type II, fiber grouping. RT did not modify the total number of satellite cells, their number per area, or the number associated with specific fiber subtypes or innervated/denervated fibers. Our results suggest that RT has a beneficial impact on skeletal innervation, even when started late in life by sedentary obese older adults.

  3. Effects of Acute Pinitol Supplementation on Plasma Pinitol Concentration, Whole Body Glucose Tolerance, and Activation of the Skeletal Muscle Insulin Receptor in Older Humans

    OpenAIRE

    Stull, A. J.; Wood, K V; Thyfault, J. P.; Campbell, W.W.

    2009-01-01

    Limited research with rodents and humans suggests that oral ingestion of pinitol (3-O-methyl-d-chiro-inositol) might positively influence glucose tolerance. This double-blinded, placebo-controlled, and cross-over study assessed the effects of acute pinitol supplementation on plasma pinitol concentration, glucose tolerance, insulin sensitivity, and activation of the skeletal muscle insulin receptor. Fifteen older, nondiabetic subjects (62 ± 1 years, mean ± SEM) completed four, 1-day trials. Su...

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

    Science.gov (United States)

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

    2016-01-01

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

  5. Active coping, personal satisfaction, and attachment to land in older African-American farmers.

    Science.gov (United States)

    Maciuba, Sandra A; Westneat, Susan C; Reed, Deborah B

    2013-05-01

    Elevated suicide mortality rates have been reported for farmers and for the elderly. Very little literature exists that looks at the health of older minority farmers. This mixed-method study describes older African-American farmers (N = 156) in the contexts of active coping, personal satisfaction from farm work, and attachment to their farmland to provide insight into the psychosocial dimensions of their mental health. Findings show that the farmers have positive perspectives on work and farm future, and strong attachment to the land. Differences were noted by gender. Nurses can use these findings to frame culturally appropriate strategies for aging farmers to maximize positive outcomes.

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

    Science.gov (United States)

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

    2016-05-01

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

  7. A Procedural Approach to Remembering Personal Identification Numbers among Older Adults

    Science.gov (United States)

    Gardner, Michael K.; Hill, Robert D.; Was, Christopher A.

    2011-01-01

    This study investigated whether a motor skill learning intervention could provide better memory for personal identification numbers (PINs) as compared to a control group. Younger (ages 18 to 40) and older (ages 61 to 92) participants were randomly assigned to conditions. All participants received three days of training consisting of 12 blocks of 12 trials each. Participants were tested immediately after training, after four days, and after seven days. Dependent measures were errors, latencies, and number of correct responses per minute. Younger participants were less error prone, faster, and produced more correct responses than older participants. Training condition (motor skill-based versus control training) had no significant effect on any of the dependent variables. Testing time had a significant effect on latency, and the effect of testing time on latency interacted with age group. In a second study, six older individuals diagnosed as having mild cognitive impairment (MCI) were trained using the motor skill learning intervention. Their performance was compared with that of the younger and older motor skill groups from the first experiment. The results showed that the older MCI group was significantly slower, more error prone, and produced fewer correct responses per minute than the older, normal group. Thus the presence of diagnosed MCI significantly impairs memory for PINs beyond the impairment expected from normal aging. PMID:21998656

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

    Science.gov (United States)

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

    2011-01-01

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

  9. Personality Traits among Community-Dwelling Chinese Older Adults in the Greater Chicago Area

    Directory of Open Access Journals (Sweden)

    E-Shien Chang

    2014-10-01

    Full Text Available Objectives: Personality traits are important indicators of health and well-being. Neuroticism and conscientiousness in particular, are closely associated with morbidity and mortality in old age. However, little is known regarding the levels of these two key personality traits among U.S. Chinese older adults. This report aimed to examine the levels of personality traits among this population. Methods: Data were from the PINE study, a population-based study of U.S. Chinese older adults aged 60 and above. We measured neuroticism and conscientiousness using modified NEO personality inventory. Results: Of the 3,159 community-dwelling Chinese older adults, 58.9% were female, and mean age was 72.8 years. Compared to neuroticism, conscientiousness trait was endorsed higher among Chinese older adults in our sample. Each conscientiousness item had at least 67.8% of participant endorsement, in comparison to the lowest endorsement rate of 14.3% in the neuroticism measure. Younger age (r-neuroticism = -0.06, r-conscientiousness = -0.14 and fewer children (r-neuroticism = -0.06, r-conscientiousness = -0.06 were correlated with both traits. Female gender (r = 0.11, poorer health status (r = -0.26, poorer quality of life (r = -0.23 and worsened health over the past year (r = -0.15 were correlated with higher levels of neuroticism. In contrast, male gender (r = -0.05, better health status (r = 0.20, higher quality of life (r = 0.17 and improved health over the past year (r = 0.07 were correlated with higher levels of conscientiousness. Education level (r = 0.15 was positively correlated with higher levels of conscientiousness, but not with neuroticism; whereas income level (r = -0.04 was negatively correlated with neuroticism but not with conscientiousness. Conclusion: U.S. Chinese older adults generally possess higher agreement level on conscientiousness traits than neuroticism. Future analysis should be conducted to explore the complex associations between

  10. Personality, self-perceptions, and daily variability in perceived usefulness among older adults.

    Science.gov (United States)

    Allen, Pamela M; Mejía, Shannon T; Hooker, Karen

    2015-09-01

    Age-based self-stereotyping is associated with a variety of long-term physical health and psychological well-being outcomes for older people. However, little is known about how older individuals' day-to-day experiences of functional limitations may be related to concurrent self-appraisals on dimensions representing negative age stereotypes. We examined how distal personality traits and global self-perceptions of aging at baseline affect processing of daily experiences relevant to age-based self-stereotyping over time. Data from the 100-day Internet-based Personal Understanding of Life and Social Experiences (PULSE) study (N = 98, age = 52 - 88) were used to examine the link between personality and self-perceptions of aging to differences in 2 age stereotype-relevant daily experiences: cognitive limitations and variation in usefulness. Multilevel random coefficient models suggested that personality and self-perceptions of aging were associated with the level of usefulness and the frequency of reporting trouble concentrating during the study period. Daily experiences of trouble concentrating were significantly associated with lower perceived usefulness on that day, and conscientiousness moderated this relationship. By linking personality and global self-perceptions to daily experiences, our findings contribute toward understanding self-stereotyping processes by which personality and perceptions may affect long-term outcomes. (c) 2015 APA, all rights reserved).

  11. Association of cognition with temporal discounting in community based older persons

    Directory of Open Access Journals (Sweden)

    Boyle Patricia A

    2012-08-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  13. Need satisfaction of older persons living in the community and in institutions, part 1. The environment.

    Science.gov (United States)

    Tickle, L S; Yerxa, E J

    1981-10-01

    A descriptive study was conducted that compared the need satisfaction of older persons living in institutions. In the first article of a two-part series, the impact of environment on the satisfaction of needs was examined. Subjects included 20 community and 21 institutionalized older persons. Using Maslow's need hierarchy as the theoretical framework, it was found that the community environment satisfied belongingness/love and esteem needs to a greater degree than the institutional environment. No difference was found in the satisfaction of physiological, safety, and self-actualization needs between the two environments. Race, mental status, and whether a community resident lived alone or with others were variables that influenced the results. The findings emphasized the complexity of need satisfaction and supported the formulation that environment is a crucial factor in need satisfaction. In the second article, the relationship between engagement in activity and need satisfaction will be explored.

  14. Effect of Cognitive Impairment on Driving-Relevant Cognition in Older Persons

    Institute of Scientific and Technical Information of China (English)

    Rahel Bieri[1; Michael Jager[1; Nora Bethencourt[1; Urs Peter Mosimann[1,2; Rene Martin Mari[1,3; Tobias Nef[3,4

    2014-01-01

    Intact cognitive abilities are fundamental for driving. Driving-relevant cognition may be affected in older drivers due to aging or cognitive impairment. The aim of this study was to investigate the effects of cognitive impairment on driving-relevant cognition in older persons. Performance in selective and divided attention, eye-hand-coordination, executive functions and the ability to regulate distance and speed of 18 older persons with CI-Group (cognitive impairment group) was compared to performance of older control group (18 age and gender-matched cognitively normal subjects) and young control group (18 gender-matched young subjects). The CI-Group showed poorer performance than the other two control groups in all cognitive tasks (significance level (p) 〈 0.001, effect size (partial r/e) = 0.63). Differences between cognitively impaired and cognitively normal subjects were still significant after controlling for age (effect sizes from 0.14 to 0.28). Dual tasking affected performance of cognitively impaired subjects more than performance of the other two groups (p = 0.016, partial η2 = 0.14). Results show that cognitive impairment has age-independent detrimental effects on selective and divided attention, eye-hand-coordination, executive functions and the ability to regulate distance and speed. Largest effect sizes are found for reaction times in attention tasks.

  15. Personality is associated with perceived health and functional status in older primary care patients.

    Science.gov (United States)

    Duberstein, Paul R; Sörensen, Silvia; Lyness, Jeffrey M; King, Deborah A; Conwell, Yeates; Seidlitz, Larry; Caine, Eric D

    2003-03-01

    Using data collected on 265 primary care medical patients 60 years of age and older, the authors examined the personality bases of subjective health (perceived health, functional status) after controlling for observer-rated depression and medical burden. Four hypotheses were tested: High Neuroticism is associated with poorer perceived health, low Extraversion is associated with poorer perceived health, low Openness to Experience is associated with worse functional status, and age moderates the relationships between personality and subjective health. Findings supported the notion that personality is associated with subjective health; moreover, this effect appeared to grow more pronounced with increasing age. This study underscores the conceptual and heuristic value of examining moderators of the links between personality variables and health.

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

    OpenAIRE

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

    2007-01-01

    The objective of the study was to evaluate the effectiveness of a multifactor and multimethod community intervention programme to reduce falls among older persons by at least 20%. In a pre-test-post test design, self-reported falls were registered for 10 months in the intervention community and two control communities. After the pre-test registration, participants followed the intervention programme (Information and education, Training and exercise and Environmental modifications) for 14 mont...

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

    Directory of Open Access Journals (Sweden)

    Angela Marie Abbatecola

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

  18. Effect of Exercise on Inflammatory Profile of Older Persons: Systematic Review and Meta-Analyses.

    Science.gov (United States)

    Monteiro Junior, Renato Sobral; de Tarso Maciel-Pinheiro, Paulo; da Matta M Portugal, Eduardo; da Silva Figueiredo, Luiz Felipe; Terra, Rodrigo; Carneiro, Lara S F; Rodrigues, Vinicius Dias; Nascimento, Osvaldo José Moreira; Deslandes, Andrea Camaz; Laks, Jerson

    2017-08-03

    Inflammatory cytokines and acute phase proteins increase with ageing, promoting a chronic low-grade inflammation. Studies have shown a positive effect of exercise on inflammatory markers in older persons. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) are the main biomarkers investigated. However, it is unclear if exercise could decrease all these biomarkers. The aim was to analyze the effect of chronic exercise on IL-6, TNF-α and CRP levels in older persons. PRISMA Guidelines were adopted. Original articles that investigated the effect of chronic exercise on inflammatory profile of the elderly were eligible for this review. Database was used to search data on PubMed, PEDro, EBSCO and BioMed Central. Three reviewers evaluated each publication for reducing bias. Data about IL-6, TNF-α and CRP were collected and analyzed. A standardized mean difference (SMD) based on estimated Pooled Effect Size was calculated considering heterogeneity index (I2) and random effect. Seventy-six studies were retrieved from databases and eight of them were analyzed. IL-6 and CRP levels decreased after chronic exercise (overall effect p<0.05). Regular exercise decreases IL-6 and CRP levels in older persons. Effect of exercise on TNF-α remain unclear.

  19. Views of older persons with multiple morbidities on competing outcomes and clinical decision-making.

    Science.gov (United States)

    Fried, Terri R; McGraw, Sarah; Agostini, Joseph V; Tinetti, Mary E

    2008-10-01

    To examine the ways in which older persons with multiple conditions think about potentially competing outcomes in order to gain insight into how processes to elicit values regarding these outcomes can be grounded in the patient's perspective. Qualitative study consisting of purposefully sampled focus groups. Community. Persons aged 65 and older taking five or more medications. Participants were asked their perceptions about whether their illnesses or treatment interacted with each other, goals of their treatment, and decisions to change or stop treatment. Although participants were largely unaware that treatment of one condition could worsen another, many had experience with adverse medication effects as a competing outcome. Participants initially discussed their conditions in terms of disease-specific outcomes, such as achieving a target blood pressure or lipid level. In the context of decision-making, participants shifted their discussion from disease-specific to global, cross-disease health outcomes, such as survival, preservation of physical function, and relief of symptoms. Despite having some misconceptions regarding the likelihood of these outcomes, they weighed the outcomes against one another to consider what was most important to them. Their preference was for the treatment that would achieve the most desired outcome. Because of their experience with adverse medication effects, older persons with multiple morbidities can understand the concept of competing outcomes. The task of prioritizing global, cross-disease outcomes can help to clarify what is most important to seniors who are faced with complex healthcare decisions.

  20. Need satisfaction of older persons living in the community and in institutions, part 2. Role of activity.

    Science.gov (United States)

    Tickle, L S; Yerxa, E J

    1981-10-01

    A descriptive study was conducted in order to examine the types of need satisfaction older persons gained from activities they performed in their living environments. This is the second of two articles that examines the relationships among need satisfaction, environment, and activity. Subjects included 20 community and 21 institutionalized older persons. It was found that the subjects' most important activities were visiting and being involved in church functions. Using Maslow's need hierarchy as the theoretical framework, both of these activities were found to be associated with satisfying belongingness/love needs. The implications the findings have for occupational therapy intervention with older persons are included.

  1. Predictors of Recovery in Activities of Daily Living Among Disabled Older Persons Living in the Community

    Science.gov (United States)

    Gill, Thomas M; Robison, Julie T.; Tinetti, Mary E

    1997-01-01

    OBJECTIVE To identify the factors that predict recovery in activities of daily living (ADLs) among disabled older persons living in the community. DESIGN Prospective cohort study with 2-year follow-up. SETTING General community. PARTICIPANTS 213 men and women 72 years or older, who reported dependence in one or more ADLs. MEASUREMENTS AND MAIN RESULTS All participants underwent a comprehensive home assessment and were followed for recovery of ADL function, defined as requiring no personal assistance in any of the ADLs within 2 years. Fifty-nine participants (28%) recovered independent ADL function. Compared with those older than 85 years, participants aged 85 years or younger were more than 8 times as likely to recover their ADL function (relative risk [RR] 8.4; 95% confidence interval [CI] 2.7, 26). Several factors besides age were associated with ADL recovery in bivariate analysis, including disability in only one ADL, self-efficacy score greater than 75, Folstein Mini-Mental State Examination (MMSE) score of 28 or better, high mobility, score in the best third of timed physical performance, fewer than five medications, and good nutritional status. In multivariable analysis, four factors were independently associated with ADL recovery—age 85 years or younger (adjusted RR 4.1; 95% CI 1.3, 13), MMSE score of 28 or better (RR 1.7; 95% CI 1.2, 2.3), high mobility (RR 1.7; 95% CI 1.0, 2.9), and good nutritional status (RR 1.6; 95% CI 1.0, 2.5). CONCLUSIONS Once disabled, few persons older than 85 years recover independent ADL function. Intact cognitive function, high mobility, and good nutritional status each improve the likelihood of ADL recovery and may serve as markers of resiliency in this population. PMID:9436895

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

    Directory of Open Access Journals (Sweden)

    Carol M. Wong

    2017-09-01

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

  3. Predictors of recovery in activities of daily living among disabled older persons living in the community.

    Science.gov (United States)

    Gill, T M; Robison, J T; Tinetti, M E

    1997-12-01

    To identify the factors that predict recovery in activities of daily living (ADLs) among disabled older persons living in the community. Prospective cohort study with 2-year follow-up. General community. 213 men and women 72 years or older, who reported dependence in one or more ADLs. All participants underwent a comprehensive home assessment and were followed for recovery of ADL function, defined as requiring no personal assistance in any of the ADLs within 2 years. Fifty-nine participants (28%) recovered independent ADL function. Compared with those older than 85 years, participants aged 85 years or younger were more than 8 times as likely to recover their ADL function (relative risk [RR] 8.4; 95% confidence interval [CI] 2.7, 26). Several factors besides age were associated with ADL recovery in bivariate analysis, including disability in only one ADL, self-efficacy score greater than 75, Folstein Mini-Mental State Examination (MMSE) score of 28 or better, high mobility, score in the best third of timed physical performance, fewer than five medications, and good nutritional status. In multivariable analysis, four factors were independently associated with ADL recovery-age 85 years or younger (adjusted RR 4.1; 95% CI 1.3, 13), MMSE score of 28 or better (RR 1.7; 95% CI 1.2, 2.3), high mobility (RR 1.7; 95% CI 1.0, 2.9), and good nutritional status (RR 1.6; 95% CI 1.0, 2.5). Once disabled, few persons older than 85 years recover independent ADL function. Intact cognitive function, high mobility, and good nutritional status each improve the likelihood of ADL recovery and may serve as markers of resiliency in this population.

  4. Special observation and older persons with dementia/delirium: a disappointing literature review.

    Science.gov (United States)

    Dewing, Jan

    2013-03-01

    In gerontological practice, special observation is a known nursing activity across different settings. The group that possibly are most effected by this intervention are older persons with dementia and/or delirium. The research literature about special observations in the mental health field is small, more disappointingly there appears to be little published literature about special observations in regard to older persons with dementia and/or delirium. The aims of this study are to (i) establish the state of current published research on special observations in regard to older persons with dementia and/or delirium and (ii) make recommendations for research and practice. A literature review. Most literature pertains to adult mental health practice and services. Themes were generated and discussed in relation to gerontological practice. This review has established there is variance in the usage of the terms 'special observation' and 'constant observation'. It concludes that there is no published research on special or constant observations in relation to older people with dementia/delirium or the purpose of this activity. There is therefore a clear need to establish a research base in the topic. Given the limited evidence, practitioners and managers need to be cautious when writing and implementing policies about special observation. However, until gerontological research is improved, research from mental health nursing will need to be drawn on with caution and the purpose of special observation determined locally. To be of therapeutic value and to be cost effective, special observation should be seen as a skilled nursing intervention and not a passive 'watching' or 'sitter' activity. © 2012 Blackwell Publishing Ltd.

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

    Science.gov (United States)

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

    2013-09-01

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

  6. Vitamin D deficiency, depression course and mortality: Longitudinal results from the Netherlands Study on Depression in Older persons (NESDO)

    NARCIS (Netherlands)

    Berg, K.S. van den; Marijnissen, R.M.; Brink, R.H. van den; Naarding, P.; Comijs, H.C.; Oude Voshaar, R.C.

    2016-01-01

    OBJECTIVE: To study the effect of vitamin D levels on depression course and remission status after two years, as well as attrition and mortality, in an older cohort. METHODS: This study was part of the Netherlands Study on Depression in Older persons (NESDO), a prospective cohort study. 367 depresse

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Protein intake as a determinant factor of physical activity in older persons

    Directory of Open Access Journals (Sweden)

    Rina K. Kusumaratna

    2016-02-01

    Full Text Available Worldwide, the proportion of people aged 60 and over is growing faster than any other age group. It has been well-established that the aging process can be associated with increased susceptibility to chronic conditions, disability, and co-morbidity, which however may be minimized or even partially reversed by physical activity. The assessment of physical activity is becoming an increasingly important component in the evaluation of elderly persons. Nutritional intake and status play an essential role in determining the physical activity level potentially capable of minimizing the health burden of older persons. The objective of this study was to find out whether nutritional intake and status were correlated with physical activity in community-dwelling older persons. The study population included 219 aged 60 to 69 years, of whom complete measures of socio-demographic characteristics, nutritional status, nutritional intake and physical activity were obtained. Serum total protein, albumin, globulin and hemoglobin concentration were measured as nutritional indicators (biomarkers. The nutrient content of food intakes was analyzed and calculated by “Nutrisurvey” software. Analysis indicated that there was a significant correlation between nutritional biomarkers [total protein (r=-0.211; p=0.002 and globulin (r=-0.247; p=0.000] and physical activity. Compared to other food intakes, intakes of carbohydrate (r=0.241; p=0.001 and animal protein (r=0.149; p=0.027 were significantly correlated with physical activity. Our findings lend support to the existence among healthy older persons of a relationship between nutrional intake and status and physical activity.

  9. Protein intake as a determinant factor of physical activity in older persons

    Directory of Open Access Journals (Sweden)

    Rina K. Kusumaratna

    2011-04-01

    Full Text Available Worldwide, the proportion of people aged 60 and over is growing faster than any other age group. It has been well-established that the aging process can be associated with increased susceptibility to chronic conditions, disability, and co-morbidity, which however may be minimized or even partially reversed by physical activity. The assessment of physical activity is becoming an increasingly important component in the evaluation of elderly persons. Nutritional intake and status play an essential role in determining the physical activity level potentially capable of minimizing the health burden of older persons. The objective of this study was to find out whether nutritional intake and status were correlated with physical activity in community-dwelling older persons. The study population included 219 aged 60 to 69 years, of whom complete measures of socio-demographic characteristics, nutritional status, nutritional intake and physical activity were obtained. Serum total protein, albumin, globulin and hemoglobin concentration were measured as nutritional indicators (biomarkers. The nutrient content of food intakes was analyzed and calculated by “Nutrisurvey” software. Analysis indicated that there was a significant correlation between nutritional biomarkers [total protein (r=-0.211; p=0.002 and globulin (r=-0.247; p=0.000] and physical activity. Compared to other food intakes, intakes of carbohydrate (r=0.241; p=0.001 and animal protein (r=0.149; p=0.027 were significantly correlated with physical activity. Our findings lend support to the existence among healthy older persons of a relationship between nutrional intake and status and physical activity.

  10. Adaptive Strategies and Person-Environment Fit among Functionally Limited Older Adults Aging in Place: A Mixed Methods Approach

    OpenAIRE

    Lien, Laura L; Carmen D. Steggell; Susanne Iwarsson

    2015-01-01

    Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E) fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected usi...

  11. Do Ankle Orthoses Improve Ankle Proprioceptive Thresholds or Unipedal Balance in Older Persons with Peripheral Neuropathy?

    Science.gov (United States)

    Son, Jaebum; Ashton-Miller, James A.; Richardson, James K.

    2010-01-01

    Objective To determine whether ankle orthoses that provide medial and lateral support, and have been found to decrease gait variability in older persons with peripheral neuropathy, decrease (improve) frontal plane ankle proprioceptive thresholds or increase unipedal stance time in that same population. Design Observational study in which unipedal stance time was determined with a stopwatch, and frontal plane ankle (inversion and eversion) proprioceptive thresholds were quantified during bipedal stance with and without the ankle orthoses, in 11 older diabetic subjects with peripheral neuropathy (8 men; age 72 ± 7.1 years) using a foot cradle system which presented a series of 100 rotational stimuli. Results The subjects demonstrated no change in combined frontal plane (inversion + eversion) proprioceptive thresholds or unipedal stance time with versus without the orthoses (1.06 ± 0.56 versus 1.13 ± 0.39 degrees, respectively; p = 0.955 and 6.1 ± 6.5 versus 6.2 ± 5.4 seconds, respectively; p = 0.922). Conclusion Ankle orthoses which provide medial-lateral support do not appear to change ankle inversion/eversion proprioceptive thresholds or unipedal stance time in older persons with diabetic peripheral neuropathy. Previously identified improvements in gait variability using orthoses in this population are therefore likely related to an orthotically-induced stiffening of the ankle rather than a change in ankle afferent function. PMID:20407302

  12. Depressive symptoms as a risk factor for disabling back pain in community-dwelling older persons.

    Science.gov (United States)

    Reid, M Carrington; Williams, Christianna S; Concato, John; Tinetti, Mary E; Gill, Thomas M

    2003-12-01

    To determine whether the presence of depressive symptoms is an independent risk factor for disabling back pain in community-dwelling older persons. Prospective cohort study with a 12-month follow-up period. General community. Seven hundred forty-four members of a large health plan who were aged 70 and older and independent in bathing, walking, dressing, and transferring at baseline. The presence of depressive symptoms, defined as a score of 16 or greater on the Center for Epidemiologic Studies-Depression Scale, was documented during a comprehensive baseline assessment that also included information regarding participants' demographic, medical, and physical/cognitive status. The occurrence of disabling back pain was ascertained during monthly telephone interviews. Depressive symptoms were present in 153 (20.6%) participants at baseline. Over the 12-month follow-up period, 186 participants (25.0%) reported disabling back pain during 1 to 2 months and 91 (12.2%) during 3 or more months. After adjustment for potential confounders, the presence of depressive symptoms was independently associated with the occurrence of disabling back pain (adjusted odds ratio (AOR)=2.3 (95% confidence interval (CI)=1.2-4.4) for 1 to 2 months with disabling back pain; AOR=7.8 (95% CI=3.7-16.4) for 3 or more months with disabling back pain). The presence of depressive symptoms is a strong, independent, and highly prevalent risk factor for the occurrence of disabling back pain in community-dwelling older persons.

  13. A pilot study examining the impact of exercise training on skeletal muscle genes related to the TLR signaling pathway in older adults following hip fracture recovery.

    Science.gov (United States)

    McKenzie, Alec I; Briggs, Robert A; Barrows, Katherine M; Nelson, Daniel S; Kwon, Oh Sung; Hopkins, Paul N; Higgins, Thomas F; Marcus, Robin L; Drummond, Micah J

    2017-01-01

    Older adults after hip fracture surgery experience progressive muscle atrophy and weakness, limiting full recovery. Further understanding of the molecular mechanisms in muscle with adaptation to exercise training in this vulnerable population is necessary. Therefore, we conducted a pilot study to investigate the skeletal muscle inflammatory and ceramide biosynthesis gene expression levels associated with the toll-like receptor (TLR) pathway before (Pre) and following a 3-mo multicomponent exercise training program in older adults (3M, 4F; 78.4 ± 13.3 yr; 25.5 ± 2.3 kg/m(2)) ~4 mo after repair from hip fracture (HipFx). Vastus lateralis biopsies from the surgical limb were obtained before (Pre) and after training. Molecular end points and muscle function data were also compared with matched nonexercise healthy controls (CON). As a follow-up analysis, we evaluated specific sphingolipid pools in HipFx and CON muscle. Following training, quadriceps cross-sectional area, strength, and 6-min walk (6MW) increased in the surgical limb (P exercise training alters skeletal muscle inflammation and ceramide metabolism associated with TLR signaling in older adults recovering from hip fracture surgery and may be related to improvements in muscle function recovery.

  14. Discursive meaning of hope for older persons with advanced cancer and their caregivers.

    Science.gov (United States)

    Duggleby, Wendy; Holtslander, Lorraine; Steeves, Megan; Duggleby-Wenzel, Shanda; Cunningham, Shannon

    2010-09-01

    This study used van Dijk's critical-discourse approach to explore the current societal discourse on hope and to explore the hope of older terminally ill cancer patients, their significant others and primary nurse. Forty-three newspaper articles dealing with hope and cancer were collected and analyzed to explore how hope is socially constructed by print media. Individual face-to-face, qualitative, open-ended interviews were conducted with three triads, each consisting of an older palliative cancer patient, a significant other, and a primary nurse. The predominant discourse of hope and cancer in the newspaper articles was considered ageist, conveying the message that only one legitimate hope existed for persons with cancer: hope for a cure. The study findings suggested that this message caused confusion and distress for the patients, significant others, and their primary nurses because their own discourses of hope were focused on comfort, peace, and maintaining relationships at the end of life.

  15. Fertility decline, family structure, and support for older persons in Latin America and Asia.

    Science.gov (United States)

    Glaser, Karen; Agree, Emily M; Costenbader, Elizabeth; Camargo, Antonio; Trench, Belkis; Natividad, Josefina; Chuang, Yi-Li

    2006-04-01

    To compare family structures and support for older persons in two Asian countries (Taiwan and the Philippines) and six urban areas in Latin America (Buenos Aires, São Paulo, Havana, Santiago, Mexico City, and Montevideo). Using the 1999 Survey of Health and Living Status of the Elderly in Taiwan, the 2000 Philippine Survey of the Near Elderly and Elderly, and the 2001 Pan American Health Organisation surveys on Salud, Bienestar y Envejecimiento en América Latina y el Caribe, descriptive tables show variations across countries in family structure, proximity, and transfers of support by the timing of the fertility transition in each location. Older people in settings with earlier transitions had fewer children and more childlessness, higher levels of solitary living, and lower levels of co-residence with children. In earlier transition settings, receipt of family support was lower and provision higher. The timing of the demographic transition has significant implications for kin availability and support.

  16. Nutritional status of older persons presenting in a primary care clinic in Nigeria.

    Science.gov (United States)

    Adebusoye, L A; Ajayi, I O; Dairo, M D; Ogunniyi, A O

    2012-01-01

    The study objective was to determine the nutritional status and its association with sociodemographic characteristics and health complaints of older persons presenting at the General Outpatients Department (GOPD) Clinic of University College Hospital (UCH), Ibadan, Nigeria. A cross-sectional descriptive design was used to select 500 consecutively presenting participants aged 60 years and older between September and December, 2009. The Mini-Nutritional Assessment (MNA) tool and body mass index were used to assess undernutrition and overweight, respectively. The prevalence of nutritional problems was 61.9% (undernutrition = 7.8% and overweight = 54.1%). Being unmarried (P problems (mouth, teeth, and tongue) were significantly (P nutritional problems in this study underscores the need for intervention in this population. Correlation analysis (Pearson's) showed a positive association between BMI and MNA scores (r = 0.152, P = 0.001).

  17. Personal networks and mortality risk in older adults: a twenty-year longitudinal study.

    Directory of Open Access Journals (Sweden)

    Lea Ellwardt

    Full Text Available Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network. The objective is to inquire which personal network characteristics are the best predictors of mortality risk after adjustment for mental, cognitive and physical health.Empirical tests were carried out by combining official register information on mortality with data from the Longitudinal Aging Study Amsterdam (LASA. The sample included 2,911 Dutch respondents aged 54 to 85 at baseline in 1992 and six follow-ups covering a time span of twenty years. Four functional characteristics (emotional and social loneliness, emotional and instrumental support and four structural characteristics (living arrangement, contact frequency, number of contacts, number of social roles of the personal network as well as mental, cognitive and physical health were assessed at all LASA follow-ups. Statistical analyses comprised of Cox proportional hazard regression models. Findings suggest differential effects of personal network characteristics on survival, with only small gender differences. Mortality risk was initially reduced by functional characteristics, but disappeared after full adjustment for the various health variables. Mortality risk was lowest for older adults embedded in large (HR = 0.986, 95% CI 0.979-0.994 and diverse networks (HR = 0.948, 95% CI 0.917-0.981, and this effect continued to show in the fully adjusted models.Functional characteristics (i.e. emotional and social loneliness are indirectly associated with a reduction in mortality risk, while structural characteristics (i.e. number of contacts and number of social roles have

  18. Place-making with older persons: Establishing sense-of-place through participatory community mapping workshops.

    Science.gov (United States)

    Fang, Mei Lan; Woolrych, Ryan; Sixsmith, Judith; Canham, Sarah; Battersby, Lupin; Sixsmith, Andrew

    2016-11-01

    Principles of aging-in-place emphasize the importance of creating sustainable environments that enable older people to maintain a sense of belonging, autonomy, independence, safety and security. Simply altering the built environment is insufficient for creating more inclusive environments for older persons, as creating 'meaningful' places for aging involves consideration of psychosocial and cultural issues that go beyond issues of physical space. This paper illustrates how applications of community-based participatory research methods, in particular, participatory community mapping workshops (PCMWs), can be used to access experiences of place, identify facilitators and barriers to accessing the built environment and co-create place-based solutions among older people and service providers in a new affordable housing development in Western Canada. Founded on tenets of empowerment and relationship building, four PCMWs were undertaken with 54 participants (N = 38 older people; N = 16 local service providers). PCMWs comprised (i) experiential group walks around the community to access understandings of place and community and (ii) mapping exercises, whereby participants articulated their place-based needs within the context of the new affordable housing development and surrounding neighbourhood. Dialogues were digitally recorded, transcribed and thematically analysed. Visual data, including photographs taken during experiential group walks were categorized and integrated into the narrative to illustrate place meanings. PCMWs enabled senior housing and social care professionals and decision-makers to co-construct knowledge with older tenants that facilitated place action and change. Key themes identified by participants included: identifying services and needs for health and wellbeing, having opportunities for social participation and overcoming cross-cultural challenges. PCMWs were found to be a nuanced method of identifying needs and resources and generating

  19. Effect of flavor enhancers on the nutritional status of older persons.

    Science.gov (United States)

    Bautista, E N; Tanchoco, C C; Tajan, M G; Magtibay, E V J

    2013-04-01

    This study on flavor enhancers aims to: 1) compare food intake of older persons, 2) determine changes in body weight, blood pressure and serum sodium and 3) determine tolerance/intolerance to the flavor enhancers. The project is a cross-over, double blind study design. A nursing home for the aged, Golden Acres Institution located in Quezon City, Philippines. Sixty eligible subjects (31 males and 29 females), aged 60 years and over. Subjects were initially given: pouch A (0.5gram monosodium glutamate) or pouch B (0.5gram iodized salt) for lunch and supper for 2 months. The intervention was switched after one week wash period. Before the start and during intervention, 24 hour food intake of subjects was recorded and anthropometric and clinical data were measured. Tolerance/intolerance to the flavor enhancer and data on the quality of life were evaluated using a pre-tested structured questionnaire. Paired t-test was used to determine significant changes among each period of dietary intervention between different groups. Energy intake and almost all nutrients increased for males and females for both interventions. Body weight and body mass index increased significantly for both gender with MSG usage but not with iodized salt. The diastolic blood pressure of all subjects was normal while the systolic blood pressure remained at pre-hypertension level before and after both interventions. The sodium serum was within normal levels for both groups for both interventions. It was also observed that systolic blood pressure increased in both groups while sodium levels did not. It was further observed that both MSG and iodized salt interventions were well tolerated by majority of the participants. The use of flavor enhancers have increased food intake and were well- tolerated among older persons. No difference in blood pressure and sodium serum was noted in both MSG and iodized salt intake. People with less appetite, especially among older persons can use flavor enhancers to

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

    Science.gov (United States)

    2010-04-01

    ... § 404.1585 Trial work period for persons age 55 or older who are blind. If you become eligible for... before you became blind or became 55 years old, whichever is later; or (b) Your last previous work ended... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Trial work period for persons age 55 or...

  1. Intrinsic Brain Activity of Cognitively Normal Older Persons Resembles More That of Patients Both with and at Risk for Alzheimer's Disease Than That of Healthy Younger Persons

    Science.gov (United States)

    Pasquini, Lorenzo; Tonch, Annika; Plant, Claudia; Zherdin, Andrew; Ortner, Marion; Kurz, Alexander; Förstl, Hans; Zimmer, Claus; Grimmer, Timo; Wohlschäger, Afra; Riedl, Valentin

    2014-01-01

    Abstract In Alzheimer's disease (AD), recent findings suggest that amyloid-β (Aβ)-pathology might start 20–30 years before first cognitive symptoms arise. To account for age as most relevant risk factor for sporadic AD, it has been hypothesized that lifespan intrinsic (i.e., ongoing) activity of hetero-modal brain areas with highest levels of functional connectivity triggers Aβ-pathology. This model induces the simple question whether in older persons without any cognitive symptoms intrinsic activity of hetero-modal areas is more similar to that of symptomatic patients with AD or to that of younger healthy persons. We hypothesize that due to advanced age and therefore potential impact of pre-clinical AD, intrinsic activity of older persons resembles more that of patients than that of younger controls. We tested this hypothesis in younger (ca. 25 years) and older healthy persons (ca. 70 years) and patients with mild cognitive impairment and AD-dementia (ca. 70 years) by the use of resting-state functional magnetic resonance imaging, distinct measures of intrinsic brain activity, and different hierarchical clustering approaches. Independently of applied methods and involved areas, healthy older persons' intrinsic brain activity was consistently more alike that of patients than that of younger controls. Our result provides evidence for larger similarity in intrinsic brain activity between healthy older persons and patients with or at-risk for AD than between older and younger ones, suggesting a significant proportion of pre-clinical AD cases in the group of cognitively normal older people. The observed link of aging and AD with intrinsic brain activity supports the view that lifespan intrinsic activity may contribute critically to the pathogenesis of AD. PMID:24689864

  2. Recommendations for Serogroup B Meningococcal Vaccine for Persons 10 Years and Older.

    Science.gov (United States)

    2016-09-01

    This policy statement provides recommendations for the prevention of serogroup B meningococcal disease through the use of 2 newly licensed serogroup B meningococcal vaccines: MenB-FHbp (Trumenba; Wyeth Pharmaceuticals, a subsidiary of Pfizer, Philadelphia, PA) and MenB-4C (Bexsero; Novartis Vaccines, Siena, Italy). Both vaccines are approved for use in persons 10 through 25 years of age. MenB-FHbp is licensed as a 2- or 3-dose series, and MenB-4C is licensed as a 2-dose series for all groups. Either vaccine is recommended for routine use in persons 10 years and older who are at increased risk of serogroup B meningococcal disease (category A recommendation). Persons at increased risk of meningococcal serogroup B disease include the following: (1) persons with persistent complement component diseases, including inherited or chronic deficiencies in C3, C5-C9, properdin, factor D, or factor H or persons receiving eculizumab (Soliris; Alexion Pharmaceuticals, Cheshire, CT), a monoclonal antibody that acts as a terminal complement inhibitor by binding C5 and inhibiting cleavage of C5 to C5A; (2) persons with anatomic or functional asplenia, including sickle cell disease; and (3) healthy persons at increased risk because of a serogroup B meningococcal disease outbreak. Both serogroup B meningococcal vaccines have been shown to be safe and immunogenic and are licensed by the US Food and Drug Administration for individuals between the ages of 10 and 25 years. On the basis of epidemiologic and antibody persistence data, the American Academy of Pediatrics agrees with the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that either vaccine may be administered to healthy adolescents and young adults 16 through 23 years of age (preferred ages are 16 through 18 years) to provide short-term protection against most strains of serogroup B meningococcal disease (category B recommendation).

  3. Personality and Other Lifelong Influences on Older-Age Health and Wellbeing: Preliminary Findings in Two Scottish Samples.

    Science.gov (United States)

    Harris, Mathew A; Brett, Caroline E; Starr, John M; Deary, Ian J; Johnson, Wendy

    2016-01-01

    Recent observations that personality traits are related to later-life health and wellbeing have inspired considerable interest in exploring the mechanisms involved. Other factors, such as cognitive ability and education, also show longitudinal influences on health and wellbeing, but it is not yet clear how all these early-life factors together contribute to later-life health and wellbeing. In this preliminary study, we assessed hypothesised relations among these variables across the life course, using structural equation modelling in a sample assessed on dependability (a personality trait related to conscientiousness) in childhood, cognitive ability and social class in childhood and older age, education, and health and subjective wellbeing in older age. Our models indicated that both health and subjective wellbeing in older age were influenced by childhood IQ and social class, via education. Some older-age personality traits mediated the effects of early-life variables, on subjective wellbeing in particular, but childhood dependability did not show significant associations. Our results therefore did not provide evidence that childhood dependability promotes older-age health and wellbeing, but did highlight the importance of other early-life factors, particularly characteristics that contribute to educational attainment. Further, personality in later life may mediate the effects of early-life factors on health and subjective wellbeing. © 2016 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology.

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

    Directory of Open Access Journals (Sweden)

    Buchman Aron S

    2011-09-01

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

  5. Developing a personal health record for community-dwelling older adults and clinicians: technology and content.

    Science.gov (United States)

    Monsen, Karen A; Westra, Bonnie L; Paitich, Nadine; Ekstrom, Dawn; Mehle, Susan C; Kaeding, Maggie; Abdo, Sajeda; Natarajan, Gowtham; Ruddarraju, Uday Kumar Raju

    2012-07-01

    To empower older consumers and improve health outcomes, a consumer-friendly personal health record (PHR) is needed. The purpose of this article was to evaluate PHR technology and content for older community-dwelling consumers. Specific aims were to: (a) develop a secure, web-based application for a PHR to enable interoperable exchanges of data between consumers and clinicians; (b) develop structured, evidence-based shared care plan content for the PHR using an interface terminology standard; and (c) validate the shared care plans with consumers. An interoperable web-based form was developed. The standardized PHR content was developed by expert panel consensus using the Omaha System problem list and care plans, and validated by consumer interviews. Evidence-based shared care plans for 21 problems common among community-dwelling older adults were developed and encoded with Omaha System terms for data capture in the PHR. An additional problem, Neighborhood-workplace safety, was identified by consumers and will be added to the care plans.

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

    Directory of Open Access Journals (Sweden)

    Slaasletten Randi

    2011-06-01

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

  7. Two novel equations to estimate kidney function in persons aged 70 years or older.

    Science.gov (United States)

    Schaeffner, Elke S; Ebert, Natalie; Delanaye, Pierre; Frei, Ulrich; Gaedeke, Jens; Jakob, Olga; Kuhlmann, Martin K; Schuchardt, Mirjam; Tölle, Markus; Ziebig, Reinhard; van der Giet, Markus; Martus, Peter

    2012-10-02

    In older adults, current equations to estimate glomerular filtration rate (GFR) are not validated and may misclassify elderly persons in terms of their stage of chronic kidney disease. To derive the Berlin Initiative Study (BIS) equation, a novel estimator of GFR in elderly participants. Cross-sectional. Data were split for analysis into 2 sets for equation development and internal validation. Random community-based population of a large insurance company. 610 participants aged 70 years or older (mean age, 78.5 years). Iohexol plasma clearance measurement as gold standard. GFR, measured as the plasma clearance of the endogenous marker iohexol, to compare performance of existing equations of estimated GFR with measured GFR of the gold standard; estimation of measured GFR from standardized creatinine and cystatin C levels, sex, and age in the learning sample; and comparison of the BIS equations (BIS1: creatinine-based; BIS2: creatinine- and cystatin C-based) with other estimating equations and determination of bias, precision, and accuracy in the validation sample. The new BIS2 equation yielded the smallest bias followed by the creatinine-based BIS1 and Cockcroft-Gault equations. All other equations considerably overestimated GFR. The BIS equations confirmed a high prevalence of persons older than 70 years with a GFR less than 60 mL/min per 1.73 m2 (BIS1, 50.4%; BIS2, 47.4%; measured GFR, 47.9%). The total misclassification rate for this criterion was smallest for the BIS2 equation (11.6%), followed by the cystatin C equation 2 (15.1%) proposed by the Chronic Kidney Disease Epidemiology Collaboration. Among the creatinine-based equations, BIS1 had the smallest misclassification rate (17.2%), followed by the Chronic Kidney Disease Epidemiology Collaboration equation (20.4%). There was no validation by an external data set. The BIS2 equation should be used to estimate GFR in persons aged 70 years or older with normal or mild to moderately reduced kidney function. If

  8. The Role of Cognition, Personality, and Trust in Fraud Victimization in Older Adults.

    Science.gov (United States)

    Judges, Rebecca A; Gallant, Sara N; Yang, Lixia; Lee, Kang

    2017-01-01

    Older adults are more at risk to become a victim of consumer fraud than any other type of crime (Carcach et al., 2001) but the research on the psychological profiles of senior fraud victims is lacking. To bridge this significant gap, we surveyed 151 (120 female, 111 Caucasian) community-dwelling older adults in Southern Ontario between 60 and 90 years of age about their experiences with fraud. Participants had not been diagnosed with cognitive impairment or a neurological disorder by their doctor and looked after their own finances. We assessed their self-reported cognitive abilities using the MASQ, personality on the 60-item HEXACO Personality Inventory, and trust tendencies using a scale from the World Values Survey. There were no demographic differences between victims and non-victims. We found that victims exhibit lower levels of cognitive ability, lower honesty-humility, and lower conscientiousness than non-victims. Victims and non-victims did not differ in reported levels of interpersonal trust. Subsequent regression analyses showed that cognition is an important component in victimization over and above other social factors. The present findings suggest that fraud prevention programs should focus on improving adults' overall cognitive functioning. Further investigation is needed to understand how age-related cognitive changes affect vulnerability to fraud and which cognitive processes are most important for preventing fraud victimization.

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Multimorbidity - not just an older person's issue. Results from an Australian biomedical study

    Directory of Open Access Journals (Sweden)

    Pilkington Rhiannon

    2010-11-01

    Full Text Available Abstract Background Multimorbidity, the simultaneous occurrence of two or more chronic conditions, is usually associated with older persons. This research assessed multimorbidity across a range of ages so that planners are informed and appropriate prevention programs, management strategies and health service/health care planning can be implemented. Methods Multimorbidity was assessed across three age groups from data collected in a major biomedical cohort study (North West Adelaide Health Study. Using randomly selected adults, diabetes, asthma, and chronic obstructive pulmonary disease were determined clinically and cardio-vascular disease, osteoporosis, arthritis and mental health by self-report (ever been told by a doctor. A range of demographic, social, risk and protective factors including high blood pressure and high cholesterol (assessed bio-medically, health service use, quality of life and medication use (linked to government records were included in the multivariate modelling. Results Overall 4.4% of the 20-39 year age group, 15.0% of the 40-59 age group and 39.2% of those aged 60 years of age or older had multimorbidity (17.1% of the total. Of those with multimorbidity, 42.1% were aged less than 60 years of age. A variety of variables were included in the final logistic regression models for the three age groups including family structure, marital status, education attainment, country of birth, smoking status, obesity measurements, medication use, health service utilisation and overall health status. Conclusions Multimorbidity is not just associated with older persons and flexible care management support systems, appropriate guidelines and care-coordination programs are required across a broader age range. Issues such as health literacy and polypharamacy are also important considerations. Future research is required into assessing multimorbidity across the life course, prevention of complications and assessment of appropriate self

  11. The impact of personality on memory function in older adults-results from the Longitudinal Aging Study Amsterdam.

    Science.gov (United States)

    Klaming, Ruth; Veltman, Dick J; Comijs, Hannie C

    2017-07-01

    The aim of the study was to explore associations between memory function and the personality constructs mastery, self-efficacy, and neuroticism in a large cohort of older adults over a 14-year period. Memory function and personality traits were assessed every three years for 14 years. Data was derived from the Longitudinal Aging Study Amsterdam (LASA). The study cohort included a total of 1966 men and women aged 65 and older at baseline. Episodic memory was assessed with a modified Dutch version of the Rey Auditory Verbal Learning Test. Personality was measured with Dutch versions of the Pearlin Mastery Scale, General Self-Efficacy Scale, and an abbreviated version of the Dutch Personality Questionnaire. All three personality questionnaires are self-rating instruments. Higher levels of mastery and self-efficacy were associated with better memory function while high neuroticism was associated with poorer memory. Personality traits did not affect the rate of memory decline over time. Results demonstrate the role personality constructs, in particular those related to control beliefs and proneness to psychological stress, play in cognitive function in older adults, and support the development of intervention programs. Targeted training has the potential to promote a sense of control over life outcomes and to lower stress in older adults who are at risk for impaired memory function. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Persistent Deterioration of Functioning (PDF) and change in well-being in older persons.

    Science.gov (United States)

    Jonker, Angèle A; Comijs, Hannie C; Knipscheer, Kees C; Deeg, Dorly J

    2008-10-01

    It is often assumed that aging is accompanied by diverse and constant functional and cognitive decline, and it is therefore surprising that the well-being of older persons does not appear to decline in the same way. This study investigates longitudinally whether well-being in older persons changes due to Persistent Deterioration of Functioning (PDF). Data were collected in the context of the Longitudinal Aging Study Amsterdam (LASA). Conditions of PDF are persistent decline in cognitive functioning, physical functioning and increase in chronic diseases. Measurements of well-being included life satisfaction, positive affect, and valuation of life. T-tests were used to analyse mean difference scores for well-being, and univariate and multivariate regression analyses were performed to examine changes in three well-being outcomes in relation to PDF. Cross-sectional analyses showed significant differences and associations between the two PDF subgroups and non- PDF for well-being at T3. In longitudinal analyses, we found significant decreases in and associations with wellbeing over time in respondents fulfilling one PDF condition (mild PDF). For respondents fulfilling two or more PDF conditions (severe PDF), longitudinally no significant associations were found. Cognitive aspects of well-being (life satisfaction and valuation of life) and the affective element (positive affect) of well-being appear to be influenced negatively by mild PDF, whereas well-being does not seem to be diminished in persons with more severe PDF. This may be due to the ability to accept finally the inevitable situation of severe PDF.

  13. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale - psychometric evaluation.

    Science.gov (United States)

    Grealish, Laurie; Chaboyer, Wendy; Harbeck, Emma; Edvardsson, David

    2017-03-01

    To test the reliability and validity of the Person-centred care of Older People with cognitive impairment in Acute Care scale to determine nurses' perceptions of person-centred care. One-third of older adults admitted to hospital are at risk of serious hospital-acquired complications such as falls, infections and pressure injuries because of cognitive impairment. These risks can be reduced through person-centred practices. The Person-centred care of Older People with cognitive impairment in Acute Care scale is a self-report staff instrument to explore the extent to which person-centred practices are undertaken; however psychometric testing is limited. A cross-sectional sample of acute care nurses (n = 240) in Queensland, Australia completing self-report questionnaires. Psychometric analyses of item performance, reliability and validity were conducted. Item analysis revealed independent items. One item was removed due to negatively associating with the scale, improving total Cronbach's alpha from 0.76 to 0.84. The three original factors were maintained with regrouping of items. Confirmatory factor analysis confirmed the revised model. The revised Person-centred care of Older People with cognitive impairment in Acute Care scale had satisfactory psychometric properties when used as a total scale. Scale brevity and simplicity together with rigorous development and testing indicates that the revised Person-centred care of Older People with cognitive impairment in Acute Care may be useful for quality improvement programmes into the care of older people in hospitals. © 2016 John Wiley & Sons Ltd.

  14. Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program.

    Science.gov (United States)

    Johansson, L; Wijk, H; Christensson, L

    2017-01-01

    The aim of the study was to investigate the outcome of change in body weight associated with use of a structured preventive care process among persons with dementia assessed as at risk of malnutrition or malnourished. The preventive care process is a pedagogical model used in the Senior Alert (SA) quality register, where nutrition is one of the prioritized areas and includes four steps: assessment, analysis of underlying causes, actions performed and outcome. An analysis of data from SA with a pre-post design was performed. The participants were living in ordinary housing or special housing in Sweden. 1912 persons, 65 years and older, registered in both SA and the dementia quality register Svedem were included. A national preventive care program including individualized actions. The Mini Nutritional Assessment-Short Form was used to assess nutritional status at baseline. Body weight was measured during baseline and follow-up (7-106 days after baseline). 74.3% persons were malnourished or at risk of malnutrition. Those at risk of malnutrition or malnourished who were registered in all four steps of the preventive care process, increased in body weight from baseline (Md 60.0 kg) to follow-up (Md 62.0 kg) (p=0.013). In those with incomplete registration no increase in body weight was found. Using all steps in the structured preventive care process seems to improve nutritional status of persons with dementia assessed as at risk of malnutrition or malnourished. This study contributes to the development of evidence-based practice regarding malnutrition and persons with dementia.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-06-28

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

  17. Mild cognitive impairment is associated with poorer decision-making in community-based older persons.

    Science.gov (United States)

    Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Bennett, David A

    2015-04-01

    To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making. Community-based epidemiological cohort study. Communities throughout northeastern Illinois. Older persons without dementia from the Rush Memory and Aging Project (N = 730). All participants underwent a detailed clinical evaluation and decision-making assessment using a measure that closely approximates materials used in real-world financial and healthcare settings. This allowed for measurement of total decision-making and financial and healthcare decision-making. Regression models were used to examine whether MCI was associated with a lower level of decision-making. In subsequent analyses, the relationship between specific cognitive systems (episodic memory, semantic memory, working memory, perceptual speed, visuospatial ability) and decision-making was explored in participants with MCI. MCI was associated with lower total, financial, and healthcare decision-making scores after accounting for the effects of age, education, and sex. The effect of MCI on total decision-making was equivalent to the effect of more than 10 additional years of age. Additional models showed that, when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision-making in participants with MCI. Persons with MCI may have poorer financial and healthcare decision-making in real-world situations, and perceptual speed may be an important contributor to poorer decision-making in persons with MCI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  18. Primary Care Clinicians’ Experiences with Treatment Decision-Making for Older Persons with Multiple Conditions

    Science.gov (United States)

    Fried, Terri R.; Tinetti, Mary E.; Iannone, Lynne

    2010-01-01

    Background Clinicians are caring for an increasing number of older patients with multiple diseases, in the face of uncertainty concerning the benefits and harms associated with guideline-directed interventions. Understanding how primary care clinicians approach treatment decision-making for these patients is critical to the design of improving the decision-making process. Methods Focus groups were conducted with study with forty primary care clinicians (physicians, nurse-practitioners, physician assistants) in academic, community, and VA-affiliated primary care practices. Participants were given open-ended questions about their approach to treatment decision-making for older persons with multiple medical conditions. Responses were organized into themes using qualitative content analysis. Results Participants were concerned about their patients’ ability to adhere to complex regimens deriving from guideline-directed care. There was variability in beliefs regarding and approaches to balancing the benefits and harms of guideline-directed care. There was also variability in how they involved patients in the process of decision making, with clinicians describing conflicts between their own and their patients’ goals. Participants listed a number of barriers to making good treatment decisions, including lack of outcome data, the role of specialists, patient and family expectations, and insufficient time and reimbursement. Conclusions The experiences of practicing clinicians suggest that they struggle with the uncertainties of applying disease-specific guidelines to their older patients with multiple conditions. To improve decision making, they need more data, alternative guidelines, approaches to reconciling their own and their patients’ priorities, the support of their subspecialist colleagues, and an altered reimbursement system. PMID:20837819

  19. Self-care practices and health-seeking behavior among older persons in a developing country: Theories-based research

    Directory of Open Access Journals (Sweden)

    Andi Masyitha Irwan

    2016-03-01

    Conclusion: An understanding of self-care practices and self-efficacy is needed to improve health care in developing countries. High self-efficacy should be promoted along with adequate health literacy. Older persons should learn the importance of regular health examinations to promote health, prevent diseases, and slow the progress of chronic diseases. The number of respondents who never limit their sugar and salt intake was especially surprising. An intervention program should be developed to limit salt and sugar intake of Indonesian elderly and to motivate older persons to use primary health services.

  20. Professional education to meet the oral health needs of older adults and persons with disabilities.

    Science.gov (United States)

    Dolan, Teresa A

    2013-01-01

    A well-prepared dental workforce is critical to improving the oral health of special needs patients. This paper, originally presented at the National Coalition Consensus Conference: Oral Health of Vulnerable Older Adults and Persons with Disabilities, reviews and suggests opportunities to enhance the professional education of the dental workforce, including enhanced faculty training in gerontology, geriatrics and special patient care, and opportunities for improved curricula and team training both within the dental team and among the diverse group of health professional that often collaborate in the care of special needs patients. Other considerations include the creation of a specialty of Special Care Dentistry, and the effective use of dental team members in the care of special needs patients.

  1. The relationship between parenting types and older adolescents' personality, academic achievement, adjustment, and substance use.

    Science.gov (United States)

    Weiss, L H; Schwarz, J C

    1996-10-01

    The purpose of the present study was to examine Baumrind's T3 conceptual framework using a multiple informant design and an older adolescent population. With 178 college students and their families as participants, the present study found many of the predicted relations between parents' child-rearing style (Authoritative, Democratic, Nondirective, Nonauthoritarian-Directive, Authoritarian-Directive, and Unengaged) and their adolescent children's behavior in the 4 domains assessed: personality, adjustment, academic achievement, and substance use. The differences between parenting types on the criterion measures were not as large as reported in Baumrind's study, and significant effects were predominantly due to the poor scores from children with Unengaged and Authoritarian-Directive parents. The results are discussed in terms of their implications for the Authoritative parenting type, the utility of using a typology, and areas for future research.

  2. Cognitive person variables in the delay of gratification of older children at risk.

    Science.gov (United States)

    Rodriguez, M L; Mischel, W; Shoda, Y

    1989-08-01

    The components of self-regulation were analyzed, extending the self-imposed delay of gratification paradigm to older children with social adjustment problems. Delay behavior was related to a network of conceptually relevant cognitive person variables, consisting of attention deployment strategies during delay, knowledge of delay rules, and intelligence. A positive relationship was demonstrated between concurrent indexes of intelligence, attention deployment, and actual delay time. Moreover, attention deployment, measured as an individual differences variable during the delay process, had a direct, positive effect on delay behavior. Specifically, as the duration of delay and the frustration of the situation increased, children who spent a higher proportion of the time distracting themselves from the tempting elements of the delay situation were able to delay longer. The effect of attention deployment on delay behavior was significant even when age, intelligence, and delay rule knowledge were controlled. Likewise, delay rule knowledge significantly predicted delay time, even when age, attention deployment, and intelligence were controlled.

  3. Acute ascorbic acid ingestion increases skeletal muscle blood flow and oxygen consumption via local vasodilation during graded handgrip exercise in older adults.

    Science.gov (United States)

    Richards, Jennifer C; Crecelius, Anne R; Larson, Dennis G; Dinenno, Frank A

    2015-07-15

    Human aging is associated with reduced skeletal muscle perfusion during exercise, which may be a result of impaired endothelium-dependent dilation and/or attenuated ability to blunt sympathetically mediated vasoconstriction. Intra-arterial infusion of ascorbic acid (AA) increases nitric oxide-mediated vasodilation and forearm blood flow (FBF) during handgrip exercise in older adults, yet it remains unknown whether an acute oral dose can similarly improve FBF or enhance the ability to blunt sympathetic vasoconstriction during exercise. We hypothesized that 1) acute oral AA would improve FBF (Doppler ultrasound) and oxygen consumption (V̇o2) via local vasodilation during graded rhythmic handgrip exercise in older adults (protocol 1), and 2) AA ingestion would not enhance sympatholysis in older adults during handgrip exercise (protocol 2). In protocol 1 (n = 8; 65 ± 3 yr), AA did not influence FBF or V̇o2 during rest or 5% maximal voluntary contraction (MVC) exercise, but increased FBF (199 ± 13 vs. 248 ± 16 ml/min and 343 ± 24 vs. 403 ± 33 ml/min; P vasodilation.

  4. Toward appropriate criteria in medication adherence assessment in older persons: Position Paper.

    Science.gov (United States)

    Giardini, Anna; Martin, Maria Teresa; Cahir, Caitriona; Lehane, Elaine; Menditto, Enrica; Strano, Maria; Pecorelli, Sergio; Monaco, Alessandro; Marengoni, Alessandra

    2016-06-01

    Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.

  5. Cross-national comparison of disability in Latin American and Caribbean persons aged 75 and older.

    Science.gov (United States)

    Reyes-Ortiz, Carlos A; Ostir, Glenn V; Pelaez, Martha; Ottenbacher, Kenneth J

    2006-01-01

    The objectives of this study were to compare rates of instrumental activity of daily living (IADL) and activity of daily living (ADL) difficulties and examine sociodemographic and health correlates of IADL and ADL difficulties. Data were extracted from the first interview of Health, Well-Being and Aging in Latin America and the Caribbean Study (abbreviated from Spanish name as: SABE = salud, bienestar y envejecimiento en America Latina y el Caribe). This analysis included 3225 subjects aged 75 and older living in seven capital cities during 1999-2000. Reporting either IADL or ADL difficulties were the outcomes. Bivariate and multiple logistic regression analyses were used to examine the associations between IADL or ADL difficulties and sociodemographics, and health characteristics. The highest prevalence of IADL difficulties was reported in Sao Paulo (33.8%) and the lowest in Montevideo (12.0%). The highest prevalence of ADL difficulties was reported in Santiago (34.7%) and the lowest in Bridgetown (16.9%). In a combined analysis across cities, increased age, fewer years of education, lower body mass index (BMI) (<20), and high number of medical conditions were independently significantly associated with IADL and ADL difficulties. In conclusion, about a third of persons aged 75 and older reported difficulty in at least one IADL or ADL. There was a wide variation on disability rates and correlates across cities.

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

    Science.gov (United States)

    Kodner, Dennis L

    2002-08-01

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

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

    Science.gov (United States)

    Porter, Eileen J; Ganong, Lawrence H

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Melanie D Logue

    2013-05-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  10. Self-report of healthcare utilization among community-dwelling older persons: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Marlies T van Dalen

    Full Text Available BACKGROUND: Self-reported data are often used for estimates on healthcare utilization in cost-effectiveness studies. OBJECTIVE: To analyze older adults' self-report of healthcare utilization compared to data obtained from the general practitioners' (GP electronic medical record (EMR and to study the differences in healthcare utilization between those who completed the study, those who did not respond, and those lost to follow-up. METHODS: A prospective cohort study was conducted among community-dwelling persons aged 70 years and above, without dementia and not living in a nursing home. Self-reporting questionnaires were compared to healthcare utilization data extracted from the EMR at the GP-office. RESULTS: Overall, 790 persons completed questionnaires at baseline, median age 75 years (IQR 72-80, 55.8% had no disabilities in (instrumental activities of daily living. Correlations between self-report data and EMR data on healthcare utilization were substantial for 'hospitalizations' and 'GP home visits' at 12 months intraclass correlation coefficient 0.63 (95% CI; 0.58-0.68. Compared to the EMR, self-reported healthcare utilization was generally slightly over-reported. Non-respondents received more GP home visits (p<0.05. Of the participants who died or were institutionalized 62.2% received 2 or more home visits (p<0.001 and 18.9% had 2 or more hospital admissions (p<0.001 versus respectively 18.6% and 3.9% of the participants who completed the study. Of the participants lost to follow-up for other reasons 33.0% received 2 or more home visits (p<0.01 versus 18.6 of the participants who completed the study. CONCLUSIONS: Self-report of hospitalizations and GP home visits in a broadly 'healthy' community-dwelling older population seems adequate and efficient. However, as people become older and more functionally impaired, collecting healthcare utilization data from the EMR should be considered to avoid measurement bias, particularly if the data will

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

    Science.gov (United States)

    Rushton, Carole; Edvardsson, David

    2016-07-26

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

  12. Health Outcome Prioritization to Elicit Preferences of Older Persons with Multiple Health Conditions

    Science.gov (United States)

    Fried, Terri R.; Tinetti, Mary; Agostini, Joe; Iannone, Lynne; Towle, Virginia

    2010-01-01

    Objective To develop and test a simple tool to elicit the preferences of older persons based on prioritization of universal health outcomes. Methods Persons age ≥ 65 participating in a larger study were asked to rank 4 outcomes on a visual analogue scale: 1) maintaining independence, 2) staying alive, 3) reducing/eliminating pain, 4) reducing/eliminating other symptoms. Results Interviewers rated 73% of the 81 participants as having good to excellent understanding, and cognitive interviews demonstrated the tool captured how participants thought about trade-offs. Test-retest reliability was fair to poor for ranking most of the outcomes as either most or least important (kappa .28-1.0). Patient characteristics associated with ranking “keeping you alive” as most important have been shown to be associated with a preference for life-sustaining treatment, a related construct. There was substantial variability in the outcome ranked as most important. Conclusions The task of ranking 4 universal health outcomes was well understood, captured what was important when considering trade-offs, and demonstrated content validity. However, test-retest reliability was fair to poor. PMID:20570078

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

    Science.gov (United States)

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

    2017-03-23

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

  14. Moderate-intensity resistance exercise alters skeletal muscle molecular and cellular structure and function in inactive older adults with knee osteoarthritis.

    Science.gov (United States)

    Miller, Mark S; Callahan, Damien M; Tourville, Timothy W; Slauterbeck, James R; Kaplan, Anna; Fiske, Brad R; Savage, Patrick D; Ades, Philip A; Beynnon, Bruce D; Toth, Michael J

    2017-04-01

    High-intensity resistance exercise (REX) training increases physical capacity, in part, by improving muscle cell size and function. Moderate-intensity REX, which is more feasible for many older adults with disease and/or disability, also increases physical function, but the mechanisms underlying such improvements are not understood. Therefore, we measured skeletal muscle structure and function from the molecular to the tissue level in response to 14 wk of moderate-intensity REX in physically inactive older adults with knee osteoarthritis (n = 17; 70 ± 1 yr). Although REX training increased quadriceps muscle cross-sectional area (CSA), average single-fiber CSA was unchanged because of reciprocal changes in myosin heavy chain (MHC) I and IIA fibers. Intermyofibrillar mitochondrial content increased with training because of increases in mitochondrial size in men, but not women, with no changes in subsarcolemmal mitochondria in either sex. REX increased whole muscle contractile performance similarly in men and women. In contrast, adaptations in single-muscle fiber force production per CSA (i.e., tension) and contractile velocity varied between men and women in a fiber type-dependent manner, with adaptations being explained at the molecular level by differential changes in myosin-actin cross-bridge kinetics and mechanics and single-fiber MHC protein expression. Our results are notable compared with studies of high-intensity REX because they show that the effects of moderate-intensity REX in older adults on muscle fiber size/structure and myofilament function are absent or modest. Moreover, our data highlight unique sex-specific adaptations due to differential cellular and subcellular structural and functional changes.NEW & NOTEWORTHY Moderate-intensity resistance training causes sex-specific adaptations in skeletal muscle structure and function at the cellular and molecular levels in inactive older adult men and women with knee osteoarthritis. However, these responses

  15. Effects of acute pinitol supplementation on plasma pinitol concentration, whole body glucose tolerance, and activation of the skeletal muscle insulin receptor in older humans.

    Science.gov (United States)

    Stull, A J; Wood, K V; Thyfault, J P; Campbell, W W

    2009-05-01

    Limited research with rodents and humans suggests that oral ingestion of pinitol (3- O-methyl- D- CHIRO-inositol) might positively influence glucose tolerance. This double-blinded, placebo-controlled, and cross-over study assessed the effects of acute pinitol supplementation on plasma pinitol concentration, glucose tolerance, insulin sensitivity, and activation of the skeletal muscle insulin receptor. Fifteen older, nondiabetic subjects (62+/-1 years, mean+/-SEM) completed four, 1-day trials. Subjects consumed a non-nutritive beverage with nothing (placebo) or 1,000 mg pinitol. Sixty minutes later, the subjects consumed beverages that were either energy- and carbohydrate-free (Sham) or contained 75 g glucose (OGTT). Blood samples were collected frequently over the 240-min testing period. For the OGTT trials only, vastus lateralis samples were obtained before the placebo and pinitol supplementation and 60 min after consuming the 75 g glucose beverage. Plasma pinitol concentration increased and was maintained for 240 min. Pinitol did not influence the fasting state and 180-min area under the curves for plasma glucose and insulin during the Sham and OGTT trials or hepatic (placebo 0.83+/-0.08; pinitol 0.80+/-0.08) and whole-body (placebo 6.10+/-0.54; pinitol 6.22+/-0.52) insulin sensitivities. Activation of the muscle insulin receptor was increased by 140% with glucose ingestion (Pre 0.62+/-0.12; Post 1.49+/-0.35), but pinitol did not influence this response. These results show that the pinitol supplement was quickly absorbed, but did not acutely influence indices of whole-body glucose tolerance and insulin sensitivity, or the activation of the skeletal muscle insulin receptor in older, nondiabetic humans.

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

    Directory of Open Access Journals (Sweden)

    De Almeida Mello Johanna

    2012-08-01

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

  17. ïSCOPE: Safer care for older persons (in residential environments: A study protocol

    Directory of Open Access Journals (Sweden)

    Barnard Debbie

    2011-07-01

    Full Text Available Abstract Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012 proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility are led by healthcare aides (non-regulated caregivers and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement

  18. Mild Cognitive Impairment is Associated with PoorerDecision Making in Community-Based Older Persons

    Science.gov (United States)

    Duke Han, S.; Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Bennett, David A.

    2015-01-01

    Background/Objectives Financial and healthcare decision making are important for maintaining wellbeing and independence in old age. We tested the hypothesis that Mild Cognitive Impairment (MCI) is associated with poorer decision making in financial and healthcare matters. Design Community-based epidemiologic cohort study. Setting Communities throughout Northeastern Illinois. Participants Participants were 730 older nondemented persons from the Rush Memory and Aging Project. Measurements All participants underwent a detailed clinical evaluation and decision making assessment using a measure that closely approximates materials utilized in real world financial and healthcare settings. This allowed for measurement of total decision making, as well as financial and healthcare decision making. Regression models were used to examine whether the presence of MCI was associated with a lower level of decision making. In subsequent analyses, we explored the relation of specific cognitive systems (i.e., episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability) with decision making in those with MCI. Results Results showed that MCI was associated with lower decision making total scores as well as financial and healthcare scores, respectively, after accounting for the effects of age, education, and sex. The effect of MCI on total decision making was equivalent to the effect of more than 10 additional years of age. Additional models showed that when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision making among participants with MCI. Conclusion Results suggest that persons with MCI may exhibit poorer financial and healthcare decision making in real world situations, and that perceptual speed may be an important contributor to poorer decision making among persons with MCI. PMID:25850350

  19. Plantar Pressure Distribution among Older Persons with Different Types of Foot and Its Correlation with Functional Reach Distance

    Directory of Open Access Journals (Sweden)

    Aisyah Mohd Said

    2016-01-01

    Full Text Available Background. Changes in biomechanical structures of human foot are common in the older person, which may lead to alteration of foot type and plantar pressure distribution. We aimed to examine how foot type affects the plantar pressure distribution and to determine the relationship between plantar pressure distribution and functional reach distance in older persons. Methods. Fifty community-dwelling older persons (age: 69.98±5.84 were categorized into three groups based on the Foot Posture Index. The plantar pressure (max⁡P and contact area were analyzed using Footscan® RSScan platform. The Kruskal-Wallis test was used to compare the plantar pressure between foot types and Spearman’s correlation coefficient was used to correlate plantar pressure with the functional reach distance. Results. There were significant differences of max⁡P in the forefoot area across all foot types. The post hoc analysis found significantly lower max⁡P in the pronated foot compared to the supinated foot. A high linear rank correlation was found between functional reach distance and max⁡P of the rearfoot region of the supinated foot. Conclusions. These findings suggested that types of the foot affect the plantar maximal pressure in older persons with functional reach distance showing some associations.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

    Previous studies have shown that the discrepancy between performance on "fluid" and "crystallized" intelligence measures may serve as an indicator for intellectual decline. The validity of this procedure in older persons is unknown. The present study developed a multiple regression equation, to predict the Raven Advanced Progressive Matrices (APM) score from the National Adult Reading Test (NART) score and demographic variables in a large sample of healthy older persons (n = 270). The discrepancy between the predicted and observed Raven APM scores was transformed into a percentile distribution as an indicator of intellectual decline, which can be used in clinical practice. The validity of the procedure was further examined by comparing the proportion of persons with a significant decline (at the -1 and -1.65 SD level) between two older patient samples (87 patients with cerebral stroke and 387 patients with diabetes mellitus) by means of χ(2) tests. There was a significantly higher rate of intellectual decline at the -1 SD ("below average") and -1.65 SD ("impaired") cutoff levels for patients with stroke compared with patients with diabetes (stroke, 34% and 14%; diabetes, 16% and 5%, p < .05). These findings suggest that the Raven APM-NART discrepancy may be a useful measure of intellectual decline in older persons.

  2. Exploration of the Raven APMNational Adult Reading Test Discrepancy as a Measure of Intellectual Decline in Older Persons

    NARCIS (Netherlands)

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

    2013-01-01

    Previous studies have shown that the discrepancy between performance on fluid and crystallized intelligence measures may serve as an indicator for intellectual decline. The validity of this procedure in older persons is unknown. The present study developed a multiple regression equation, to predict

  3. Psychological attributes and changes in disability among low-functioning older persons : Does attrition affect the outcomes?

    NARCIS (Netherlands)

    Kempen, GIJM; van Sonderen, E

    2002-01-01

    The impact of attrition was studied in a two-wave panel study on the associations between psychological attributes (mastery, self-efficacy expectancies) and disability increase among low-functioning older persons (n=753, 76.4% participated at the follow-up 2 years later). The results showed that: (1

  4. Community Violence and Psychological Distress: The Protective Effects of Emotional Social Support and Sense of Personal Control among Older Adolescents

    Science.gov (United States)

    Rosenthal, Beth Spenciner; Wilson, W. Cody

    2008-01-01

    This empirical study investigated three mechanisms of protection (preventive, compensatory, buffering) for two factors (emotional social support, sense of personal control) in the relationship between exposure to community violence and psychological distress among 947 diverse, older adolescents. Findings indicate that social support and sense of…

  5. Combating the maltreatment of older persons by staff in long-term care nursing homes: legal aspects.

    Science.gov (United States)

    Ben Natan, Merav; Tabak, Nili

    2013-03-01

    A great deal of research has considered the dynamics of family violence and the way that family violence is processed and handled in the criminal justice system. Very little nursing research has considered the dynamics of older persons' maltreatment in long-term care. Older people living in a residential setting have the right to respectful care based on professional ethics. To fill this void, the current study proposes to identify policy implications for effectively implementing the recently developed Israeli public law designed to protect vulnerable older adults in nursing homes. In addition, this article presents the elder abuse reporting systems and the service delivery systems that have been established to protect older adults at risk of abuse and neglect.

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

    LENUS (Irish Health Repository)

    Gallagher, P

    2012-02-03

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

  7. THE RELATIONSHIP BETWEEN SEX HORMONES, SEX HORMONE BINDING GLOBULIN AND PERIPHERAL ARTERY DISEASE IN OLDER PERSONS

    Science.gov (United States)

    Maggio, M; Cattabiani, C; Lauretani, F; Artoni, A; Bandinelli, S; Schiavi, G; Vignali, A; Volpi, R; Ceresini, G; Lippi, G; Aloe, R; De Vita, F; Giallauria, F; McDermott, MM; Ferrucci, L; Ceda, GP

    2014-01-01

    Objective The prevalence of peripheral artery disease (PAD) increases with aging and is higher in persons with metabolic syndrome and diabetes. PAD is associated with adverse outcomes, including frailty and disability. The protective effect of testosterone and sex hormone binding globulin (SHBG) for diabetes in men suggests that the biological activity of sex hormones may affect PAD, especially in older populations. Methods Nine hundred and twenty-one elderly subjects with data on SHBG, testosterone (T), estradiol (E2) were selected from InCHIANTI study. PAD was defined as an Ankle-Brachial Index (ABI) <0.90. Logistic regression models adjusted for age (Model 1), age, BMI, insulin, interleukin-6, physical activity, smoking, chronic diseases including metabolic syndrome (Model 2), and a final model including also sex hormones (Model 3) were performed to test the relationship between SHBG, sex hormones and PAD. Results The mean age (± SD) of the 419 men and 502 women was 75.0 ± 6.8 years (Sixty two participants (41 men, 21 women) had ABI<0.90. Men with PAD had SHBG levels lower than men without PAD (p=0.03). SHBG was negatively and independently associated with PAD in men (p=0.028). but not in women. The relationship was however attenuated after adjusting for sex hormones (p=0.07). The E2 was not significantly associated with PAD in both men and women. In women, but not in men, T was positively associated with PAD, even after adjusting for multiple confounders, including E2 (p=0.01). Conclusions Low SHBG and high T levels are significantly and independently associated with the presence of PAD in older men and women, respectively. PMID:23102785

  8. Hand-grip strength cut points to screen older persons at risk for mobility limitation.

    Science.gov (United States)

    Sallinen, Janne; Stenholm, Sari; Rantanen, Taina; Heliövaara, Markku; Sainio, Päivi; Koskinen, Seppo

    2010-09-01

    To determine optimal hand-grip strength cut points for likelihood of mobility limitation in older people and to study whether these cut points differ according to body mass index (BMI). Cross-sectional analysis of data. Data collected in the Finnish population-based Health 2000 Survey. One thousand eighty-four men and 1,562 women aged 55 and older with complete data on anthropometry, hand-grip strength and self-reported mobility. Mobility limitation was defined as difficulty walking 0.5 km or climbing stairs. Receiver operating characteristic analysis was used to estimate hand-grip strength cut points for likelihood of mobility limitation. The overall hand-grip strength cut points for likelihood of mobility limitation were 37 kg (sensitivity 62%; specificity 76%) for men and 21 kg (sensitivity 67%; specificity 73%) for women. The effect of the interaction between hand-grip strength and BMI on mobility limitation was significant in men (P=.02), but no such interaction was observed in women (P=.16). In men, the most-optimal cutoff points were 33 kg (sensitivity 73%; specificity 79%) for normal-weight men, 39 kg (sensitivity 67%; specificity 71%) for overweight men, and 40 kg (sensitivity 57%; specificity 68%) for obese men. In women, BMI-specific hand-grip strength cutoff values was not markedly more accurate than the overall cutoff value. The hand-grip strength test is a useful tool to identify persons at risk of mobility limitation. In men, hand-grip strength cut points for mobility increased with BMI, whereas in women, only one hand-grip strength threshold was identified. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  11. Systematic home-based physical and functional therapy for older persons after hip fracture.

    Science.gov (United States)

    Tinetti, M E; Baker, D I; Gottschalk, M; Garrett, P; McGeary, S; Pollack, D; Charpentier, P

    1997-11-01

    To describe the development, implementation, and results of a home-based rehabilitation protocol for older persons after hip fracture. Demonstration study. Community. One hundred forty-eight community-living, nondemented participants at least 65 years of age who underwent repair of a fractured hip at two local hospitals. A linked assessment-intervention, home-based rehabilitation strategy. The physical therapy (PT) component of the intervention was designed to identify and ameliorate impairments in balance, strength, transfers, gait, and stair climbing; the functional therapy (FT) component was designed to identify and improve unsafe and/or inefficient performance of specific activities of daily living (ADL). The percentage of participants able to complete each component and the extent of progress noted in strength, balance, transfers, gait, and daily functioning. A total of 104 of the 148 participants (70%) completed the 6-month PT and FT program; 4 completed only PT and 6 refused both PT and FT. The remaining 32 participants (22%) received partial PT and FT that was terminated by death, hospitalization, or institutionalization. Seventy-seven percent of participants reported performing at least half of the recommended daily exercise sessions. Ninety-four percent and 96% of participants progressed in upper and lower extremity conditioning respectively; 33% progressed to the highest level in the graduated resisted exercise program. All participants progressed in the competency-based graded balance program, with 55% progressing to the fifth (most difficult) level. Similarly, the majority progressed in transfer maneuvers, stair climbing, and outdoor gait. One repetition maximum (RM) elbow extension increased from a mean of 5.8 (SD 4.6) pounds at baseline to 7.2 (SD 3.8) pounds at 6mo (t 2.22; p Score increased from 13.0 (SD 4.8) to 20.5 (SD 6.8) (t = 16.6; p Score increased from a mean of 48.2 (SD 15.0) to 77.7 (SD 18.8) (t = 17.03; p = .0001). This systematic

  12. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons

    National Research Council Canada - National Science Library

    Scheffer, Alice C; Schuurmans, Marieke J; van Dijk, Nynke; van Der Hooft, Truus; De Rooij, Sophia E

    Background fear of falling (FOF) is a major health problem among the elderly living in communities, present in older people who have fallen but also in older people who have never experienced a fall...

  13. What Do Older Adults Seek in Their Potential Romantic Partners? Evidence from Online Personal Ads

    Science.gov (United States)

    McIntosh, William D.; Locker, Lawrence; Briley, Katherine; Ryan, Rebecca; Scott, Alison J.

    2011-01-01

    Because of the dearth of available partners, older women looking to date may have to relax their dating standards to find a dating partner, perhaps accepting a life situation that is not what they had hoped for. However older women may be reluctant to sacrifice an often recently-gained lifestyle free of caregiving obligations. Older men, on the…

  14. Sleep-wake cycle in young and older persons with a lifetime history of mood disorders.

    Directory of Open Access Journals (Sweden)

    Rébecca Robillard

    Full Text Available Considering the marked changes in sleep and circadian rhythms across the lifespan, age may contribute to the heterogeneity in sleep-wake profiles linked to mood disorders. This study aimed to investigate the contributions of age and depression severity to sleep-wake disturbances. The Hamilton Depression Rating Scale (HDRS was administered to assess current symptoms severity in 238 persons with a history of a mood disorder between 12 and 90 years of age (y.o.. Actigraphy was recorded over five to 22 days. Regression analyses and analyses of variance [age (12-19 y.o., 20-39 y.o., 40-59 y.o., and ≥ 60 y.o. by depression severity (HDRS< and ≥ 8] were conducted. The 12-19 y.o. and 20-39 y.o. groups had a delayed sleep schedule and acrophase compared to all other groups. The ≥ 60 y.o. group had a lower rhythmicity and amplitude (p ≤ .006 than the 12-19 y.o. group (p ≤ .046. Participants with a HDRS ≥ 8 spent longer time in bed, had later sleep offset times and had lower circadian rhythmicity than those with a HDRS<8 (p ≤ .036. Younger age and higher HDRS score correlated with later sleep onset and offset times, longer time in bed, higher WASO, lower sleep efficiency and later acrophase (p ≤ .023. Age was a significant predictor of delayed sleep and activity schedules (p ≤ .001. The profile of sleep-wake cycle disturbances associated with mood disorders changes with age, with prominent sleep phase delay during youth and reduced circadian strength in older persons. Conversely, disruptions in sleep consolidation seem more stable across age.

  15. The Metabolic Syndrome: Prevalence, Associated Factors, and Impact on Survival among Older Persons in Rural Bangladesh

    Science.gov (United States)

    Khanam, Masuma Akter; Qiu, Chengxuan; Lindeboom, Wietze; Streatfield, Peter Kim; Kabir, Zarina Nahar; Wahlin, Åke

    2011-01-01

    Objectives To describe the prevalence of the metabolic syndrome (MetS) among older persons in rural Bangladesh, to investigate whether the prevalence varies by age, sex, literacy, marital status, nutritional status and socio-economic status, and to assess the impact of MetS on survival. Methods The study consisted of 456 persons who were aged ≥60 years living in a rural area of Bangladesh during July 2003–March 2004. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until 30th June 2009 was ascertained through the Matlab surveillance system. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg); random blood glucose (RBG) level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L); low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women); and BMI ≥25.0 kg/m2. Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status. Findings The overall prevalence of MetS was 19.5%, 20.8% in women, and 18.0% in men. Asset-index and nutritional status were independently associated with MetS. During 4.93 years of follow-up, 18.2% died. In the presence of high RBG, MetS has a significant negative effect on survival (69.4% vs 95.2%, log rank p = 0.02). Conclusion This study highlights the importance of the metabolic syndrome in rural Bangladesh. Our findings suggest that there is a need for screening programmes involving the metabolic syndrome to prevent diabetes and cardiovascular diseases. PMID:21697988

  16. The metabolic syndrome: prevalence, associated factors, and impact on survival among older persons in rural Bangladesh.

    Directory of Open Access Journals (Sweden)

    Masuma Akter Khanam

    Full Text Available OBJECTIVES: To describe the prevalence of the metabolic syndrome (MetS among older persons in rural Bangladesh, to investigate whether the prevalence varies by age, sex, literacy, marital status, nutritional status and socio-economic status, and to assess the impact of MetS on survival. METHODS: The study consisted of 456 persons who were aged ≥60 years living in a rural area of Bangladesh during July 2003-March 2004. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until 30(th June 2009 was ascertained through the Matlab surveillance system. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg; random blood glucose (RBG level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L; low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women; and BMI ≥25.0 kg/m(2. Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status. FINDINGS: The overall prevalence of MetS was 19.5%, 20.8% in women, and 18.0% in men. Asset-index and nutritional status were independently associated with MetS. During 4.93 years of follow-up, 18.2% died. In the presence of high RBG, MetS has a significant negative effect on survival (69.4% vs 95.2%, log rank p = 0.02. CONCLUSION: This study highlights the importance of the metabolic syndrome in rural Bangladesh. Our findings suggest that there is a need for screening programmes involving the metabolic syndrome to prevent diabetes and cardiovascular diseases.

  17. Inappropriate prescribing among older persons in primary care: protocol for systematic review and meta-analysis of observational studies

    Science.gov (United States)

    Lee, Cia Sin; Liew, Tau Ming

    2017-01-01

    Introduction Inappropriate prescribing has a significant impact on older persons in primary care. Previous reviews on inappropriate prescribing included a heterogeneous range of populations and may not be generalisable to primary care. In this study we aim to conduct a comprehensive systematic review and meta-analysis of the prevalence, risk factors and adverse outcome associated with inappropriate prescribing, specifically among older persons in primary care. Methods and analysis We will search PubMed, Embase, CINAHL, Web of Science, Scopus, PsycINFO and references of other review articles for observational studies related to the keywords ‘older persons’, ‘primary care’ and ‘inappropriate prescribing’. Two reviewers will independently select the eligible articles. For each included article, the two reviewers will independently extract the data and assess the risk of bias using the Newcastle–Ottawa Scale. If appropriate, meta-analyses will be performed to pool the data across all the studies. In the presence of heterogeneity, meta-regression and subgroup analyses will also be performed. The quality of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Ethics and dissemination The results will be disseminated through conference presentations and peer-reviewed publications. They will provide consolidated evidence to support informed actions by policymakers to address inappropriate prescribing in primary care, thus reducing preventable and iatrogenic risk to older persons in primary care. Trial registration number CRD42016048874. PMID:28237963

  18. Spiritual coping of older persons in Malta and Australia (part 2).

    Science.gov (United States)

    Baldacchino, Donia R; Bonello, Lilian; Debattista, Clifford J

    2014-08-12

    Part I presented the research methodology and the quantitative findings of this descriptive sequential explanatory study. Part 2 will discuss the qualitative findings that explain the impact of the use of spiritual coping strategies on institutionalised older persons. Participants were recruited from six institutions in Malta and Australia: four private homes (two in Australia, n=30; two in Malta, n=43) and two state residences in Malta (n=64). The residents (n=137; 103 women, 34 men), aged 72.8 years (mean) were all Roman Catholics, mobile and with a minimal residence of 6 months. The quantitative data (phase I) were collected by the Maltese version of the Spiritual Coping scale (SCS) ( Baldacchino and Buhagiar, 2003 ) while the qualitative data were collected through audiotaped face-to-face interviews (n=42) (phase II) and three focus groups (n=23) (phase III). The qualitative data generated three main themes, namely: self-empowerment through connectedness with God, self, others and nature; belongingness to the residence; and the finding of meaning and purpose in life or the perceived afterlife. Recommendations were made for integration of spirituality into nursing education and clinical practice; more frequent participation in the socio-religious activities at ward level; self-awareness exercises and support groups; and further crosscultural longitudinal studies.

  19. Dietary B Vitamins and a 10-Year Risk of Dementia in Older Persons

    Directory of Open Access Journals (Sweden)

    Sophie Lefèvre-Arbogast

    2016-11-01

    Full Text Available B vitamins may lower the risk of dementia, yet epidemiological findings, mostly from countries with folic acid fortification, have remained inconsistent. We evaluated in a large French cohort of older persons the associations between dietary B vitamins and long-term incident dementia. We included 1321 participants from the Three-City Study who completed a 24 h dietary recall, were free of dementia at the time of diet assessment, and were followed for an average of 7.4 years. In Cox proportional hazards models adjusted for multiple potential confounders, including overall diet quality, higher intake of folate was inversely associated with the risk of dementia (p for trend = 0.02, with an approximately 50% lower risk for individuals in the highest compared to the lowest quintile of folate (HR = 0.47; 95% CI 0.28; 0.81. No association was found for vitamins B6 and B12. In conclusion, in a large French cohort with a relatively low baseline folate status (average intake = 278 µg/day, higher folate intakes were associated with a decreased risk of dementia.

  20. Cognitive Interventions in Older Persons: Do They Change the Functioning of the Brain?

    Directory of Open Access Journals (Sweden)

    Yindee van Os

    2015-01-01

    Full Text Available Background. Cognitive interventions for older persons that may diminish the burden of cognitive problems and could delay conversion to dementia are of great importance. The underlying mechanisms of such interventions might be psychological compensation and neuronal plasticity. This review provides an overview of the literature concerning the evidence that cognitive interventions cause brain activation changes, even in damaged neural systems. Method. A systematic search of the literature was conducted in several international databases, Medline, Embase, Cinahl, Cochrane, and Psychinfo. The methodological quality was assessed according to the guidelines of the Dutch Institute for Health Care Improvement (CBO. Results. Nineteen relevant articles were included with varied methodological quality. All studies were conducted in diverse populations from healthy elderly to patients with dementia and show changes in brain activation after intervention. Conclusions. The results thus far show that cognitive interventions cause changes in brain activation patterns. The exact interpretation of these neurobiological changes remains unclear. More study is needed to understand the extent to which cognitive interventions are effective to delay conversion to dementia. Future studies should more explicitly try to relate clinically significant improvement to changes in brain activation. Long-term follow-up data are necessary to evaluate the stability of the effects.

  1. Feelings of abandonment and quality of life among older persons in rural northeast Thailand.

    Science.gov (United States)

    Sudnongbua, Supaporn; LaGrow, Steven; Boddy, Julie

    2010-09-01

    The purpose of this study was to determine the extent to which older persons in rural Northeast Thailand felt abandoned by the emigration of their children and the impact this may have on their quality of life. A cross sectional survey, consisting of 113 questions including the 26-item WHOQOL-BREF and the 24-item WHOQOL-OLD was administered to 212 participants. Participants ranged in age from 60 to 107 with a mean age of 71. While only 9% were found to live alone, 20% stated that they felt abandoned to some degree. A one-way between groups MANOVA was conducted to determine if those who felt abandoned differed from those who did not on a single-item question of Overall QOL and the total scores for the WHOQOL-BREF and WHOQOL-OLD. A statistically significant difference was found between the groups on the combined dependent variable [F (3, 208) = 4.75, p = .003; Wilks' Lambda = .94]. When the results for each of the dependent variables were considered separately, statistically significant differences were found on the WHOQOL-BREF [F (1, 210) = 13.61, p < .001] and the WHOQOL-OLD [F (1, 210) = 9.85, p = .001] only.

  2. Effects of dance on physical and psychological well-being in older persons.

    Science.gov (United States)

    Hui, Elsie; Chui, Bo Tsan-keung; Woo, Jean

    2009-01-01

    This study was aimed at determining the effects of dancing on the health status of older persons. A pool of 111 community-dwelling subjects were allocated to either an intervention group (IG), which included 23 sessions of dance over 12 weeks, or a control group (CG). All participants were assessed at baseline and 12 weeks. Physical outcome measures included the 6-min timed walking test (6MWT), trunk flexibility, body composition, lower limb endurance and strength, balance, the timed up-and-go test (TUG), resting heart rate and blood pressure. Quality of life was assessed by the Medical Outcomes Survey Short Form (SF-36) questionnaire. The IG's views toward dancing were also evaluated at 12 weeks. Significant difference was observed between the groups in six outcome measures: mean change in resting heart rate, 6MWT, TUG, lower limb endurance and the 'general health' and 'bodily pain' domains of SF-36. The majority of the dance group felt the intervention improved their health status. These findings demonstrate that dancing has physical and psychological benefits, and should be promoted as a form of leisure activity for senior citizens.

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

    Science.gov (United States)

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

    2017-05-01

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

  4. An evaluation of performance by older persons on a simulated telecommuting task.

    Science.gov (United States)

    Sharit, Joseph; Czaja, Sara J; Hernandez, Mario; Yang, Yulong; Perdomo, Dolores; Lewis, John E; Lee, Chin Chin; Nair, Sankaran

    2004-11-01

    Telecommuting work represents a strategy for managing the growing number of older people in the workforce. This study involved a simulated customer service telecommuting task that used e-mail to answer customer queries about media-related products and company policies. Participants included 27 "younger" older adults (50-65 years) and 25 "older" older adults (66-80 years). The participants performed the task for two 2-hr sessions a day over 4 consecutive days. Although both age groups showed significant improvement across sessions on many of the performance criteria, in general the improvements were more marked for the older age-group participants. However, the participants from both age groups had difficulty meeting some of the task performance requirements. These results are discussed in terms of training strategies for older workers.

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

    Science.gov (United States)

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

    2016-03-01

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

  6. Adaptive Strategies and Person-Environment Fit among Functionally Limited Older Adults Aging in Place: A Mixed Methods Approach

    Directory of Open Access Journals (Sweden)

    Laura L. Lien

    2015-09-01

    Full Text Available Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected using objective and perceived indicators of P-E fit among 12 older adults living in community-dwelling housing. Quantitative data described objective P-E fit in terms of accessibility, while qualitative data explored perceived P-E fit in terms of usability. While accessibility problems were prevalent, participants’ perceptions of usability revealed a range of adaptive environmental behaviors employed to meet functional needs. A closer examination of the P-E interaction suggests that objective accessibility does not always stipulate perceived usability, which appears to be malleable with age, self-perception, and functional competency. Findings stress the importance of evaluating both objective and perceived indicators of P-E fit to provide housing interventions that support independence. Further exploration of adaptive processes in older age may serve to deepen our understanding of both P-E fit frameworks and theoretical models of aging well.

  7. Personal views about aging among Korean American older adults: the role of physical health, social network, and acculturation.

    Science.gov (United States)

    Kim, Giyeon; Jang, Yuri; Chiriboga, David A

    2012-06-01

    Given the importance of a positive attitude towards one's own aging, we examined its predictors in a sample of 230 Korean American older adults (M (age) = 69.8 years, SD = 7.05). Personal views about aging, measured with a subscale of the Philadelphia Geriatric Center Morale Scale (PGCMS), were regressed on demographic variables, physical health-related factors, and psychosocial attributes (social network and acculturation). Results from the hierarchical regression analysis showed that better physical health conditions (fewer chronic conditions, less functional disability, and better vision) were associated with more positive personal views about aging. Other significant contributors included larger social networks and higher levels of acculturation. Findings suggest that personal views about aging among immigrant elderly populations can be enhanced by promoting physical health, social connectedness, and acculturation. Ways to maintain and improve positive attitudes about personal aging are discussed in a cultural context.

  8. The influence of personality on reported pain and self-efficacy for pain management in older cancer patients.

    Science.gov (United States)

    Krok, Jessica L; Baker, Tamara A

    2014-10-01

    This study examines the relationship of personality traits and affect on cancer-related pain in 150 older adults receiving outpatient treatment at a comprehensive cancer center. Regression analyses revealed extraversion as a significant predictor of current pain, with openness to experience as a significant indicator of average pain. Similarly, positive affect and negative affect were significant predictors of self-efficacy for pain management. Moderation models showed that conscientiousness and extraversion were significant moderators in the relationship between self-efficacy for pain management and worst pain. These findings suggest that different personality types may influence perceptions of pain severity.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Caregivers in older peoples' care: perception of quality of care, working conditions, competence and personal health.

    Science.gov (United States)

    From, Ingrid; Nordström, Gun; Wilde-Larsson, Bodil; Johansson, Inger

    2013-09-01

    The aim was to describe and compare nursing assistants', enrolled nurses' and registered nurses' perceptions of quality of care, working conditions, competence and personal health in older peoples' care. Altogether 70 nursing assistants, 163 enrolled nurses and 198 registered nurses completed a questionnaire comprising Quality from the Patient's Perspective modified for caregivers, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items on education and competence and Health Index. The caregivers reported higher perceived reality of quality of care in medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere. In subjective importance, the highest rating was assessed in one of the physical-technical items. The organisational climate was for three of the dimensions rather close/reached the value for a creative climate, for seven dimensions close to a stagnant climate. In perceived stress of conscience, there were low values. Nursing assistants had lower values than enrolled nurses and registered nurses. The caregivers reported highest values regarding previous education making them feel safe at work and lowest value on the item about education increasing the ability for a scientific attitude. Registered nurses could use knowledge in practice and to a higher degree than nursing assistants/enrolled nurses reported a need to gain knowledge, but the latter more often received education during working hours. The health index among caregivers was high, but registered nurses scored lower on emotional well-being than nursing assistants/enrolled nurses. The caregivers' different perceptions of quality of care and work climate need further attention. Although stress of conscience was low, it is important to acknowledge what affected the caregivers work in a negative way. Attention should be paid to the greater need for competence development among registered nurses during working hours.

  12. Does chair type influence outcome in the timed "Up and Go" test in older persons?

    Science.gov (United States)

    Kalula, S Z; Swingler, G H; Sayer, A A; Badri, M; Ferreira, M

    2010-04-01

    To test the effects of the use of a collapsible, portable chair (chair B), as opposed to a 'standard' chair (chair A), on the outcome of the timed "Up and Go" (TUG) test. Cross-sectional. Multipurpose senior centres. Mobile older persons (N=118, mean age 77 years (range 62-99 years)). Time to complete the timed "Up and Go" test using chair A and chair B, and inter-rater agreement in the time scores. Time taken to complete the TUG test did not differ by chair type [median (interquartile range, IQR) = 12.3 (9.53-15.9) and 12.6 (9.7-16.6)] seconds for Chair A and B respectively, p-value=0.87. In multiple regression analyses, factors that impacted on time difference in test performance for the two chairs were use of a walking aid during the test [Odds ratio (OR) = 3.7 95%CI 1.1-11.9, p=0.031], observed difficulty with mobility (OR= 27.7 95%CI 2.6-290, p=0.006), and a history of arthritis in the knees (OR= 2.9 95%CI 1.0-8.7, P=0.05). In an inter-rater agreement analysis, no significant difference was found between time scores recorded by the two raters; median (IQR) = 12.4 (10.9-15.9) and 12.3 (7.2-59.1) seconds for the occupation therapist and for the research assistant, respectively (Wilcoxon matched pairs test, p=0.124, Spearman correlation coefficient = 0.99, p test in field settings where field workers are reliant on public transport.

  13. The association between depression and emotional and social loneliness in older persons and the influence of social support, cognitive functioning and personality: A cross-sectional study.

    Science.gov (United States)

    Peerenboom, L; Collard, R M; Naarding, P; Comijs, H C

    2015-08-15

    We investigated the association between old age depression and emotional and social loneliness. A cross-sectional study was performed using data from the Netherlands Study of Depression in Older Persons (NESDO). A total of 341 participants diagnosed with a depressive disorder, and 125 non-depressed participants were included. Depression diagnosis was confirmed with the Composite International Diagnostic Interview. Emotional and social loneliness were assessed using the De Jong Gierveld Loneliness Scale. Socio-demographic variables, social support variables, depression characteristics (Inventory of Depressive Symptoms), cognitive functioning (Mini Mental State Examination) and personality factors (the NEO- Five Factor Inventory and the Pearlin Mastery Scale) were considered as possible explanatory factors or confounders. (Multiple) logistic regression analyses were performed. Depression was strongly associated with emotional loneliness, but not with social loneliness. A higher sense of neuroticism and lower sense of mastery were the most important explanatory factors. Also, we found several other explanatory and confounding factors in the association of depression and emotional loneliness; a lower sense of extraversion and higher severity of depression. We performed a cross-sectional observational study. Therefore we cannot add evidence in regard to causation; whether depression leads to loneliness or vice versa. Depression in older persons is strongly associated with emotional loneliness but not with social loneliness. Several personality traits and the severity of depression are important in regard to the association of depression and emotional loneliness. It is important to develop interventions in which both can be treated. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Effects of Lower Limb Length and Body Proportions on the Energy Cost of Overground Walking in Older Persons

    Directory of Open Access Journals (Sweden)

    Federica Vannetti

    2014-01-01

    Full Text Available Background. Although walking has been extensively investigated in its biomechanical and physiological aspects, little is known on whether lower limb length and body proportions affect the energy cost of overground walking in older persons. Methods. We enrolled 50 men and 12 women aged 65 years and over, mean 69.1 ± SD 5.4, who at the end of their cardiac rehabilitation program performed the six-minute walk test while wearing a portable device for direct calorimetry and who walked a distance comparable to that of nondisabled community-dwelling older persons. Results. In the multivariable regression model (F = 12.75, P<0.001, adjusted R2=0.278 the energy cost of overground walking, expressed as the net energy expenditure, in kg−1 sec−1, needed to provide own body mass with 1 joule kinetic energy, was inversely related to lower limb length and directly related to lower limb length to height ratio (β±SEβ = -3.72*10-3±0.74*10-3, P<0.001, and 6.61*10-3±2.14*10-3, P=0.003, resp.. Ancillary analyses also showed that, altogether, 1 cm increase in lower limb length reduced the energy cost of overground walking by 2.57% (95%CI 2.35–2.79. Conclusions. Lower limb length and body proportions actually affect the energy cost of overground walking in older persons.

  15. Using Personal Narratives for Curriculum Development about Substance Abuse and Older Adults

    Science.gov (United States)

    Bial, Martha C.; Gutheil, Irene A.; Hanson, Meredith; White-Ryan, Linda

    2012-01-01

    This article reports on a project to sensitize graduate social work students taking courses in substance abuse to the needs of older adults. Graduate social work students at a major urban school of social work in the Northeast were recruited and trained to interview older adults with a history of substance abuse problems regarding their life…

  16. Poor decision making is a consequence of cognitive decline among older persons without Alzheimer's disease or mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Patricia A Boyle

    Full Text Available Decision making is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential decisions are made just as cognitive function declines. Increasing evidence suggests that older adults, even those without dementia, often make poor decisions and are selectively vulnerable to scams. To date, however, the factors associated with poor decision making in old age are unknown. The objective of this study was to test the hypothesis that poor decision making is a consequence of cognitive decline among older persons without Alzheimer's disease or mild cognitive impairment.Participants were 420 non-demented persons from the Memory and Aging Project, a longitudinal, clinical-pathologic cohort study of aging in the Chicago metropolitan area. All underwent repeated cognitive evaluations and subsequently completed assessments of decision making and susceptibility to scams. Decision making was measured using 12 items from a previously established performance-based measure and a self-report measure of susceptibility to scams.Cognitive function data were collected over an average of 5.5 years prior to the decision making assessment. Regression analyses were used to examine whether the prior rate of cognitive decline predicted the level of decision making and susceptibility to scams; analyses controlled for age, sex, education, and starting level of cognition. Among 420 persons without dementia, more rapid cognitive decline predicted poorer decision making and increased susceptibility to scams (p's<0.001. Further, the relations between cognitive decline, decision making and scams persisted in analyses restricted to persons without any cognitive impairment (i.e., no dementia or even mild cognitive impairment.Poor decision making is a consequence of cognitive decline among older persons without Alzheimer's disease or mild cognitive impairment, those widely considered "cognitively healthy." These findings suggest

  17. Use of opioid analgesics among older persons with colorectal cancer in two health districts with palliative care programs.

    Science.gov (United States)

    Fisher, Judith; Urquhart, Robin; Johnston, Grace

    2013-07-01

    Prescription of opioid analgesics is a key component of pain management among persons with cancer at the end of life. To use a population-based method to assess the use of opioid analgesics within the community among older persons with colorectal cancer (CRC) before death and determine factors associated with the use of opioid analgesics. Data were derived from a retrospective, linked administrative database study of all persons who were diagnosed with CRC between January 1, 2001 and December 31, 2005 in Nova Scotia, Canada. This study included all persons who 1) were 66 years or older at the date of diagnosis; 2) died between January 1, 2001 and April 1, 2008; and 3) resided in health districts with formal palliative care programs (PCPs) (n=657). Factors associated with having filled at least one prescription for a so-called "strong" opioid analgesic in the six months before death were examined using multivariate logistic regression. In all, 36.7% filled at least one prescription for any opioid in the six months before death. Adjusting for all covariates, filling a prescription for a strong opioid was associated with enrollment in a PCP (odds ratio [OR]=3.18, 95% CI=2.05-4.94), residence in a long-term care facility (OR=2.19, 95% CI=1.23-3.89), and a CRC cause of death (OR=1.75, 95% CI=1.14-2.68). Persons were less likely to fill a prescription for a strong opioid if they were older (OR=0.97, 95% CI=0.95-0.99), male (OR=0.59, 95% 0.40-0.86), and diagnosed less than six months before death (OR=0.62, 95% CI=0.41-0.93). PCPs may play an important role in enabling access to end-of-life care within the community. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  18. Design of a website for home modifications for older persons with dementia

    NARCIS (Netherlands)

    Kort, Helianthe S.M.; Hoof, Joost van

    2014-01-01

    At present, persons with dementia and their family caregivers in the Netherlands are not adequately supported to modify their dwellings to match their personal needs.To facilitate aging-in-place for persons with dementia, a website was designed. The website was designed with persons with dementia an

  19. Design of a website for home modifications for older persons with dementia

    NARCIS (Netherlands)

    Kort, H.S.M.; Hoof, J. van

    2014-01-01

    At present, persons with dementia and their family caregivers in the Netherlands are not adequately supported to modify their dwellings to match their personal needs. To facilitate aging-in-place for persons with dementia, a website was designed. The website was designed with persons with dementia a

  20. Family and Marital Conflict Among Chinese Older Adults in the United States: The Influence of Personal Coping Resources.

    Science.gov (United States)

    Guo, Man; Dong, Xinqi; Tiwari, Agnes

    2017-07-01

    Conflict in the family is a major risk factor for the well-being of older immigrants, whose lives are centered around their families. This study examined the potential linkage between personal coping resources and family and marital conflict among U.S. Chinese older adults. Data were derived from the PINE study, a population-based study of Chinese elders in Chicago (N = 3,157). Logistic regressions were carried out to predict the likelihood of having conflict with family members and with the spouse, respectively, using indicators of personal coping resources (ie, socioeconomic status, physical health, acculturation level, perceived children's filial piety, number of friends, and sense of mastery). The results showed that older adults with higher education (odds ratio [OR] = 1.03, confidence interval [CI] = 1.01-1.06; OR = 1.09, CI = 1.06-1.11, respectively), lower perception of children being filial (OR = 0.95, CI = 0.93-0.97; OR = 0.96, CI = 0.94-0.98], respectively), and lower sense of mastery (OR = 0.95, CI = 0.94-0.96; OR = 0.98, CI = 0.97-0.99, respectively) were more likely to report both family and marital conflict. Older adults who had more friends were less likely to report marital conflict (OR = 0.61, CI = 0.43-0.86). Overall, older immigrants with greater coping resources seemed to have less family and marital conflict. Particularly important are their own sense of control and available support from children and friends in the new society. Higher education could be a risk factor for these conflicts. Future studies are needed to distinguish everyday life conflict from acculturation-related conflict in this population.

  1. The transition experience of rural older persons with advanced cancer and their families: a grounded theory study

    Directory of Open Access Journals (Sweden)

    Berry Patricia H

    2010-04-01

    Full Text Available Abstract Background Transitions often occur suddenly and can be traumatic to both patients with advanced disease and their families. The purpose of this study was to explore the transition experience of older rural persons with advanced cancer and their families from the perspective of palliative home care patients, bereaved family caregivers, and health care professionals. The specific aims were to: (1 describe the experience of significant transitions experienced by older rural persons who were receiving palliative home care and their families and (2 develop a substantive theory of transitions in this population. Methods Using a grounded theory approach, 27 open-ended individual audio-taped interviews were conducted with six older rural persons with advanced cancer and 10 bereaved family caregivers. Four focus group interviews were conducted with 12 palliative care health care professionals. All interviews were transcribed verbatim, coded, and analyzed using Charmaz's constructivist grounded theory approach. Results Within a rural context of isolation, lack of information and limited accessibility to services, and values of individuality and community connectedness, older rural palliative patients and their families experienced multiple complex transitions in environment, roles/relationships, activities of daily living, and physical and mental health. Transitions disrupted the lives of palliative patients and their caregivers, resulting in distress and uncertainty. Rural palliative patients and their families adapted to transitions through the processes of "Navigating Unknown Waters". This tentative theory includes processes of coming to terms with their situation, connecting, and redefining normal. Timely communication, provision of information and support networks facilitated the processes. Conclusion The emerging theory provides a foundation for future research. Significant transitions identified in this study may serve as a focus for

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Narratives of Self-Neglect: Patterns of Traumatic Personal Experiences and Maladaptive Behaviors in Cognitively Intact Older Adults.

    Science.gov (United States)

    Lien, Cynthia; Rosen, Tony; Bloemen, Elizabeth M; Abrams, Robert C; Pavlou, Maria; Lachs, Mark S

    2016-11-01

    To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. Descriptive study involving semistructured interviews and unstructured narratives. A parent study of self-neglect characteristics. Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69). Interviews included a comprehensive psychiatric assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis-I and II Disorders and an unstructured interview that allowed subjects to describe important elements of their life stories. Content analysis was used to identify personal experiences and behavior patterns in each subject's narrative. Four types of traumatic personal experiences (psychologically traumatic loss, separation or abandonment (29%); violent victimization, physical trauma, or sexual abuse (19%); exposure to war or political violence (9%); prolonged mourning (7%)) and five behavior patterns (significant financial instability (23%), severe lifelong mental illness (16%), mistrust of people or paranoia (13%), distrust and avoidance of the medical establishment (13%), substance abuse or dependence (13%)) were identified in the life stories. Patterns of traumatic personal experiences and maladaptive behaviors that self-neglecters frequently report were identified. Experiences, perceptions, and behaviors developed over a lifetime may contribute to elder self-neglect. Further exploration and better understanding of these patterns may identify potential risk factors and areas for future targeted screening, intervention, and prevention. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  4. Developing integrated health and social care services for older persons in Europe

    Directory of Open Access Journals (Sweden)

    Kai Leichsenring

    2004-09-01

    the state of service development, various approaches and instruments can be observed. Different national frameworks, in particular with respect to financing and organisation, systemic development, professionalisation and professional cultures, basic societal values (family ethics, and political approaches have to be taken into account during the second phase of PROCARE during which transversal and transnational analysis will be undertaken based on an in-depth analysis of two model ways of working in each country. Discussion: Far from a European vision concerning integrated care, national health and social care systems remain—at best—loosely coupled systems that are facing increasing difficulties, given the current challenges, in particular in long-term care for older persons: increasing marketisation, lack of managerial knowledge (co-operation, co-ordination, shortage of care workers and a general trend towards down-sizing of social care services continue to hamper the first tentative pathways towards integrated care systems.

  5. Characterization of hepatic enzyme activity in older adults with dementia: potential impact on personalizing pharmacotherapy

    Directory of Open Access Journals (Sweden)

    Campbell NL

    2015-01-01

    medication considered a strong or moderate inhibitor of CYP3A4/5. In total, 28.6% of the study population was predicted to have reduced activity of the CYP2D6 or CYP3A4/5 enzymes due to either genetic variants or concomitant medications.Conclusion: Both pharmacogenetic variants and concurrent drug therapies that are predicted to alter the pharmacokinetics of AChEIs should be evaluated in older adults with AD. Pharmacogenetic and drug-interaction data may help personalize AD therapy and increase adherence by improving tolerability.Keywords: dementia, acetylcholinesterase inhibitor, pharmacogenomics

  6. 16 CFR Figure 4 to Part 1203 - Location of Test Lines for Helmets Intended for Persons Five (5) Years of Age and Older

    Science.gov (United States)

    2010-01-01

    ... for Persons Five (5) Years of Age and Older 4 Figure 4 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt...) Years of Age and Older ER10MR98.004...

  7. The Development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): A Large-Scale Data Sharing Initiative

    NARCIS (Netherlands)

    Lutomski, J.E.; Baars, M.A.E.; Schalk, B.W.M; Boter, H.; Buurman, B.M.; Elzen, W.P. den; Jansen, A.P.; Kempen, G.I.J.M.; Steunenberg, B.; Steyerberg, E.W.; Olde Rikkert, M.G.; Melis, R.J.F.

    2013-01-01

    INTRODUCTION: In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons' health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Pers

  8. The Development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) : A Large-Scale Data Sharing Initiative

    NARCIS (Netherlands)

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

    2013-01-01

    INTRODUCTION: In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons' health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Pers

  9. Oropharyngeal dysphagia in older persons – from pathophysiology to adequate intervention

    DEFF Research Database (Denmark)

    Wirth, Rainer; Beck, Anne Marie; Dziewas, Rainer

    2016-01-01

    Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why...... the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition......, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation...

  10. Oropharyngeal dysphagia in older persons – from pathophysiology to adequate intervention

    DEFF Research Database (Denmark)

    Wirth, Rainer; Beck, Anne Marie; Dziewas, Rainer

    2016-01-01

    Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why...... the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition......, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation...

  11. Problem-solving variability in older spouses: how is it linked to problem-, person-, and couple-characteristics?

    Science.gov (United States)

    Hoppmann, Christiane A; Blanchard-Fields, Fredda

    2011-09-01

    Problem-solving does not take place in isolation and often involves social others such as spouses. Using repeated daily life assessments from 98 older spouses (M age = 72 years; M marriage length = 42 years), the present study examined theoretical notions from social-contextual models of coping regarding (a) the origins of problem-solving variability and (b) associations between problem-solving and specific problem-, person-, and couple- characteristics. Multilevel models indicate that the lion's share of variability in everyday problem-solving is located at the level of the problem situation. Importantly, participants reported more proactive emotion regulation and collaborative problem-solving for social than nonsocial problems. We also found person-specific consistencies in problem-solving. That is, older spouses high in Neuroticism reported more problems across the study period as well as less instrumental problem-solving and more passive emotion regulation than older spouses low in Neuroticism. Contrary to expectations, relationship satisfaction was unrelated to problem-solving in the present sample. Results are in line with the stress and coping literature in demonstrating that everyday problem-solving is a dynamic process that has to be viewed in the broader context in which it occurs. Our findings also complement previous laboratory-based work on everyday problem-solving by underscoring the benefits of examining everyday problem-solving as it unfolds in spouses' own environment.

  12. Perfectionism and the Five-factor Personality Traits as Predictors of Mortality in Older Adults

    NARCIS (Netherlands)

    Fry, Prem S.; Debats, Dominique L.

    2009-01-01

    The major hypothesis of the study was that perfectionism as a personality trait, along with the five-factor personality traits and dispositional optimism, is strongly associated with mortality in late life. After baseline assessment of health and personality traits as predictors of mortality, 450 pa

  13. Understanding the role of an educational model in developing knowledge of caring for older persons with dementia.

    Science.gov (United States)

    Prahl, Charlotte; Krook, Caroline; Fagerberg, Ingegerd

    2016-03-01

    Statistics show that the number of older people in need of care is increasing worldwide, especially those with dementia. This implies demands on knowledge and competence among health care staff to care for them. In Sweden, Silviahemmet offers dementia care units the opportunity to become certified according to a special certification educational model. Silviahemmet provides educational programs for staff in dementia care and day care for person with dementia. All staff undergoes a systematic training course in dementia care. The aim of the study was to gain an understanding of how an educational model developed the perceived knowledge of staff caring for older persons with dementia in a nursing home. A phenomenographical approach was used and qualitative interviews were carried out with 13 staff members in a nursing home. The main results show that staff perceives the importance of knowledge, working together and creating a sense of fellowship. The care of persons with dementia requires a special approach and adherence. Participating in the educational program made the staff realize and acknowledge their tacit knowledge and the importance of reflection-in-action together in the team. The results indicate the need for a common theoretical knowledge base and value system to achieve coherence in daily work. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. A community virtual ward model to support older persons with complex health care and social care needs

    Directory of Open Access Journals (Sweden)

    Lewis C

    2017-06-01

    Full Text Available C Lewis,1 Z Moore,1 F Doyle,2 A Martin,3 D Patton,1 LE Nugent1 1School of Nursing and Midwifery, Royal College of Surgeons Ireland, 2Department of Psychology, Royal College of Surgeons in Ireland, 3Beaumont Hospital, Dublin, Ireland Background: Globally the older population is increasing rapidly. As a result there is an increase in frail older persons living within the community, with increased risks of a hospital admission and higher mortality and morbidity rates. Due to complexity of care, health care professionals face challenges in providing effective case management and avoiding unplanned admissions to hospital. A community virtual ward (CVW model was developed to assist health care professionals to support older persons at home during periods of illness and/or functional decline.Methods: A quantitative observational study was conducted to examine if a CVW model of care reduced unplanned hospital admissions and emergency department (ED presentations in 54 patients over a 12-month period. The sign-rank test examined matched data on bed days, ED presentations, and unplanned hospital admissions pre- and post-CVW implementation. Other risk factors for admission to hospital were examined using the Mann–Whitney test pre- and post-CVW admission, including falls, living alone, and cognition. Correlations between hospital admission avoidances and unplanned hospital admissions and ED presentations were tested using Spearman’s p test.Results: There was a reduction in ED presentations post-CVW admission (P<0.001, and median unscheduled admissions were reduced (P=0.001. Those living alone had a lower number of ED presentations (median 0.5, interquartile range 0–1 prior to admission in comparison to those living with a caregiver, with no differences observed during admission to CVW. For those who experienced a fall during CVW admission, the odds ratio (OR of requiring long-term care doubled for each extra fall (OR =2.24, 95% CI 1.11 to 4.52, P=0

  15. Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike

    Science.gov (United States)

    Pietrzak, Robert H.; Southwick, Steven M.; Tracy, Melissa; Galea, Sandro; Norris, Fran H.

    2012-01-01

    Objective To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike. Method A total of 193 adults age 60 or older who resided in the Galveston Bay area were interviewed 2–5 months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed. Results Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care. Limitations This study is limited by its cross-sectional design and employment of psychiatric screening instruments. Conclusions A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care. PMID:22285792

  16. Recovery rate and prognosis in older persons who develop acute lung injury and the acute respiratory distress syndrome.

    Science.gov (United States)

    Ely, E Wesley; Wheeler, Arthur P; Thompson, B Taylor; Ancukiewicz, Marek; Steinberg, Kenneth P; Bernard, Gordon R

    2002-01-01

    The incidence of acute respiratory failure requiring mechanical ventilation increases 10-fold from the ages of 55 to 85 years, yet the rate of recovery and outcomes in older persons who develop acute lung injury are poorly defined. To examine age as an independent risk factor in recovery and intensive care unit discharge after acute lung injury. Prospective cohort study. 10 U.S. university-based medical centers. 902 mechanically ventilated patients enrolled in randomized, controlled trials for the treatment of acute lung injury. All patients were managed according to a standardized protocol for ventilator management and weaning. Frequency and time to achieve well-defined recovery landmarks, duration of ventilation and intensive care unit stay, and survival. Median duration of mechanical ventilation was 19 days (interquartile range, 7 to >28 days) for patients 70 years of age or older (n = 173) compared with 10 days (interquartile range, 5 to 26 days) for patients younger than 70 years of age (n = 729) (P 28 days) and 16 days for the younger group (8 to >28 days) (P = 0.004). Survival rates decreased across increasing decades of age (P 0.2). After passing a spontaneous breathing trial, however, older patients required 1 more day than younger patients to achieve unassisted breathing (P = 0.002) and 3 more days to leave the intensive care unit (P = 0.005). In a multivariable Cox proportional hazards analysis, age of 70 years or older was a strong predictor of in-hospital death (hazard ratio, 2.5 [95% CI, 2.0 to 3.2]; P acute lung injury compared with their younger counterparts, even after adjustment for covariates. Older survivors recovered from respiratory failure and achieved spontaneous breathing at the same rate as younger patients but had greater difficulty achieving liberation from the ventilator and being discharged from the intensive care unit.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Goisser S

    2015-08-01

    Full Text Available Sabine Goisser,1 Wolfgang Kemmler,2 Simone Porzel,3 Dorothee Volkert,1 Cornel Christian Sieber,1,4 Leo Cornelius Bollheimer,1,4 Ellen Freiberger1 1Institute for Biomedicine of Aging (IBA, Friedrich-Alexander-Universität (FAU Erlangen-Nürnberg, Nuremberg, 2Institute of Medical Physics (IMP, Friedrich-Alexander-Universität (FAU Erlangen-Nürnberg, 3Nutricia GmbH, Danone Medical Nutrition, Erlangen, 4Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder, Regensburg, Germany Abstract: One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study

  19. It is not just a meal, it is an emotional experience – A segmentation of older persons based on the emotions that they associate with mealtimes

    NARCIS (Netherlands)

    Uijl, den L.C.; Jager, G.; Graaf, de C.; Waddell, W.J.; Kremer, S.

    2014-01-01

    Worldwide, the group of older persons is growing fast. To aid this important group in their food and meal requirements, a deeper insight into the expectations and experiences of these persons regarding their mealtimes and snack times is needed. In the current study, we aim to identify consumer segme

  20. Becoming Old as a "Pharmaceutical Person": Negotiation of Health and Medicines among Ethnoculturally Diverse Older Adults

    Science.gov (United States)

    Ballantyne, Peri J.; Mirza, Raza M.; Austin, Zubin; Boon, Heather S.; Fisher, Judith E.

    2011-01-01

    Because medication prescribing and use have become a normative aspect of health care for older adults, we seek to understand how individuals navigate prescribed-medication use within the context of aging. We reasoned that, for those who are ambulatory, medication use is likely influenced by ethnocultural meanings of health and experiences with…

  1. Geographic proximity of adult children and the well-being of older persons.

    NARCIS (Netherlands)

    van der Pers, Marieke; Mulder, Clara H.; Steverink, Nardi

    2015-01-01

    This article aims to contribute to the discussion of how adult children affect the well-being of their older parents by investigating the importance of living in close geographic proximity. We investigate whether having children at all, and/or having them geographically proximate, contributes differ

  2. Assessment of vaccine candidates for persons aged 50 and older : a review

    NARCIS (Netherlands)

    Eilers, Renske; Krabbe, Paul F. M.; van Essen, Ted G. A.; Suijkerbuijk, Anita; van Lier, Alies; de Melker, Hester E.

    2013-01-01

    Background: The increasing life expectancy in most European countries has resulted in growth of the population 50 and older. This population is more susceptible to infectious diseases because of immunosenescence, comorbidity and general frailty. Thus, to promote healthy aging, vaccination against va

  3. Prevention Activities for Older Adults: Social Structures and Personal Competencies That Maintain Useful Social Roles.

    Science.gov (United States)

    Heller, Kenneth

    1993-01-01

    Presents conceptual reorientation for providing responsive psychological services to older adults, focusing on need to develop prevention programs that encourage maintenance of social roles. Discusses changes in social structures that encourage more active social engagement, with examples from housing options, part-time employment, and ways to…

  4. Gender differences in recovery from injuries to the extremities in older persons. A prospective study

    NARCIS (Netherlands)

    Kempen, GIJM; Sanderman, R; Scaf-Klomp, W; Ormel, J

    2003-01-01

    Purpose: This paper examines gender differences in trajectories of basic activities of daily living after fall-related injuries to the extremities in independently living older people in the Netherlands. Method: The study comprised a prospective design. Data were collected from 31 men and 140 women

  5. Becoming Old as a "Pharmaceutical Person": Negotiation of Health and Medicines among Ethnoculturally Diverse Older Adults

    Science.gov (United States)

    Ballantyne, Peri J.; Mirza, Raza M.; Austin, Zubin; Boon, Heather S.; Fisher, Judith E.

    2011-01-01

    Because medication prescribing and use have become a normative aspect of health care for older adults, we seek to understand how individuals navigate prescribed-medication use within the context of aging. We reasoned that, for those who are ambulatory, medication use is likely influenced by ethnocultural meanings of health and experiences with…

  6. Susceptibility to a multisensory speech illusion in older persons is driven by perceptual processes

    Directory of Open Access Journals (Sweden)

    Annalisa eSetti

    2013-09-01

    Full Text Available Recent studies suggest that multisensory integration is enhanced in older adults but it is not known whether this enhancement is solely driven by perceptual processes or affected by cognitive processes. Using the ‘McGurk illusion’, in Experiment 1 we found that audio-visual integration of incongruent audio-visual words was higher in older adults than in younger adults, although the recognition of either audio- or visual-only presented words was the same across groups. In Experiment 2 we tested recall of sentences within which an incongruent audio-visual speech word was embedded. The overall semantic meaning of the sentence was compatible with either one of the unisensory components of the target word and/or with the illusory percept. Older participants recalled more illusory audio-visual words in sentences than younger adults, however, there was no differential effect of word compatibility on recall for the two groups. Our findings suggest that the relatively high susceptibility to the audio-visual speech illusion in older participants is due more to perceptual than cognitive processing.

  7. Being Active, Engaged, and Healthy : Older Persons' Plans and Wishes to Age Successfully

    NARCIS (Netherlands)

    Huijg, Johanna M; van Delden, A Lex E Q; van der Ouderaa, Frans J G; Westendorp, Rudi G J; Slaets, Joris P J; Lindenberg, Jolanda

    2016-01-01

    OBJECTIVES: This study took an emic multidimensional approach on successful aging and examined what older people consider important to age successfully by asking them about their plans and wishes (PWs). Associations between participants' demographics, health status, working life, social contacts, li

  8. Falls in older persons : Associated factors and the effects of drug withdrawal

    NARCIS (Netherlands)

    N.D.A. Boyé (Nicole)

    2015-01-01

    markdownabstractAbstract Part I starts with a literature overview on the impact of falls in the elderly, the burden on healthcare, and the costs for society. Part II provides insight into various factors associated with falls in older adults. Part III includes the IMPROveFALL study protocol in Ch

  9. Trajectories of Disability Among Older Persons Before and After a Hospitalization Leading to a Skilled Nursing Facility Admission.

    Science.gov (United States)

    Buurman, Bianca M; Han, Ling; Murphy, Terrence E; Gahbauer, Evelyne A; Leo-Summers, Linda; Allore, Heather G; Gill, Thomas M

    2016-03-01

    To identify distinct sets of disability trajectories in the year before and after a Medicare qualifying skilled nursing facility (Q-SNF) admission, evaluate the associations between the pre-and post-Q-SNF disability trajectories, and determine short-term outcomes (readmission, mortality). Prospective cohort study including 754 community-dwelling older persons, 70+ years, and initially nondisabled in their basic activities of daily living. The analytic sample included 394 persons, with a first hospitalization followed by a Q-SNF admission between 1998 and 2012. Disability in the year before and after a Q-SNF admission using 13 basic, instrumental, and mobility activities. Secondary outcomes included 30-day readmission and 12-month mortality. The mean (SD) age of the sample was 84.9 (5.5) years. We identified 3 disability trajectories in the year before a Q-SNF admission: minimal disability (37.3% of participants), mild disability (44.6%), and moderate disability (18.2%). In the year after a Q-SNF admission, all participants started with moderate to severe disability scores. Three disability trajectories were identified: substantial improvement (26.0% of participants), minimal improvement (36.5%), and no improvement (37.5%). Among participants with minimal disability pre-Q-SNF, 52% demonstrated substantial improvement; the other 48% demonstrated minimal improvement (32%) or no improvement (16%) and remained moderately to severely disabled in the year post-Q-SNF. Among participants with mild disability pre-Q-SNF, 5% showed substantial improvement, whereas 95% showed little to no improvement. Of participants with moderate disability pre-Q-SNF, 15% remained moderately disabled showing little improvement, whereas 85% showed no improvement. Participants who transitioned from minimal disability pre-Q-SNF to no improvement post-Q-SNF had the highest rates of 30-day readmission and 12-month mortality (rate/100 person-days 1.3 [95% CI 0.6-2.8] and 0.3 [95% CI 0

  10. Trajectories of disability among older persons before and after a hospitalization leading to a skilled nursing facility admission

    Science.gov (United States)

    Buurman, Bianca M.; Han, Ling; Murphy, Terrence E.; Gahbauer, Evelyne A.; Leo-Summers, Linda; Allore, Heather G.; Gill, Thomas M.

    2015-01-01

    Objectives To identify distinct sets of disability trajectories in the year before and after a Q-SNF admission, evaluate the associations between the pre- and post-Q-SNF disability trajectories, and determine short-term outcomes (readmission, mortality). Design, setting and participants Prospective cohort study including 754 community-dwelling older persons, 70+ years, and initially nondisabled in their basic activities of daily living. The analytic sample included 394 persons, with a first hospitalization followed by a Q-SNF admission between 1998–2012. Main outcomes and measures Disability in the year before and after a Q-SNF admission using 13 basic, instrumental and mobility activities. Secondary outcomes included 30-day readmission and 12-month mortality. Results The mean (SD) age of the sample was 84.9(5.5) years. We identified three disability trajectories in the year before a Q-SNF admission: minimal disability (37.3% of participants) mild disability (44.6%), and moderate disability (18.2%). In the year after a Q-SNF admission, all participants started with moderate to severe disability scores. Three disability trajectories were identified: substantial improvement (26.0% of participants), minimal improvement (36.5%), and no improvement (37.5%). Among participants with minimal disability pre-Q-SNF, 52% demonstrated substantial improvement; the other 48% demonstrated minimal improvement (32%) or no improvement (16%) and remained moderately to severely disabled in the year post-Q-SNF. Among participants with mild disability pre-Q-SNF, 5% showed substantial improvement, whereas 95% showed little to no improvement. Of participants with moderate disability pre-Q-SNF, 15% remained moderately disabled showing little improvement, whereas 85% showed no improvement. Participants who transitioned from minimal disability pre-Q-SNF to no improvement post-Q-SNF had the highest rates of 30-day readmission and 12-month mortality (rate/100 person days 1.3 [95% CI 0.6–2

  11. Trunk lean mass and its association with 4 different measures of thoracic kyphosis in older community dwelling persons

    Science.gov (United States)

    Yamamoto, J.; Bergstrom, J.; Davis, A.; Wing, D.; Schousboe, J. T.; Nichols, J. F.

    2017-01-01

    Background The causes of age-related hyperkyphosis (HK) include osteoporosis, but only 1/3 of those most severely affected have vertebral fractures, suggesting that there are other important, and potentially modifiable causes. We hypothesized that muscle mass and quality may be important determinants of kyphosis in older persons. Methods We recruited 72 persons >65 years to participate in a prospective study designed to evaluate kyphosis and fall risk. At the baseline visit, participants had their body composition measures completed using Dual Energy X-ray Absorptiometry (DXA). They had kyphosis measured in either the standing [S] or lying [L] position: 1) Cobb angle from DXA [L]; 2) Debrunner kyphometer [S]; 3) architect’s flexicurve ruler [S]; and 4) blocks method [L]. Multivariable linear/logistic regression analyses were done to assess the association between each body composition and 4 kyphosis measures. Results Women (n = 52) were an average age of 76.8 (SD 6.7) and men 80.5 (SD 7.8) years. They reported overall good/excellent health (93%), the average body mass index was 25.3 (SD 4.6) and 35% reported a fall in the past year. Using published cut-offs, about 20–30% were determined to have HK. For the standing assessments of kyphosis only, after adjusting for age, sex, weight and hip BMD, persons with lower TLM were more likely to be hyperkyphotic. Conclusions Lower TLM is associated with HK in older persons. The results were stronger when standing measures of kyphosis were used, suggesting that the effects of muscle on thoracic kyphosis are best appreciated under spinal loading conditions. PMID:28369088

  12. The Association of APOE Genotype with Cognitive Function in Persons Aged 35 Years or Older

    NARCIS (Netherlands)

    Izaks, Gerbrand J.; Gansevoort, Ron T.; van der Knaap, Aafke M.; Navis, Gerjan; Dullaart, Robin P. F.; Slaets, Joris P. J.

    2011-01-01

    APOE genotype is associated with the risk of Alzheimer's disease. In the present study, we investigated whether APOE genotype was associated with cognitive function in predominantly middle-aged persons. In a population-based cohort of 4,135 persons aged 35 to 82 years (mean age (SD), 55 (12) years),

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

    NARCIS (Netherlands)

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

    2013-01-01

    Background: Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. Methods: The NEO-Five Factor Inventory (NEO-FFI) was

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

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Jensen, Barbara

    2007-02-01

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

  15. Development of a person-centred lifestyle intervention for older adults following a stroke or transient ischaemic attack.

    Science.gov (United States)

    Lund, Anne; Michelet, Mona; Kjeken, Ingvild; Wyller, Torgeir Bruun; Sveen, Unni

    2012-03-01

    Older adults with mild to moderate stroke or transient ischaemic attack often experience anxiety, depression and reduced social participation in their daily lives. Interventions addressing the long-term consequences of stroke are needed. To describe the process of developing a person-centred lifestyle intervention for older adults with stroke. The Canadian Occupational Performance Measure was used to develop the content of the intervention. Lifestyle groups were implemented at senior centres once a week for nine months. Content analysis was used to analyse the intervention content. A total of 132 participants (median age 79 years, 55% women, 52% lived alone) were recruited from hospitals. The participants prioritized 392 occupational problems, mainly related to active recreation, household and community management, mobility, and socialization. The occupational issues were addressed in the group interventions. New themes also emerged in line with the participants' choices through group discussions, such as information on stroke and prevention of new strokes, outdoor mobility and transportation, "brain use" and memory. The study demonstrates the development of intervention following stroke, addressing its process, structure, and components. Whether the person-centred process increases the potential for enhancing participants' social participation and well-being should be evaluated in future studies.

  16. Neurocognition and social skill in older persons with schizophrenia and major mood disorders: An analysis of gender and diagnosis effects

    Science.gov (United States)

    Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Forester, Brent; Wolfe, Rosemarie; Cather, Corinne

    2010-01-01

    Effective social interactions necessary for getting affiliative and instrumental needs met require the smooth integration of social skills, including verbal, non-verbal, and paralinguistic behaviors. Schizophrenia is characterized by prominent impairments in social and role functioning, and research on younger individuals with the illness has shown that social skills deficits are both common and distinguish the disease from other psychiatric disorders. However, less research has focused on diagnostic differences and correlates of social skills in older persons with schizophrenia. To address this question, we examined diagnostic and gender differences in social skills in a community-dwelling sample of 183 people older than age 50 with severe mental illness, and the relationships between social skills and neurocognitive functioning, symptoms, and social contact. Individuals with schizophrenia had worse social skills than those with bipolar disorder or major depression, with people with schizoaffective disorder in between. Social contact and cognitive functioning, especially executive functions and verbal fluency, were strongly predictive of social skills in people with schizophrenia and schizoaffective disorder, but not those with mood disorder. Other than blunted affect, symptoms were not predictive of social skills in either the schizophrenia spectrum or the mood disorder group. Older age was associated with worse social skills in both groups, whereas female gender was related to better skills in the mood disorder group, but not the schizophrenia group. The findings suggest that poor social skills, which are related to the cognitive impairment associated with the illness, are a fundamental feature of schizophrenia that persists from the onset of the illness into older age. PMID:21113403

  17. Development and psychometric testing of a semantic differential scale of sexual attitude for the older person.

    Science.gov (United States)

    Park, Hyojung; Shin, Sunhwa

    2015-12-01

    The purpose of this study was to develop and test a semantic differential scale of sexual attitudes for older people in Korea. The scale was based on items derived from a literature review and focus group interviews. A methodological study was used to test the reliability and validity of the instrument. A total of 368 older men and women were recruited to complete the semantic differential scale. Fifteen pairs of adjective ratings were extracted through factor analysis. Total variance explained was 63.40%. To test for construct validity, group comparisons were implemented. The total score of sexual attitudes showed significant differences depending on gender and availability of sexual activity. Cronbach's alpha coefficient for internal consistency was 0.96. The findings of this study demonstrate that the semantic differential scale of sexual attitude is a reliable and valid instrument. © 2015 Wiley Publishing Asia Pty Ltd.

  18. The National Single Assessment Tool (SAT) a pilot study in older persons care-survey results.

    Science.gov (United States)

    McDermott-Scales, L; Beaton, D; McMahon, F; Vereker, N; McCormack, B; Coen, R F; O'Keefe, S T

    2013-01-01

    Following a consultation and review process, the interRAI suite of assessment tools was chosen as the most suitable instrument for assessment of the care needs of older people in Ireland. We used previously validated questionnaires to examine the usability, practicality and acceptability of these tools to professionals, carers and clients in rural and urban acute, long-term care and community settings. Of the 45 professionals, 42-44 (93-98%) agreed or strongly agreed with 14 of 15 positive statements regarding the acceptability, clinical value and ease of use of the interRAl tools; 39 (87%) felt the terminology was consistent and familiar, although 35 (78%) felt some areas would require further explanation. Responses from carers (n = 15) and clients (n = 68) were similarly overwhelmingly positive regarding the experience of being assessed using these tools. These results support the clinical utility and practicality of using this approach to assess older people in Irish clinical practice.

  19. Chronicity of posttraumatic stress disorder and risk of disability in older persons.

    Science.gov (United States)

    Byers, Amy L; Covinsky, Kenneth E; Neylan, Thomas C; Yaffe, Kristine

    2014-05-01

    Little is known about the association between posttraumatic stress disorder (PTSD) and disability into later life. Most studies of late-life psychiatric disorders and function have focused on depression and generalized anxiety disorder. To determine the association between PTSD and disability among older adults and investigate if association differs by chronicity of PTSD. In total, 3287 participants 55 years and older (mean [SD] age, 66.0 [8.7] years, 60.1% women) involved in the Collaborative Psychiatric Epidemiology Surveys (2001-2003), including 3 aggregated, nationally representative studies (National Comorbidity Survey Replication, National Survey of American Life, and National Latino and Asian American Study). Analyses used weights and complex design-corrected statistical tests to infer generalizability to the US population. Disability defined by 5 domains (out of role, self-care, mobility, cognition, and social) using the World Health Organization Disability Assessment Schedule. Of the 3.7% older adults who had a history of PTSD defined by DSM-IV criteria, 1.8% had persistent PTSD into later life (age of onset PTSD, 69.6% for pre-late life (age of onset PTSD (P PTSD were 3 times more likely to have any disability than were respondents with no PTSD (odds ratio, 3.18; 95% CI, 1.32-7.64). Global disability results were nonsignificant for pre-late life relative to no PTSD (odds ratio, 1.99; 95% CI, 0.97-4.08). Disability in older Americans is strongly associated with PTSD, particularly PTSD that persists into later life. These findings suggest that monitoring and treatment of PTSD are important over the long term.

  20. The significance of healthy aging for older persons who participated in health education groups

    OpenAIRE

    Valer, Daiany Borghetti; Bierhals, Carla Cristiane Becker Kottwitz; Aires,Marinês; Paskulin, Lisiane Manganelli Girardi

    2015-01-01

    Introduction: Different terms have been used to describe the aging process while avoiding the negative consequences of advanced age. In this context healthy aging assumes a more extensive meaning than the absence of disease, and includes a process of adapting to the changes that occur throughout life, related to the maintenance of a healthy old age. Objective : To describe the meaning of healthy aging for older adults who participated in health education groups in the Basic Health Care Servi...

  1. What does living alone really mean for older persons? A comparative study of Myanmar, Vietnam, and Thailand

    Directory of Open Access Journals (Sweden)

    Bussarawan Teerawichitchainan

    2015-06-01

    Full Text Available Background: Rapid development and social change in Asia have led many to assume that the proportion of elderly people living alone is rising and that they tend to live in destitute situations. These assumptions often lack empirical validation. Objective: We address the trends and correlates of solitary living among older persons in Myanmar, Vietnam, and Thailand. We examine the extent to which this form of living arrangement equates with their financial stress, physical and social isolation, psychological distress, and met need for personal care. Methods: We analyze 2011-12 national surveys of older persons from the three countries. We employ descriptive and multivariate analyses using either binary logistic regression or multiple classification analysis. Results: There has been a modest upward trend in solo living among the elderly in the three countries over the last few decades. The prevalence of solo living remains low, accounting for less than one-tenth of all elders in each setting. A substantial proportion of solo-dwelling elders live in quasi-coresidence. Solo living is not always associated with financial stress. Although solitary dwellers report more psychological distress than others, our evidence does not support the claim that they are socially alienated. Note, however, that solo-living elders who are childless are the most vulnerable group and will need attention from policymakers and social workers. While solitary living tends to be correlated with adverse wellbeing outcomes in Myanmar and Vietnam, this is less the case in Thailand. Conclusions: Our evidence provides a varied and nuanced view regarding the trends and situations of solitary-living elders in developing Southeast Asia.

  2. Relation of depression with health behaviors and social conditions of dependent community-dwelling older persons in the Republic of Chile.

    Science.gov (United States)

    Sandoval Garrido, Felipe Alfonso; Tamiya, Nanako; Lloyd-Sherlock, Peter; Noguchi, Haruko

    2016-12-01

    Depressive symptoms are a leading cause of disability and emotional suffering, particularly in old age. However, evidence on depression and old age in developing countries remains largely ignored. The aim of this study was to examine the relation between health behavior and social conditions with depression among dependent community-dwelling older persons in the Republic of Chile. This is a cross-sectional and inferential study, using nationally representative secondary data. Two models used logistic regression on 640 dependent community-dwelling older persons from all over Chile, who personally answered a depression assessment, excluding those taking antidepressants. The geriatric depression scale (GDS-15) was used as outcome. The first model aims at any kind of depression (GDS 5>). The second aims at severe depression (GDS 10>). As exposure, we used the health behavior and social conditions of the older persons. Socio-demographic and physical conditions were used as adjustment. 44.5% of the older persons presented depressive symptoms. Among them, 11% had severe depression. Logistic regression showed that significant detrimental factors for being depressed in both models were visiting the doctor five times or over because of acute diseases, feeling uncomfortable with their living arrangement, and feeling discriminated. On the other hand, every additional day of physical exercise and living alone had a beneficial and detrimental effect only in model one. Analyses on ways to support older persons living alone and the promotion of physical exercise to avoid depression are needed, along with a deeper understanding of the comfort with their living arrangement. Finally, ways to address the discrimination among older persons should be further explored.

  3. Prevalence and Associated Factors of Sarcopenia in Older Adults with Intellectual Disabilities

    Science.gov (United States)

    Bastiaanse, Luc P.; Hilgenkamp, Thessa I. M.; Echteld, Michael A.; Evenhuis, Heleen M.

    2012-01-01

    Sarcopenia is defined as a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength. It has hardly been studied in older people with intellectual disabilities (ID). In this study 884 persons with borderline to profound ID aged 50 years and over, were investigated to determine the prevalence of sarcopenia in…

  4. Prevalence and Associated Factors of Sarcopenia in Older Adults with Intellectual Disabilities

    Science.gov (United States)

    Bastiaanse, Luc P.; Hilgenkamp, Thessa I. M.; Echteld, Michael A.; Evenhuis, Heleen M.

    2012-01-01

    Sarcopenia is defined as a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength. It has hardly been studied in older people with intellectual disabilities (ID). In this study 884 persons with borderline to profound ID aged 50 years and over, were investigated to determine the prevalence of sarcopenia in…

  5. Religiousness/Spirituality and anger management in community-dwelling older persons.

    Science.gov (United States)

    Mefford, Linda; Thomas, Sandra P; Callen, Bonnie; Groer, Maureen

    2014-04-01

    Mismanaged anger is associated with adverse health outcomes. This study examined whether dimensions of religiousness/spirituality could predict healthy anger management in a sample of 82 community-dwelling older Americans. A correlational research design was employed using the Deffenbacher Anger Scale and the Brief Multidimensional Measure of Religiousness/Spirituality. Higher scores on Forgiveness, Daily Spiritual Experiences, Religiousness/Spirituality as Coping, and Self-Ranking of Religiousness/Spirituality were correlated with healthier anger management; however forgiveness was the only significant predictor in the regression analysis. Interventions to facilitate forgiveness may promote healthy anger management and minimize the adverse health effects of mismanaged anger.

  6. The effect of humor on short-term memory in older adults: a new component for whole-person wellness.

    Science.gov (United States)

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

    2014-01-01

    For older adults, the damaging effects of aging and stress can impair the ability to learn and sustain memory. Humor, with its associated mirthful laughter, can reduce stress and cortisol, a stress hormone. Chronic release of cortisol can damage hippocampus neurons, leading to impairment of learning and memory. The primary goal of this study was to determine whether watching a humorous video had an effect on short-term memory in an older population. The research team designed a randomized, controlled trial. The study took place at Loma Linda University in Loma Linda, California. The research team recruited 20 normal, healthy, older adults, 11 males and 9 females. The humor group (n = 10, mean = 69.3 ± 3.7 y) self-selected 1 of 2 humorous videos--a Red Skelton comedy or a montage of America's Funniest Home Videos--and watched it for 20 min. A control group (n = 10, mean = 68.7 ± 5.5 y) sat calmly for 20 min and were not allowed to read, sleep, or talk on a cell phone. The Rey Auditory Verbal Learning Test was used to assess short-term memory--learning ability, delayed recall, and visual recognition. Salivary cortisol levels were measured at predetermined times. Learning ability improved by 38.5% and 24.0% in the humor and control groups, respectively (P = .014). Delayed recall improved by 43.6% and 20.3% in the humor and control groups, respectively (P =.029). Within the humor group, delayed recall (43.6%) was significant compared with learning ability (38.5%) (P = .002). At 3 predetermined time points, significant decreases in salivary cortisol were observed in the humor group (P = .047, P = .046, and P = .062, respectively). The study's findings suggest that humor can have clinical benefits and rehabilitative implications and can be implemented in programs that support whole-person wellness for older adults. Learning ability and delayed recall are important to these individuals for a better quality of life--considering mind, body, spirit, social, and economic

  7. Physical Behavior in Older Persons during Daily Life: Insights from Instrumented Shoes

    Directory of Open Access Journals (Sweden)

    Christopher Moufawad el Achkar

    2016-08-01

    Full Text Available Activity level and gait parameters during daily life are important indicators for clinicians because they can provide critical insights into modifications of mobility and function over time. Wearable activity monitoring has been gaining momentum in daily life health assessment. Consequently, this study seeks to validate an algorithm for the classification of daily life activities and to provide a detailed gait analysis in older adults. A system consisting of an inertial sensor combined with a pressure sensing insole has been developed. Using an algorithm that we previously validated during a semi structured protocol, activities in 10 healthy elderly participants were recorded and compared to a wearable reference system over a 4 h recording period at home. Detailed gait parameters were calculated from inertial sensors. Dynamics of physical behavior were characterized using barcodes that express the measure of behavioral complexity. Activity classification based on the algorithm led to a 93% accuracy in classifying basic activities of daily life, i.e., sitting, standing, and walking. Gait analysis emphasizes the importance of metrics such as foot clearance in daily life assessment. Results also underline that measures of physical behavior and gait performance are complementary, especially since gait parameters were not correlated to complexity. Participants gave positive feedback regarding the use of the instrumented shoes. These results extend previous observations in showing the concurrent validity of the instrumented shoes compared to a body-worn reference system for daily-life physical behavior monitoring in older adults.

  8. Physical Behavior in Older Persons during Daily Life: Insights from Instrumented Shoes

    Science.gov (United States)

    Moufawad el Achkar, Christopher; Lenoble-Hoskovec, Constanze; Paraschiv-Ionescu, Anisoara; Major, Kristof; Büla, Christophe; Aminian, Kamiar

    2016-01-01

    Activity level and gait parameters during daily life are important indicators for clinicians because they can provide critical insights into modifications of mobility and function over time. Wearable activity monitoring has been gaining momentum in daily life health assessment. Consequently, this study seeks to validate an algorithm for the classification of daily life activities and to provide a detailed gait analysis in older adults. A system consisting of an inertial sensor combined with a pressure sensing insole has been developed. Using an algorithm that we previously validated during a semi structured protocol, activities in 10 healthy elderly participants were recorded and compared to a wearable reference system over a 4 h recording period at home. Detailed gait parameters were calculated from inertial sensors. Dynamics of physical behavior were characterized using barcodes that express the measure of behavioral complexity. Activity classification based on the algorithm led to a 93% accuracy in classifying basic activities of daily life, i.e., sitting, standing, and walking. Gait analysis emphasizes the importance of metrics such as foot clearance in daily life assessment. Results also underline that measures of physical behavior and gait performance are complementary, especially since gait parameters were not correlated to complexity. Participants gave positive feedback regarding the use of the instrumented shoes. These results extend previous observations in showing the concurrent validity of the instrumented shoes compared to a body-worn reference system for daily-life physical behavior monitoring in older adults. PMID:27527172

  9. The emotional overlay: older person and carer perspectives on negotiating aging and care in rural Ontario.

    Science.gov (United States)

    Herron, Rachel V; Skinner, Mark W

    2013-08-01

    This paper extends the burgeoning interest in emotion, health and place by investigating the emotionally complex experiences of aging and care in rural settings. Featuring a thematic analysis of 44 semi-structured interviews and two focus groups with older people and their carers in rural Ontario (Canada) we examine the importance and implications of emotions within and across multiple scales at which care relationships, expectations and responsibilities are negotiated. With the aim of broadening the discussion surrounding geographical dimensions of ethical care, our approach draws on feminist care ethics to understand the multifaceted ways in which emotions shape and are shaped by experiences of aging and caring at the interpersonal, household and community scales. The findings reveal how emotions are central, yet often-overlooked and even hidden within care relationships among older rural people and their carers. We argue that ethical care is contingent on recognizing and valuing the situated emotions involved in doing care work, sustaining care relationships and asking for care. In doing so, we demonstrate how qualitative research on the emotional geographies of care can contribute to the development of informed policies that are contextually sensitive and, ultimately, have the potential to build more ethical rural conditions of care.

  10. Personality Differences in Attempted Suicide versus Suicide in Adults 50 Years of Age or Older

    Science.gov (United States)

    Useda, J. David; Duberstein, Paul R.; Conner, Kenneth R.; Beckman, Anthony; Franus, Nathan; Tu, Xin; Conwell, Yeates

    2007-01-01

    The authors tested hypotheses concerning personality differences in treatment-seeking suicide attempters (AT; n = 60) and a community sample of suicides (SU; n = 43) over age 50. On the basis of prior research, the authors hypothesized that SU would be lower in Neuroticism and Openness and higher in Conscientiousness. A 2-group (AT vs. SU)…

  11. Cholesteryl Ester Transfer Protein (CETP) genotype and cognitive function in persons aged 35 years or older

    NARCIS (Netherlands)

    Izaks, Gerbrand J.; van der Knaap, Aafke M.; Gansevoort, Ron T.; Navis, Gerjan; Slaets, Joris P. J.; Dullaart, Robin P. F.

    2012-01-01

    Common polymorphisms of the Cholestryl Ester Transfer Protein (CETP) gene may predict lower risk of cognitive decline. We investigated the association of cognitive function with CETP genotype in a population-based cohort of 4135 persons aged 35-82 years. Cognitive function was measured with the Ruff

  12. Well-being and control in older persons: the prediction of well-being from control measures.

    Science.gov (United States)

    Smits, C H; Deeg, D J; Bosscher, R J

    1995-01-01

    The interrelation of six facets of control and their ability to predict well-being in older persons were studied in an age and gender stratified community sample aged fifty-five to eighty-nine. An extended conceptual framework of control facets is introduced including "established" facets, such as mastery, self-efficacy and internal health locus of control and "new" control facets such as neuroticism, social inadequacy, and sense of coherence. An interview and a postal questionnaire included measures of the control facets and the Affect Balance Scale. Correlations between control measures were mostly modest. Negative affect was predicted by neuroticism and sense of coherence. Tendencies of independent association of mastery with global well-being and of social inadequacy with positive affect were established.

  13. Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

    Directory of Open Access Journals (Sweden)

    Shuk Kwan Tang

    2014-01-01

    Full Text Available To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males were in the intervention group and 38 participants (30 females, 8 males were in the control group. The pain scores were 4.75 (SD 2.32 on a 10-point scale for the intervention group and 5.24 (SD 2.14 for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18, 9.64 (SD 7.05, and 12.91 (SD 7.70, respectively. A significant reduction in negative emotions was found in the intervention group (P<0.05. The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

  14. Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons?

    Science.gov (United States)

    Tang, Shuk Kwan; Tse, M Y Mimi

    2014-01-01

    To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (Paromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

  15. STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2012-02-03

    Introduction: STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) is a new, systems-defined medicine review tool. We compared the performance of STOPP to that of established Beers\\' criteria in detecting potentially inappropriate medicines (PIMs) and related adverse drug events (ADEs) in older patients presenting for hospital admission. METHODS: we prospectively studied 715 consecutive acute admissions to a university teaching hospital. Diagnoses, reason for admission and concurrent medications were recorded. STOPP and Beers\\' criteria were applied. PIMs with clear causal connection or contribution to the principal reason for admission were determined. RESULTS: median patient age (interquartile range) was 77 (72-82) years. Median number of prescription medicines was 6 (range 0-21). STOPP identified 336 PIMs affecting 247 patients (35%), of whom one-third (n = 82) presented with an associated ADE. Beers\\' criteria identified 226 PIMs affecting 177 patients (25%), of whom 43 presented with an associated ADE. STOPP-related PIMs contributed to 11.5% of all admissions. Beers\\' criteria-related PIMs contributed to significantly fewer admissions (6%). CONCLUSION: STOPP criteria identified a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events than Beers\\' criteria. This finding has significant implications for hospital geriatric practice.

  16. The effect of music relaxation versus progressive muscular relaxation on insomnia in older people and their relationship to personality traits.

    Science.gov (United States)

    Ziv, Naomi; Rotem, Tomer; Arnon, Zahi; Haimov, Iris

    2008-01-01

    A large percentage of older people suffer from chronic insomnia, affecting many aspects of life quality and well-being. Although insomnia is most often treated with medication, a growing number of studies demonstrate the efficiency of various relaxation techniques. The present study had three aims: first, to compare two relaxation techniques--music relaxation and progressive muscular relaxation--on various objective and subjective measures of sleep quality; second, to examine the effect of these techniques on anxiety and depression; and finally, to explore possible relationships between the efficiency of both techniques and personality variables. Fifteen older adults took part in the study. Following one week of base-line measurements of sleep quality, participants followed one week of music relaxation and one week of progressive muscular relaxation before going to sleep. Order of relaxation techniques was controlled. Results show music relaxation was more efficient in improving sleep. Sleep efficiency was higher after music relaxation than after progressive muscular relaxation. Moreover, anxiety was lower after music relaxation. Progressive muscular relaxation was related to deterioration of sleep quality on subjective measures. Beyond differences between the relaxation techniques, extraverts seemed to benefit more from both music and progressive muscular relaxation. The advantage of non-pharmacological means to treat insomnia, and the importance of taking individual differences into account are discussed.

  17. Modernization, Aging and Coresidence of Older Persons: the Sri Lankan Experience

    Directory of Open Access Journals (Sweden)

    Amarasiri de Silva

    2014-12-01

    Full Text Available This paper examines the effects of the modernization on the living arrangements of elderly people in six selected communities representing urban, semi-urban, estate, rural, colonized settlement and fishing villages in Sri Lanka. The paper concludes that the modernization of the economy and society has exacerbated an intergenerational rift leading to an intensification of tensions between elderly people and other family members, despite the fact that the percentage of older people living with their children remains high. Such coresidence or intergenerational living comprises many types of living arrangements, and leads to mixed results for care of the elderly. Many elderly people have developed mechanisms to counteract the negative effects of coresidence: seeking independence during old age, by earning their own income and living alone or living with the spouse, indulging in behaviors such as drinking, spending time outside the home with friends of similar age, or creating their own living space within coresidence.

  18. Eye movement desensitization and reprocessing therapy for personality disorders in older adults?

    Science.gov (United States)

    Gielkens, E M J; Sobczak, S; Van Alphen, S P J

    2016-10-01

    Eye Movement Desensitization and Reprocessing (EMDR) is a kind of psychotherapy, which is growing in popularity, particularly for treatment of post-traumatic stress disorder (PTSD). When Shapiro first introduced EMDR in 1989, it was approached as a controversial treatment because of lack of evidence. However, nowadays there is growing evidence for EMDR efficacy in PTSD (Mc Guire et al., 2014) and EMDR is recommended by international and national treatment guidelines for PTSD. Moreover, EMDR is also used for the treatment of other anxiety disorders, such as panic disorders (De Jongh et al., 2002). Furthermore, research continues on effects of EMDR in addiction, somatoform disorders and psychosis. So far, there is no empirical research on the efficacy of EMDR treatment in older adults.

  19. Diagnosis and Management of Oropharyngeal Dysphagia Among Older Persons, State of the Art.

    Science.gov (United States)

    Ortega, Omar; Martín, Alberto; Clavé, Pere

    2017-07-01

    Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce. The etiology of OD in this population includes many concomitant risk factors with neurogenic and neurodegenerative processes, muscular weakness, and sarcopenia. The pathophysiology includes mechanical deficits in the swallow response (mainly delayed laryngeal vestibule closure time and weak tongue thrust), reduced pharyngeal sensitivity, and sensory/motor central nervous system impairments. Recently, OD has been recognized as a geriatric syndrome due to its high prevalence and its relationship with many comorbidities and their poor outcomes, including malnutrition, respiratory infections and aspiration pneumonia, functional disability and frailty, institutionalization and increased readmissions, and mortality. There is an evidence-based and effective treatment for OD in the elderly mainly oriented to compensating swallow impairments through adaptation of fluid viscosity and solid food textures to avoid aspiration and choking, and improving nutritional status and oral health to avoid respiratory infections. This has been defined as the minimal effective treatment to be provided to this population. New treatments aiming at recovering the swallowing function are under research with promising results, and the near future will provide us with methods to stimulate the swallow response with pharmacological or physical stimuli. Copyright © 2017 AMDA – The Society

  20. Temporal Discounting Is Associated with an Increased Risk of Mortality among Community-Based Older Persons without Dementia.

    Directory of Open Access Journals (Sweden)

    Patricia A Boyle

    Full Text Available Temporal discounting is an important determinant of many health and financial outcomes, but we are not aware of studies that have examined the association of temporal discounting with mortality.Participants were 406 older persons without dementia from the Rush Memory and Aging Project, a longitudinal cohort study of aging. Temporal discounting was measured using standard preference elicitation questions. Individual discount rates were estimated using a well-established hyperbolic function and used to predict the risk of mortality during up to 5 years of follow-up.The mean estimate of discounting was 0.45 (SD = 0.33, range: 0.08-0.90, with higher scores indicating a greater propensity to prefer smaller immediate rewards over larger but delayed ones. During up to 5 years of follow-up (mean = 3.6 years, 62 (15% of 406 persons died. In a proportional hazards model adjusted for age, sex, and education, temporal discounting was associated with an increased risk of mortality (HR = 1.103, 95% CI 1.024, 1.190, p = 0.010. Thus, a person with the highest discount rate (score = 0.90 was about twice more likely to die over the study period compared to a person with the lowest discount rate (score = 0.08. Further, the association of discounting with mortality persisted after adjustment for the level of global cognitive function, the burden of vascular risk factors and diseases, and an indicator of psychological well being (i.e., purpose in life.Temporal discounting is associated with an increased risk of mortality in old age after accounting for global cognitive function and indicators of physical and mental health.

  1. Shorter telomeres in peripheral blood mononuclear cells from older persons with sarcopenia: results from an exploratory study

    Directory of Open Access Journals (Sweden)

    Emanuele eMarzetti

    2014-08-01

    Full Text Available Background. Telomere shortening in peripheral blood mononuclear cells (PBMCs has been associated with biological age and several chronic degenerative diseases. However, the relationship between telomere length and sarcopenia, a hallmark of the aging process, is unknown. The aim of the present study was therefore to determine whether PBMC telomeres obtained from sarcopenic older persons were shorter relative to non-sarcopenic peers. We further explored if PBMC telomere length was associated with frailty, a major clinical correlate of sarcopenia.Methods. Analyses were conducted in 142 persons aged >/= 65 years referred to a geriatric outpatient clinic (University Hospital. The presence of sarcopenia was established according to the European Working Group on Sarcopenia in Older People criteria, with bioelectrical impedance analysis used for muscle mass estimation. The frailty status was determined by both the Fried’s criteria (physical frailty, PF and a modified Rockwood’s frailty index (FI. Telomere length was measured in PBMCs by quantitative real-time polymerase chain reaction according to the Telomere/Single copy gene ratio (T/S method.Results. Among 142 outpatients (mean age 75.0 ± 6.5 years, 59.2% women, sarcopenia was diagnosed in 23 individuals (19.3%. The PF phenotype was detected in 74 participants (52.1%. The average FI score was 0.46 ± 0.17. PBMC telomeres were shorter in sarcopenic subjects (T/S = 0.21; 95% CI: 0.18 – 0.24 relative to non-sarcopenic individuals (T/S = 0.26; 95%: CI: 0.24 – 0.28; p = 0.01, independent of age, gender, smoking habit, or comorbidity. No significant associations were determined between telomere length and either PF or FI.Conclusion. PBMC telomere length, expressed as T/S values, is shorter in older outpatients with sarcopenia. The cross-sectional assessment of PBMC telomere length is not sufficient at capturing the complex, multidimensional syndrome of frailty.

  2. Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic.

    Science.gov (United States)

    Vance, David E; Brennan, Mark; Enah, Comfort; Smith, Glenda L; Kaur, Jaspreet

    2011-01-01

    By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.

  3. Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic

    Directory of Open Access Journals (Sweden)

    Vance D

    2011-05-01

    Full Text Available David E Vance1, Mark Brennan2, Comfort Enah1, Glenda L Smith1, Jaspreet Kaur31School of Nursing, University of Alabama at Birmingham (UAB, Birmingham, AL, USA; 2New York University College of Nursing, AIDS Community Research Initiative of America, New York, NY, USA; 3Department of Psychology and Edward R. Roybal Center for Translational Research in Aging and Mobility, University of Alabama at Birmingham (UAB, Birmingham, AL, USAAbstract: By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.Keywords: HIV, aging, spirituality, religion, stigma, coping, successful aging

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

    Directory of Open Access Journals (Sweden)

    Anne Roberts

    2015-09-01

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

  5. Agreement between PRE2DUP register data modeling method and comprehensive drug use interview among older persons

    Directory of Open Access Journals (Sweden)

    Taipale H

    2016-10-01

    Full Text Available Heidi Taipale,1–4,* Antti Tanskanen,3–5,* Marjaana Koponen,1,2 Anna-Maija Tolppanen,2,6 Jari Tiihonen,3,4 Sirpa Hartikainen1,2,7 1Kuopio Research Centre of Geriatric Care, University of Eastern Finland, 2School of Pharmacy, University of Eastern Finland, Kuopio, Finland; 3Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; 4Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, 5National Institute for Health and Welfare, Helsinki, 6Research Centre for Comparative Effectiveness and Patient Safety (RECEPS, University of Eastern Finland, 7Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland *These authors contributed equally to this work. Background: PRE2DUP is a modeling method that generates drug use periods (ie, when drug use started and ended from drug purchases recorded in dispensing-based register data. It is based on the evaluation of personal drug purchasing patterns and considers hospital stays, possible stockpiling of drugs, and package information. Objective: The objective of this study was to investigate person-level agreement between self-reported drug use in the interview and drug use modeled from dispensing data with PRE2DUP method for various drug classes used by older persons. Methods: Self-reported drug use was assessed from the GeMS Study including a random sample of persons aged ≥75 years from the city of Kuopio, Finland, in 2006. Drug purchases recorded in the Prescription register data of these persons were modeled to determine drug use periods with PRE2DUP modeling method. Agreement between self-reported drug use on the interview date and drug use calculated from register-based data was compared in order to find the frequently used drugs and drug classes, which was evaluated by Cohen’s kappa. Kappa values 0.61–0.80 were considered to represent good and 0.81–1.00 as very good agreement.Results: Among 569 participants with mean age

  6. Epidemiology of hip and knee pain in a community based sample of Italian persons aged 65 and older1

    Science.gov (United States)

    Cecchi, F.; Mannoni, A.; Molino-Lova, R.; Ceppatelli, S.; Benvenuti, E.; Bandinelli, S.; Lauretani, F.; Macchi, C.; Ferrucci, L.

    2016-01-01

    Summary Objective To describe prevalence, characteristics and correlates of hip pain (HP) and knee pain (KP) in an Italian community based cohort aged 65 and older (65+). Method Baseline survey (1998–2000), population-based study in the Chianti area (Tuscany, Italy); 1299 persons aged 65+ were selected from the city registry of Greve in Chianti and Bagno a Ripoli (multistage sampling method); 1006 participants (564 women and 442 men, age 75.2 ± 7.1) provided information for this analysis. Persons reporting HP/KP in the past 4 weeks were recorded and their Western Ontario and McMaster University Osteoarthritis Index pain score (WPS-range 0–20) calculated. Potential correlates of HP/KP, including clinical, lifestyle and psycho-social features and physical measures, were tested in age- and gender-adjusted regression analyses and then entered a multivariate regression model. Results HP was reported by 11.9% participants, while 22.4% reported KP and 7.2% both conditions. Climbing/descending stairs and walking were the activities eliciting more severe pain in either condition. Average WPSs were 5.6 ± 3.5 for HP and 5.4 ± 10.4 for KP. Both HP and KP were related to back pain, reduced hip abduction, reduced muscle power and increased trunk flexibility. HP was also related to KP and poor self-rated health (SRH), while KP to HP, foot pain, high body mass index, reduced knee passive flexion and knee extension torque, low education. Conclusion In a community sample of an Italian persons aged 65+, the prevalence of KP almost doubled that of HP. While both conditions were related to pain in other joints and specific joint impairment, only HP was related to poor SRH, and only KP to mechanical overload. PMID:18343164

  7. Trends in Fall-Related Traumatic Brain Injury among Older Persons in Connecticut from 2000–2007

    Science.gov (United States)

    Murphy, Terrence E; Baker, Dorothy I; Leo-Summers, Linda S; Tinetti, Mary E

    2014-01-01

    Background Anecdotal evidence suggests a rising trend in the occurrence of fall-related traumatic brain injuries (FR-TBI) among persons ≥ 70 years. To document this apparent trend on a more substantive basis, this report longitudinally describes overall and age-stratified rates of three outcomes attributed to FR-TBI among persons ≥ 70 years: emergency department visits (ED), hospitalizations, and terminal hospitalizations. Methods Eight years (2000–2007) of observational data from emergency departments and acute care hospitals serving a non-randomly selected, densely populated region in southern Connecticut, U.S. Results From 2000–2007 among persons 70 years and older, overall rates of FR-TBI visits to emergency departments more than doubled while corresponding rates of hospitalization and terminal hospitalization rose 58% each. The point estimate of growth in the rate of ED in the oldest stratum was nearly triple that of the younger stratum whereas point estimates of growth in rates of hospitalization and terminal hospitalization were nearly four times higher. Total Medicare costs for ED visits increased nearly four-fold while corresponding costs for hospitalizations and terminal hospitalizations rose by 64% and 76%. The most common discharge diagnoses for ED and hospitalization were unspecified head injury and intracranial hemorrhage. Conclusions The rapid rise in rates of FR-TBI and associated Medicare costs underscore the urgent need to prevent this burgeoning source of human suffering and health care utilization. We believe the rise in rates is at least partially due to a greater public awareness of the outcome that has been facilitated by increasing use of diagnostic imaging in the ED and hospital. PMID:25558438

  8. Trends in Fall-Related Traumatic Brain Injury among Older Persons in Connecticut from 2000-2007.

    Science.gov (United States)

    Murphy, Terrence E; Baker, Dorothy I; Leo-Summers, Linda S; Tinetti, Mary E

    2014-01-01

    Anecdotal evidence suggests a rising trend in the occurrence of fall-related traumatic brain injuries (FR-TBI) among persons ≥ 70 years. To document this apparent trend on a more substantive basis, this report longitudinally describes overall and age-stratified rates of three outcomes attributed to FR-TBI among persons ≥ 70 years: emergency department visits (ED), hospitalizations, and terminal hospitalizations. Eight years (2000-2007) of observational data from emergency departments and acute care hospitals serving a non-randomly selected, densely populated region in southern Connecticut, U.S. From 2000-2007 among persons 70 years and older, overall rates of FR-TBI visits to emergency departments more than doubled while corresponding rates of hospitalization and terminal hospitalization rose 58% each. The point estimate of growth in the rate of ED in the oldest stratum was nearly triple that of the younger stratum whereas point estimates of growth in rates of hospitalization and terminal hospitalization were nearly four times higher. Total Medicare costs for ED visits increased nearly four-fold while corresponding costs for hospitalizations and terminal hospitalizations rose by 64% and 76%. The most common discharge diagnoses for ED and hospitalization were unspecified head injury and intracranial hemorrhage. The rapid rise in rates of FR-TBI and associated Medicare costs underscore the urgent need to prevent this burgeoning source of human suffering and health care utilization. We believe the rise in rates is at least partially due to a greater public awareness of the outcome that has been facilitated by increasing use of diagnostic imaging in the ED and hospital.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  10. Transformative Narrative Therapy: How Transforming a Personal Life Story into Fairy-Tale Format Impacts Measures of Health and Well-Being in Older Adults

    Science.gov (United States)

    Oumarou, Sahibou

    2013-01-01

    Recalling and reframing a personal life story in the form of a fairy tale, then engaging in a practice on meditation and reflecting on it, is one way older adults can relieve their positive experience and thereby impact their mental and emotional health and well-being. Although prior research has established the benefits of narrative therapy (NT)…

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  12. Performance-based and self-reported physical functioning in low-functioning older persons: Congruence of change and the impact of depressive symptoms

    NARCIS (Netherlands)

    Kempen, G.I J M; Sullivan, M.; van Sonderen, E.; Ormel, J.

    1999-01-01

    This prospective cohort study examines the impact of depressive symptoms on changes in self-reported physical functioning in 574 low-functioning older persons. The data were collected in two waves in 1993 and 1995. initial levels of depressive symptoms were not predictive for subsequent change in se

  13. Performance-based and self-reported physical functioning in low-functioning older persons : Congruence of change and the impact of depressive symptoms

    NARCIS (Netherlands)

    Kempen, GIJM; Sullivan, M; van Sonderen, E; Ormel, J

    1999-01-01

    This prospective cohort study examines the impact of depressive symptoms on changes in self-reported physical functioning in 574 low-functioning older persons. The data were collected in two waves in 1993 and 1995. initial levels of depressive symptoms were not predictive for subsequent change in se

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

    NARCIS (Netherlands)

    Hoogendam, Y.Y.; Van der Lijn, F.; Vernooij, M.W.; Hofman, A.; Niessen, W.J.; Van der Lugt, A.; Arfan Ikram, M.; Van der Geest, J.N.

    2014-01-01

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

  15. Establishing a composite endpoint for measuring the effectiveness of geriatric interventions based on older persons' and informal caregivers' preference weights : a vignette study

    NARCIS (Netherlands)

    Hofman, Cynthia S.; Makai, Peter; Boter, Han; Buurman, Bianca M.; de Craen, Anton J. M.; Rikkert, Marcel G. M. Olde; Donders, Rogier A. R. T.; Melis, Rene J. F.

    2014-01-01

    Background: The Older Persons and Informal Caregivers Survey Minimal Dataset's (TOPICS-MDS) questionnaire which measures relevant outcomes for elderly people was successfully incorporated into over 60 research projects of the Dutch National Care for the Elderly Programme. A composite endpoint (CEP)

  16. Older persons' expressions of emotional cues and concerns during home care visits. Application of the Verona coding definitions of emotional sequences (VR-CoDES) in home care.

    Science.gov (United States)

    Sundler, Annelie J; Höglander, Jessica; Eklund, Jakob Håkansson; Eide, Hilde; Holmström, Inger K

    2017-02-01

    This study aims to a) explore to what extent older persons express emotional cues and concerns during home care visits; b) describe what cues and concerns these older persons expressed, and c) explore who initiated these cues and concerns. A descriptive and cross-sectional study was conducted. Data consisted of 188 audio recorded home care visits with older persons and registered nurses or nurse assistants, coded with the Verona coding definitions on emotional sequences (VR-CoDES). Emotional expressions of cues and concerns occurred in 95 (51%) of the 188 recorded home care visits. Most frequent were implicit expressions of cues (n=292) rather than explicit concerns (n=24). Utterances with hints to hidden concerns (63,9%, n=202) were most prevalent, followed by vague or unspecific expressions of emotional worries (15,8%, n=50). Most of these were elicited by the nursing staff (63%, n=200). Emotional needs expressed by the older persons receiving home care were mainly communicated implicitly. To be attentive to such vaguely expressed emotions may demand nursing staff to be sensitive and open. The VR-CoDES can be applied on audio recorded home care visits to analyse verbal and emotional communication, and may allow comparative research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Determinants of the Overall Quality of Life of Older Persons Who Have Difficulty Seeing: The Importance of the Ability to Get Around

    Science.gov (United States)

    La Grow, Steven; Yeung, Polly; Towers, Andrew; Alpass, Fiona; Stephens, Christine

    2011-01-01

    A model of vision rehabilitation that assumes that functional ability will affect the emotional and psychosocial adjustment of older persons with visual impairments, and ultimately their quality of life, was assessed using structured equation modeling. The proposed model was upheld. In addition, the ability to get around was found to contribute to…

  18. How Older Adults Use Virtual Personal Learning Networks to Support Informal, Self-Directed Lifelong Learning Goals: A Research Program Description

    Science.gov (United States)

    Morrison, Dirk

    2015-01-01

    This short paper will describe the details of a SSHRC/IDG-funded research program currently underway (2015-2016) that will investigate how older adults (65+) use Web 2.0 tools and Internet-based resources to establish and expand their virtual personal learning networks (PLNs) for the purposes of enriching their expertise and knowledge within the…

  19. Maximizing clinical research participation in vulnerable older persons: identification of barriers and motivators.

    Science.gov (United States)

    Marcantonio, Edward R; Aneja, Jasneet; Jones, Richard N; Alsop, David C; Fong, Tamara G; Crosby, Gregory J; Culley, Deborah J; Cupples, L Adrienne; Inouye, Sharon K

    2008-08-01

    To identify barriers and motivators to participation in long-term clinical research by high-risk elderly people and to develop procedures to maximize recruitment and retention. Quantitative and qualitative survey. Academic primary care medicine and pre-anesthesia testing clinics. Fifty patients aged 70 and older, including 25 medical patients at high risk of hospitalization and 25 patients with planned major surgery. Fifteen- to 20-minute interviews involved open- and closed-ended questions guided by an in-depth script. Two planned study protocols were presented to each participant. Both involved serial neuropsychological assessments, blood testing, and magnetic resonance brain imaging (MRI); one added lumbar puncture (LP). Participants were asked whether they would be willing to participate in these protocols, rated barriers and incentives to participation, and were probed with open-ended questions. Of 50 participants (average age 78, 44% male, 40% nonwhite), 32 (64%) expressed willingness to participate in the LP-containing protocol, with LP cited as the strongest disincentive. Thirty-eight (76%) expressed willingness to participate in the protocol without LP, with phlebotomy and long interviews cited as the strongest disincentives. Altruism was a strong motivator for participation, whereas transportation was a major barrier. Study visits at home, flexible appointment times, assessments shorter than 75 minutes, and providing transportation and free parking were strategies developed to maximize study participation. Vulnerable elderly people expressed a high rate of willingness to participate in an 18-month prospective study. Participants identified incentives and barriers that enabled investigators to develop procedures to maximize recruitment and retention.

  20. Associations between human rights environments and healthy longevity: the case of older persons in China.

    Science.gov (United States)

    Brown, Bethany L; Qiu, Li; Gu, Danan

    2012-12-15

    Individual health can deteriorate through neglect or violation of human rights or can improve through favorable health policies and programs on human rights. Yet quantitative associations between human rights and health are insufficiently studied. Based on a nationwide dataset of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with more than 18,800 adults aged 65 and older in mainland China interviewed in 2002 and 2005 and their follow-ups three years later, we examine how an individual's longevity and health are associated with some domains of human rights. We use three individual-level variables in early life stages (whether a respondent went to bed hungry, accessed adequate medical services, and years of schooling), three individual-level variables at present (whether a respondent has adequate housing; whether a respondent has adequate economic resources to support his/her daily subsistence, and whether a respondent gets adequate medical services when in need), and one community-level variable (air quality) as proxies to measure several fundamental domains of human rights in terms of access to adequate food/nutrition, housing/shelter, education, social security, health care, and clean-air environments. An indicator of healthy survival is introduced to measure survivors at sequent follow-ups with a good health condition. Our results demonstrate that better conditions of proxy measures of human rights at different life stages, especially at present, are associated with a higher likelihood of healthy survival after taking various confounding variables into consideration, suggesting the possibility of a significant linkage between good environments in human rights and healthy longevity. These findings may have important implications for promoting better environments in human rights, especially in the context of population aging.

  1. The PRO-AGE study: an international randomised controlled study of health risk appraisal for older persons based in general practice

    Directory of Open Access Journals (Sweden)

    Bachmann Martin D

    2007-01-01

    Full Text Available Abstract Background This paper describes the study protocol, the recruitment, and base-line data for evaluating the success of randomisation of the PRO-AGE (PRevention in Older people – Assessment in GEneralists' practices project. Methods/Design A group of general practitioners (GPs in London (U.K., Hamburg (Germany and Solothurn (Switzerland were trained in risk identification, health promotion, and prevention in older people. Their non-disabled older patients were invited to participate in a randomised controlled study. Participants allocated to the intervention group were offered the Health Risk Appraisal for Older Persons (HRA-O instrument with a site-specific method for reinforcement (London: physician reminders in electronic medical record; Hamburg: one group session or two preventive home visits; Solothurn: six-monthly preventive home visits over a two-year period. Participants allocated to the control group received usual care. At each site, an additional group of GPs did not receive the training, and their eligible patients were invited to participate in a concurrent comparison group. Primary outcomes are self-reported health behaviour and preventative care use at one-year follow-up. In Solothurn, an additional follow-up was conducted at two years. The number of older persons agreeing to participate (% of eligible persons in the randomised controlled study was 2503 (66.0% in London, 2580 (53.6% in Hamburg, and 2284 (67.5% in Solothurn. Base-line findings confirm that randomisation of participants was successful, with comparable characteristics between intervention and control groups. The number of persons (% of eligible enrolled in the concurrent comparison group was 636 (48.8% in London, 746 (35.7% in Hamburg, and 1171 (63.0% in Solothurn. Discussion PRO-AGE is the first large-scale randomised controlled trial of health risk appraisal for older people in Europe. Its results will inform about the effects of implementing HRA-O with

  2. Tracking down a solution: exploring the acceptability and value of wearable GPS devices for older persons, individuals with a disability and their support persons.

    Science.gov (United States)

    Williamson, Brittany; Aplin, Tammy; de Jonge, Desleigh; Goyne, Matthew

    2017-11-01

    To explore the acceptability and value of three wearable GPS devices for older persons and individuals with a disability and safety concerns when accessing the community. This pilot study explored six wearers' and their support persons' experience of using three different wearable GPS devices (a pendant, watch, and mini GPS phone), each for a two-week period. Participants identified safety as the main value of using a wearable GPS device. The acceptability and value of these devices was strongly influenced by device features, ease of use, cost, appearance, the reliability of the GPS coordinates, the wearer's health condition and the users familiarity with technology. Overall, participants indicated that they preferred the pendant. Wearable GPS devices are potentially useful in providing individuals who have safety concerns with reassurance and access to assistance as required. To ensure successful utilization, future device design and device selection should consider the user's familiarity with technology and their health condition. This study also revealed that not all wearable GPS devices provide continuous location tracking. It is therefore critical to ensure that the device's location tracking functions address the wearer's requirements and reason for using the device. Implications for Rehabilitation The acceptability and usability of wearable GPS devices is strongly influenced by the device features, ease of use, cost, appearance, the reliability of the device to provide accurate and timely GPS coordinates, as well as the health condition of the wearer and their familiarity with technology. Wearable GPS devices need to be simple to use and support and training is essential to ensure they are successfully utilized. Not all wearable GPS devices provide continuous location tracking and accuracy of location is impacted by line of sight to satellites. Therefore, care needs to be taken when choosing a suitable device, to ensure that the device's location tracking

  3. Multidisciplinary transmural rehabilitation for older persons with a stroke: the design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Vluggen Tom PMM

    2012-12-01

    Full Text Available Abstract Background Stroke is one of the major causes of loss of independence, decreased quality of life and mortality among elderly people. About half of the elderly stroke patients discharged after rehabilitation in a nursing home still experience serious impairments in daily functioning one year post stroke, which can lead to difficulties in picking up and managing their social life. The aim of this study is to evaluate the effectiveness and feasibility of a new multidisciplinary transmural rehabilitation programme for older stroke patients. Methods A two group multicentre randomised controlled trial is used to evaluate the effects of the rehabilitation programme. The programme consists of three care modules: 1 neurorehabilitation treatment for elderly stroke patients; 2 empowerment training for patient and informal caregiver; and 3 stroke education for patient and informal caregiver. The total programme has a duration of between two and six months, depending on the individual problems of the patient and informal caregiver. The control group receives usual care in the nursing home and after discharge. Patients aged 65 years and over are eligible for study participation when they are admitted to a geriatric rehabilitation unit in a nursing home due to a recent stroke and are expected to be able to return to their original home environment after discharge. Data are gathered by face-to-face interviews, self-administered questionnaires, focus groups and registration forms. Primary outcomes for patients are activity level after stroke, functional dependence, perceived quality of life and social participation. Outcomes for informal caregivers are perceived care burden, objective care burden, quality of life and perceived health. Outcome measures of the process evaluation are implementation fidelity, programme deliverance and the opinion of the stroke professionals, patients and informal caregivers about the programme. Outcome measures of the

  4. Development and validation of the FRAGIRE tool for assessment an older person's risk for frailty.

    Science.gov (United States)

    Vernerey, Dewi; Anota, Amelie; Vandel, Pierre; Paget-Bailly, Sophie; Dion, Michele; Bailly, Vanessa; Bonin, Marie; Pozet, Astrid; Foubert, Audrey; Benetkiewicz, Magdalena; Mankoundia, Patrick; Bonnetain, Franck

    2016-11-17

    Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE) that accurately predicts the risk for frailty in older adults. A prospective multicenter recruitment of the elderly patients was undertaken in France. The subjects were classified into financially-helped group (FH, with financial assistance) and non-financially helped group (NFH, without any financial assistance), considering FH subjects are more frail than the NFH group and thus representing an acceptable surrogate population for frailty. Psychometric properties of the FRAGIRE grid were assessed including discrimination between the FH and NFH groups. Items reduction was made according to statistical analyses and experts' point of view. The association between items response and tests with "help requested status" was assessed in univariate and multivariate unconditional logistic regression analyses and a prognostic score to become frail was finally proposed for each subject. Between May 2013 and July 2013, 385 subjects were included: 338 (88%) in the FH group and 47 (12%) in the NFH group. The initial FRAGIRE grid included 65 items. After conducting the item selection, the final grid of the FRAGIRE was reduced to 19 items. The final grid showed fair discrimination ability to predict frailty (area under the curve (AUC) = 0.85) and good calibration (Hosmer-Lemeshow P-value = 0.580), reflecting a good agreement between the prediction by the final model and actual observation. The Cronbach's alpha for the developed tool scored as high as 0.69 (95% Confidence Interval: 0.64 to 0.74). The final prognostic score was excellent, with an AUC of 0

  5. Older depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis.

    Science.gov (United States)

    Izquierdo, Adriana; Sarkisian, Catherine; Ryan, Gery; Wells, Kenneth B; Miranda, Jeanne

    2014-01-01

    To describe salient experiences with a primary care visit (eg, the context leading up to the visit, the experience and/or outcomes of that visit) for emotional, personal and/or mental health problems older Latinos with a history of depression and recent depressive symptoms and/or antidepressant medication use reported 10 years after enrollment into a randomized controlled trial of quality-improvement for depression in primary care. Secondary analysis of existing qualitative data from the second stage of the continuation study of Partners in Care (PIC). Latino ethnicity, aged > or =50 years, recent depressive symptoms and/or antidepressant medication use, and a recent primary care visit for mental health problems. Of 280 second-stage participants, 47 were eligible. Both stages of the continuation study included participants from the PIC parent study control and 2 intervention groups, and all had a history of depression. Data analyzed by a multidisciplinary team using grounded theory methodology. Five themes were identified: beliefs about the nature of depression; prior experiences with mental health disorders/treatments; sociocultural context (eg, social relationships, caregiving, the media); clinic-related features (eg, accessibility of providers, staff continuity, amount of visit time); and provider attributes (eg, interpersonal skills, holistic care approach). Findings emphasize the importance of key features for shaping the context leading up to primary care visits for help-seeking for mental health problems, and the experience and/or outcomes of those visits, among older depressed Latinos at long-term follow-up, and may help tailor chronic depression care for the clinical management of this vulnerable population.

  6. Outcomes of older persons receiving rehabilitation for medical and surgical conditions compared with hip fracture and stroke.

    Science.gov (United States)

    Johnson, M F; Kramer, A M; Lin, M K; Kowalsky, J C; Steiner, J F

    2000-11-01

    Older persons with general medical and surgical conditions increasingly receive posthospital rehabilitation care in nursing homes and rehabilitation hospitals. This study describes the characteristics of such patients, contrasted with patients with traditional rehabilitation diagnoses of hip fracture and stroke. Prospective cohort study. Seventeen skilled nursing facilities and six rehabilitation hospitals in seven states. Medicare patients age 65 or older receiving posthospital rehabilitation. A total of 290 medical/surgical patients were compared with 336 hip fracture and 429 stroke patients. Data were collected prospectively from charts, nursing assessments, and patient interviews. Patient characteristics associated with functional recovery and mortality were estimated using multivariate regression. Medical/surgical patients had greater premorbid activities of daily living (ADL) (P < .001) and instrumental activities of daily living (IADL) (P < .01) disability, but suffered less decline with the acute event than hip fracture or stroke patients (P < .001). Medical/surgical patients were more likely to recover premorbid ADL function (P < .05) but 1-year mortality was significantly greater (30% vs. 14% hip fracture; 18% stroke; P < .001). Predictors of functional recovery and mortality differed between the three groups. Among medical/surgical patients, premorbid ADL difficulty, cognitive impairment, a pressure ulcer at rehabilitation admission, and depression were associated with failure to recover premorbid function whereas increasing comorbidity and incontinence were associated with mortality. Medical/surgical patients represent a unique rehabilitation population. They experienced greater premorbid functional disability, less acute decline, but greater mortality than patients with traditional rehabilitation diagnoses. Further study of this distinct rehabilitation population may help identify patients most likely to benefit from rehabilitation.

  7. Multiple diabetic complications, as well as impaired physical and mental function, are associated with declining balance function in older persons with diabetes mellitus

    Science.gov (United States)

    Hong, Xiufang; Chen, Xujiao; Chu, Jiaojiao; Shen, Shanshan; Chai, Qichen; Lou, Gaobo; Chen, Lingyan

    2017-01-01

    Objective To investigate whether there is a difference in balance function between older persons with and without diabetes mellitus (DM), and to identify whether mediating factors, such as diabetic complications, Instrumental Activities of Daily Living (IADL) score, Mini-Mental State Examination (MMSE) score, as well as hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), serum total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL), are associated with balance function in older persons with DM. Methods In this cross-sectional study, a total of 208 older persons were divided into a DM group (n=80) and a control group who did not have DM (n=128). Balance function was evaluated with the Tinetti performance-oriented mobility assessment (POMA), which includes balance and gait subscales. Activities of daily living (ADL), IADL, and the MMSE were also measured. Fall incidents in last 12 months, the use of walking aids, fear of falling, comorbidities, and polypharmacy were recorded. Diabetic complications were recorded, and HbA1c, FPG, TC, TG, and LDL were measured in the patients of the DM group. Results Fall incidents in last 12 months were higher in the DM group than in the control group (PIADL scores were lower in the diabetic group than the control group (PIADL score (OR, 16.286; 95% CI, 4.793–55.333; PIADL score (OR, 10.288; 95% CI, 2.410–43.915; PIADL scores were associated with declining balance function in the older persons with DM. These findings can alert physicians to detect and intervene earlier on declining balance in older persons with DM. PMID:28182146

  8. Influence of the Flo-Dynamics Movement System© intervention on measures of performance in older persons

    Directory of Open Access Journals (Sweden)

    Carlson LA

    2013-07-01

    Full Text Available Lara A Carlson,1 Alexander J Koch,2 Michael Lawrence11University of New England, Biddeford, ME, 2Lenoir-Rhyne University, Hickory, NC, USABackground: Fall-related injuries associated with aging are a serious clinical and economic problem. The Flo-Dynamics Movement System© (FDMS, which consists of eight movements with a water-filled device, may be a useful low-impact exercise suited for older persons. This study investigated the effects of the FDMS regimen with the Wun-Jo™ trainer on measures of strength, flexibility, and balance in older individuals.Methods: In a quasi-experimental study, 15 healthy subjects aged 61–79 years participated in an FDMS exercise program with the Wun-Jo trainer, consisting of three weekly 30-minute sessions. The following measures were assessed pretraining and after 8 weeks of training: knee flexor and extensor isokinetic strength; grip strength; the Short Physical Performance Battery; functional reach; and low back and hamstring flexibility. Data were analyzed using repeated measures analysis of variance, with statistical significance set at the P ≤ 0.05 confidence level.Results: Sit and reach test scores significantly increased (+21% from baseline to week 8 (P < 0.001. Forward-left functional reach testing significantly increased (P = 0.012, while forward-right functional reach testing did not change (P = 0.474. Both left-lateral (P = 0.012 and right-lateral (P = 0.036 functional reach scores improved. Grip strength increased in both the left (+11.9% and right (+14.5% hands (P < 0.001 for each. Isokinetic knee extension at 60° per second increased for the left (+15.6% and right (+17.6% significantly (P = 0.001 for each. Isokinetic knee flexion at 60° per second significantly increased for both the left (+43.2%, P = 0.010 and right (+41.7%, P < 0.001. Time to complete the ten-repetition chair stand decreased significantly (-31%, P = 0.004. The 8-feet walk time also significantly decreased (-21.6%, P < 0

  9. Living with dementia: communicating with an older person and her family.

    Science.gov (United States)

    Long, A; Slevin, E

    1999-01-01

    This article is designed to explore and examine the key components of communication that emerged during the interactional analysis of a role play that took place in the classroom. The 'actors' were nurses who perceived the interaction to reflect an everyday encounter in a hospital ward. Permission to tape the interaction was sought and given by all persons involved. The principal 'players' in the scenario were: the patient, a 70-year-old-woman who had been admitted with dementia, her son and daughter, and the nurse in charge of the ward. The fundamental dynamics of the use of power and restriction, truth telling, family stress, interpersonal conflict, ageism, sexism, empathy and humanism surfaced during the analysis. The findings show that therapeutic communication should be the foundation on which nursing should stand. The article continues with an exploration of the theoretical frameworks that guided the analysis of interaction and concludes by suggesting tentatively some meaningful implications for nursing practice. It plans to furnish provocative new insights into the sometimes covert communication dynamics occurring within the nurse-patient relationship. Finally, it aims to generate discussion on this little-charted realm of human social interaction.

  10. Struggling to adapt: caring for older persons while under threat of organizational change and termination notice.

    Science.gov (United States)

    Fläckman, Birgitta; Hansebo, Görel; Kihlgren, Annica

    2009-03-01

    Organizational changes are common in elder care today. Such changes affect caregivers, who are essential to providing good quality care. The aim of the present study was to illuminate caregivers' experiences of working in elder care while under threat of organizational change and termination notice. Qualitative content analysis was used to examine interview data from 11 caregivers. Interviews were conducted at three occasions during a two-year period. The findings show a transition in their experiences from 'having a professional identity and self-confidence', to 'being a professional in a threatening situation caused by someone else' and to 'struggling to adapt to a changed working environment as a person and a professional'. The caregivers experienced a loss of pride and satisfaction. Previous literature indicates that this may have consequences for the quality of care and that employees may be at risk of negative health effects. However, the caregivers continued to struggle, doing their best to complete their duties. The study has implications for high-level decision-makers, managers and caregivers in similar work-life situations in that it deals with factors that facilitate or impede similar transitions.

  11. Self-Reported Hindering Health Complaints of Community-Dwelling Older Persons: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Sophie C E van Blijswijk

    Full Text Available Proactive care for community-dwelling older persons targeting self-reported hindering health complaints might prevent a decline in function. We investigated the spectrum of self-reported hindering complaints of community-dwelling older persons, the association with functional outcomes, and help-seeking behavior for these complaints.Within the ISCOPE trial, participants (aged ≥75 years received the ISCOPE screening questionnaire, including the open-ended question "At the moment, which health complaints limit you the most in your day-to-day life?". After coding the answers with the ICPC-1-NL, we examined the prevalence and the association between the number and type of complaints and functional outcomes (Groningen Activities Restriction Scale, quality of life measured on Cantril's Ladder, Mini-Mental State Examination, Geriatric Depression Scale-15, and De Jong Gierveld Loneliness Scale. Electronic patient registers were searched for the most reported complaints.7285 participants (median age: 81.0 years [IQR 77.8-85.3], 38.6% males reported 13,524 hindering complaints (median 1, range 0-18; 32.7% reported no complaints. Participants mostly reported problems with walking/standing (22.1%, pain (20.8% or weakness/tiredness (8.5%. These complaints were mentioned in the electronic patient registers in 28.3%, 91.3% and 55.5%, respectively. Higher numbers of hindering complaints were related to poorer scores on the number of domains with problems, Cantril's Ladder for quality of life, Groningen Activities Restriction Scale, Geriatric Depression Scale, and De Jong Gierveld Loneliness Scale. Self-reported weakness, problems with walking/standing, visual limitations, cognitive problems, dyspnea and back complaints were associated with poorer scores on the number of domains with problems, Groningen Activities Restriction Scale, MMSE or Geriatric Depression Scale.One third of the participants reported no hindering complaints. Problems with walking

  12. Effects of a 12-week, short-interval, intermittent, low-intensity, slow-jogging program on skeletal muscle, fat infiltration, and fitness in older adults: randomized controlled trial.

    Science.gov (United States)

    Ikenaga, Masahiro; Yamada, Yosuke; Kose, Yujiro; Morimura, Kazuhiro; Higaki, Yasuki; Kiyonaga, Akira; Tanaka, Hiroaki

    2017-01-01

    We developed a short-interval, low-intensity, slow-jogging (SJ) program consisting of sets of 1 min of SJ at walking speed and 1 min of walking. We aimed to examine the effects of an easily performed SJ program on skeletal muscle, fat infiltration, and fitness in older adults. A total of 81 community-dwelling, independent, older adults (70.8 ± 4.0 years) were randomly assigned to the SJ or control group. The SJ group participants were encouraged to perform 90 min of SJ at their anaerobic threshold (AT) intensity and 90 min of walking intermittently per week. Aerobic capacity at the AT and sit-to-stand (STS) scores were measured. Intracellular water (ICW) in the legs was assessed by segmental multi-frequency bioelectrical impedance analysis. Subcutaneous (SAT) and intermuscular (IMAT) adipose tissue and muscle cross-sectional area (CSA) were measured at the mid-thigh using computed tomography. A total of 75 participants (37 SJ group, 38 controls) completed the 12-week intervention. The AT and STS improved in the SJ group compared with the controls (AT 15.7 vs. 4.9 %, p increased only in the SJ group (9.7 %, p decreased only in the SJ group (p muscle mass, improved aerobic capacity, muscle function, and muscle composition in older adults.

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

    Science.gov (United States)

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

    2017-04-18

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

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

    Directory of Open Access Journals (Sweden)

    Jennifer E Lutomski

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

  15. Proposal of a service delivery integration index of home care for older persons: application in several European cities

    Directory of Open Access Journals (Sweden)

    Jean-Claude Henrard

    2006-07-01

    Full Text Available Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method: Items considered as part of both dimensions according to an expert consensus (face validity were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results: Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion: The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity.

  16. Proposal of a service delivery integration index of home care for older persons: application in several European cities

    Directory of Open Access Journals (Sweden)

    Jean-Claude Henrard

    2006-07-01

    Full Text Available Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method: Items considered as part of both dimensions according to an expert consensus (face validity were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results: Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion: The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity.

  17. Personality trait levels within older couples and between-spouse trait differences as predictors of marital satisfaction.

    Science.gov (United States)

    O'Rourke, Norm; Claxton, Amy; Chou, Pak Hei Benedito; Smith, JuliAnna Z; Hadjistavropoulos, Thomas

    2011-04-01

    In this study of 125 older couples married for an average of 34 years, multilevel models were computed to simultaneously examine intra-couple personality trait averages and between-spouse trait similarity as predictors of marital satisfaction. Our findings suggest that higher intra-couple levels of extraversion predict marital satisfaction, both husbands and wives. In addition, between-spouse similarity in openness to experience appears associated with higher levels of marital satisfaction as reported by husbands; concomitantly, between-spouse similarity in agreeableness predicts wives' marital satisfaction. With respect to openness (husbands) and agreeableness (wives), it did not matter which spouse within couples reported higher or lower trait levels. The most notable finding to emerge from this study is that neuroticism is not associated with marital satisfaction, neither husbands nor wives. This result stands in contrast to previously reported findings--the vast majority of prior research conducted with dating and newlywed couples. Conflicting results may reflect the degree to which neuroticism determines divorce within the first years of married life, adaptation to the foibles of one's spouse over time, overreliance on younger samples in marriage and family research, or some combination of these alternate explanations.

  18. [Reliability of the PRISCUS-PAQ. Questionnaire to assess physical activity of persons aged 70 years and older].

    Science.gov (United States)

    Trampisch, U; Platen, P; Burghaus, I; Moschny, A; Wilm, S; Thiem, U; Hinrichs, T

    2010-12-01

    A questionnaire (Q) to measure physical activity (PA) of persons ≥70 years for epidemiological research is lacking. The aim was to develop the PRISCUS-PAQ and test the reliability in community-dwelling people (≥70 years). Validated PA questionnaires were translated and adapted to design the PRISCUS-PAQ. Its test-retest reliability for 91 randomly selected people (36% men) aged 70-98 (76±5) years ranged from 0.47 (walking) to 0.82 (riding a bicycle). The overall activity score was 0.59 as determined by the intraclass correlation coefficient (ICC). Recording of general activities, e.g., housework (ICC=0.59), was in general less reliable than athletic activities, e.g., gymnastics (ICC=0.76). The PRISCUS-PAQ, which is a short instrument with acceptable reliability to collect the physical activity of the elderly in a telephone interview, will be used to collect data in a large cohort of older people in the German research consortium PRISCUS.

  19. Circulating Docosahexaenoic Acid Associates with Insulin-Dependent Skeletal Muscle and Whole Body Glucose Uptake in Older Women Born from Normal Weight Mothers

    Science.gov (United States)

    Badeau, Robert M.; Honka, Miikka-Juhani; Bucci, Marco; Iozzo, Patricia; Eriksson, Johan G.; Nuutila, Pirjo

    2017-01-01

    Background: Obesity among pregnant women is common, and their offspring are predisposed to obesity, insulin resistance, and diabetes. The circulating metabolites that are related to insulin resistance and are associated with this decreased tissue-specific uptake are unknown. Here, we assessed metabolite profiles in elderly women who were either female offspring from obese mothers (OOM) or offspring of lean mothers (OLM). Metabolic changes were tested for associations with metrics for insulin resistance. Methods: Thirty-seven elderly women were separated into elderly offspring from obese mothers (OOM; n = 17) and elderly offspring from lean/normal weight mothers (OLM; n = 20) groups. We measured plasma metabolites using proton nuclear magnetic resonance (1H-NMR) and insulin-dependent tissue-specific glucose uptake in skeletal muscle was assessed. Associations were made between metabolites and glucose uptake. Results: Compared to the OLM group, we found that the docosahexaenoic acid percentage of the total long-chain n-3 fatty acids (DHA/FA) was significantly lower in OOM (p = 0.015). DHA/FA associated significantly with skeletal muscle glucose uptake (GU) (p = 0.031) and the metabolizable glucose value derived from hyperinsulinemic-euglycemic clamp technique (M-value) in the OLM group only (p = 0.050). Conclusions: DHA/FA is associated with insulin-dependent skeletal muscle glucose uptake and this association is significantly weakened in the offspring of obese mothers. PMID:28165405

  20. Circulating Docosahexaenoic Acid Associates with Insulin-Dependent Skeletal Muscle and Whole Body Glucose Uptake in Older Women Born from Normal Weight Mothers

    Directory of Open Access Journals (Sweden)

    Robert M. Badeau

    2017-02-01

    Full Text Available Background: Obesity among pregnant women is common, and their offspring are predisposed to obesity, insulin resistance, and diabetes. The circulating metabolites that are related to insulin resistance and are associated with this decreased tissue-specific uptake are unknown. Here, we assessed metabolite profiles in elderly women who were either female offspring from obese mothers (OOM or offspring of lean mothers (OLM. Metabolic changes were tested for associations with metrics for insulin resistance. Methods: Thirty-seven elderly women were separated into elderly offspring from obese mothers (OOM; n = 17 and elderly offspring from lean/normal weight mothers (OLM; n = 20 groups. We measured plasma metabolites using proton nuclear magnetic resonance (1H-NMR and insulin-dependent tissue-specific glucose uptake in skeletal muscle was assessed. Associations were made between metabolites and glucose uptake. Results: Compared to the OLM group, we found that the docosahexaenoic acid percentage of the total long-chain n-3 fatty acids (DHA/FA was significantly lower in OOM (p = 0.015. DHA/FA associated significantly with skeletal muscle glucose uptake (GU (p = 0.031 and the metabolizable glucose value derived from hyperinsulinemic-euglycemic clamp technique (M-value in the OLM group only (p = 0.050. Conclusions: DHA/FA is associated with insulin-dependent skeletal muscle glucose uptake and this association is significantly weakened in the offspring of obese mothers.

  1. It is not just a meal, it is an emotional experience - a segmentation of older persons based on the emotions that they associate with mealtimes.

    Science.gov (United States)

    den Uijl, Louise C; Jager, Gerry; de Graaf, Cees; Waddell, Jason; Kremer, Stefanie

    2014-12-01

    Worldwide, the group of older persons is growing fast. To aid this important group in their food and meal requirements, a deeper insight into the expectations and experiences of these persons regarding their mealtimes and snack times is needed. In the current study, we aim to identify consumer segments within the group of vital community-dwelling older persons on the basis of the emotions they associate with their mealtimes and snack times (from now on referred to as mealtimes). Participants (n = 392, mean age 65.8 (years) ± 5.9 (SD)) completed an online survey. The survey consisted of three questionnaires: emotions associated with mealtimes, functionality of mealtimes, and psychographic characteristics (health and taste attitudes, food fussiness, and food neophobia). Consumer segments were identified and characterised based on the emotions that the respondents reported to experience at mealtimes, using a hierarchical cluster analysis. Clusters were described using variables previously not included in the cluster analysis, such as functionality of mealtimes and psychographic characteristics. Four consumer segments were identified: Pleasurable averages, Adventurous arousals, Convivial indulgers, and Indifferent restrictives. These segments differed significantly in their emotional associations with mealtimes both in valence and level of arousal. The present study provides actionable insights for the development of products and communication strategies tailored to the needs of vital community-dwelling older persons.

  2. Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach

    Directory of Open Access Journals (Sweden)

    Markus Hjelm

    2015-03-01

    Full Text Available Background: Family members of older persons (75+ with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers.Objectives: The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+ with multi-morbidity.Design: The study design was based on an interpretive phenomenological approach.Method: Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach.Results: The findings revealed one overarching theme: “Helps to fulfil my unmet needs”, based on three sub-themes: (1 “Helps me feel secure – Experiencing a trusting relationship”, (2 “Confirms and strengthens me – Challenging my sense of being alone” and (3 “Being my personal guide – Increasing my competence”.Conclusion and discussion: The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.

  3. Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach

    Directory of Open Access Journals (Sweden)

    Markus Hjelm

    2015-03-01

    Full Text Available Background: Family members of older persons (75+ with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. Objectives: The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+ with multi-morbidity. Design: The study design was based on an interpretive phenomenological approach. Method: Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. Results: The findings revealed one overarching theme: “Helps to fulfil my unmet needs”, based on three sub-themes: (1 “Helps me feel secure – Experiencing a trusting relationship”, (2 “Confirms and strengthens me – Challenging my sense of being alone” and (3 “Being my personal guide – Increasing my competence”. Conclusion and discussion: The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.

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

    Directory of Open Access Journals (Sweden)

    Johan Denollet

    2013-01-01

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

  5. Heart failure in community-dwelling older persons: aims, design and adherence rate of the ICARe Dicomano project: an epidemiologic study. Insufficienza Cardiaca negli Anziani Residenti a Dicomano.

    Science.gov (United States)

    Di Bari, M; Marchionni, N; Ferrucci, L; Pini, R; Antonini, E; Chiarlone, M; Marsilii, A; De Alfieri, W; Fumagalli, S; Masotti, G

    1999-06-01

    The prevalence of heart failure (HF) increases with age, and HF is a major cause of disability and mortality in older persons. Detection of HF in epidemiological studies has relied on criteria validated only in young and middle-age adults, and, therefore, may prove inadequate in older subjects, because they do not take into account the pathophysiologic and clinical peculiarities of HF in old age. Thus, the true prevalence of HF in the older general population remains uncertain and has probably been underestimated in previous studies. Moreover, the mechanism and the extent by which HF hinders physical functioning in older people has not been fully elucidated. This paper describes the design of the ICARe study, carried out in an older home-dwelling population to collect data about: (1) the sensitivity and specificity of diagnostic criteria used previously in epidemiological studies of HF; (2) the prevalence of the different pathophysiologic forms of HF; and (3) the impact of HF on overall health status, and on physical functioning, in the absence or presence of chronic comorbidity. This was a cross-sectional survey. Eligible were all community-dwelling persons aged 65 years or older recorded in the Registry Office of Dicomano, a small town nearby Florence (Italy). All the domains of multidimensional geriatric assessment were explored through different phases of the study (home interview, laboratory testing, geriatric visit) that comprised an extensive cardiopulmonary instrumental assessment including: color Doppler echocardiography, echotomography of the carotid arteries used in an original method to determine arterial compliance, and bell spirometry. Presence of major chronic conditions was ascertained by predefined, standard algorithms that were based largely on clinical examination. There were 864 older persons eligible for the ICARe study. Even with a substantial decline from home interview (91.2%) to the cardiopulmonary study (71.1%), the adherence rate remained

  6. Self-reported health and personal social networks of older people living with HIV/AIDS in Lomé, Togo.

    Science.gov (United States)

    Moore, Ami R; Prybutok, Victor

    2014-09-01

    Personal social networks and their association with the health of older people have been explored, but there are few studies that examined the relationship between the general health of older people living with HIV/AIDS (OPLWHA) and their personal social networks. This exploratory study investigates the characteristics of personal networks among OPLWHA and the relationship between the self-rated health and personal social networks of OPLWHA in Lomé, Togo. Forty-nine OPLWHA were interviewed via an egocentric survey. We examined the composition and size of the networks of OPLWHA. Also, the correlation between networks and self-reported health was examined. Findings show that the OPLWHA had personal social networks that included three types of people: immediate kin, extended kin, and non-kin. Additionally, these networks varied by size. While the mean number of people in the smaller network (people from whom the OPLWHA can borrow an important sum of money) was less than one person (0.55), the mean number of people in the larger network was three (people with whom the OPLWHA enjoy socializing). Furthermore, only the network of people with whom OPLWHA enjoy socializing had a significant positive correlation on the self-rated health of OPLWHA. Consistent with prior research, we found that the mere existence of a network does not imply that the network has a positive correlation with the subject or that the network provides the social support needed to positively influence health. A study of the correlation between social network characteristics and health in the population of older people with HIV/AIDS is important as the number of OPLWHA continues to grow.

  7. Skeletal idiopathic osteosclerosis helps to perform personal identification of unknown decedents: A novel contribution from anatomical variants through CT scan.

    Science.gov (United States)

    De Angelis, D; Gibelli, D; Palazzo, E; Sconfienza, L; Obertova, Z; Cattaneo, C

    2016-07-01

    Personal identification consists of the comparison of ante-mortem information from a missing person with post-mortem data obtained from an unidentified corpse. Such procedure is based on the assessment of individualizing features which may help in providing a conclusive identification between ante-mortem and post-mortem material. Anatomical variants may provide important clues to correctly identify human remains. Areas of idiopathic osteosclerosis (IO), or dense bone islands (DBIs) characterized by radiopaque areas of dense, trabeculated, non-inflamed vital bone represent one of these, potentially individualizing, anatomical features. This study presents a case where the finding of DBI was crucial for a positive identification through CT-scan. A decomposed body was found in an apartment in June 2014 in advanced decomposition and no dental records were available to perform a comparison for positive identification. Genetic tests were not applicable because of the lack of relatives in a direct line. The analysis of the only ante-mortem documentation, a CT-scan to the deceased dating back to August 2009, showed the presence of three DBIs within the trabecular bone of the proximal portion of the right femur. The same bony district was removed from the corpse during the autopsy and analysed by CT-scan, which verified the presence of the same features. Forensic practitioners should therefore be aware of the great importance of anatomical bone variants, such as dense bone islands for identification purposes, and the importance of advanced radiological technique for addressing the individualizing potential of such variants. We propose that anatomical variants of the human skeleton should be considered as being "primary identification characteristics" similar to dental status, fingerprints and DNA.

  8. Rosuvastatin for Primary Prevention in Older Persons With Elevated C-Reactive Protein and Low to Average Low-Density Lipoprotein Cholesterol Levels: Exploratory Analysis of a Randomized Trial

    DEFF Research Database (Denmark)

    Glynn, R.J.; Koenig, W.; Nordestgaard, B.G.

    2010-01-01

    Background: Randomized data on statins for primary prevention in older persons are limited, and the relative hazard of cardiovascular disease associated with an elevated cholesterol level weakens with advancing age. Objective: To assess the efficacy and safety of rosuvastatin in persons 70 years......: The 32% of trial participants 70 years or older accrued 49% (n = 194) of the 393 confirmed primary end points. The rates of the primary end point in this age group were 1.22 and 1.99 per 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively ( hazard ratio, 0.61 [95% CI, 0...... greater in older persons. The relative rate of any serious adverse event among older persons in the rosuvastatin versus placebo group was 1.05 ( CI, 0.93 to 1.17). Limitation: Effect estimates from this exploratory analysis with age cut-point chosen after trial completion should be viewed in the context...

  9. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Suijker Jacqueline J

    2012-04-01

    Full Text Available Abstract Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. Methods/Design In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC score (≥ 2. These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP. The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. Discussion This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. Trial registration NTR2653 Grant Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201

  10. Hierarchical structure of maladaptive personality traits in older adults: joint factor analysis of the PID-5 and the DAPP-BQ.

    Science.gov (United States)

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

    2014-04-01

    In DSM-5, the categorical model and criteria for the 10 personality disorders included in DSM-IV will be reprinted in Section II. Moreover, an alternative dimensional classification model will appear in Section III. This alternative DSM-5 proposal for the diagnosis of a personality disorder is based on two fundamental criteria: impairments in personality functioning (Criterion A) and the presence of pathological personality traits (Criterion B). In the maladaptive trait model that has been developed to operationalize Criterion B, 25 pathological traits are organized according to five higher order dimensions. The current study focuses on the convergence of the proposed DSM-5 trait model (as measured by the Personality Inventory for DSM-5 [PID-5]) with the Dimensional Assessment of Personality Pathology (DAPP) model (as measured by the Dimensional Assessment of Personality Pathology-Basic Questionnaire [DAPP-BQ]) in a sample of older people. A joint hierarchical factor analysis showed clear convergence between four PID-5 dimensions (Negative Affect, Detachment, Antagonism, Disinhibition) and conceptually similar DAPP-BQ components. Moreover, the PID-5 and the DAPP-BQ showed meaningful associations on different levels of their joint hierarchical factor structure. Methodological and theoretical implications of these initial results for the conceptualization of personality pathology are discussed.

  11. Prescription of potentially inappropriate medication in older persons in Switzerland: does the dispensing channel make a difference?

    Directory of Open Access Journals (Sweden)

    Blozik E

    2015-04-01

    Full Text Available Eva Blozik,1,2 Roland Rapold,1 Oliver Reich1 1Department of Health Sciences, Helsana Group, Zürich, Switzerland; 2Department of Medicine, Division of General Practice, University Medical Centre Freiburg, Freiburg, Germany Background: Drugs can be supplied either directly from the prescribing physician (physician dispensing [PD] or via a pharmacy. It is unclear whether the dispensing channel is associated with quality problems. Potentially inappropriate medication (PIM is associated with adverse outcomes in older persons and can be considered a marker for quality deficits in prescribing. We investigated whether prevalence of PIM differs across dispensing channels. Patients and methods: We analyzed basic health insurance claims of 50,747 person quarter years with PIM use of residents of the Swiss cantons Aargau and Lucerne of the years 2012 and 2013. PIM was identified using the Beers 2012 criteria and the PRISCUS list. We calculated PIM prevalence stratified by supply channel. Adjusted mixed effects logistic regression analysis was done to estimate the effect of obtaining medications through the dispensing physician as compared to the pharmacy channel on receipt of PIM. The most frequent PIMs were identified. Results: There is a small but detectable difference in total PIM prevalence: 30.7% of the population supplied by a dispensing physician as opposed to 29.3% individuals who received medication in a pharmacy. According to adjusted logistic regression individuals who obtained the majority of their medications from their prescribing physician had a 15% higher chance to receive a PIM (odds ratio 1.15, 95% confidence interval 1.08–1.22; P<0.001. Conclusion: Physician dispensing seems to affect quality and safety of drug prescriptions. Quality issues should not be neglected in the political discussion about the regulations on PD. Future studies should explore whether PD is related to other indicators of inefficiency or quality flaws. The present

  12. Emergency nurses' perceptions of the role of confidence, self-efficacy and reflexivity in managing the cognitively impaired older person in pain.

    Science.gov (United States)

    Fry, Margaret; MacGregor, Casimir; Hyland, Simone; Payne, Barbara; Chenoweth, Lynn

    2015-06-01

    The study aimed to explore the practice of care among emergency nurses caring for older persons with cognitive impairment and who presented in pain from a long bone fracture, to highlight nurse confidence and self-efficacy in practice. Cognitive impairment is an issue increasingly facing emergency departments. Older persons with cognitive impairment have complex care needs, requiring effective clinical decision-making and provision of care. Nurse confidence and self-efficacy are critical to meeting the necessary standards of care for this vulnerable patient group. A multi-centre study. The study was undertaken across four emergency departments in Sydney, Australia. Sixteen focus group discussions were conducted with 80 emergency departments of nurses. Four main themes emerged: confidence and self-efficacy through experience; confidence and self-efficacy as a balancing act; confidence and self-efficacy as practice; and confidence and self-efficacy and interpersonal relations. Our findings demonstrate that confidence, self-efficacy and reflexivity enabled the delivery of appropriate, timely and compassionate care. Further, confidence and self-efficacy within nursing praxis relied on clinical experience and reflective learning and was crucial to skill and knowledge acquisition. Our research suggests that confidence, self-efficacy and reflexivity need to be developed and valued in nurses' careers to better meet the needs of complex older persons encountered within everyday practice. © 2015 John Wiley & Sons Ltd.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    OBJECTIVES: To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (>= 80) is at risk of becoming frail and whether a multiprofessional group....... SETTING: Two urban districts of Gothenburg, Sweden. PARTICIPANTS: Four hundred fifty-nine communityliving adults aged 80 and older not dependent on the municipal home help service. INTERVENTION: A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit...... dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated. CONCLUSION: Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention...

  14. The influence of olfactory impairment in vital, independently living older persons on their eating behaviour and foodliking

    NARCIS (Netherlands)

    Kremer, S.; Holthuysen, N.T.E.; Boesveldt, S.

    2014-01-01

    These two studies investigated eating behaviour and food liking of independently living Dutch older people with and without olfactory impairment. In the first study, an internet survey was conducted in relation to their olfactory status (n = 512; age 55–91). Hyposmic older people reported eating the

  15. First- and Third-Person Perceptions of Images of Older People in Advertising: An Inter-Generational Evaluation

    Science.gov (United States)

    Robinson, Tom; Umphery, Don

    2006-01-01

    With the baby boomers increasing in age, the number of older Americans is projected to increase to 82 million by 2050, an increase of 225% from the year 2000. But despite their growing numbers, older individuals continue to face negative attitudes toward them, their way of thinking, and their abilities. These negative attitudes result from the…

  16. Multiple diabetic complications, as well as impaired physical and mental function, are associated with declining balance function in older persons with diabetes mellitus.

    Science.gov (United States)

    Hong, Xiufang; Chen, Xujiao; Chu, Jiaojiao; Shen, Shanshan; Chai, Qichen; Lou, Gaobo; Chen, Lingyan

    2017-01-01

    To investigate whether there is a difference in balance function between older persons with and without diabetes mellitus (DM), and to identify whether mediating factors, such as diabetic complications, Instrumental Activities of Daily Living (IADL) score, Mini-Mental State Examination (MMSE) score, as well as hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), serum total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL), are associated with balance function in older persons with DM. In this cross-sectional study, a total of 208 older persons were divided into a DM group (n=80) and a control group who did not have DM (n=128). Balance function was evaluated with the Tinetti performance-oriented mobility assessment (POMA), which includes balance and gait subscales. Activities of daily living (ADL), IADL, and the MMSE were also measured. Fall incidents in last 12 months, the use of walking aids, fear of falling, comorbidities, and polypharmacy were recorded. Diabetic complications were recorded, and HbA1c, FPG, TC, TG, and LDL were measured in the patients of the DM group. Fall incidents in last 12 months were higher in the DM group than in the control group (Pscore as well as ADL and IADL scores were lower in the diabetic group than the control group (Pscore was positively related to the ADL score (odds ratio [OR], 11.7; 95% confidence interval [CI], 3.076-44.497; Pscore (OR, 16.286; 95% CI, 4.793-55.333; Pscore (OR, 10.524; 95% CI, 2.764-40.074; Pscore was associated with multiple diabetic complications (OR, 5.977; 95% CI, 1.378-25.926; Pscore (OR, 10.288; 95% CI, 2.410-43.915; Pscore (OR, 13.757; 95% CI, 2.556-74.048; Pscores were associated with declining balance function in the older persons with DM. These findings can alert physicians to detect and intervene earlier on declining balance in older persons with DM.

  17. Understanding the “black box” of a health-promotion program: Keys to enable health among older persons aging in the context of migration

    Directory of Open Access Journals (Sweden)

    Emmelie Barenfeld

    2015-12-01

    Full Text Available Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researcher–community partnership. Fourteen persons aged 70–83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

  18. Onset and persistence of person-perceived participation restriction in older adults: a 3-year follow-up study in the general population

    Directory of Open Access Journals (Sweden)

    Peat George

    2008-11-01

    Full Text Available Abstract Background Participation restriction is defined as "problems an individual may experience in involvement in life situations" and refers to the personal and societal consequences of health conditions. There is a growing interest in participation restriction because (i problems with work or looking after others may be more concerning to individuals than the signs and symptoms of health conditions and (ii even when poor health persists, participation may still be maintained. The natural history of participation restriction in the general population is unknown and the aim of this report is to describe change in status of person-perceived participation restriction over three years in community-dwelling adults aged 50 years and over. Method Prospective cohort study (baseline and 3-year follow-up using postal questionnaires mailed to a population-based sample of older adults. Responders were included in this study if they completed all items of the Keele Assessment of Participation at baseline (n = 6965. Estimates of onset and persistence of person-perceived participation restriction at 3-year follow-up were calculated for any and for each aspect of life in the sample as a whole, and then by age and gender using attrition re-weighted logistic regression to take account of sample attrition. Results In the whole sample of 6965 persons, overall participation status at three years was unchanged in 69%, and changed in 31%. Of 3431 persons with no restriction at baseline, it is estimated that 29.8% (95% confidence interval: 27.6%, 32.0% would report restriction in at least one aspect of life at 3-year follow-up. Of 3534 persons who had baseline restriction, it is estimated that 68.8% (66.2%, 71.3% would report continuing restriction in at least one aspect of life after 3 years. Onset and persistence both increased with age, and were most frequently recorded for restricted mobility outside the home. Conclusion Although most older persons do not

  19. Mobility in different generations of older persons The development of daily travel in different cohorts in Denmark, Norway and Sweden

    DEFF Research Database (Denmark)

    Hjorthol, R.J.; Levin, L.; Siren, Anu Kristiina

    2010-01-01

    people today travel more than the comparable age groups 20-25 years ago: everyday trip rates are higher and activities outside home are more common. While commuting and work-related trips decline after retirement, shopping and leisure trips do not start to decline before high age. From the cohort...... in the Scandinavian countries is the question of everyday mobility. The purpose of this paper is to get a better understanding of the activity and travel patterns of different groups of older people, examine how travel- and activity patterns are developing during the life course, study the changes over time and how...... the "new" generations of older people behave compared to the older ones. The method used is cohort analysis of National Travel Surveys from the three countries in a 20 years perspective. Results show a significant period effect in car ownership and use among older people in Denmark. Norway and Sweden...

  20. Understanding causal associations between self-rated health and personal relationships in older adults: A review of evidence from longitudinal studies.

    Science.gov (United States)

    Craigs, Cheryl L; Twiddy, Maureen; Parker, Stuart G; West, Robert M

    2014-01-01

    As we age we experience many life changes in our health, personal relationships, work, or home life which can impact on other aspects of our life. There is compelling evidence that how we feel about our health influences, or is influenced by, the personal relationships we experience with friends and relatives. Currently the direction this association takes is unclear. To assess the level of published evidence available on causal links between self-rated health and personal relationships in older adults. MEDLINE, CINAHL, and PsycINFO searches from inception to June 2012 and hand searches of publication lists, reference lists and citations were used to identify primary studies utilizing longitudinal data to investigate self-rated health and personal relationships in older adults. Thirty-one articles were identified. Only three articles employed methods suitable to explore causal associations between changes in self-rated health and changes in personal relationships. Two of these articles suggested that widowhood leads to a reduction in self-rated health in the short term, while the remaining article suggested a causal relationship between self-rated health and negative emotional support from family or friends, but this was complex and mediated by self-esteem and sense of control. While there is an abundance of longitudinal aging cohorts available which can be used to investigate self-rated health and personal relationships over time the potential for these databases to be used to investigate causal associations is currently not being recognized. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Present situation of older persons sports training in Dalian City%大连市老年人体育锻炼现状研究

    Institute of Scientific and Technical Information of China (English)

    徐立阳

    2012-01-01

      随着中国社会步入老龄化社会,老年人的体育锻炼现状引起了社会各方面的广泛关注,本文以大连市60岁以上的老年人为研究对象进行研究,分析了当前大连市老年人体育锻炼的现状,并就如何科学促进老年人体育锻炼提出了一些合理化建议,希望为大连市老年人体育健身的发展提供一些指导。%  Along with the Chinese society enters the aging society, the situation of old people 's physical exercise causes the attention in various social aspects, taking Dalian city over 60 years old as the research object for research, analyzes the current situation of older persons sports training in Dalian City, and put forward some rationalization proposals on how to promote physical exercise of older adults, hope to provide some guidance to older persons sports development in Dalian City.

  2. Personality.

    Science.gov (United States)

    Funder, D C

    2001-01-01

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

  3. The Contribution of a “Supportive Community” Program for Older Persons in Israel to Their Offspring Who Are Primary Caregivers

    Directory of Open Access Journals (Sweden)

    Ahuva Even-Zohar

    2015-01-01

    Full Text Available The “supportive community” programs in Israel provide a basket of services for older persons living in their own homes. This study examined the differences between caregiver burden and quality of life of 55 offspring who were the primary caregivers of their older parents who were members of a supportive community, compared to 64 offspring whose parents were nonmembers. The findings showed that the role stress factor of caregiving burden was lower, and the psychological health domain of quality of life was higher among offspring whose parents were members of supportive communities. Some of the predictor variables of burden were income status of caregiver, sharing with others in caregiving, and membership of the parent in a supportive community. The primary predictor variable of the quality of life was caregiving burden. The practical conclusion of this study is to further develop and market supportive community programs in various communities.

  4. Prevalence of dental caries and periodontal diseases, and their association with socio-demographic risk factors among older persons in Delhi, India: a community-based study.

    Science.gov (United States)

    Srivastava, Rahul; Gupta, Sanjeev Kumar; Mathur, Vijay Prakash; Goswami, Anil; Nongkynrih, Baridalyne

    2013-05-01

    Dental health is often neglected in the older persons, and dental conditions associated with aging are complex, adversely affecting the quality of life. The present study was undertaken to estimate the prevalence of dental caries and periodontal diseases among older persons from Delhi, India, and to study their association with selected socio-behavioral risk factors. We conducted a community-based cross sectional study among persons aged > or = 60 years from Delhi during 2009-2010. A questionnaire was used to interview elderly regarding dental health. The World Health Organization (WHO) oral health assessment form was used for examining the study participants. A total of 448 participants were examined and included in the study. Of the dentate, 47.1% had active dental caries. The mean decayed, missing and filled teeth (DMFT) score for the study population was 14.4. The prevalence of gingival bleeding, periodontal pockets and loss of attachment was 96.6, 89.1, and 80.3%, respectively. The prevalence of tobacco use was 47.9%. Age, frequency of teeth cleaning, and method used for teeth cleaning were statistically associated with the DMFT score. The prevalence of dental caries and periodontal disease was high in the study population, and warrants intervention.

  5. The effects of resistance exercise training on macro- and micro-circulatory responses to feeding and skeletal muscle protein anabolism in older men

    DEFF Research Database (Denmark)

    Phillips, Bethan E; Atherton, Philip J; Varadhan, Krishna;

    2015-01-01

    turnover under post-absorptive and fed state (i.v. Glamin to double amino acids, dextrose to sustain glucose ∼7-7.5 mmol l(-1) ) conditions in two groups: 10 untrained men (72.3 ± 1.4 years; body mass index (BMI) 26.5 ± 1.15 kg m(2) ) and 10 men who had undertaken 20 weeks of fully supervised, whole...... ] phenylalanine tracers. Plasma insulin was measured via ELISA and indices of anabolic signalling (e.g. Akt/mTORC1) by immunoblotting from muscle biopsies. Whereas older untrained men did not exhibit fed-state increases in LBF or MBV, the RET group exhibited increases in both LBF and MBV. Despite our hypothesis...

  6. Skeletal Effects of Smoking.

    Science.gov (United States)

    Cusano, Natalie E

    2015-10-01

    Smoking is a leading cause of preventable death and disability. Smoking has long been identified as a risk factor for osteoporosis, with data showing that older smokers have decreased bone mineral density and increased fracture risk compared to nonsmokers, particularly at the hip. The increase in fracture risk in smokers is out of proportion to the effects on bone density, indicating deficits in bone quality. Advanced imaging techniques have demonstrated microarchitectural deterioration in smokers, particularly in the trabecular compartment. The mechanisms by which smoking affects skeletal health remain unclear, although multiple pathways have been proposed. Smoking cessation may at least partially reverse the adverse effects of smoking on the skeleton.

  7. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons.

    Science.gov (United States)

    2011-01-01

    The following article is a summary of the American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons (2010). This article provides additional discussion of the guideline process and the differences between the current guideline and the 2001 version and includes the guidelines' recommendations, algorithm, and acknowledgments. The complete guideline is published on the American Geriatrics Society's Web site (http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010/). © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  8. Catechol-o-methyltransferase gene polymorphism is associated with skeletal muscle properties in older women alone and together with physical activity.

    Directory of Open Access Journals (Sweden)

    Paula H A Ronkainen

    Full Text Available BACKGROUND: Muscle strength declines on average by one percent annually from midlife on. In postmenopausal women this decrement coincides with a rapid decline in estrogen production. The genetics underlying the effects of estrogen on skeletal muscle remains unclear. In the present study, we examined whether polymorphisms within COMT and ESR1 are associated with muscle properties and assessed their interaction and their combined effects with physical activity. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional data analysis was conducted with 434 63-76-year-old women from the population-based Finnish Twin Study on Aging. Body anthropometry, muscle cross-sectional area (mCSA, isometric hand grip and knee extension strengths, and leg extension power were measured. COMT Val158Met and ESR1 PvuII genotypes were determined by the RFLP method. mCSA differed by COMT genotypes (p = 0.014 being significantly larger in LL than HL individuals in unadjusted (p = 0.001 and age- and height-adjusted model (p = 0.004. When physical activity and age were entered into GEE model, COMT genotype had a significant main effect (p = 0.038 on mCSA. Furthermore, sedentary individuals with the HH genotype had lower muscle mass, strength and power, but they also appeared to benefit the most from physical activity. No association of ESR1 PvuII polymorphism with any of the muscle outcomes was observed. CONCLUSIONS/SIGNIFICANCE: The present study suggests that the COMT polymorphism, affecting the activity of the enzyme, is associated with muscle mass. Furthermore, sedentary individuals with potential high enzyme activity were the weakest group, but they may potentially benefit the most from physical activity. This observation elucidates the importance of both environmental and genetic factors in muscle properties.

  9. Aging: empirical contribution. A longitudinal analysis of personality disorder dimensions and personality traits in a community sample of older adults: perspectives from selves and informants.

    Science.gov (United States)

    Cooper, Luke D; Balsis, Steve; Oltmanns, Thomas F

    2014-02-01

    Research has indicated that personality disorders (PDs) and normal-range personality traits generally "get better" with time, as evidenced by mean-level decreases in PD traits and mean-level increases in broad factors such as emotional stability, agreeableness, and conscientiousness. One limitation of many of these studies is their reliance on self reported data. In the current study, the authors analyzed the 2.5-year course of PD dimensions and normal personality traits in a representative sample of adults approaching later life (originally ages 55-65) by using a semistructured diagnostic interview as well as self- and informant-reported data from two personality inventories. Consistent with previous literature, many self-reported PD traits showed mean-level decreases over time, and self-reported normal-range personality traits generally showed positive aging effects (e.g., mean-level increases in emotional stability, agreeableness, and conscientiousness). Surprisingly, however, informant-reported PD traits often demonstrated small but significant increases over time, and informant-reported normal-range personality generally "worsened" with age (e.g., mean-level decreases in extraversion, agreeableness, and conscientiousness). Informant reports may challenge the finding that personality and PDs tend to "improve" over time.

  10. Rosuvastatin for Primary Prevention in Older Persons With Elevated C-Reactive Protein and Low to Average Low-Density Lipoprotein Cholesterol Levels: Exploratory Analysis of a Randomized Trial

    DEFF Research Database (Denmark)

    Glynn, R.J.; Koenig, W.; Nordestgaard, B.G.;

    2010-01-01

    Background: Randomized data on statins for primary prevention in older persons are limited, and the relative hazard of cardiovascular disease associated with an elevated cholesterol level weakens with advancing age. Objective: To assess the efficacy and safety of rosuvastatin in persons 70 years ...

  11. Personality and Risk for Alzheimer’s Disease in Adults 72 Years of Age and Older: A Six-Year Follow-Up

    Science.gov (United States)

    Duberstein, Paul R.; Chapman, Benjamin P.; Tindle, Hilary A.; Sink, Kaycee M.; Bamonti, Patricia; Robbins, John; Jerant, Anthony F.; Franks, Peter

    2010-01-01

    We conducted secondary analyses to determine the relationship between longstanding personality traits and risk for Alzheimer’s disease (AD) among 767 participants 72 years of age or older who were followed for more than 6 years. Personality was assessed with the NEO-FFI. We hypothesized that elevated Neuroticism, lower Openness, and lower Conscientiousness would be independently associated with risk of AD. Hypotheses were supported. The finding that AD risk is associated with elevated Neuroticism and lower Conscientiousness can be added to the accumulating literature documenting the pathogenic effects of these two traits. The link between lower Openness and AD risk is consistent with recent findings on cognitive activity and AD risk. Findings have implications for prevention research and for the conceptualization of the etiology of Alzheimer’s Disease. PMID:20973606

  12. Older job seekers' job search intensity : the interplay of proactive personality, age and occupational future time perspective

    NARCIS (Netherlands)

    Zacher, Hannes

    2013-01-01

    Long-term unemployment of older people can have severe consequences for individuals, communities and ultimately economies, and is therefore a serious concern in countries with an ageing population. However, the interplay of chronological age and other individual difference characteristics in

  13. Motives of Dutch persons aged 50 years and older to accept vaccination : a qualitative study

    NARCIS (Netherlands)

    Eilers, Renske; Krabbe, Paul F. M.; de Melker, Hester E.

    2015-01-01

    Background: Elderly in several European countries are currently being vaccinated against influenza and pneumococcal disease, and various reasons have been put forward to expand these programs. To successfully immunize the older adult population, however, it is crucial for the target group to accept

  14. Aspirin for the older person: report of a meeting at the Royal Society of Medicine, London, 3rd November 2011

    Science.gov (United States)

    Armitage, J; Cuzick, J; Elwood, P; Longley, M; Perkins, A; Spencer, K; Turner, H; Porch, S; Lyness, S; Kennedy, J; Henderson, GN

    2012-01-01

    On November 23rd 2011, the Aspirin Foundation held a meeting at the Royal Society of Medicine in London to review current thinking on the potential role of aspirin in preventing cardiovascular disease and reducing the risk of cancer in older people. The meeting was supported by Bayer Pharma AG and Novacyl. PMID:22423252

  15. Self-reported physical fitness of older persons: A substitute for performance-based measures of physical fitness?

    NARCIS (Netherlands)

    vanHeuvelen, M.J.G.; Kempen, G.I J M; Ormel, J.; deGreef, M.H.G.

    1997-01-01

    To evaluate the validity of self-report measures of physical fitness as substitutes for performance-based tests, self-reports and performance-based tests of physical fitness were compared. Subjects were a community-based sample of older adults (N = 624) aged 57 and over. The performance-based tests

  16. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons

    NARCIS (Netherlands)

    Visser, M.; Goodpaster, B.H.; Kritchevsky, S.B.; Newman, A.B.; Nevitt, M.C.; Rubin, S.M.; Simonsick, E.M.; Harris, T.B.

    2005-01-01

    .05). Among men and women, associations were similar for blacks and whites. CONCLUSION: Lower muscle mass (smaller cross-sectional thigh muscle area), greater fat infiltration into the muscle, and lower knee extensor muscle strength are associated with increased risk of mobility loss in older men

  17. Oropharyngeal dysphagia in older persons – from pathophysiology to adequate intervention: a review and summary of an international expert meeting

    Science.gov (United States)

    Wirth, Rainer; Dziewas, Rainer; Beck, Anne Marie; Clavé, Pere; Hamdy, Shaheen; Heppner, Hans Juergen; Langmore, Susan; Leischker, Andreas Herbert; Martino, Rosemary; Pluschinski, Petra; Rösler, Alexander; Shaker, Reza; Warnecke, Tobias; Sieber, Cornel Christian; Volkert, Dorothee

    2016-01-01

    Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies. PMID:26966356

  18. Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting.

    Science.gov (United States)

    Wirth, Rainer; Dziewas, Rainer; Beck, Anne Marie; Clavé, Pere; Hamdy, Shaheen; Heppner, Hans Juergen; Langmore, Susan; Leischker, Andreas Herbert; Martino, Rosemary; Pluschinski, Petra; Rösler, Alexander; Shaker, Reza; Warnecke, Tobias; Sieber, Cornel Christian; Volkert, Dorothee

    2016-01-01

    Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.

  19. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons

    NARCIS (Netherlands)

    Visser, M.; Goodpaster, B.H.; Kritchevsky, S.B.; Newman, A.B.; Nevitt, M.C.; Rubin, S.M.; Simonsick, E.M.; Harris, T.B.

    2005-01-01

    .05). Among men and women, associations were similar for blacks and whites. CONCLUSION: Lower muscle mass (smaller cross-sectional thigh muscle area), greater fat infiltration into the muscle, and lower knee extensor muscle strength are associated with increased risk of mobility loss in older men an

  20. Self-reported physical fitness of older persons : A substitute for performance-based measures of physical fitness?

    NARCIS (Netherlands)

    vanHeuvelen, MJG; Kempen, GIJM; Ormel, J; de Greef, M.H.G.

    1997-01-01

    To evaluate the validity of self-report measures of physical fitness as substitutes for performance-based tests, self-reports and performance-based tests of physical fitness were compared. Subjects were a community-based sample of older adults (N = 624) aged 57 and over. The performance-based tests

  1. Motives of Dutch persons aged 50 years and older to accept vaccination : a qualitative study

    NARCIS (Netherlands)

    Eilers, Renske; Krabbe, Paul F. M.; de Melker, Hester E.

    2015-01-01

    Background: Elderly in several European countries are currently being vaccinated against influenza and pneumococcal disease, and various reasons have been put forward to expand these programs. To successfully immunize the older adult population, however, it is crucial for the target group to accept

  2. Older job seekers' job search intensity : the interplay of proactive personality, age and occupational future time perspective

    NARCIS (Netherlands)

    Zacher, Hannes

    2013-01-01

    Long-term unemployment of older people can have severe consequences for individuals, communities and ultimately economies, and is therefore a serious concern in countries with an ageing population. However, the interplay of chronological age and other individual difference characteristics in predict

  3. The FARE: A new way to express FAlls Risk among older persons including physical activity as a measure of Exposure

    NARCIS (Netherlands)

    Wijlhuizen, G.J.; Chorus, A.M.J.; Hopman-Rock, M.

    2010-01-01

    Background: Common expressions of falls risk do not include exposure to hazards. We compared two expressions: the commonly used population incidence (fallers per 1000 person-years) and the FARE (FAlls Risk by Exposure): the number of fallers per 1000 physically active person-days. Methods: Prospecti

  4. Using a personalized DVD to prescribe an exercise program to older people post-hip fracture enhances adherence to the exercises - A feasibility study.

    Science.gov (United States)

    Moran, Luke; Francis-Coad, Jacqueline; Patman, Shane; Hill, Anne-Marie

    2015-01-01

    Optimum recovery from hip fracture has been linked to the provision of effective rehabilitation, but levels of adherence vary among older patients. In this feasibility study a novel personalized DVD was designed for four participants, which delivered a 5 week tailored home exercise program (HEP), with the participant being videoed completing their exercises. Treatment fidelity of the DVD HEP was evaluated, including participants' perceptions of and response to the DVD-HEP, which was explored using diaries and interviews and analyzed thematically. Secondary outcome measures including exercise adherence and self-efficacy for exercise were analyzed using descriptive statistics. Levels of adherence to the HEP were 1.2-3.5 times more than the minimum prescribed dose and participants demonstrated higher levels of self-efficacy for exercise. Adherence was found to be enhanced by physical improvement, positive self-reflection about engagement in the DVD-HEP, the format of the DVD, and increased self-efficacy. Personalized DVDs may be a feasible method of promoting adherence to home exercise programs among older patients.

  5. Progress on long-term care of older persons with disabilities%长期照护残疾老人的研究进展

    Institute of Scientific and Technical Information of China (English)

    李鸿; 何作顺

    2013-01-01

    长期照护是受到普遍关注的老年问题之一,随着我国人口老龄化的发展进程,残疾老人将成为残疾人口数量中的主要群体.残疾老人作为一类特殊群体,需要社会给予更多的关注.目前国内外学者对长期照护进行大量的研究,对有关护理研究进展进行总结.%Long-term care is to be one of the issues of common concern to the older persons,with the development process of China's aging population,the older persons with disabilities will become the major groups in the number of disabled population.They need to get more attention by society as they become a class of special groups.Domestic and foreign scholars have conducted a lot of research on the longterm care,the relevant progress are summarized below.

  6. Instrumental activities of daily living among community-dwelling older adults: personality associations with self-report, performance, and awareness of functional difficulties.

    Science.gov (United States)

    Suchy, Yana; Williams, Paula G; Kraybill, Matthew L; Franchow, Emilie; Butner, Jonathan

    2010-09-01

    Self-reports of the ability to engage in instrumental activities of daily living (IADLs) among older adults are known to be related to personality traits. However, self-reports are sometimes discrepant with performance-based IADL assessments, and little is known about personality associations with objective functionality or with poor insight about functional deficits. This study examined the NEO Personality Inventory-Revised profiles associated with (a) self-report of functional problems, (b) functional errors evidenced on performance-based IADL assessment, and (c) discrepancies between self-report and performance. Participants were 65 community-dwelling individuals ranging in age from 60 to 87 years. The results showed that self-report of IADL problems are associated with higher neuroticism and lower conscientiousness, actual IADL difficulties with higher neuroticism and lower agreeableness and openness to experience, underreporting of problems with higher conscientiousness, and overreporting of problems with higher extraversion and neuroticism. These relationships were partly mediated by age, education, and cognitive status. When unique personality associations with self-report and performance were examined, neuroticism and agreeableness, respectively, emerged as the strongest predictors.

  7. Multiple diabetic complications, as well as impaired physical and mental function, are associated with declining balance function in older persons with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hong XF

    2017-01-01

    Full Text Available Xiufang Hong,1,2 Xujiao Chen,2 Jiaojiao Chu,2 Shanshan Shen,2 Qichen Chai,2 Gaobo Lou,2 Lingyan Chen2 1Zhejiang Chinese Medical University, 2Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, People’s Republic of China Objective: To investigate whether there is a difference in balance function between older persons with and without diabetes mellitus (DM, and to identify whether mediating factors, such as diabetic complications, Instrumental Activities of Daily Living (IADL score, Mini-Mental State Examination (MMSE score, as well as hemoglobin A1c (HbA1c, fasting plasma glucose (FPG, serum total cholesterol (TC, triglycerides (TG, and low-density lipoprotein (LDL, are associated with balance function in older persons with DM.Methods: In this cross-sectional study, a total of 208 older persons were divided into a DM group (n=80 and a control group who did not have DM (n=128. Balance function was evaluated with the Tinetti performance-oriented mobility assessment (POMA, which includes balance and gait subscales. Activities of daily living (ADL, IADL, and the MMSE were also measured. Fall incidents in last 12 months, the use of walking aids, fear of falling, comorbidities, and polypharmacy were recorded. Diabetic complications were recorded, and HbA1c, FPG, TC, TG, and LDL were measured in the patients of the DM group.Results: Fall incidents in last 12 months were higher in the DM group than in the control group (P<0.01. POMA score as well as ADL and IADL scores were lower in the diabetic group than the control group (P<0.05. Within the diabetic group, the POMA score was positively related to the ADL score (odds ratio [OR], 11.7; 95% confidence interval [CI], 3.076–44.497; P<0.01, IADL score (OR, 16.286; 95% CI, 4.793–55.333; P<0.01, and MMSE score (OR, 10.524; 95% CI, 2.764–40.074; P<0.01, but was negatively related to age (OR, 7.707; 95% CI, 2.035–29.185; P<0.01 and diabetic complication (OR, 6.667; 95% CI, 2.279–19

  8. Patterns of circulating inflammatory biomarkers in older persons with varying levels of physical performance: a Partial Least Squares–Discriminant Analysis (PLS–DA approach

    Directory of Open Access Journals (Sweden)

    Emanuele eMarzetti

    2014-09-01

    Full Text Available Background. Chronic, low–grade inflammation and declining physical function are hallmarks of the aging process. However, previous attempts to correlate individual inflammatory biomarkers with physical performance in older people have produced mixed results. Given the complexity of the inflammatory response, the simultaneous analysis of an array of inflammatory mediators may provide more insights into the relationship between inflammation and age–related physical function decline. This study was designed to explore the association between a panel of inflammatory markers and physical performance in older adults through a multivariate statistical approach.Methods. Community–dwelling older persons were categorized into normal walkers (NWs; n = 27 or slow walkers (SWs; n = 11 groups using 0.8 m/s as the 4–meter gait speed cutoff. A panel of 14 circulating inflammatory biomarkers was assayed by multiplex analysis. Partial Least Squares–Discriminant Analysis (PLS–DA was used to identify patterns of inflammatory mediators associated with gait speed categories.Results. The optimal complexity of the PLS–DA model was found to be 5 latent variables. The proportion of correct classification was 88.9% for NW subjects (74.1% in cross–validation and 90.9% for SW individuals (81.8% in cross–validation. Discriminant cytokines in the model were interleukin 8, myeloperoxidase, tumor necrosis factor alpha (all higher in the SW group, and P–selectin, interferon gamma and granulocyte–macrophage colony–stimulating factor (all higher in the NW group. Conclusions. Distinct profiles of circulating inflammatory biomarkers characterize older subjects with different levels of physical performance. The dissection of these patterns may provide novel insights into the role played by inflammation in the disabling cascade and possible new targets for interventions.

  9. Practice Guidelines for Assessing Pain in Older Persons with Dementia Residing in Long-Term Care Facilities

    OpenAIRE

    Hadjistavropoulos, Thomas; Fitzgerald, Theresa Dever; MARCHILDON, GREGORY P.

    2010-01-01

    Purpose: Frail patients with dementia most frequently present with musculoskeletal pain and mobility concerns; therefore, physiotherapy interventions for this population are likely to be of great benefit. However, physiotherapists who work with older adults with dementia confront a considerable challenge: the communication impairments that characterize dementia make it difficult to assess pain and determine its source. For an effective physiotherapy programme to be implemented, valid pain ass...

  10. Experiences of HIV-related stigma among HIV-positive older persons in Uganda--a mixed methods analysis.

    Science.gov (United States)

    Kuteesa, Monica O; Wright, Stuart; Seeley, Janet; Mugisha, Joseph; Kinyanda, Eugene; Kakembo, Frederick; Mwesigwa, Richard; Scholten, Francis

    2014-01-01

    There is limited data on stigma among older HIV-infected adults in sub-Saharan Africa. We describe the experiences of stigma and disclosure in a cohort of HIV-positive older people in Uganda. Using data from the Wellbeing of Older Peoples' Study of Kalungu (rural site) and Wakiso district (peri-urban site) residents, we measured self-reported stigma levels for 183 respondents (94 on antiretroviral therapy (ART); 88, not on ART) using a stigma score generated using three questions on stigma perceptions where 0 meant no stigma at all and 100 was maximum stigma. Based on two questions on disclosure, an overall score was computed. High disclosure was assigned to those who often or very often disclosed to the family and were never or seldom afraid to disclose elsewhere. We examined the experiences of HIV stigma of 25 adults (52% females) using semi-structured, open-ended interviews and monthly oral diaries over one year. Mean age of the respondents was 70 years (range 60-80 years) and 80% of all respondents were enrolled in ART. Interview transcripts were analysed using thematic content analysis. Overall, 55% of respondents had a high disclosure score, meaning they disclosed easily, and 47% had a high stigma score. The stigma scores were similar among those with high and low disclosure scores. In multivariate analyses with disclosure and stigma scores as dependent variables none of the respondents' characteristics had a significant effect at the 5% level. Qualitative data revealed that stigma ranges from: (1) perceptions (relatively passive, but leading to behaviour such as gossip, especially if not intended maliciously); to (2) discriminatory behaviour (active or enacted stigma; from malicious gossip to outright discrimination). Despite the relatively high levels of disclosure, older people suffer from high levels of stigma of various forms apart from HIV-related stigma. Efforts to assess for different forms of stigma at an individual level deserve greater attention

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

    OpenAIRE

    Logue, Melanie D.; Effken, Judith A.

    2013-01-01

    Background Despite international efforts moving toward integrated care using health information technologies and the potential of electronic PHRs to help us better coordinate patient-centered care, PHR adoption in the United States remains low among patients who have been offered free access to them from private-sector companies. If older adult stand to benefit from the use of PHRs for its usefulness in self-managing chronic illness, why have they not been more readily adopted? Since the chro...

  12. Skeletal muscle

    Science.gov (United States)

    There are approximately 650-850 muscles in the human body these include skeletal (striated), smooth and cardiac muscle. The approximation is based on what some anatomists consider separate muscle or muscle systems. Muscles are classified based on their anatomy (striated vs. smooth) and if they are v...

  13. Adherence to guidelines and the screening tool of older persons' potentially inappropriate prescriptions criteria for colchicine dosing for gout treatment in beneficiaries of the Nova Scotia Seniors' Pharmacare Program.

    Science.gov (United States)

    Black, Emily; Sketris, Ingrid; Skedgel, Chris; MacLean, Erica; Hanly, John G

    2015-10-01

    Colchicine is commonly used in the management of gout; however, older persons have higher risks of toxicity. Accordingly, the Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria for colchicine consider >3 months of treatment as potentially inappropriate in older persons. Recent evidence also suggests lower dosing of colchicine is as effective and results in fewer toxicities than high-dose colchicine. The objectives of this study were to determine the dose, duration, and prescribers of colchicine and to evaluate adherence to the STOPP criteria and international guidelines for colchicine in older persons. A retrospective, observational study was conducted from April 1, 2006 to March 31, 2011 to evaluate colchicine use. Nova Scotia Seniors' Pharmacare Program beneficiaries who met inclusion criteria for an incident case of gout and who filled at least 1 prescription for colchicine during the study period were included. Colchicine dose and duration were reported descriptively. Multivariate logistic regression was used to identify predictors of the study population in making a claim for colchicine >90 and >180 days. A total of 518 persons were dispensed 1327 courses of colchicine during the study period. The mean daily dose of colchicine ranged from 1.39 to 1.50 mg. Colchicine doses >1.2 mg were prescribed in approximately one-third of the study population. Colchicine was prescribed for >90 days in 14.2% of treatment courses and for >180 days in 8.1% of treatment courses. Female sex was the only predictor of treatment duration >90 days. This study is the first to report on colchicine dose and duration using STOPP criteria in a specific cohort of older persons with incident gout. Strategies to improve colchicine prescribing in older persons are needed. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ramakers Michel

    2011-05-01

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

  15. Differences in the use of everyday technology among persons with MCI, SCI and older adults without known cognitive impairment.

    Science.gov (United States)

    Malinowsky, Camilla; Kottorp, Anders; Wallin, Anders; Nordlund, Arto; Björklund, Eva; Melin, Ilse; Pernevik, Anette; Rosenberg, Lena; Nygård, Louise

    2017-07-01

    To use valid subjective reports sensible to cognitive decline is vital to identify very early signs of dementia development. Use of everyday technology (ET) has been shown to be sensitive to differentiate adults with mild cognitive impairment (MCI) from controls, but the group with subjective cognitive impairment (SCI) has not yet been examined. This study aims to investigate and compare self-perceived ability in ET use and number of ETs reported as actually used in a sample of older adults with SCI, MCI, and older adults with no known cognitive impairment, i.e. Older adults with MCI (n = 29), SCI ( n = 26), and controls (n = 30) were interviewed with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) to capture self-perceived ability in ET use and number of ETs used. To generate individual measures of ability to use ET, Rasch analysis was used. The measures were then compared group-wise using ANCOVA. The numbers of ETs used were compared group-wise with ANOVA. Controls versus SCI and MCI differed significantly regarding ETs reported as used, but not SCI versus MCI. Similarly, in ability to use ET, controls versus SCI and MCI differed significantly but not SCI versus MCI. The significantly lower numbers of ETs reported as actually used and the lower ability in SCI and MCI groups compared to controls suggest that ET use is affected already in very minor cognitive decline. This indicates that self-reported ET use based on the S-ETUQ is sensitive to detect changes already in SCI.

  16. Strategies to Improve Medication Adherence in Older Persons: Consensus Statement from the Senior Italia Federanziani Advisory Board.

    Science.gov (United States)

    Marengoni, Alessandra; Monaco, Alessandro; Costa, Elisio; Cherubini, Antonio; Prados-Torres, Alexandra; Muth, Christiane; Melis, Renè J F; Pasina, Luca; van der Cammen, Tischa J M; Palmer, Katie; Pecorelli, Sergio; Onder, Graziano

    2016-09-01

    Poor adherence to treatment regimens has long been recognized as a substantial roadblock to achieving better outcomes for patients. Non-adherence to medications affects the quality and length of life and has been associated with negative health outcomes and increasing healthcare costs. The problem of non-adherence is particularly troublesome in older patients who are affected by multiple chronic diseases and for this reason receive multiple treatments. To date, no single intervention strategy has been shown to be effective in improving adherence across all patients, conditions, and settings. Between September and October 2014, a group of experts in geriatrics, pharmacology, epidemiology, and public health applied a modified RAND appropriateness method to reach a consensus on the possible best interventions to improve adherence in older individuals. Seven interventions were identified, classified based on their target (patient, therapy, and public health/society): (1) Comprehensive Geriatric Assessment, (2) patient (and caregiver) education to improve patient empowerment, (3) optimization of treatment, (4) use of adherence aids, (5) physician and other healthcare professionals' education, (6) adherence assessment, (7) facilitating access to medicine by service integration. For each intervention, experts assessed (a) target population, (b) health professionals potentially involved in the intervention, (c) strategies/instruments needed for implementation, and (d) time of the intervention. Interventions that target adherence must combine different approaches targeting the complex aspects of older adults in a holistic approach. Tackling non-adherence, with its complexity, requires a multi-stakeholder patient-centred approach acting in a defined framework of interactions in which the different players may provide different services but are integrated with one another.

  17. [Prevalence of cardiovascular diseases and cardiovascular risk factors in older than 65 years persons in an urban area: DERIVA study].

    Science.gov (United States)

    Rodríguez-Sánchez, Emiliano; García-Ortiz, Luis; Gómez-Marcos, Manuel A; Recio-Rodríguez, José I; Mora-Simón, Sara; Pérez-Arechaederra, Diana; Agudo-Conde, Cristina; Escribano-Hernández, Alfonso; Patino-Alonso, María C

    2013-01-01

    To estimate the prevalence of cardiovascular diseases, cardiovascular risk factors, and the psychosocial characteristics associated with them in an urban population aged 65 years and older. Descriptive cross-sectional study of the population. City of Salamanca (Spain). A total of 480 participants aged 65 and older were selected using a stratified randomized sampling method. A health questionnaire was completed in the participants' homes. Weight, height, waist circumference, arterial pressure, blood glucose and cholesterol, were measured, and the standardized prevalence for a European population was estimated. A total of 327 participants were interviewed (68.10% of those selected), mean age of participants was 76 (SD: 7.33). Of the total, 64.5% were women and 20.2% (15.8-24.5) had some cardiovascular disease. In males, the most prevalent cardiovascular disease was ischemic heart disease (12.1% [6.1-18]), while in females it was heart failure (10.4% [6.3-14.6]). Hypertension was the most frequent cardiovascular risk factor for males (63.8% [53.2-70.9]) and females (69.7%.[63.5-75.9]), followed by diabetes in males (36.2% [27.5-45]), and sedentary lifestyle in females (36.0% [29.5-42.5]). Those with cardiovascular diseases were more dependent and had a worse prognosis (Charlson's Comorbility Index). Ischemic heart disease is the most prevalent heart disease in males, while heart failure is the most prevalent disease for females. Almost 80% of the population aged 65 and older did not suffer any of the three cardiovascular diseases that are the main causes of mortality in this group of age. Participants who had a CVD were more dependent for activities of daily living. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  18. The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI study.

    Science.gov (United States)

    Stenholm, S; Alley, D; Bandinelli, S; Griswold, M E; Koskinen, S; Rantanen, T; Guralnik, J M; Ferrucci, L

    2009-06-01

    Both obesity and muscle impairment are increasingly prevalent among older persons and negatively affect health and physical functioning. However, the combined effect of coexisting obesity and muscle impairment on physical function decline has been little studied. We examined whether obese persons with low muscle strength experience significantly greater declines in walking speed and mobility than persons with only obesity or low muscle strength. Community-dwelling adults aged > or = 65 years (n = 930) living in the Chianti geographic area (Tuscany, Italy) were followed for 6 years in the population-based InCHIANTI study. On the basis of baseline measurements (1998-2000), obesity was defined as body mass index (BMI) > or = 30 kg/m(2) and low muscle strength as lowest sex-specific tertile of knee extensor strength. Walking speed and self-reported mobility disability (ability to walk 400 m or climb one flight of stairs) were assessed at baseline and at 3- and 6-year follow-up. At baseline, obese persons with low muscle strength had significantly lower walking speed compared with all other groups (P walking speed and high risk of developing new mobility disability over the 6-year follow-up compared with those without obesity or low muscle strength. After the age of 80, the differences between groups were substantially attenuated. The differences seen in walking speed across combination of low muscle strength and obesity groups were partly explained by 6-year changes in muscle strength, BMI and waist circumference. Obesity combined with low muscle strength increases the risk of decline in walking speed and developing mobility disability, especially among persons < 80 years old.

  19. An examination of an enhancing effect of music on attentional abilities in older persons with mild cognitive impairment.

    Science.gov (United States)

    Lake, Jessica I; Goldstein, Felicia C

    2011-02-01

    While the effect of listening to music on cognitive abilities is highly debated, studies reporting an enhancing effect of music in elderly populations appear to be more consistent. In this study, the effects of listening to music on attention in groups of cognitively normal older adults and those with mild cognitive impairment were considered. Participants were exposed to both a music and silence condition, and after each condition performed Digit Span and Coding tasks which require attention for maximal performance. The hypothesis that listening to music, compared to a silence condition, enhances performance was not supported for either group. Various explanations for these findings are considered.

  20. Symptoms of borderline personality disorder predict interpersonal (but not independent) stressful life events in a community sample of older adults.

    Science.gov (United States)

    Powers, Abigail D; Gleason, Marci E J; Oltmanns, Thomas F

    2013-05-01

    Individuals with borderline personality disorder (BPD) often experience stressful life events at a higher frequency than those without BPD. It is less clear what specific types of events are involved in this effect, and it has not been determined whether some features of BPD are more important than others in accounting for this effect. The latter issue is important in light of the heterogeneous nature of this diagnostic construct. These issues were examined in a large, representative community sample of men and women, ages 55-64. Ten Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, Washington, DC, American Psychiatric Association, 2000) personality disorders were assessed at baseline using the Structured Interview for DSM-IV Personality: SIDP-IV (B. Pfohl, N. Blum, & M. Zimmerman, 1997, Washington, DC, American Psychiatric Press). Life events were measured at three sequential assessments following baseline at 6-month (N = 1,294), 12-month (N = 1,070), and 18-month (N = 837) follow-ups. Stressful life events were identified using a self-report questionnaire (LTE-Q; List of Threatening Experiences Questionnaire: A subset of prescribed life events with considerable long-term contextual threat by T. Brugha, C. Bebbington, P. Tennant, and J. Hurry, 1985, Psychological Medicine, Vol. 15, pp. 189-194.) followed by a telephone interview. Only borderline personality pathology was related to an increase in the frequency of interpersonal stressful life events. Three specific symptoms of BPD were largely responsible for this connection: unstable interpersonal relationships, impulsivity, and chronic feelings of emptiness (negative association). Symptoms of avoidant and schizoid personality disorders were associated with a reduced number of stressful life events that are considered to be outside a person's control (e.g., serious illness, injury, or death of a loved one). None of the personality disorders predicted an increase in the number of

  1. Relationships among depressive, passive-aggressive, sadistic and self-defeating personality disorder features with suicidal ideation and reasons for living among older adults.

    Science.gov (United States)

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

    2015-01-01

    Suicide among older adults is a major public health problem in the USA. In our recent study, we examined relationships between the 10 standard DSM-5 personality disorders (PDs) and suicidal ideation, and found that the PD dimensions explained a majority (55%) of the variance in suicidal ideation. To extend this line of research, the purpose of the present follow-up study was to explore relationships between the four PDs that previously were included in prior versions of the DSM (depressive, passive-aggressive, sadistic, and self-defeating) with suicidal ideation and reasons for living. Community-dwelling older adults (N = 109; age range = 60-95 years; 61% women; 88% European-American) completed anonymously the Coolidge Axis II Inventory, the Reasons for Living Inventory (RFL), and the Geriatric Suicide Ideation Scale (GSIS). Correlational analyses revealed that simple relationships between PD scales with GSIS subscales were generally stronger than with RFL subscales. Regarding GSIS subscales, all four PD scales had medium-to-large positive relationships, with the exception of sadistic PD traits, which was unrelated to the death ideation subscale. Multiple regression analyses showed that the amount of explained variance for the GSIS (48%) was higher than for the RFL (11%), and this finding was attributable to the high predictive power of depressive PD. These findings suggest that depressive PD features are strongly related to increased suicidal thinking and lowered resilience to suicide among older adults. Assessment of depressive PD features should also be especially included in the assessment of later-life suicidal risk.

  2. Predictive value of a profile of routine blood measurements on mortality in older persons in the general population: the Leiden 85-plus Study.

    Directory of Open Access Journals (Sweden)

    Anne H van Houwelingen

    Full Text Available BACKGROUND: Various questionnaires and performance tests predict mortality in older people. However, most are heterogeneous, laborious and a validated consensus index is not available yet. Since most older people are regularly monitored by laboratory tests, we compared the predictive value of a profile of seven routine laboratory measurements on mortality in older persons in the general population with other predictors of mortality; gait speed and disability in instrumental activities of daily living (IADL. METHODOLOGY/PRINCIPAL FINDINGS: Within the Leiden 85-plus Study, a prospective population-based study, we followed 562 participants aged 85 years for mortality over five years. At baseline (age 85 years high-density lipoprotein cholesterol, albumin, alanine transaminase, hemoglobin, creatinin clearance, C-reactive protein and homocysteine were measured. Participants were stratified based on their number of laboratory abnormalities (0, 1, 2-4 and 5-7. The predictive capacity was compared with gait speed (6-meter walking test and disability in IADL (Groningen Activity Restriction Scale by C-statistics. At baseline, 418 (74% 85-year old participants had at least one laboratory abnormality. All cause mortality risk increased with increasing number of laboratory abnormalities to a hazard ratio of 5.64 [95% CI 3.49-9.12] for those with 5-7 laboratory abnormalities (p<0.001 compared to those without abnormalities. The c-statistic was 0.66 [95% CI 0.59-0.69], similar to that of gait speed and disability in IADL. CONCLUSIONS/SIGNIFICANCE: In the general population of oldest old, the number of abnormalities in seven routine laboratory measurements predicts five-year mortality as accurately as gait speed and IADL disability.

  3. Cross-sectional relationship between physical fitness components and functional performance in older persons living in long-term care facilities

    Directory of Open Access Journals (Sweden)

    van Mechelen Willem

    2006-02-01

    Full Text Available Abstract Background The age-related deterioration of physiological capacities such as muscle strength and balance is associated with increased dependence. Understanding the contribution of physical fitness components to functional performance facilitates the development of adequate exercise interventions aiming at preservation of function and independence of older people. The aim of the study was to investigate the relationship between physical fitness components and functional performance in older people living in long-term care facilities. Methods Design cross-sectional study Subjects 226 persons living in long-term care facilities (mean age: 81.6 ± 5.6. Outcome measures Physical fitness and functional performance were measured by performance-based tests. Results Knee and elbow extension strength were significantly higher in men (difference = 44.5 and 50.0 N, respectively, whereas women were more flexible (difference sit & reach test = 7.2 cm. Functional performance was not significantly different between the genders. In men, motor coordination (eye-hand coordination and measures of strength were the main contributors to functional performance, whereas in women flexibility (sit and reach test and motor coordination (tandem stance and eye-hand coordination played a major role. Conclusion The results of this study show that besides muscle strength, fitness components such as coordination and flexibility are associated with functional performance of older people living in long-term care facilities. This suggests that men and women living in long-term care facilities, differ considerably concerning the fitness factors contributing to functional performance. Women and men may, therefore, need exercise programs emphasizing different fitness aspects in order to improve functional performance.

  4. Narrated lived experiences of self-care and health among rural-living older persons with a strong sense of coherence

    Directory of Open Access Journals (Sweden)

    Söderhamn U

    2011-11-01

    Full Text Available Ulrika Söderhamn, Bjørg Dale, Olle SöderhamnFaculty of Health and Sport Sciences, University of Agder, Centre for Caring Research – Southern Norway, Grimstad, NorwayAbstract: Sense of coherence (SOC, with its components comprehensibility, manageability, and meaningfulness, is a major factor in the ability to cope successfully with stressors and is closely related to health. Qualitative studies related to SOC are scarce, and in this phenomenological interview study, self-care is investigated in relation to SOC. The aim of this study was to describe the lived experiences of self-care and features that may influence health and self-care among older home-dwelling individuals living in rural areas and who have a strong SOC. Eleven persons with a mean age of 73.5 years and a SOC value in the range of 153–188, measured by Antonovsky’s 29-item SOC scale, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a phenomenological descriptive method. The findings showed that successful self-care involves having, when needed, contact with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and/or others, and being satisfied and positive and looking forward. Formal and informal caregivers should be conscious of the importance of motivating and supporting older individuals with respect to these dimensions of self-care.Keywords: aged, activity, contacts, phenomenology, well-being

  5. Plasma retinol and association with socio-demographic and dietary characteristics of free-living older persons: the Bordeaux sample of the three-city study.

    Science.gov (United States)

    Féart, Catherine; Siewe, Aisha; Samieri, Cécilia; Peuchant, Evelyne; Helmer, Catherine; Alfos, Serge; Pallet, Véronique; Barberger-Gateau, Pascale

    2010-01-01

    The objective was to describe retinol plasma concentration and its association with socio-demographic characteristics and dietary habits in French older persons. The study population consisted of 1664 subjects aged 65 + from Bordeaux (France), included in the Three-City cohort. Retinol plasma concentration was determined in fasting blood samples. Dietary assessment was performed by a food frequency questionnaire allowing estimation of weekly intake of dietary sources of vitamin A or provitamin A. The weekly number of glasses of alcohol was also recorded. Age, sex, marital status, educational and income levels, body-mass index (BMI), and smoking were registered. Cross-sectional analysis of the association between plasma retinol and socio-demographic characteristics and dietary habits was performed by multilinear regression. Mean plasma retinol was close to the homeostatically regulated concentration of 2.0 micromol/L but ranged from 0.35 to 6.77 micromol/L. It was higher in women and divorced or separated individuals, and increased with income but not with age or educational level. Plasma retinol was positively and independently associated with the frequency of offal consumption and to the number of glasses of alcohol consumed per week. These results allow targeting older individuals who are at risk of either excessive or deficient vitamin A status and who should benefit from dietary counseling.

  6. A pilot study of cognitive training with and without transcranial direct current stimulation to improve cognition in older persons with HIV-related cognitive impairment

    Directory of Open Access Journals (Sweden)

    Ownby RL

    2016-10-01

    Full Text Available Raymond L Ownby,1 Amarilis Acevedo2 1Department of Psychiatry and Behavioral Medicine, 2College of Psychology, Nova Southeastern University, Fort Lauderdale, FL, USA Background: In spite of treatment advances, HIV infection is associated with cognitive deficits. This is even more important as many persons with HIV infection age and experience age-related cognitive impairments. Both computer-based cognitive training and transcranial direct current stimulation (tDCS have shown promise as interventions to improve cognitive function. In this study, we investigate the acceptability and efficacy of cognitive training with and without tDCS in older persons with HIV. Patients and methods: In this single-blind randomized study, participants were 14 individuals of whom 11 completed study procedures (mean age =51.5 years; nine men and two women with HIV-related mild neurocognitive disorder. Participants completed a battery of neuropsychological and self-report measures and then six 20-minute cognitive training sessions while receiving either active or sham anodal tDCS over the left dorsolateral prefrontal cortex. After training, participants completed the same measures. Success of the blind and participant reactions were assessed during a final interview. Assessments were completed by an assessor blind to treatment assignment. Pre- and post-training changes were evaluated via analysis of covariance yielding estimates of effect size. Results: All participants believed that they had been assigned to active treatment; nine of the 11 believed that the intervention had improved their cognitive functioning. Both participants who felt the intervention was ineffective were assigned to the sham condition. None of the planned tested interactions of time with treatment was significant, but 12 of 13 favored tDCS (P=0.08. All participants indicated that they would participate in similar studies in the future. Conclusion: Results show that both cognitive training via

  7. Health-related quality of life and functional status quality indicators for older persons with multiple chronic conditions.

    Science.gov (United States)

    Dy, Sydney M; Pfoh, Elizabeth R; Salive, Marcel E; Boyd, Cynthia M

    2013-12-01

    To explore central challenges with translating self-reported measurement tools for functional status and health-related quality of life (HRQOL) into ambulatory quality indicators for older people with multiple chronic conditions (MCCs). Review. Sources including the National Quality Measures Clearinghouse and National Quality Forum were reviewed for existing ambulatory quality indicators relevant to functional status, HRQOL, and people with MCCs. Seven informants with expertise in indicators using functional status and HRQOL. Informant interviews were conducted to explore knowledge about these types of indicators, particularly usability and feasibility. Nine important existing indicators were identified in the review. For process, identified indicators addressed whether providers assessed functional status; outcome indicators addressed quality of life. In interviews, informants agreed that indicators using self-reported data were important in this population. Challenges identified included concerns about usability due to inability to discriminate quality of care adequately between organizations and feasibility concerns regarding high data collection burden, with a correspondingly low response rate. Validity was also a concern because evidence is mixed that healthcare interventions can improve HRQOL or functional status for this population. As a possible first step, a structural standard could be systematic collection of these measures in a specific setting. Although functional status and HRQOL are important outcomes for older people with MCCs, few relevant ambulatory quality indicators exist, and there are concerns with usability, feasibility, and validity. Further research is needed on how best to incorporate these outcomes into quality indicators for people with MCCs. © Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.

  8. Healthcare utilization in older patients using personal emergency response systems: an analysis of electronic health records and medical alert data : Brief Description: A Longitudinal Retrospective Analyses of healthcare utilization rates in older patients using Personal Emergency Response Systems from 2011 to 2015.

    Science.gov (United States)

    Agboola, Stephen; Golas, Sara; Fischer, Nils; Nikolova-Simons, Mariana; Op den Buijs, Jorn; Schertzer, Linda; Kvedar, Joseph; Jethwani, Kamal

    2017-04-18

    Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization. Retrospective, longitudinal analyses of healthcare and PERS utilization records of older patients over a 5-years period from 2011-2015. The primary outcome was to characterize the healthcare utilization of PERS patients. This outcome was assessed by 30-, 90-, and 180-day readmission rates, frequency of principal admitting diagnoses, and prevalence of conditions leading to potentially avoidable admissions based on Centers for Medicare and Medicaid Services classification criteria. The overall 30-day readmission rate was 14.2%, 90-days readmission rate was 34.4%, and 180-days readmission rate was 42.2%. While 30-day readmission rates did not increase significantly (p = 0.16) over the study period, 90-days (p = 0.03) and 180-days (p = 0.04) readmission rates did increase significantly. The top 5 most frequent principal diagnoses for inpatient admissions included congestive heart failure (5.7%), chronic obstructive pulmonary disease (4.6%), dysrhythmias (4.3%), septicemia (4.1%), and pneumonia (4.1%). Additionally, 21% of all admissions were due to conditions leading to potentially avoidable admissions in either institutional or non-institutional settings (16% in institutional settings only). Chronic medical conditions account for the majority of healthcare utilization in older patients using PERS. Results suggest that PERS data combined with electronic medical records data can

  9. Nutrient-rich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Alemán-Mateo H

    2014-09-01

    Full Text Available Heliodoro Alemán-Mateo,1 Virginia Ramírez Carreón,1 Liliana Macías,1 Humberto Astiazaran-García,1 Ana Cristina Gallegos-Aguilar,1 José Rogelio Ramos Enríquez2 1Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C., 2Laboratorio de Análisis Clínicos e Investigación, Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Mexico Background: At present, it is unknown whether the use of nutrient-rich dairy proteins improves the markers of sarcopenia syndrome. Therefore, our proposal was to investigate whether ­adding 210 g of ricotta cheese daily would improve skeletal muscle mass, handgrip strength, and ­physical performance in non-sarcopenic older subjects.Subjects and methods: This was a single-blind randomized clinical trial that included two homogeneous, randomized groups of men and women over 60 years of age. Participants in the intervention group were asked to consume their habitual diet but add 210 g of ricotta cheese (IG/HD + RCH, while the control group was instructed to consume only their habitual diet (CG/HD. Basal and 12-week follow-up measurements included appendicular skeletal muscle mass (ASMM by dual-energy X-ray absorptiometry, handgrip strength by a handheld dynamometer, and physical performance using the short physical performance battery (SPPB and the stair-climb power test (SCPT. The main outcomes were relative changes in ASMM, strength, SPPB, and SCPT.Results: ASMM increased in the IG/HD + RCH (0.6±3.5 kg, but decreased in the CG/HD (–1.0±2.6. The relative change between groups was statistically significant (P=0.009. The relative change in strength in both groups was negative, but the loss of muscle strength was more pronounced in CG/HD, though in this regard statistical analysis found only a tendency (P=0.07. The relative change in the balance-test scores was positive for the IG/HD + RCH, while in the CG/HD it was negative, as those individuals had

  10. Prevention of falls, malnutrition and pressure ulcers among older persons - nursing staff's experiences of a structured preventive care process.

    Science.gov (United States)

    Lannering, Christina; Ernsth Bravell, Marie; Johansson, Linda

    2017-05-01

    A structured and systematic care process for preventive work, aimed to reduce falls, pressure ulcers and malnutrition among older people, has been developed in Sweden. The process involves risk assessment, team-based interventions and evaluation of results. Since development, this structured work process has become web-based and has been implemented in a national quality registry called 'Senior Alert' and used countrywide. The aim of this study was to describe nursing staff's experience of preventive work by using the structured preventive care process as outlined by Senior Alert. Eight focus group interviews were conducted during 2015 including staff from nursing homes and home-based nursing care in three municipalities. The interview material was subjected to qualitative content analysis. In this study, both positive and negative opinions were expressed about the process. The systematic and structured work flow seemed to only partly facilitate care providers to improve care quality by making better clinical assessments, performing team-based planned interventions and learning from results. Participants described lack of reliability in the assessments and varying opinions about the structure. Furthermore, organisational structures limited the preventive work. © 2016 John Wiley & Sons Ltd.

  11. Skeletal muscle connective tissue

    DEFF Research Database (Denmark)

    Brüggemann, Dagmar Adeline

      The connective tissue content of skeletal muscle is believed to be the major factor responsible for defining the eating quality of different meat cuts, although attempts to correlate quantifications based on traditional histological methods have not as yet been able to prove this relation....... Collagen, being the major protein in connective tissue, has been extensively investigated with regard to its relation to meat tenderness, but the results have been rather conflicting. Meat from older animals is tougher than that from younger animals, and changes in the properties of the collagen due...... that collagen plays a significant role in determining the tenderness of meat. What are we missing? Therefore, fundamental aspects of connective tissue research have been the centre of attention throughout this thesis. A holistic view has been applied, glancing at this complex tissue which has many facets...

  12. A Description of Older Adults' Participation in a Technology-Based Piano Program and Their Musical Skill Development, Perceptions of Personal Fulfillment, and Attitudes toward Music Learning

    Science.gov (United States)

    Mitak, Kirsten Nora

    2012-01-01

    The purpose of this study was to determine the feasibility of Piano Wizard(TM) as a viable technological and instructional tool for older adults. Piano Wizard's applicability for seniors was determined by participants' musical skill development, perceptions of personal fulfillment, attitudes toward music learning, and opinions about the…

  13. Patterns of Multimorbidity in an Older Population of Persons with an Intellectual Disability: Results from the Intellectual Disability Supplement to the Irish Longitudinal Study on Aging (IDS-TILDA)

    Science.gov (United States)

    McCarron, Mary; Swinburne, Janet; Burke, Eilish; McGlinchey, Eimear; Carroll, Rachael; McCallion, Philip

    2013-01-01

    Multimorbidity (2 or more chronic conditions) is being widely studied in older populations and this study explores both the relevance of emerging conceptualizations and the extent to which multimorbidity is a feature of aging in persons with an intellectual disability. Methods: Data was generated from wave one of the intellectual disability…

  14. A Description of Older Adults' Participation in a Technology-Based Piano Program and Their Musical Skill Development, Perceptions of Personal Fulfillment, and Attitudes toward Music Learning

    Science.gov (United States)

    Mitak, Kirsten Nora

    2012-01-01

    The purpose of this study was to determine the feasibility of Piano Wizard(TM) as a viable technological and instructional tool for older adults. Piano Wizard's applicability for seniors was determined by participants' musical skill development, perceptions of personal fulfillment, attitudes toward music learning, and opinions about the…

  15. Examining the construct and known-group validity of a composite endpoint for The Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS); A large-scale data sharing initiative

    NARCIS (Netherlands)

    Hofman, C.S.; Lutomski, J.E.; Boter, H.; Buurman, B.M.; Craen, A.J. de; Donders, R.; Olde Rikkert, M.G.M.; Makai, P.; Melis, R.J.F.

    2017-01-01

    BACKGROUND: Preference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey-Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating

  16. Appropriateness of oral drugs for long-term treatment of lower urinary tract symptoms in older persons: results of a systematic literature review and international consensus validation process (LUTS-FORTA 2014)

    Science.gov (United States)

    Oelke, Matthias; Becher, Klaus; Castro-Diaz, David; Chartier-Kastler, Emmanuel; Kirby, Mike; Wagg, Adrian; Wehling, Martin

    2015-01-01

    Aim: we aimed to systematically review drugs to treat lower urinary tract symptoms (LUTS) regularly used in older persons to classify appropriate and inappropriate drugs based on efficacy, safety and tolerability by using the Fit fOR The Aged (FORTA) classification. Methods: to evaluate the efficacy, safety and tolerability of drugs used for treatment of LUTS in older persons, a systematic review was performed. Papers on clinical trials and summaries of individual product characteristics were analysed regarding efficacy and safety in older persons (≥65 years). The most frequently used drugs were selected based on current prescription data. An interdisciplinary international expert panel assessed the drugs in a Delphi process. Results: for the 16 drugs included here, a total of 896 citations were identified; of those, only 25 reported clinical trials with explicit data on, or solely performed in older people, underlining the lack of evidence in older people for drug treatment of LUTS. No drug was rated at the FORTA-A-level (indispensable). Only three were assigned to FORTA B (beneficial): dutasteride, fesoterodine and finasteride. The majority was rated FORTA C (questionable): darifenacin, mirabegron, extended release oxybutynin, silodosin, solifenacin, tadalafil, tamsulosin, tolterodine and trospium. FORTA D (avoid) was assigned to alfuzosin, doxazosin, immediate release oxybutynin, propiverine and terazosin. Conclusions: dutasteride, fesoterodine and finasteride were classified as beneficial in older persons or frail elderly people (FORTA B). For most drugs, in particular those from the group of α-blockers and antimuscarinics, use in this group seems questionable (FORTA C) or should be avoided (FORTA D). PMID:26104505

  17. Examining the construct and known-group validity of a composite endpoint for The Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS); A large-scale data sharing initiative.

    Science.gov (United States)

    Hofman, Cynthia S; Lutomski, Jennifer E; Boter, Han; Buurman, Bianca M; de Craen, Anton J M; Donders, Rogier; Olde Rikkert, Marcel G M; Makai, Peter; Melis, René J F

    2017-01-01

    Preference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey-Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating interventions in geriatric care as it combines multiple outcomes relevant to older persons in a single metric. The objective of this study was to validate TOPICS-CEP across different study settings (general population, primary care and hospital). Data were extracted from TOPICS Minimum Dataset (MDS), a pooled public-access national database with information on older persons throughout the Netherlands. Data of 17,603 older persons were used. Meta-correlations were performed between TOPICS-CEP indexed scores, EuroQol5-D utility scores and Cantril's ladder life satisfaction scores. Mixed linear regression analyses were performed to compare TOPICS-CEP indexed scores between known groups, e.g. persons with versus without depression. In the complete sample and when stratified by study setting TOPICS-CEP and Cantril's ladder were moderately correlated, whereas TOPICS-CEP and EQ-5D were highly correlated. Higher mean TOPICS-CEP scores were found in persons who were: married, lived independently and had an education at university level. Moreover, higher mean TOPICS-CEP scores were found in persons without dementia, depression, and dizziness with falls, respectively. Similar results were found when stratified by subgroup. This study supports that TOPICS-CEP is a robust measure which can potentially be used in broad settings to identify the effect of intervention or of prevention in elderly care.

  18. Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Shah Raj C

    2012-10-01

    Full Text Available Abstract Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL. The odds ratio and 95% Confidence Interval (CI were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6 and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6. At baseline, 718 (82.5% participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65. Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total

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

    Science.gov (United States)

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

    2016-09-01

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

  20. Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference?

    Directory of Open Access Journals (Sweden)

    Raîche Michel

    2011-10-01

    Full Text Available Abstract Background The PRISMA Model is an innovative coordination-type integrated-service-delivery (ISD network designed to manage and better match resources to the complex and evolving needs of elders. The goal of this study was to examine the impact of this ISD network on unmet needs among disabled older persons living in the community. Methods Using data from the PRISMA study, we compared unmet needs of elders living in the community in areas with or without an ISD network. Disabilities and unmet needs were assessed with the Functional Autonomy Measurement System (SMAF. We used growth-curve analysis to examine changes in unmet needs over time and the variables associated with initial status and change. Sociodemographic characteristics, level of disability, self-perceived health status, cognitive functioning, level of empowerment, and the hours of care received were investigated as covariates. Lastly, we report the prevalence of needs and unmet needs for 29 activities in both areas at the end of the study. Results On average, participants were 83 years old; 62% were women. They had a moderate level of disability and mild cognitive problems. On average, they received 2.07 hours/day (SD = 1.08 of disability-related care, mostly provided by family. The findings from growth-curve analysis suggest that elders living in the area where ISD was implemented and those with higher levels of disability experience better fulfillment of their needs over time. Besides the area, being a woman, living alone, having a higher level of disability, more cognitive impairments, and a lower level of empowerment were linked to initial unmet needs (r2 = 0.25; p Conclusions In spite of more than 30 years of home-care services in the province of Quebec, disabled older adults living in the community still have unmet needs. ISD networks such as the PRISMA Model, however, appear to offer an effective response to the long-term-care needs of the elderly.

  1. Sense of coherence, depressive feelings and life satisfaction in older persons: a closer look at the role of integrity and despair.

    Science.gov (United States)

    Dezutter, Jessie; Wiesmann, Ulrich; Apers, Silke; Luyckx, Koen

    2013-01-01

    The present study investigated the relationship between Antonovsky's sense of coherence (SOC) and well-being in a sample of Flemish elderly. In addition, the mediating role of Erikson's developmental task of integrity versus despair was examined in the relationship between SOC, depression, and life satisfaction. Data on sociodemographic variables, SOC, depressive symptoms, life satisfaction, ego-integrity, and despair were collected. In total, 100 older persons with a mean age of 76.5 years participated. Mplus was used to test the mediating role of integrity and despair in the relationship between SOC and both life satisfaction and depression. A positive relationship between SOC and well-being was found. More precisely, elderly individuals with a strong SOC experienced less depressive symptoms and higher levels of satisfaction with their life. In addition, mediation analysis indicated that the relationship between SOC and depressive symptoms was partially mediated by the positive resolution of the integrity-despair crisis, whereas the relationship between SOC and life satisfaction was fully mediated by integrity and despair. Our findings indicate that SOC might be a resource for greater well-being in the elderly. Furthermore, our study offers a partial explanation for the relations found and points to the importance of finding integrity and resolving despair in this stage of life.

  2. Effects of Activity-Based Personalized Nutrition Education on Dietary Behaviors and Blood Parameters in Middle-Aged and Older Type 2 Diabetes Korean Outpatients

    Science.gov (United States)

    2016-01-01

    This study aimed to compare the effects of activity-based personalized nutrition education (APNE) with a general instruction for diabetes (control, CTRL) in middle-aged and older Korean outpatients with type 2 diabetes. After an initial screening, 70 subjects were randomly assigned to APNE (n = 37) or CTRL (n = 33) group. APNE considered each patient’s anthropometry, blood chemistry data, and dietary habits in addition to planning meal choices with the aid of registered dietitians. After 3 months, dietary behavior, food intake, and anthropometric and blood measurement results were evaluated. Fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels decreased in the APNE group (n = 33) but not in the CTRL group (n = 23). In the APNE group, the meal intervals and number of days of consuming high-fat food were decreased, while the number of days following a meal plan and balanced diet that entailed consuming fruits, vegetables, and healthy food was increased. A lower consumption of carbohydrates, saccharides, grains, and tuber crops and a higher protein, pulses, and fat-derived calorie intake compared with the initial values were observed in the APNE group. In contrast, only the number of days following the meal plan and balanced diet was increased in the CRTL group, without significantly changing the individual macronutrient-derived calorie intake. The APNE approach appeared to effectively educate outpatients with type 2 diabetes about changing their dietary behavior and food intake and improving the clinical parameters related to diabetic conditions. PMID:27812513

  3. Schizophrenia in older adults.

    Science.gov (United States)

    Collier, Elizabeth; Sorrell, Jeanne M

    2011-11-01

    Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.

  4. Skeletal muscle sodium channelopathies.

    Science.gov (United States)

    Nicole, Sophie; Fontaine, Bertrand

    2015-10-01

    This is an update on skeletal muscle sodium channelopathies since knowledge in the field have dramatically increased in the past years. The relationship between two phenotypes and SCN4A has been confirmed with additional cases that remain extremely rare: severe neonatal episodic laryngospasm mimicking encephalopathy, which should be actively searched for since patients respond well to sodium channel blockers; congenital myasthenic syndromes, which have the particularity to be the first recessive Nav1.4 channelopathy. Deep DNA sequencing suggests the contribution of other ion channels in the clinical expressivity of sodium channelopathies, which may be one of the factors modulating the latter. The increased knowledge of channel molecular structure, the quantity of sodium channel blockers, and the availability of preclinical models would permit a most personalized choice of medication for patients suffering from these debilitating neuromuscular diseases. Advances in the understanding of the molecular structure of voltage-gated sodium channels, as well as availability of preclinical models, would lead to improved medical care of patients suffering from skeletal muscle, as well as other sodium channelopathies.

  5. Hearing aid fitting in older persons with hearing impairment: the influence of cognitive function, age, and hearing loss on hearing aid benefit

    Directory of Open Access Journals (Sweden)

    Meister H

    2015-02-01

    Full Text Available Hartmut Meister,1 Sebastian Rählmann,1 Martin Walger,2 Sabine Margolf-Hackl,3 Jürgen Kießling3 1Jean Uhrmacher Institute for Clinical ENT-Research, University of Cologne, Cologne, Germany; 2Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany; 3Department of Othorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany Purpose: To examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons.Methods: Hearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated.Results: Most of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity – as determined by the fluid intelligence measure – was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered.Conclusion: The present study does not give evidence that hearing aid benefit is critically associated with cognitive

  6. Exploring experience and perspectives of foreign-born direct care workers in dementia care: Accounts of Korean American personal care aides caring for older Korean Americans with dementia symptoms.

    Science.gov (United States)

    Lee, Sang E; Casado, Banghwa Lee; Hong, Michin

    2016-05-06

    This focus group study explored experience of Korean American personal care aides caring for older Korean Americans with dementia symptoms. Personal care aides described dementia caregiving as challenging, demanding and stressful, yet they cared for their clients with love and affection, particularly with jeong (i.e., a Korean cultural concept of love, affection, sympathy, and bondage). They learned about dementia mostly through their caregiving experience and expressed their need and strong desire to learn more about dementia. They felt for family struggle and observed family conflict and filial obligation. They advocated the value of personal care aides' involvement in dementia care. This study revealed a pressing need for dementia training for personal care aides and called for an outreach effort to recruit and train direct care workers with potential of providing culturally competent care for traditionally underserved ethnic minorities.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  9. Skeletal brucellosis.

    Science.gov (United States)

    Patil, M Y; Antin, S M; Gupta, Abhishek

    2011-03-01

    Brucellosis is a bacterial infection causing severe public and socioeconomic problem, most prevalent in human beings in those areas in which infection of cattle, dogs, pigs, and goats is common. Out of a total number of 100 patients, there were 65 males (65%) and 35 females (35%). Forty patients lost to follow-up. Detection of specific antibodies was done by brucella agglutination test. In majority of the patients the titre was 1:320; the highest titre was 1:2560 and least titre was 1:40. All the patients were treated by combination therapy of doxycycline 100 to 200 mg/day, rifampicin 600 to 900 mg/day and streptomycin one g/day (for high titres above 600 IU) for six weeks. To check the efficacy of treatment the titres were repeated after four weeks, in 42 (70%) the titres were negative, 1:40 in 8 (13%), 1:80 in 4 (7%), 1:160 in 4 (7%) and 1:640 in 2 (3%). Brucella is a zoonotic disease and found most commonly in person who handles the animal most frequently but can occur in other persons also by other modes of infection. The most common joint involved was sacro-iliac joint in 31 (52%) and least common joints involved were ankle and elbow 2 (3%) each. The patients responded well to three-drug regimen and their antibody titre came down drastically following four weeks of treatment.

  10. The older worker.

    Science.gov (United States)

    Fulks, J S; Fallon, L F

    2001-01-01

    About one person in eight remains employed past 65, the average age for retirement in the U.S. These persons tend to be highly reliable. They can adapt and learn new technology, but may require extra time to do so. Older workers have particular needs in the workplace due to physiological changes that accompany aging. They may require more lighting, and they may have decreased mobility, physical strength, and dexterity. These factors often have no impact on their ability to accomplish job duties. This chapter underscores the significant contributions that older workers often provide, and also addresses retirement planning.

  11. “I felt like a new person.” The effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries

    OpenAIRE

    Morone, Natalia E.; Lynch, Cheryl S.; Greco, Carol M.; Tindle, Hilary A.; Weiner, Debra K.

    2008-01-01

    To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP) we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an eight week mindfulness meditation program. Participants were 27 adults ≥ 65 years with CLBP of at least moderate severity and of at least three months duration. We found several themes reflecting the beneficial effects of mindfulne...

  12. Skeletal Analysis: Investigating Senescence in Ancient Nubia

    OpenAIRE

    Reavis, Katelyn

    2014-01-01

    The understanding of older adult life experiences is deficient when compared to younger adults and children in the archaeological record. Research has been devoted toward aging techniques and studies of osteoarthritis, but there are few discussions describing senescence, the cumulative process of aging, in the past. Most research includes the oldest cohort (45 years and above) within the broad category of adults, but it is useful to look at this demographic separately. Skeletal remains were a...

  13. Older Drivers

    Science.gov (United States)

    ... in this topic was provided by the National Highway Traffic Safety Administration Topic last reviewed: March 2015 For ... see Traffic Safety Facts 2012: Older Population. (National Highway Traffic Safety Administration). Crashes Down Among Older Drivers Fortunately, ...

  14. Cohort Influences in Older Marriages.

    Science.gov (United States)

    Eskew, Ron W.

    Cohort differentiation has been posited to crystallize around periods of social crises and to be most impactful on the young adults of a given socio-historical period. The two most prominent socio-historical events in the pasts of today's older married persons were the Great Depression of the 1930's and World War II. Older married couples were…

  15. The Mental Health of Older Persons After Human-Induced Disasters: A Systematic Review and Meta-Analysis of Epidemiological Data.

    Science.gov (United States)

    Siskind, Dan J; Sawyer, Emily; Lee, Irene; Lie, David C; Martin-Khan, Melinda; Farrington, Julia; Crompton, David; Kisely, Steve

    2016-05-01

    Older people are increasingly "in harm's way" following human-induced disasters (HIDs). There is debate in the literature as to the relative impact of disasters on their psychological health compared with other age groups. Natural disasters and HIDs are thought to affect survivors differentially, and this may extend to older adults as a group. In the absence of existing systematic reviews, we aimed to synthesize the available evidence and conduct meta-analyses of the effects of HIDs on the psychological health of older versus younger adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified 11 papers from 10 studies on HIDs (N = 26,753), of which 8 had sufficient data for a random-effects meta-analysis. Older adults were 2.85 times less likely to experience PTSD symptoms following HID (95% CI: 1.42-5.70) when compared with younger adults. There was no statistically significant difference in terms of anxiety and depressive symptoms. Health and emergency services need to be increasingly prepared to meet the psychological needs of older people, given the global rise in the numbers of older adults affected by disasters of all kinds. Preliminary evidence suggests that old age may be a protective factor for the development of PTSD in the wake of HID. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  16. A 10-year follow-up study on subjective well-being and relationships to person-environment (P-E) fit and activity of daily living (ADL) dependence of older Swedish adults.

    OpenAIRE

    Werngren-Elgström, Monica; Carlsson, Gunilla; Iwarsson, Susanne

    2009-01-01

    In order to investigate how well-being and ill health is affected by the process of aging, the main aim was to investigate these self-perceived aspects of health over a 10-year period among older Swedish adults. The aim was also to study how these aspects correlated with objectively assessed functional limitations, use of mobility device, person-environment (P-E) fit (also denoted accessibility), problems in housing, and activity of daily living (ADL) dependence. Using the Swedish national po...

  17. Fomento de la actitud resiliente en los adultos mayores en situación del abandono familiar. Promotion of the resilient attitude in older persons in situations of family abandonment.

    OpenAIRE

    Carvajal Correa, Victoria Eugenia; Castaño Restrepo, Blanca Arelis; Noguera, Greissy Yadith; Klimenko, Olena

    2011-01-01

    Promotion of the resilient attitude in older persons in situations of family abandonment. Resumen El articulo presenta los resultados de la investigación realizada para optar el titulo de psicólogo, cuyo objetivo fue diseñar, aplicar y evaluar un Programa de fomento de la actitud resiliente en adultos mayores que se encuentran en situación de abandono familiar pertenecientes al Hogar Gerontológico Santa Isabel. Para ello, se hizo necesario identificar los intereses, metas, motivaciones, as...

  18. Practitioner research to promote practice development: the continued development by means of practitioner research of a multidisciplinary learning environment within neurorehabilitation care for older persons

    Directory of Open Access Journals (Sweden)

    Cyrilla van der Donk

    2015-11-01

    Full Text Available Background: Continuous innovation is required to help clinical practice adapt to healthcare demand and there is a pressing need for sufficient numbers of professionals trained to work in this ever-changing context. New environments for learning are needed to enhance the development of these skills for existing and future care professionals. This article gives an account of how practitioner research was used to further develop a multidisciplinary learning environment for students of the Institute of Health Studies and the Institute of Nursing Studies of HAN University of Applied Sciences in a department specialising in neurorehabilitation for older persons from ZZG Herstelhotel, a public hospital offering long-term residential care in the Netherlands. Aim: The aim of the study was to pursue the development of the learning environment by exploring stakeholders’ visions of their ideal multidisciplinary learning environment. Method: Practitioner research was chosen as a methodology as it deliberately seeks to generate local knowledge and theories through exploring different perspectives, and to encourage learning and reflection. A research group was formed consisting of the first author and three practice supervisors. A mixed-methods approach was used by the research group. First, a selection of relevant publications was reviewed by the group. This was followed by learning sessions in which students, supervisors and managers were invited to dream and design on the basis of their own experiences, thereby linking up with the constructionist-based change approach of Appreciative Inquiry. Results: A collective view of the characteristics of a workbased learning environment was developed by students, supervisors and managers. These characteristics were placed in one of four ideal perspectives: the core professional competencies to be acquired; the resources available; the learning culture; and the supervision. Not all students valued multidisciplinary

  19. Skeletally Dugundji spaces

    OpenAIRE

    2012-01-01

    We introduce and investigate the class of skeletally Dugundji spaces as a skeletal analogue of Dugundji space. The main result states that the following conditions are equivalent for a given space $X$: (i) $X$ is skeletally Dugundji; (ii) Every compactification of $X$ is co-absolute to a Dugundji space; (iii) Every $C^*$-embedding of the absolute $p(X)$ in another space is strongly $\\pi$-regular; (iv) $X$ has a multiplicative lattice in the sense of Shchepin \\cite{s76} consisting of skeletal ...

  20. Riding performance on a conventional bicycle and a pedelec in low speed exercises : objective and subjective evaluation of middle-aged and older persons.

    NARCIS (Netherlands)

    Kovácsová, M. Winter, J.C.F. de Schwab, A.L. Christoph, M. Twisk, D.A.M. & Hagenzieker, M.P.

    2016-01-01

    This study investigated cycling performance of middle-aged (30–45 years old; n = 30) versus older (65+ years; n = 31) participants during low-speed tasks for which stabilization skills are known to be important. Additionally, participants’ self-ratings of their cycling skills and performance were as

  1. Impact of the economic crisis on the health of older persons in Spain: research clues based on an analysis of mortality. SESPAS report 2014.

    Science.gov (United States)

    Benmarhnia, Tarik; Zunzunegui, Maria-Victoria; Llácer, Alicia; Béland, Francois

    2014-06-01

    Older adults are seldom considered in studies on the health impact of economic recessions or crises. However, they constitute a population group that is highly vulnerable to decreases in investment in health and social services and social security. Our aim is to examine the relationship between the economic crisis starting in 2008 and the health status of older adults in Spain. More specifically, we analyze changes in trends of mortality in relation to the crisis, the specific impact of winter on mortality and gender differences in the crisis' impact on mortality. Using data from the National Institute of Statistics of Spain on people over 60 years of age, the number of monthly deaths by age and sex from January 2005 to December 2012 was analyzed. Interrupted time series analyses and the "difference in differences" method were used. During the crisis, for adults 60 years and older: 1) the observed mortality seems to be decreasing at a slower rate than what would have been expected in the absence of the crisis; 2) there has been an increase in winter mortality; 3) the impact of the crisis has been greater for female than for male mortality. These results suggest sizable effects of the economic crisis on the mortality of older adults and argue for research done using more detailed analyses integrating economic indicators.

  2. Loneliness is associated with poor prognosis in late-life depression : Longitudinal analysis of the Netherlands study of depression in older persons

    NARCIS (Netherlands)

    Holvast, Floor; Burger, Huibert; de Waal, Margot M. W.; van Marwijk, Harm W. J.; Comijs, Hannie C.; Verhaak, Peter F. M.

    2015-01-01

    Background: Although depression and loneliness are common among older adults, the role of loneliness on the prognosis of late life depression has not yet been determined. Therefore, we examined the association between loneliness and the course of depression. Methods: We conducted a 2-year follow-up

  3. Pain and psychological well-being of older persons living in nursing homes: an exploratory study in planning patient-centred intervention.

    Science.gov (United States)

    Tse, Mimi; Leung, Rincy; Ho, Suki

    2012-02-01

    This article is a report on a study to examine the pain situation, the use of oral analgesics and non-pharmacological strategies and the psychological well-being of older patients living in nursing homes; the relationships between pain and psychological well-being were also explored. Pain is common among older adults world-wide, and tends to be under-treated. Indeed, the high prevalence of pain may further hinder the fulfilment of psychological needs in a Maslow hierarchy of needs model. It was a quantitative cross-sectional study; older adults from six nursing homes were invited to join the study in 2007-2009, with a response rate of 100%. Pain was measured using the Geriatric Pain Assessment, happiness using the Subjective Happiness Scale, life satisfaction using the Life Satisfaction Index - A Form, loneliness using the Revised UCLA Loneliness Scale and depression was measured using the Geriatric Depression Scale. A convenience sample of 302 older patients (213 females and 89 males aged from 60 to 101, mean age of 84·99) joined the study. The majority of them had experienced pain in the previous 3 months, with a pain intensity of 4·51 on a 10-point scale. Pain sites were mainly the knee, back, shoulder and musculoskeletal areas. Only 50% of them took oral analgesics, and 70% used non-pharmacological measures for pain relief. The pain group reported significantly more loneliness and depression when compared with their no-pain counterparts. As the number of older patients increases, so does the need for alternative accommodation; thus, pain management education is urgently needed for staff and nursing home residents. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  4. Clinical Measures Are Feasible and Sensitive to Assess Balance and Gait Capacities in Older Persons with Mild to Moderate Intellectual Disabilities

    Science.gov (United States)

    Enkelaar, Lotte; Smulders, Ellen; Lantman-de Valk, Henny van Schrojenstein; Weerdesteyn, Vivian; Geurts, Alexander C. H.

    2013-01-01

    Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive equipment such as force plates or a 3D motion…

  5. Clinical measures are feasible and sensitive to assess balance and gait capacities in older persons with mild to moderate Intellectual Disabilities

    NARCIS (Netherlands)

    Enkelaar, L.; Smulders, E.; Schrojenstein Lantman, H.M.J. van; Weerdesteijn, V.G.M.; Geurts, A.C.H.

    2013-01-01

    Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive

  6. Striving to maintain a dignified life for the patient in transition: Next of kin’s experiences during the transition process of an older person in transition from hospital to home

    Directory of Open Access Journals (Sweden)

    Sigrun Hvalvik

    2015-03-01

    Full Text Available Next of kin represent significant resources in the care for older patients. The aim of this study was to describe and illuminate the meaning of the next of kin’s experiences during the transition of an older person with continuing care needs from hospital to home. The study has a phenomenological hermeneutic design. Individual, narrative interviews were conducted, and the data analysis was conducted in accordance with Lindseth and Norberg’s phenomenological hermeneutic method. Two themes and four subthemes were identified and formulated. The first theme: “Balancing vulnerability and strength,” encompassed the subthemes “enduring emotional stress” and “striving to maintain security and continuity.” The second theme: “Coping with an altered everyday life,” encompassed “dealing with changes” and “being in readiness.” Our findings suggest that the next of kin in striving to maintain continuity and safety in the older person’s transition process are both vulnerable individuals and significant agents. Thus, it is urgent that health care providers accommodate both their vulnerability and their abilities to act, and thereby make them feel valued as respected agents and human beings in the transition process.

  7. Older Adults and Gambling: A Review

    Science.gov (United States)

    Ariyabuddhiphongs, Vanchai

    2012-01-01

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

  8. Effective communication with older adults.

    Science.gov (United States)

    Daly, Louise

    2017-06-07

    Communication is an essential aspect of life, yet it can be taken for granted. Its centrality to being in the world and in professional practice often becomes evident when nurses and older adults encounter communication difficulties. The factors that can affect nurses' communication with older adults relate to the older adult, the nurse, sociocultural considerations and the environment, and the interactions between these factors. In adopting a person-centred approach to communicating with older adults, it is necessary to get to know the person as an individual and ensure communication meets their needs and abilities. Effective communication is essential in nursing practice and requires professional competence and engagement. This article can be used by nurses to support effective communication with older adults across the continuum of care.

  9. Skeletal limb abnormalities

    Science.gov (United States)

    ... JA. Skeletal dysplasias. In: Herring JA, ed. Tachdjian's Pediatric Orthopaedics . 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 40. Moore KL, Persaud V, Torchia MG. Skeletal system. In: Moore KL, Persaud V, Torchia MG, eds. ... Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. ...

  10. Proteomics of Skeletal Muscle

    DEFF Research Database (Denmark)

    Deshmukh, Atul

    2016-01-01

    Skeletal muscle is the largest tissue in the human body and plays an important role in locomotion and whole body metabolism. It accounts for ~80% of insulin stimulated glucose disposal. Skeletal muscle insulin resistance, a primary feature of Type 2 diabetes, is caused by a decreased ability...... of muscle to respond to circulating insulin. Physical exercise improves insulin sensitivity and whole body metabolism and remains one of the most promising interventions for the prevention of Type 2 diabetes. Insulin resistance and exercise adaptations in skeletal muscle might be a cause, or consequence......, of altered protein expressions profiles and/or their posttranslational modifications (PTMs). Mass spectrometry (MS)-based proteomics offer enormous promise for investigating the molecular mechanisms underlying skeletal muscle insulin resistance and exercise-induced adaptation; however, skeletal muscle...

  11. Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: "You Only Get Things Done When Working in Concert with Clients".

    Science.gov (United States)

    Coulourides Kogan, Alexis; Wilber, Kathleen; Mosqueda, Laura

    2016-01-01

    Specialized, fragmented acute care is not aligned optimally to serve older adults. Person-centered care (PCC) has emerged as an evidence-based solution that involves enlisting patients as partners in treatment planning. Although several efforts have captured person-centered voices in outpatient care, more information is needed at the organizational and provider level to better understand the feasibility, challenges, and effect of PCC in community-based and social services settings. To assess themes and emerging trends, researchers conducted telephone interviews with leaders at nine organizations providing PCC for older adults. Questions were focused on the legacy of PCC services, whether and how PCC was connected to better quality care, and what tools were used for measuring PCC. Three themes on PCC for older adults emerged. (1) Each organization ascribed to a unique definition and operational structure for PCC. (2) Despite these differences, all organizations specified a strong commitment to PCC. Most noted financial resources and staffing as challenges and opportunities affecting feasibility. (3) Terms such as "patient-centered" care and other PCC synonyms may warrant greater clarification, because ideological differences set these classifications apart. Results from this analysis indicate the lack of a single, established definition for PCC. As interest in and support for PCC mounts, organizations in outpatient medical and community-based settings clearly have undertaken individual efforts to interpret what PCC is and how to provide it. Interview responses reflect this inconsistency, highlighting how staff and financing in particular can bolster or burden the PCC paradigm and what a consensus definition could do for the field.

  12. Gait Training with Real-Time Augmented Toe-Ground Clearance Information Decreases Tripping Risk in Older Adults and a Person with Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Rezaul K Begg

    2014-05-01

    Full Text Available Falls risk increases with ageing but is substantially higher in people with stroke. Tripping-related balance loss is the primary cause of falls, and Minimum Toe Clearance (MTC during walking is closely linked to tripping risk. The aim of this study was to determine whether real-time augmented information of toe-ground clearance at MTC can increase toe clearance, and reduce tripping risk. Nine healthy older adults (76±9 years and one 71 year old female stroke patient participated. Vertical toe displacement was displayed in real-time such that participants could adjust their toe clearance during treadmill walking. Participants undertook a session of unconstrained walking (no-feedback baseline and, in a subsequent Feedback condition, were asked to modify their swing phase trajectory to match a target increased MTC. Tripping probability (PT pre- and post-training was calculated by modelling MTC distributions. Older adults showed significantly higher mean MTC for the post-training retention session (27.7 ±3.79mm compared to the normal walking trial (14.1± 8.3 mm. The PT on a 1cm obstacle for the older adults reduced from 1 in 578 strides to 1 in 105,988 strides. With gait training the stroke patient increased MTC and reduced variability (baseline 16±12 mm, post-training 24±8 mm which reduced obstacle contact probability from 1 in 3 strides in baseline to 1 in 161 strides post-training. The findings confirm that concurrent visual feedback of a lower limb kinematic gait parameter is effective in changing foot trajectory control and reducing tripping probability in older adults. There is potential for further investigation of augmented feedback training across a range of gait-impaired populations, such as stroke.

  13. AN EXAMINATION OF AN ENHANCING EFFECT OF MUSIC ON ATTENTIONAL ABILITIES IN OLDER PERSONS WITH MILD COGNITIVE IMPAIRMENT1,2

    OpenAIRE

    Lake, Jessica I.; Goldstein, Felicia C.

    2011-01-01

    While the effect of listening to music on cognitive abilities is highly debated, studies reporting an enhancing effect of music in elderly populations appear to be more consistent. This study considered the effect of listening to music on attention in groups of cognitively normal older adults and those with mild cognitive impairment. Participants were exposed to both a music and silence condition, and after each condition performed Digit Span and Coding tasks which require attention for maxim...

  14. 社会支持与唐山市福利院老年人抑郁的相关性分析%CORRELATION ANALYSIS ON SOCIAL SUPPORT AND DEPRESSION SYMPTOM FOR OLDER PERSONS OF WELFARE IN TANGSHAN CITY

    Institute of Scientific and Technical Information of China (English)

    夏颖佳; 陈长香; 王羽晗; 褚海彦; 张红; 赵春双; 张健

    2011-01-01

    [目的]探讨唐山市区内福利院老年人抑郁症与社会支持水平的关系及各因素对抑郁患病的作用.[方法]以河北省唐山市区内402名居住于福利院的老年人为研究对象,采用抑郁量表、社会支持问卷、个人一般情况问卷进行评定分析.[结果]老年人抑郁的患病率与其社会支持水平相关,社会支持水平高者抑郁患病率低,差异有统计学意义(P<0.01),[结论]唐山市区内福利院老年人抑郁的患病率与社会支持水平相关,应该提高其社会支持度.%[Objective]To study the relationship of depression symptoms of older persons in welfare house and social support level in the urban areas of Tangshan.[Methods]402 elderly people living in welfare institutions were selected in Tangshan City, Hebei Province for the study.Geriatric Depressive Scale (GDS) , Social Support Rating Scale (SSRS) and general personal information were used for investigation.[Results]The incidence of depression in the older persons was associated with their level of social support.The more high levels of social support they had, the lower incidence of depression was.The difference was significant (P < 0.01).[Conclusion]The incidence of depression in the elderly in welfare house is associated with social support level in the urban areas of Tangshan, thus we should enhance their social support

  15. Proteomics of Skeletal Muscle

    DEFF Research Database (Denmark)

    Deshmukh, Atul

    2016-01-01

    Skeletal muscle is the largest tissue in the human body and plays an important role in locomotion and whole body metabolism. It accounts for ~80% of insulin stimulated glucose disposal. Skeletal muscle insulin resistance, a primary feature of Type 2 diabetes, is caused by a decreased ability...... of muscle to respond to circulating insulin. Physical exercise improves insulin sensitivity and whole body metabolism and remains one of the most promising interventions for the prevention of Type 2 diabetes. Insulin resistance and exercise adaptations in skeletal muscle might be a cause, or consequence...

  16. AN EXAMINATION OF AN ENHANCING EFFECT OF MUSIC ON ATTENTIONAL ABILITIES IN OLDER PERSONS WITH MILD COGNITIVE IMPAIRMENT1,2

    Science.gov (United States)

    LAKE, JESSICA I.; GOLDSTEIN, FELICIA C.

    2012-01-01

    Summary While the effect of listening to music on cognitive abilities is highly debated, studies reporting an enhancing effect of music in elderly populations appear to be more consistent. This study considered the effect of listening to music on attention in groups of cognitively normal older adults and those with mild cognitive impairment. Participants were exposed to both a music and silence condition, and after each condition performed Digit Span and Coding tasks which require attention for maximal performance. The hypothesis that listening to music compared to a silence condition enhances performance was not supported for either group. Various explanations for these findings are considered. PMID:21466100

  17. The effect of a designated tool on person-centred goal identification and service planning among older people receiving homecare in New Zealand.

    Science.gov (United States)

    Parsons, John G M; Parsons, Matthew J G

    2012-11-01

    This study sought to determine the ability of a designated tool developed to identify client-directed goals in a sample of older people referred for homecare. A retrospective pre/post-intervention design was used and a total of 360 older people in an urban centre in New Zealand were included in the analysis. All clients receiving services at the time of data collection (July 2007) who were referred for service provision between July 2003 and the implementation in January 2007 of a restorative model of homecare were included in the analysis. The restorative model of homecare included a designated goal-facilitation tool [Towards Achieving Realistic Goal in Elders Tool (TARGET)]. Prior to the use of TARGET, participants had a goal recorded for their home-care episode in 31 cases (8.6%), whereas following the implementation of TARGET, goals were recorded in 339 cases (94.2%). At a quarterly review, eight clients (2.2%) achieved their goal prior to TARGET, whereas 172 clients (47.8%) fully achieved their goal when TARGET was utilised. Within the sample, multinomial logistic regression showed that the use of TARGET significantly improved goal attainment. Furthermore, moderate-to-severe cognitive impairment significantly reduced the successful attainment of goals. The study highlighted the importance of a designated tool for facilitating older people to set goals that are then used in developing support plans to structure services to assist them in the home. The need for alternative strategies for goal setting for people with significant cognitive impairment was highlighted. This study, in attempting to determine the effect of a goal-facilitation tool as a driver for quality improvement in homecare, had an observational comparative design, this being the most pragmatic option to assess the feasibility of TARGET prior to further work being undertaken. The results do show that in this sample of older people receiving homecare, the use of TARGET led to a greater proportion

  18. Skeletal muscle tissue engineering

    National Research Council Canada - National Science Library

    Bach, A. D; Beier, J. P; Stern‐Staeter, J; Horch, R. E

    2004-01-01

    The reconstruction of skeletal muscle tissue either lost by traumatic injury or tumor ablation or functional damage due to myopathies is hampered by the lack of availability of functional substitution...

  19. BDNF Responses in Healthy Older Persons to 35 Minutes of Physical Exercise, Cognitive Training, and Mindfulness: Associations with Working Memory Function.

    Science.gov (United States)

    Håkansson, Krister; Ledreux, Aurélie; Daffner, Kirk; Terjestam, Yvonne; Bergman, Patrick; Carlsson, Roger; Kivipelto, Miia; Winblad, Bengt; Granholm, Ann-Charlotte; Mohammed, Abdul Kadir H

    2017-01-01

    Brain-derived neurotrophic factor (BDNF) has a central role in brain plasticity by mediating changes in cortical thickness and synaptic density in response to physical activity and environmental enrichment. Previous studies suggest that physical exercise can augment BDNF levels, both in serum and the brain, but no other study has examined how different types of activities compare with physical exercise in their ability to affect BDNF levels. By using a balanced cross over experimental design, we exposed nineteen healthy older adults to 35-minute sessions of physical exercise, cognitive training, and mindfulness practice, and compared the resulting changes in mature BDNF levels between the three activities. We show that a single bout of physical exercise has significantly larger impact on serum BDNF levels than either cognitive training or mindfulness practice in the same persons. This is the first study on immediate BDNF effects of physical activity in older healthy humans and also the first study to demonstrate an association between serum BDNF responsivity to acute physical exercise and working memory function. We conclude that the BDNF increase we found after physical exercise more probably has a peripheral than a central origin, but that the association between post-intervention BDNF levels and cognitive function could have implications for BDNF responsivity in serum as a potential marker of cognitive health.

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

    Science.gov (United States)

    Singer, Jefferson; Rexhaj, Blerim; Baddeley, Jenna

    2007-11-01

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