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Sample records for older population special

  1. How many steps/day are enough? For older adults and special populations

    Directory of Open Access Journals (Sweden)

    Tudor-Locke Catrine

    2011-07-01

    Full Text Available Abstract Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1 healthy older adults average 2,000-9,000 steps/day, and 2 special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26 and 2,215 steps/day (or an effect size of 0.67, respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs, and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations, a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA, and approximately 7,100 steps/day if averaged over a week. Measured

  2. Heart Failure in Non-Caucasians, Women, and Older Adults: A White Paper on Special Populations From the Heart Failure Society of America Guideline Committee.

    Science.gov (United States)

    Colvin, Monica; Sweitzer, Nancy K; Albert, Nancy M; Krishnamani, Rajan; Rich, Michael W; Stough, Wendy Gattis; Walsh, Mary Norine; Westlake Canary, Cheryl A; Allen, Larry A; Bonnell, Mark R; Carson, Peter E; Chan, Michael C; Dickinson, Michael G; Dries, Daniel L; Ewald, Gregory A; Fang, James C; Hernandez, Adrian F; Hershberger, Ray E; Katz, Stuart D; Moore, Stephanie; Rodgers, Jo E; Rogers, Joseph G; Vest, Amanda R; Whellan, David J; Givertz, Michael M

    2015-08-01

    The presentation, natural history, clinical outcomes, and response to therapy in patients with heart failure differ in some ways across populations. Women, older adults, and non-Caucasian racial or ethnic groups compose a substantial proportion of the overall heart failure population, but they have typically been underrepresented in clinical trials. As a result, uncertainty exists about the efficacy of some guideline-directed medical therapies and devices in specific populations, which may result in the under- or overtreatment of these patients. Even when guideline-based treatments are prescribed, socioeconomic, physical, or psychologic factors may affect non-Caucasian and older adult patient groups to a different extent and affect the application, effectiveness, and tolerability of these therapies. Individualized therapy based on tailored biology (genetics, proteomics, metabolomics), socioeconomic and cultural considerations, and individual goals and preferences may be the optimal approach for managing diverse patients. This comprehensive approach to personalized medicine is evolving, but in the interim, the scientific community should continue efforts focused on intensifying research in special populations, prescribing guideline-directed medical therapy unless contraindicated, and implementing evidence-based strategies including patient and family education and multidisciplinary team care in the management of patients.

  3. Distance Learning for Special Populations

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    Bates, Rodger A.

    2012-01-01

    Distance education strategies for remotely deployed, highly mobile, or institutionalized populations are reviewed and critiqued. Specifically, asynchronous, offline responses for special military units, Native Americans on remote reservations, prison populations and other geographically, temporally or technologically isolated niche populations are…

  4. Hyponatremia: Special Considerations in Older Patients

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    Roy L. Soiza

    2014-08-01

    Full Text Available Hyponatremia is especially common in older people. Recent evidence highlights that even mild, chronic hyponatremia can lead to cognitive impairment, falls and fractures, the latter being in part due to bone demineralization and reduced bone quality. Hyponatremia is therefore of special significance in frail older people. Management of hyponatremia in elderly individuals is particularly challenging. The underlying cause is often multi-factorial, a clear history may be difficult to obtain and clinical examination is unreliable. Established treatment modalities are often ineffective and carry considerable risks, especially if the diagnosis of underlying causes is incorrect. Nevertheless, there is some evidence that correction of hyponatremia can improve cognitive performance and postural balance, potentially minimizing the risk of falls and fractures. Oral vasopressin receptor antagonists (vaptans are a promising innovation, but evidence of their safety and effect on important clinical outcomes in frail elderly individuals is limited.

  5. Socioeconomic in enequalities in health in Europe : studies of middle-aged and older populations with a special focus on the role of smoking

    NARCIS (Netherlands)

    M. Huisman (Martijn)

    2004-01-01

    textabstractThe purpose of this study was to determine the magnitude of socioeconomic inequalities in health among middle-aged and older men and women within Europe, and to contribute to the explanation of these inequalities. The contribution of smoking to socioeconomic inequalities in health was es

  6. Raltegravir use in special populations

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    Johnson Margaret

    2009-11-01

    Full Text Available Abstract Raltegravir, the first approved integrase inhibitor, has been shown to be virologically effective in Phase II and Phase III clinical trials in both treatment naïve and triple class resistant patients. It also has an excellent tolerability profile and lacks significant drug-drug interactions making it an important drug in the treatment of a number of special patient populations. In this review its use in patients undergoing solid organ and bone marrow transplantation and patients receiving cancer chemotherapy, will be discussed. In addition other indications including patients with metabolic complications of existing antiretroviral drugs as well as patients with side effects on current HAART regimens. Other groups of patients where raltegravir may play an important role are patients with renal disease and tuberculosis. Finally, although not licensed for use in pregnancy, raltegravir may need to be considered in some pregnant women with antiretroviral resistance or tolerability issues with current HAART regimens.

  7. Dermatophytosis in special patient populations

    Institute of Scientific and Technical Information of China (English)

    Salama A Ouf; Tarek A Moussa; Alshimaa M Abd-Elmegeed; Samar R Eltahlawy

    2016-01-01

    Objective:To study the occurrence and prevalence of dermatomycosis in special patient populations suffering from diabetes, cancer and heart diseases. Methods: A total of 640 patients suffering from diabetes, 280 patients suffering from cancer and 210 patients suffering from heart diseases from Cairo City were evaluated for dermatophytosis at the dermatology clinics of four different hospitals from January 2005 to December 2006. Results: The presence of diabetes looks a risk factor for tinea pedis and tinea corporis. Tinea cruris and tinea unguium were not common among diabetics, while tinea capitis and tinea versicolor were completely missed. Tinea capitis followed by tinea pedis are the most common among cancer patients. Thirty cases were recorded for tinea among 210 patients with heart diseases of which tinea capitis and tinea versicolor were recorded once while the other clinical types of tinea were estimated in 6-8 patients for each type. Conclusions: The present investigation shows that diabetes remains to be a risk factor for dermatophytosis and cancer comes next due to the use of radioactive irradiation.

  8. Nutrition Considerations for the Growing Population of Older Adults With Diabetes

    OpenAIRE

    Stanley, Kathleen

    2014-01-01

    The growing older adult population and its higher incidence of diabetes are creating demands on health care providers to address the special needs of these patients. Because nutrition is essential to the proper treatment and self-management of diabetes, clinicians must develop and adopt various strategies to address some of the common nutritional, lifestyle, and self-management barriers that older adults face. Nutrition assessments of older adults with diabetes should be comprehensive, with a...

  9. Reconsidering "special needs" populations during a disaster.

    Science.gov (United States)

    Lavin, Roberta Proffitt; Schemmel-Rettenmeier, Lisa; Frommelt-Kuhle, Molly

    2012-01-01

    Meeting the "special needs" of at-risk populations affected by disasters is of the utmost importance. In the United States, there are 54 million people who fit into the special needs category who are defined as handicapped, disabled, vulnerable, challenged, or having special needs. The paramount importance for the special needs population is maintaining human dignity throughout the disaster management cycle. Government agencies, nongovernmental organizations, and advocacy organizations have all worked together to attempt to address and ensure that the needs of all individuals are addressed throughout the disaster cycle. Each provider and emergency responder should be familiar with the Americans with Disabilities Act requirements, but this alone does not begin to address the needs of children, the elderly, or other individuals and their special needs. There are multiple theoretical frameworks that may be useful, but the most human approach may be to consider needs based on Maslow's hierarchy of needs.

  10. Population distribution and population growth in Yogyakarta special region

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    Ida Bagus Mantra

    2013-07-01

    The annual rate of population growth in Yogyakarta Special Region is much lower compared with other provinces in Java. During 1961 and 1971 the rate of population growth was 1.1 percent, for the period 1971— 1980 became 1.09 percent. This region experienced a net loss of population through migration, and that the losses were greater in the poor areas of Gunung Kidul and Kulon Progo

  11. Special Populations. Distress Therapy through Leisure.

    Science.gov (United States)

    Martin, P. Kelly

    1982-01-01

    Education for leisure and stress management, combined with carefully planned recreational experiences, are the key components for distress therapy through leisure. The ultimate goal is to design and implement leisure programs, for special populations, which alleviate distress, channel stress into positive avenues, and enhance their quality of…

  12. Financial Literacy and Financial Sophistication in the Older Population.

    Science.gov (United States)

    Lusardi, Annamaria; Mitchell, Olivia S; Curto, Vilsa

    2014-10-01

    Using a special-purpose module implemented in the Health and Retirement Study, we evaluate financial sophistication in the American population over the age of 50. We combine several financial literacy questions into an overall index to highlight which questions best capture financial sophistication and examine the sensitivity of financial literacy responses to framing effects. Results show that many older respondents are not financially sophisticated: they fail to grasp essential aspects of risk diversification, asset valuation, portfolio choice, and investment fees. Subgroups with notable deficits include women, the least educated, non-Whites, and those over age 75. In view of the fact that retirees increasingly must take on responsibility for their own retirement security, such meager levels of knowledge have potentially serious and negative implications.

  13. Financial Literacy and Financial Sophistication in the Older Population

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    Lusardi, Annamaria; Mitchell, Olivia S.; Curto, Vilsa

    2017-01-01

    Using a special-purpose module implemented in the Health and Retirement Study, we evaluate financial sophistication in the American population over the age of 50. We combine several financial literacy questions into an overall index to highlight which questions best capture financial sophistication and examine the sensitivity of financial literacy responses to framing effects. Results show that many older respondents are not financially sophisticated: they fail to grasp essential aspects of risk diversification, asset valuation, portfolio choice, and investment fees. Subgroups with notable deficits include women, the least educated, non-Whites, and those over age 75. In view of the fact that retirees increasingly must take on responsibility for their own retirement security, such meager levels of knowledge have potentially serious and negative implications. PMID:28553191

  14. Gender differences in special needs populations.

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    Connick, C M; Fos, P J; Barsley, R E

    2001-07-01

    The August 2000 Surgeon General's report confirmed that neglected, vulnerable populations in the United States are not adequately receiving oral health services. The silent epidemic of dental and oral diseases in population groups such as persons with MRDD and the geriatric population results in a diminished quality of life. This article presents a study and research design intended to gather data and report the results as related to the needs of a population with MRDD. The Surgeon General stated that oral health issues in relation to gender have not been explored adequately. The data that were collected add information on health, [table: see text] disease, and health practices in a neglected population, helping in part to address this important concern. The analysis of study data statistically confirmed certain differences between women and men in this special needs population. Women and men experienced a similar number of filled surfaces and missing teeth. Reports of oral pain and daily tooth cleaning were also similar. The rates of fluorosis and the need for urgent treatment differed by gender, as did the number of persons missing a combination of anterior and posterior teeth. In this population men exhibited a greater frequency of past oral injury than women and a greater burden of untreated caries. Men also exhibited a greater frequency of gingival signs, indicating a possible lack of attention to proper oral hygiene; this finding was coupled with their greater frequency of need for urgent dental treatment. Although some reasons for these findings can be postulated, more research into the causes is warranted. Those findings can then form the basis for sound policy decisions that will improve the oral health of both men and women with special needs. Barriers to improved oral health, whether they result from problems with access to providers, from attitudinal problems inherent in the providers themselves, the patient, or the patient's caretakers, or from a

  15. Nutrition Considerations for the Growing Population of Older Adults With Diabetes

    Science.gov (United States)

    Stanley, Kathleen

    2014-01-01

    In Brief The growing older adult population and its higher incidence of diabetes are creating demands on health care providers to address the special needs of these patients. Because nutrition is essential to the proper treatment and self-management of diabetes, clinicians must develop and adopt various strategies to address some of the common nutritional, lifestyle, and self-management barriers that older adults face. Nutrition assessments of older adults with diabetes should be comprehensive, with attention to each patient’s unique nutritional needs. Constructing a realistic nutrition care plan is essential for success. This article addresses some of the key nutrition-related aspects of diabetes self-care in older adults with diabetes. PMID:26246753

  16. Special population planner, version 4.0.

    Energy Technology Data Exchange (ETDEWEB)

    Kuiper, J.; Tanzman, E.; Metz, W.

    2007-03-26

    Emergencies happen every day. Many are caused by storms or auto accidents and can be planned for, if not predicted. Emergencies resulting from natural hazards often affect a large number of people, and planning for them can be difficult, since knowledge of the needs of the people involved is generally unavailable. Emergencies resulting from accidents at industrial and military facilities can also be large scale in nature if people must be evacuated or sheltered in place. Federal planning for large scale emergencies is the responsibility of the Federal Emergency Management Agency (FEMA), which provides assistance to various emergency management agencies at the national, state and local level. More information about FEMA is available at http://www.fema.gov/. The purpose of the Special Population Planner (SPP) is to help emergency planners address the needs of persons with special needs. The exact definition of 'special population' is a policy decision. Policymakers have included a variety of groups in this term, such as persons with disabilities, those who do not have vehicles with which to evacuate, children who are unattended at times (latchkey children), and many others. The SPP was developed initially for the Alabama Emergency Management Agency as part of its Chemical Stockpile Emergency Preparedness Program (CSEPP), which aids emergency planning and preparedness in communities surrounding military installations across the United States where chemical weapons are stored pending their destruction under federal law. Like that specialized application, this open-source version contains a set of specialized Geographic Information System (GIS) tools to facilitate emergency planning on behalf of persons with special needs, regardless of how the term is defined. While the original SPP system was developed for emergency planning relating to chemical hazards, it can be applied to other threats as well. It is apparent from Hurricane Katrina and other natural and

  17. Special acute care unit for older adults with Alzheimer's disease.

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    Soto, Maria E; Nourhashemi, Fati; Arbus, Christophe; Villars, Hélène; Balardy, Laurent; Andrieu, Sandrine; Vellas, Bruno

    2008-02-01

    To describe the cognitive, functional, and nutritional features of patients admitted to a Special Acute Care Unit (SACU) for elderly patients with Alzheimer's disease (AD). One-year observational study of patients with AD and other related disorders hospitalized in the SACU, Department of Geriatrics, Toulouse university Hospital during 2005. A comprehensive neurocognitive and non-cognitive geriatric assessment was performed. Data on full clinical evaluation, nutritional status, activities of daily living (ADL), gait and balance disturbance, behavioural and psychological symptoms (BPSD), and sociodemographics were recorded. Four-hundred and ninety-two patients were assessed. Their mean age was 81.1+/-7.7, the mean length of stay was 10.7+/-6.3 days, 62% were female, 63.9% were admitted from their own home and 30.4% from a nursing home. Eighty percent of patients had probable Alzheimer's disease or mixed dementia, less than 20% had other causes of dementia. Results of their comprehensive assessment showed a mean mini-mental state examination of 14.5+/-7.4; a mean total ADL score of 3.7+/-1.7. Seventy-seven percent had gait or balance disturbances; 90% of patients presented an unsatisfactory nutritional status. The most common reason for admission was BPSD. AD complications are responsible for many acute admissions. Elderly patients suffering from dementia represent a population with unique clinical characteristics. Further randomised clinical trials are needed to evaluate the effectiveness of Special Acute Care Units for patients with AD and other related disorders. Copyright (c) 2007 John Wiley & Sons, Ltd.

  18. The Growth of Older Inmate Populations: How Population Aging Explains Rising Age at Admission.

    Science.gov (United States)

    Luallen, Jeremy; Cutler, Christopher

    2017-09-01

    Older inmates are the fastest growing segment of the prison population; however, the reasons for this are not well understood. One explanation is that the general population is aging, driving prison age distributions to change. For this article, we study the role of population aging in prison growth by investigating how the baby boom phenomenon of post-World War II has contributed to the growth of older inmate populations. We identify the impact of population aging using simulation methods that explain prison growth as the combination of criminal justice processes. Overall, we find evidence that population aging has played a significant role in explaining the growth of older inmate populations, in particular among inmates aged between 50 and 64 years, contributing to as much as half of the observed increase in these groups since 2000. This finding stands in contrast to the notion that population aging has little explanatory power in describing the growth of prison populations and implies that older inmate groups are more sensitive to compositional changes in the general population. We argue that prediction-based modeling of prison growth should more seriously consider the impacts and consequences of demographic shifts among older prisoner populations.

  19. 2001 New York State NHTS: Travel Patterns of Special Populations

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Patricia S [ORNL; Reuscher, Tim [ORNL

    2010-03-01

    pertinent to geographic areas that are significantly smaller than what the national NHTS data allowed. The final sample size for New York State was 13,423 usable households. In this report, Oak Ridge National Laboratory (ORNL) identifies and analyzes differences, if any, in travel patterns that are attributable to demographic characteristics (e.g., gender, age, race and ethnicity), household characteristics (e.g., low income households, zero and one car households), modal characteristics and geographic location. Travel patterns of those who work at home are examined and compared to those of conventional workers, as well as those who do not work. Focus is given to trip frequency, travel by time of day, trip purpose, and mode choice. For example, included in this analysis is the mobility of the elderly population in New York State. The American society is undergoing a major demographic transformation that is resulting in a greater percentage of older individuals in the population. In addition to demographic changes, recent travel surveys show that an increasing number of older individuals are licensed to drive and that they drive more than their same age cohort did a decade ago. Cohort differences in driving are particularly apparent - not only are more of today's elderly population licensed to drive than their age cohort two decades ago, they also drive more. Equally important are the increase in immigration and in racial and cultural diversity. This report also discusses vehicle availability, socioeconomic characteristics, travel trends (e.g., miles travelled, distance driven, commute patterns), and the transportation accessibility of these populations. Specifically, this report addresses in detail the travel behavior of the following special populations: (1) the elderly, defined as those who were 65 years old or older, (2) low-income households, (3) ethnic groups and immigrants, and (4) those who worked at home.

  20. 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.

  1. Primary hypertension and special aspects of hypertension in older children and adolescents

    Directory of Open Access Journals (Sweden)

    Ellis D

    2011-07-01

    Full Text Available Demetrius Ellis, Yosuke MiyashitaChildren’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, PA, USAAbstract: The prevalence of hypertension has increased at an accelerated rate in older children and adolescents. This has raised great concern about premature development of cardiovascular disease, which has major long-term health and financial implications. While obesity and sedentary habits largely explain this phenomenon, there are other social and cultural influences that may unmask genetic susceptibility to hypertension in the pediatric population. While it is essential to exclude numerous causes of secondary hypertension in every child, these disorders are not discussed in this review. Rather, the aim of this review is to familiarize pediatricians with casual and ambulatory blood pressure measurement, epidemiology, pathophysiology, and management of several common conditions that play a role in the development of hypertension in children and adolescents. Besides primary hypertension and obesity-related hypertension, emphasis is given to epidemiology, measurement of blood pressure, including ambulatory blood pressure monitoring, hypertension associated with drug use, teenage pregnancy, and video and computer games. Lastly, because pediatricians are increasingly confronted with special issues concerning the management of the hypertensive athlete, this topic is also addressed.Keywords: hypertension, adolescents, obesity, drugs, pregnancy, athletes

  2. Treating rhinitis in the older population: special considerations

    Directory of Open Access Journals (Sweden)

    Slavin Raymond G

    2009-12-01

    Full Text Available Abstract Rhinitis in the elderly is a common but often neglected condition. Structural changes in the nose associated with aging, predisposes the elderly to rhinitis. There are a number of specific factors that affect medical treatment of the elderly including polypharmacy, cognitive dysfunction, changes in body composition, impairment of liver and renal function and the cost of medications in the face of limited resources. Rhinitis in the elderly can be placed in several categories and treatment should be appropriate for each condition. The most important aim is to moisten the nasal mucosa since the nose of the elderly is so dry. Great caution should be used in treatment with first generation antihistamines and decongestants. Medications generally well tolerated by the elderly are second generation antihistamines, intra-nasal anti-inflammatory agents, leukotriene modifiers and iprapropium nasal spray.

  3. Management of chronic heart failure in the older population

    Institute of Scientific and Technical Information of China (English)

    Nahid Azad; Genevieve Lemay

    2014-01-01

    Chronic heart failure (CHF) is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

  4. Treatment of osteoporosis in an older home care population

    Directory of Open Access Journals (Sweden)

    Maxwell Colleen J

    2005-02-01

    Full Text Available Abstract Background Previous research indicates that many patients with fractures indicative of underlying osteoporosis are not receiving appropriate diagnostic follow-up and therapy. We assessed osteoporosis treatment coverage in older home care clients with a diagnosis of osteoporosis and/or prevalent fracture. Methods Subjects included 330 home care clients, aged 65+, participating in a longitudinal study of medication adherence and health-related outcomes. Data on clients' demographic, health and functional status and service utilization patterns were collected using the Minimum Data Set for Home Care (MDS-HC. A medication review included prescribed and over-the-counter medications taken in the past 7 days. Criteria for indications for osteoporosis therapy included diagnosis of osteoporosis or a recent fracture. Coverage for treatment was examined for anti-osteoporotic therapies approved for use in 2000. Results Of the 330 home care clients, 78 (24% had a diagnosis of osteoporosis (n = 47 and/or had sustained a recent fracture (n = 34. Drug data were available for 77/78 subjects. Among the subjects with osteoporosis or a recent fracture, 45.5% were receiving treatment for osteoporosis; 14% were receiving only calcium and vitamin D, and an additional 31% were receiving drug therapy (bisphosphonate or hormone replacement therapy. The remaining 54.5% of subjects were not receiving any approved osteoporosis therapy. Conclusions The high prevalence of undertreatment among a population of older adults with relatively high access to health care services raises concern regarding the adequacy of diagnosis and treatment of osteoporosis in the community.

  5. Obesity Rates in Special Populations of Children and Potential Interventions

    Science.gov (United States)

    Holcomb, Matthew J.; Pufpaff, Lisa A.; McIntosh, David E.

    2009-01-01

    Childhood obesity has become a problem of epidemic proportions in the United States, but much of the research has focused on prevention and intervention programs, which target the general population of school children. Overlooked in the literature are children with special needs (including autism, genetic disorders, Down syndrome, and Prader-Willi…

  6. Special Populations in Gifted Education: Working with Diverse Gifted Learners.

    Science.gov (United States)

    Castellano, Jaime A.

    This book provides 13 readings on special populations in gifted education. It is based on the premise that gifted and talented students transcend (1) cultural, ethnic, and linguistic ties; (2) conditions that are disabling; (3) sexual orientation; (4) poverty; and (5) geography. Chapters are: (1) "Casting a Wider Net: Linking Bilingual and Gifted…

  7. Association of Subclinical Inflammation With Polyneuropathy in the Older Population

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    Herder, Christian; Bongaerts, Brenda W.C.; Rathmann, Wolfgang; Heier, Margit; Kowall, Bernd; Koenig, Wolfgang; Thorand, Barbara; Roden, Michael; Meisinger, Christa; Ziegler, Dan

    2013-01-01

    OBJECTIVE Inflammatory processes have been implicated in the pathogenesis of diabetic distal sensorimotor polyneuropathy (DSPN), but their possible relationship has not been assessed at the population level. RESEARCH DESIGN AND METHODS We determined serum concentrations of mediators of subclinical inflammation among 1,047 participants 61–82 years of age from the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4 study (Germany). Logistic and linear regression models were fitted to assess associations between immune mediators (log-transformed) and the presence of clinical DSPN (dichotomous variable) or Michigan Neuropathy Screening Instrument (MNSI) examination score (continuous variable), respectively. RESULTS Serum concentrations of the anti-inflammatory interleukin (IL)-1 receptor antagonist (IL-1RA) were positively associated with the presence of DSPN and higher MNSI scores in age-adjusted and sex-adjusted analyses, whereas IL-6, IL-18, and soluble intercellular adhesion molecule-1 were positively associated with only MNSI scores. No associations were observed for adiponectin, C-reactive protein, or tumor necrosis factor-α. Associations for IL-1RA and IL-6 with the MNSI score remained statistically significant after additional adjustment for waist circumference, height, hypertension, cholesterol, smoking, alcohol intake, physical activity, history of myocardial infarction or stroke, presence of neurological conditions, and use of nonsteroidal anti-inflammatory drugs. CONCLUSIONS We conclude that DSPN is linked to proinflammatory and anti-inflammatory, possibly compensatory, processes in the older general population. Future studies should clarify the temporal sequence and causality of these associations. PMID:24009302

  8. Treatment for alcohol-related problems: special populations: research opportunities.

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    Gomberg, Edith S Lisansky

    2003-01-01

    For the subgroups indicated, a few questions/issues are relevant to all three (women, elderly, minorities): 1. Heterogeneity of the special populations, for example, Hispanic-Americans are from different countries with different cultures. Women and the elderly vary by age, education, income, social class, health status, etc., to say nothing of ethnicity/color/religion. 2. Of therapy modalities, professional and indigenous, which are more efficacious? 3. Are group-specific therapies needed, or will sensitivity to a particular group work as well? WOMEN: Stereotypes and myths have prevailed, for example, the long-standing belief that women have poorer prognoses than male alcoholics. When female and male alcoholics are compared, women report more positive family history, a later onset of drinking and problems, more marital disruption, more comorbidity, etc. The review of treatment outcomes (Vannicelli, 1986) showed few significant gender differences in outcomes. Research recommendations include biological and genetic studies, women's view of and use of therapeutic modalities, and outcome studies of different modalities, including all female facilities. ELDERLY: Medications are used more by older patients, and such patients are more likely to experience adverse drug reactions. In the moderate social use of alcohol, there are conflicting reports and the extent of elderly use awaits decisive study. The etiology of problem drinking by older persons is studied rarely. An attempt has been made to explain onset later in life (vs. earlier onset) based on the stresses of aging (loss, loneliness, health problems, etc.); research results have not been supportive. Consequences of older persons' heavy drinking seems to be most often alcohol-related medical disorders, although there are often familial and social consequences. Atkinson (1995) recommended the development of elder-specific outcome measures, study of the efficacy of different treatment modalities, and study of the

  9. Maldives. Package on population education for special interest groups developed.

    Science.gov (United States)

    1995-01-01

    The Population Education Program of the Non-Formal Education Center has developed a package of Population Education for Special Interest Groups comprising a learning package and fieldworker's guide. The learning package is especially developed for teaching population education for out-of-school populations. Special interest groups in Maldives include newly married couples, adolescents, and working youth. Produced under the guidance of UNESCO, Bangkok, the package contains 36 different materials such as posters, charts, leaflets, booklets, stories, and illustrated booklets which may be taught in 36 to 45 periods. The materials deal with eight themes, namely, family size and family welfare, population and resources, delayed marriage and parenthood, responsible parenthood, population-related values and beliefs, women in development, AIDS/STD, and respect for old people. Accompanying the learning package is the fieldworker's guide used to teach the package. It contains individual guides for each of the 36 learning materials. The guide gives the titles of the materials, format, objectives of the materials, messages, target groups, and an overview of the content of each learning materials. The methodologies used for teaching the learning materials include role playing, group discussion, questioning, brainstorming, survey, creative writing, problem-solving and evaluation. The package will be used by fieldworkers to conduct island-based population education courses.

  10. The role of podiatry in the prevention of falls in older people: a JAPMA special issue.

    Science.gov (United States)

    Najafi, Bijan; de Bruin, Eling D; Reeves, Neil D; Armstrong, David G; Menz, Hylton B

    2013-01-01

    Given the age-related decline in foot strength and flexibility, and the emerging evidence that foot problems increase the risk of falls, established guidelines for falls prevention recommend that older adults have their feet examined by a podiatrist as a precautionary measure. However, these guidelines do not specify which intervention activities might be performed. Published in this special issue of JAPMA are nine high-quality articles, including seven original studies and two basic science reviews, focusing on the benefit and impact of footwear and foot and ankle interventions in reducing the risk of falling. The selected studies discuss various relevant questions related to podiatric intervention, including adherence to intervention; preference and perception of older adults in selecting footwear; benefit of insoles, footwear, and nonslip socks in preventing falls; fear of falling related to foot problems; benefit of podiatric surgical intervention; and benefit of foot and ankle exercise in preventing falls.

  11. 34 CFR 668.149 - Special provisions for the approval of assessment procedures for special populations for whom no...

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Special provisions for the approval of assessment procedures for special populations for whom no tests are reasonably available. 668.149 Section 668.149... the approval of assessment procedures for special populations for whom no tests are...

  12. Give consideration to financial abuse among the older population.

    Science.gov (United States)

    Swan, Amy

    2007-10-01

    This article, brought to you in association with Help the Aged, considers financial exclusion, low levels of financial capability, and cognitive impairment among older people, which can lead to them becoming reliant on significant others to manage their finances.

  13. Periodontal treatment needs and systemic diseases in an older population in Greece

    OpenAIRE

    Chatzopoulos, Georgios S.; Tsalikis, Lazaros

    2016-01-01

    Background To evaluate the relationship between systemic diseases, body mass index and periodontal treatment needs in an older population in Greece. Material and Methods A total of 262 older people were clinically examined about their periodontal status and medical histories were recorded using a health history questionnaire. Additionally, weight and height measurements as well as demographic data were obtained from the participants in the study. Results Older people exhibited mean age of 63....

  14. The National Blueprint for Promoting Physical Activity in the Mid-Life and Older Adult Population

    Science.gov (United States)

    Chodzko-Zajko, Wojtek; Sheppard, Lisa; Senior, Jane; Park, Chae-Hee; Mockenhaupt, Robin; Bazzarre, Terry

    2005-01-01

    The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The Blueprint identifies barriers to physical activity in the areas of research, home and community programs, medical…

  15. The National Blueprint for Promoting Physical Activity in the Mid-Life and Older Adult Population

    Science.gov (United States)

    Chodzko-Zajko, Wojtek; Sheppard, Lisa; Senior, Jane; Park, Chae-Hee; Mockenhaupt, Robin; Bazzarre, Terry

    2005-01-01

    The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The Blueprint identifies barriers to physical activity in the areas of research, home and community programs, medical…

  16. A Systematic Review on Effect of Canagliflozin in Special Population.

    Science.gov (United States)

    Patel, Sanket; Gohel, Kalpesh; Patel, Bharat Gordhanbhai

    2016-01-01

    Canagliflozin is a competitive, reversible, highly selective SGLT2 inhibitor and available in 100mg and 300mg as oral tablet form. Owing to this, it induced glucosuria and cause changes in glucose homeostasis without affecting insulin. This review addressed the efficacy and safety of canagliflozin in a specialized patients such as chronic kidney disease (stage III CKD), high risk cardiovascular patient and elderly population. Canagliflozin has reduced HbA1c in all the specialized population, albeit reduction is less as compared to the normal cohort. Additionally, canagliflozin causes reduction in body weight as well as in blood pressure. It was very well tolerated and did not produce significant adverse events compared to standard care (placebo) except genital mycotic infection due to glucosuria. In cardio vascular safety analysis, canagliflozin might be associated with increased incidence of major adverse cardiovascular plus (MACE plus) events in the initial period, which is of concern in a high- risk cardiovascular cohort. In patients with type 2 diabetes mellitus (T2 DM) and stage III CKD cohort, canagliflozin was well tolerated without much affecting eGFR and should be initiated with 100mg. Canagliflozin showed good safety profile in elderly population with T2DM without significantly affecting overall bone mineral density and bone resorption.

  17. Correction: Expected values for pedometer-determined physical activity in older populations

    Directory of Open Access Journals (Sweden)

    Hart Teresa L

    2009-10-01

    Full Text Available Abstract Correction to Tudor-Locke C, Hart TL, Washington TL: Expected values for pedometer-determined physical activity in older populations. International Journal of Behavioral Nutrition and Physical Activity 2009, 6:59

  18. Growing Older With a Physical Disability: A Special Application of the Successful Aging Paradigm.

    Science.gov (United States)

    Molton, Ivan R; Yorkston, Kathryn M

    2017-03-01

    In the United States, the average age of people living with early-acquired physical disabilities is increasing. This cohort is said to be aging with disability and represents a unique population among older adults. Given recent policy efforts designed to merge aging and disability services, it is critical that models of "successful aging" include and are relevant to this population. However, many current definitions of successful aging emphasize avoidance of disability and high levels of physical function as necessary to well-being. In 9 focus groups, we examined perspectives of "successful aging" in 49 middle-aged and older individuals living with spinal cord injury, multiple sclerosis, muscular dystrophy, or postpolio syndrome. Transcripts were analyzed using a structured qualitative coding approach and Dedoose indexing software. Participants ranged in age from 45 to 80 years (M = 62) and had lived with their disability diagnosis for an average of 21 years. Analysis revealed 4 primary themes of successful aging: resilience/adaptation, autonomy, social connectedness, and physical health (including access to general and specialty healthcare). Results highlight the need for a nuanced application of the "successful aging" paradigm in this population.

  19. Potentially inappropriate prescribing and cost outcomes for older people: a national population study.

    LENUS (Irish Health Repository)

    Cahir, Caitriona

    2010-05-01

    Optimization of drug prescribing in older populations is a priority due to the significant clinical and economic costs of drug-related illness. This study aimed to: (i) estimate the prevalence of potentially inappropriate prescribing (PIP) in a national Irish older population using European specific explicit prescribing criteria; (ii) investigate the association between PIP, number of drug classes, gender and age and; (iii) establish the total cost of PIP.

  20. Special agents can promote cooperation in the population.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available Cooperation is ubiquitous in our real life but everyone would like to maximize her own profits. How does cooperation occur in the group of self-interested agents without centralized control? Furthermore, in a hostile scenario, for example, cooperation is unlikely to emerge. Is there any mechanism to promote cooperation if populations are given and play rules are not allowed to change? In this paper, numerical experiments show that complete population interaction is unfriendly to cooperation in the finite but end-unknown Repeated Prisoner's Dilemma (RPD. Then a mechanism called soft control is proposed to promote cooperation. According to the basic idea of soft control, a number of special agents are introduced to intervene in the evolution of cooperation. They comply with play rules in the original group so that they are always treated as normal agents. For our purpose, these special agents have their own strategies and share knowledge. The capability of the mechanism is studied under different settings. We find that soft control can promote cooperation and is robust to noise. Meanwhile simulation results demonstrate the applicability of the mechanism in other scenarios. Besides, the analytical proof also illustrates the effectiveness of soft control and validates simulation results. As a way of intervention in collective behaviors, soft control provides a possible direction for the study of reciprocal behaviors.

  1. 15 CFR 50.10 - Fee structure for special population censuses.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Fee structure for special population... § 50.10 Fee structure for special population censuses. The Bureau of the Census is authorized to conduct special population censuses at the request of and at the expense of the community concerned. To...

  2. 34 CFR 403.205 - What are the State's responsibilities for members of special populations?

    Science.gov (United States)

    2010-07-01

    ... special populations? 403.205 Section 403.205 Education Regulations of the Offices of the Department of... responsibilities for members of special populations? The State board shall— (a) Establish effective procedures, including an expedited appeals procedure, by which students who are members of special populations and...

  3. Treatment of osteoporosis in an older home care population

    OpenAIRE

    Maxwell Colleen J; Vik Shelly A; Hanley David A

    2005-01-01

    Abstract Background Previous research indicates that many patients with fractures indicative of underlying osteoporosis are not receiving appropriate diagnostic follow-up and therapy. We assessed osteoporosis treatment coverage in older home care clients with a diagnosis of osteoporosis and/or prevalent fracture. Methods Subjects included 330 home care clients, aged 65+, participating in a longitudinal study of medication adherence and health-related outcomes. Data on clients' demographic, he...

  4. Clinical presentation of urolithiasis in older and younger population

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2014-12-01

    Full Text Available Aim of the study: We compared stone size, localization, complaint at the time of applying, comorbidity, treatment and complications between older (60 years of age and older and younger patients with urolithiasis (59 years of age and younger. Materials and Methods: We retrospectively reviewed the records of 950 consecutive patients who presented to our clinic and underwent surgery for urolithiasis from January 2007 to March 2012. The patients were divided into two groups: patients ≥ 60 years an patients < 60 years. Results: There were 174 men and 61 women in elderly group, 528 men and 187 women in younger group. Ureteral stones were found more often in the younger group compared to elderly patients (p < 0.05. Conversely, bladder stone was more frequent in the elderly group. In the elderly group comorbidities are more frequent (diabetes mellitus, hypertension, ischemic heart disease, congestive heart disease, osteoarthritis and chronic obstructive lung. Patients ≥ 60 years significantly had larger kidney and bladder stones compared the younger, but ureteral stone sizes were not statistically different between the two groups. Older patients had a higher postoperative complication rate than younger patients (16% versus 3%, p < 0.05 although postoperative complications (e.g. urinary retention, cardiac dysrythmia, fever, constipation were not serious and resolved with medical treatment. The average length of stay in hospital was longer in the elderly group, but the difference was not statistically significant. Conclusions: Elderly patients with urolithiasis usually have larger and more complex stone disease, more comorbidities and atypical presentation.

  5. Inappropriate prescribing in the older population: need for new criteria.

    LENUS (Irish Health Repository)

    O'Mahony, Denis

    2012-02-03

    Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.

  6. Special Educational Resources in the Swedish Upper Secondary Schools: A Total Population Survey

    Science.gov (United States)

    Ramberg, Joacim

    2013-01-01

    This paper analyses the special educational resources in the Swedish upper secondary schools using a total population survey that covers all upper secondary schools. Special educators and special teachers together constitute the special educational resources at each school. With two types of regression models (logistic and linear regression), the…

  7. 34 CFR 403.193 - What are the information requirements regarding special populations?

    Science.gov (United States)

    2010-07-01

    ... populations? 403.193 Section 403.193 Education Regulations of the Offices of the Department of Education... information requirements regarding special populations? (a)(1) Each local educational agency that receives funds under Title II of the Act shall provide to students who are members of special populations...

  8. Increasing opportunities for the productive engagement of older adults: a response to population aging.

    Science.gov (United States)

    Gonzales, Ernest; Matz-Costa, Christina; Morrow-Howell, Nancy

    2015-04-01

    "Productive aging" puts forward the fundamental view that the capacity of older adults must be better developed and utilized in activities that make economic contributions to society-working, caregiving, volunteering. It is suggested that productive engagement can lead to multiple positive ends: offsetting fiscal strains of a larger older population, contributing to the betterment of families and civil society, and maintaining the health and economic security of older adults. Advocates claim that outdated social structures and discriminatory behaviors limit participation of older adults in these important social roles as well as prevent the optimization of outcomes for older adults, families, and society. We ask two important questions: (a) How can we shape policies and programs to optimally engage the growing resources of an aging population for the sake of society and older adults themselves? and (b) How can policies pertaining to productive engagement reduce health and economic disparities? We answer these questions by first describing the current state of engagement in each of the three productive activities and summarize some current policies and programs that affect engagement. Next we highlight challenges that cross-cut productive engagement. Finally, we provide policy recommendations to address these challenges.

  9. Visual Impairment and quality of life in the Older European Population, the EUREYE study

    NARCIS (Netherlands)

    J.H. Seland; J.R. Vingerling; C.A. Augood; G. Bentham; U. Chakravarthy; P.T.V.M. deJong; M. Rahu; G. Soubrane; L. Tomazzoli; F. Topouzis; A.E. Fletcher

    2011-01-01

    Purpose: To determine the prevalence of visual impairment (VI) in populations 65 year or older from six European countries and describe the association with vision-related quality of life. VI was defined according to WHO as best corrected visual acuity < 6/18/log MAR > 0,48 (World Health Organizatio

  10. Perceived Stress and Mortality in a Taiwanese Older Adult Population

    Science.gov (United States)

    Vasunilashorn, Sarinnapha; Glei, Dana A.; Weinstein, Maxine; Goldman, Noreen

    2015-01-01

    Perceived stress is associated with poor health outcomes including negative affect, increased susceptibility to the common cold, and cardiovascular disease; the consequences of perceived stress for mortality, however, have received less attention. This study characterizes the relationship between perceived stress and 11-year mortality in a population of Taiwanese adults aged 53+. Using the Survey of Health and Living Status of the Near Elderly and Elderly of Taiwan, we calculated a composite measure of perceived stress based on six items pertaining to the health, financial situation, and occupation of the respondents and their families. Proportional hazard models were used to determine whether perceived stress predicted mortality. After adjusting for sociodemographic factors only, we found that a one standard deviation increase in perceived stress was associated with a 19% increase in all-cause mortality risk during the 11-year follow-up period (HR=1.19, 95% CI 1.13–1.26). The relationship was greatly attenuated when perceptions of stress regarding health were excluded, and was not significant after adjusting for medical conditions, mobility limitations, and depressive symptoms. We conclude that the association between perceived stress and mortality is explained by an individual's current health; however, our data do not allow us to distinguish between two possible interpretations of this conclusion: a) the relationship between perceived stress and mortality is spurious, or b) poor health acts as the mediator. PMID:23869432

  11. Perceived stress and mortality in a Taiwanese older adult population.

    Science.gov (United States)

    Vasunilashorn, Sarinnapha; Glei, Dana A; Weinstein, Maxine; Goldman, Noreen

    2013-11-01

    Perceived stress is associated with poor health outcomes including negative affect, increased susceptibility to the common cold and cardiovascular disease; the consequences of perceived stress for mortality, however, have received less attention. This study characterizes the relationship between perceived stress and 11-year mortality in a population of Taiwanese adults aged 53+ years. Using the Survey of Health and Living Status of the Near Elderly and Elderly of Taiwan, we calculated a composite measure of perceived stress based on six items pertaining to the health, financial situation, and occupation of the respondents and their families. Proportional hazard models were used to determine whether perceived stress predicted mortality. After adjusting for sociodemographic factors only, we found that a one standard deviation increase in perceived stress was associated with a 19% increase in all-cause mortality risk during the 11-year follow-up period (hazard ratio, HR = 1.19, 95% confidence interval, CI 1.13-1.26). The relationship was greatly attenuated when perceptions of stress regarding health were excluded, and was not significant after adjusting for medical conditions, mobility limitations and depressive symptoms. We conclude that the association between perceived stress and mortality is explained by an individual's current health; however, our data do not allow us to distinguish between two possible interpretations of this conclusion: (a) the relationship between perceived stress and mortality is spurious, or (b) poor health acts as the mediator.

  12. Hodgkin lymphoma in special populations and rare localizations

    DEFF Research Database (Denmark)

    Petersen, Peter Meidahl

    2011-01-01

    Hodgkin lymphoma (HL) is seen in patients over the age of 60 in 20–40% of cases. Prognosis is poorer, largely due to suboptimal staging and treatment in some patients due to concurrent disease. If possible, older patients should be treated along the same principles as younger patients. HL...

  13. [Frailty in older population: a brief position paper from the French society of geriatrics and gerontology].

    Science.gov (United States)

    Rolland, Yves; Benetos, Athanase; Gentric, Armelle; Ankri, Joël; Blanchard, François; Bonnefoy, Marc; de Decker, Laure; Ferry, Monique; Gonthier, Régis; Hanon, Olivier; Jeandel, Claude; Nourhashemi, Fathi; Perret-Guillaume, Christine; Retornaz, Frédérique; Bouvier, Hélène; Ruault, Geneviève; Berrut, Gilles

    2011-12-01

    Frailty in the older population is a clinical syndrome which evaluate a risk level. The Frailty syndrome defines a reduction of the adaptation capacity to a stress. It can be modulated by physical, psychological and social factors. The screening of the frailty syndrome is relevant for older people without disability for basic activities of daily living. The clinical criteria of frailty must be predictive of the risk of functional decline and adverse outcomes, consensual at the international level, and easy to perform in primary care as well as in the clinical researches.

  14. Building "Special Capital" for Entrepreneurial Development: Special Populations as Human Capital in the Context of Global Development

    Science.gov (United States)

    Walker, Gabriela

    2010-01-01

    Ten to twelve percent of the world population is identified as having one or more types of disability. This ecodeme has been historically known to be discriminated, marginalized, and disempowered by the lack of access to resources and to education. This article discusses the importance of adding special capital to the global human capital in the…

  15. Biofeedback for training balance and mobility tasks in older populations: a systematic review

    Science.gov (United States)

    2010-01-01

    sit-to-stand transfers in older patients post-stroke were identified for training-specific aspects. The same applies for auditory feedback-based training of gait in older patients with lower-limb surgery. Implications Further appropriate studies are needed in different populations of older adults to be able to make definitive statements regarding the (long-term) added effectiveness, particularly on measures of functioning. PMID:21143921

  16. Biofeedback for training balance and mobility tasks in older populations: a systematic review

    Directory of Open Access Journals (Sweden)

    Chiari Lorenzo

    2010-12-01

    balance, gait, or sit-to-stand transfers in older patients post-stroke were identified for training-specific aspects. The same applies for auditory feedback-based training of gait in older patients with lower-limb surgery. Implications Further appropriate studies are needed in different populations of older adults to be able to make definitive statements regarding the (long-term added effectiveness, particularly on measures of functioning.

  17. Are peripheral populations special? Congruent patterns in two butterfly species

    NARCIS (Netherlands)

    Cassel-Lundhagen, A.; Tammaru, T.; Windig, J.J.; Ryrholm, N.; Nylin, S.

    2009-01-01

    Populations at range margins may be genetically different from more central ones for a number of mutually non-exclusive reasons. Specific selection pressures may operate in environments that are more marginal for the species. Genetic drift may also have a strong effect in these populations if they a

  18. Social Networks among the Older Chinese Population in the USA: Findings from the PINE Study.

    Science.gov (United States)

    Dong, XinQi; Chang, E-Shien

    2017-01-01

    Social network research has become central to studies of health and aging. Its results may yield public health insights that are actionable and improve the quality of life of older adults. However, little is known about the social networks of older immigrant adults, whose social relationships often develop in the context of migration, compounded by cultural and linguistic barriers. This report aims to describe the structure, composition, and emotional components of social networks in the Chinese aging population of the USA, and to explore ways in which their social networks may be critical to their health decision-making. Our data come from the PINE study, a population-based epidemiological study of community-dwelling older Chinese American adults, aged 60 years and above, in the greater Chicago area. We conducted individual interviews in participants' homes from 2011 until 2013. Based on sociodemographic and socioeconomic characteristics, this study computed descriptive statistics and trend tests for the social network measures adapted from the National Social Life, Health, and Aging Project study. The findings show that older Chinese adults have a relatively small social network in comparison with their counterparts from other ethnic and racial backgrounds. Only 29.6% of the participants could name 5 close network members, and 2.2% could name 0 members. Their network composition was more heavily kin oriented (95.0%). Relationships with network members differed according to the older adults' sociodemographic and socioeconomic characteristics. Subgroup variations included the likelihood of discussing health-related issues with network members. This study highlights the dynamic nature of social networks in later-life Chinese immigrants. For healthcare practitioners, developing cost-effective strategies that can mobilize social network support remains a critical undertaking in health intervention. Longitudinal studies are needed to examine the causal impact of social

  19. 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.

  20. Assessment of dentally related functional competency for older adults with cognitive impairment--a survey for special-care dental professionals.

    Science.gov (United States)

    Chen, Xi; Clark, Jennifer J J

    2013-01-01

    This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population.

  1. Skin-cleansing and care principles for special pediatric populations.

    OpenAIRE

    Horowitz, P; McLeod, RP; Eichenfield, LF; Fowler, JF; Elias, PM

    2013-01-01

    Good skin care has two overall goals: to support and maintain healthy stratum corneum function and to help restore barrier function perturbed by disease processes or injuries. In this article, we discuss the special attention that is required in the initial skin care of newborns, and we address what measures, beyond the basic skin care principles, are required for patients with conditions such as atopic dermatitis, acne, contact and allergic dermatitis, and diaper rash.

  2. Older Doctoral Scientists and Engineers: Selected Labor Force Characteristics. Special Report.

    Science.gov (United States)

    Morgan, Robert P.

    This report presents the labor force characteristics of older doctoral scientists and engineers using data from the National Science Foundation's (NSF) Survey of Doctorate Recipients (SDR) from 1997. The information presented in the report includes employment, education, and demographic data on all graduate degrees considering the age factor. (YDS)

  3. Spain: promoting the welfare of older adults in the context of population aging.

    Science.gov (United States)

    Serrano, Juan P; Latorre, José M; Gatz, Margaret

    2014-10-01

    Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population, in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio. Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons. The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain.

  4. Developing Effective Partnerships for Special Populations: The Challenge of Partnerships and Alliances.

    Science.gov (United States)

    Phelps, L. Allen; Maddy-Bernstein, Carolyn

    1992-01-01

    Effective business-education partnerships can have the following benefits for special populations: additional resources in resource-poor areas, employment opportunities, increased personal attention, improved facilities, and better teacher morale. Partnerships should complement, not replace, existing educational programs. (SK)

  5. Educational Preparation of Hygienists Working with Special Populations in Nontraditional Settings.

    Science.gov (United States)

    Cohen, Leonard; And Others

    1985-01-01

    The results of a study of the employment patterns, academic preparation, and work characteristics of dental hygienists working with special populations (including the physically handicapped, mentally and emotionally handicapped, geriatric, mentally compromised, homebound, low income, and children) are reported. (MSE)

  6. [Potentially inappropriate prescribing in older Spanish population according to STOPP/START criteria (STARTREC study)].

    Science.gov (United States)

    Cruz-Esteve, Inés; Marsal-Mora, Josep Ramón; Galindo-Ortego, Gisela; Galván-Santiago, Leonardo; Serrano-Godoy, Marcos; Ribes-Murillo, Esther; Real-Gatius, Jordi

    2017-03-01

    Rational prescribing in older people is a priority for health care organizations. The STOPP/START screening tool has been developed to identify potentially inappropriate prescribing (PIP) in individuals. In a primary care setting, STOPP/START can estimate PIP prevalence and related factors at population level. The aim of this study is to measure the prevalence rates of PPI in elderly population using clinical and prescription claim databases. Cross-sectional population study. Primary Care, Lleida Health Region, Spain. 45.408 patients 70 years old and over, attended in the primary health care centers at least once the last year. 43 STOPP and 12 START criteria are applied to their 2012 clinical and prescription records. Logistic regression models are adjusted to determine PIP association with several factors. 45,408 patients are included. The mean age is 79.7 years, 58% being female. The overall prevalence of PPI is 58.1%. According to STOPP, the most common drugs identified are benzodiazepines, non-steroidal anti-inflammatory drugs and proton pump inhibitors; according to START, osteoporosis treatments, antiplatelet agents, statins, metformin and beta blockers. PIP increases with age and polypharmacy and it is higher in long-term care facilities residents and patients receiving home health care. In our Health Region, at least 50% of the population aged 70 or older has one or more PIP, according to STOPP/START criteria. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. Using Positive Psychology with Special Mental Health Populations

    Science.gov (United States)

    Mohiuddin, Ahmed; Boisvert, Charles M.

    2006-01-01

    In our clinical practice, we have attempted to use a positive psychology approach in working with people with schizophrenia and youths with behavioral disorders. We present three clinical applications that use a positive psychology approach with these populations: group treatment with persons with schizophrenia; individual cognitive stimulation…

  8. The feasibility of measuring social networks among older adults in assisted living and dementia special care units.

    Science.gov (United States)

    Abbott, Katherine M; Bettger, Janet Prvu; Hampton, Keith N; Kohler, Hans-Peter

    2015-03-01

    Studies indicate that social integration has a significant influence on physical and mental health. Older adults experience an increased risk of social isolation as their social networks decline with fewer traditional opportunities to add new social relationships. Deaths of similar aged friends, cognitive and functional impairments, and relocating to a nursing home (NH) or assisted-living (AL) facility contribute to difficulties in maintaining one's social network. Due to the paucity of research examining the social networks of people residing in AL and NH, this study was designed to develop and test the feasibility of using a combination of methodological approaches to capture social network data among older adults living in AL and a dementia special care unit NH. Social network analysis of both egocentric and sociocentric networks was conducted to visualize the social networks of 15 residents of an AL neighborhood and 12 residents of a dementia special care unit NH and to calculate measures network size, centrality, and reciprocity. The combined egocentric and sociocentric method was feasible and provided a robust indicator of resident social networks highlighting individuals who were socially integrated as well as isolated. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. Differences in Sleep Duration among Four Different Population Groups of Older Adults in South Africa.

    Science.gov (United States)

    Peltzer, Karl

    2017-05-09

    The study aims to investigate sleep duration in four different population groups in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) Wave 1. A national population-based cross-sectional study with a sample of 3284 aged 50 years or older in South Africa was conducted in 2008. The questionnaire included socio-demographic characteristics, health variables, and self-reported sleep duration. Results indicate that White Africans compared to other population groups had the lowest mean sleep duration (7.88 h among men and 7.46 h among women). The prevalence of short sleep was the highest among both men and women among the White African (18.8% in men and 16.9% in women) and Indian or Asian African population groups (14.5% in men and 17.1% in women), and lowest among both men and women in the Black African (7.0% in men and 6.5% in women) and multi-ancestry population groups (15.6% in men and 12.7% in women). The prevalence of long sleep was among both men and women the highest in the Black African population group (56.2% in men and 58.5% in women), and the lowest in the White African population group (36.4% in men and 24.3% in women). In a Poisson regression model, adjusted for sociodemographics and chronic disease status, coming from the male and female White African population group was associated with short sleep. In addition, coming from the Indian or Asian African population group was associated with short sleep. No population group differences were found regarding long sleep prevalence. White Africans reported more short sleep duration than the other population groups, while there were no racial or ethnic differences in long sleep. White Africans are more likely to have sleep durations that are associated with negative health outcomes. An explanation of the high short sleep prevalence among White Africans may be related to their racial or ethnic minority status in South Africa.

  10. Differences in Sleep Duration among Four Different Population Groups of Older Adults in South Africa

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2017-05-01

    Full Text Available The study aims to investigate sleep duration in four different population groups in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE Wave 1. A national population-based cross-sectional study with a sample of 3284 aged 50 years or older in South Africa was conducted in 2008. The questionnaire included socio-demographic characteristics, health variables, and self-reported sleep duration. Results indicate that White Africans compared to other population groups had the lowest mean sleep duration (7.88 h among men and 7.46 h among women. The prevalence of short sleep was the highest among both men and women among the White African (18.8% in men and 16.9% in women and Indian or Asian African population groups (14.5% in men and 17.1% in women, and lowest among both men and women in the Black African (7.0% in men and 6.5% in women and multi-ancestry population groups (15.6% in men and 12.7% in women. The prevalence of long sleep was among both men and women the highest in the Black African population group (56.2% in men and 58.5% in women, and the lowest in the White African population group (36.4% in men and 24.3% in women. In a Poisson regression model, adjusted for sociodemographics and chronic disease status, coming from the male and female White African population group was associated with short sleep. In addition, coming from the Indian or Asian African population group was associated with short sleep. No population group differences were found regarding long sleep prevalence. White Africans reported more short sleep duration than the other population groups, while there were no racial or ethnic differences in long sleep. White Africans are more likely to have sleep durations that are associated with negative health outcomes. An explanation of the high short sleep prevalence among White Africans may be related to their racial or ethnic minority status in South Africa.

  11. Barriers to disaster preparedness among medical special needs populations

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    Leslie eMeyer

    2015-09-01

    Full Text Available A medical special needs (MSN assessment was conducted among 3088 respondents in a hurricane prone area. The sample was female (51.7%, Hispanic (92.9%, aged > 45 years (51%, not insured for health (59.2%, and with an MSN (33.2%. Barriers to preparedness were characterized for all households, including those with inhabitants reporting MSN ranging from level 0 (mild to level 4 (most severe. Multivariable logistic regression tested associations between hurricane preparedness and barriers to evacuation by level of MSN. A significant interaction effect between number of evacuation barriers and MSN was found. Among households that reported individuals with level 0 MSN, the odds of being unprepared increased 18% for each additional evacuation barrier [OR=1.18, 95% CI (1.08, 1.30]. Among households that reported individuals with level 1 MSN, the odds of being unprepared increased 29% for each additional evacuation barrier [OR=1.29, 95% CI (1.11, 1.51]. Among households that reported individuals with level 3 MSN, the odds of being unprepared increased 68% for each additional evacuation barrier [OR=1.68, 95% CI (1.21, 1.32]. MSN alone did not explain the probability of unpreparedness, but rather MSN in the presence of barriers helped explain unpreparedness.

  12. Can money buy happiness? Depressive symptoms in an affluent older population.

    Science.gov (United States)

    West, C G; Reed, D M; Gildengorin, G L

    1998-01-01

    To determine if the inverse association between depressive symptoms and income reported in predominantly low- and middle-income older populations is present in a more affluent population of older adults and to determine if this pattern is independent of other known correlates of depressive symptoms such as medical problems, physical disability, and social support. Cross-sectional analysis within a prospective cohort study. An ongoing, community-based cohort study conducted by an independent research institution in an affluent Northern California county. A total of 1948 randomly selected, noninstitutionalized county residents 55 years of age and older who completed the baseline questionnaire and physical performance tests. The outcome measure was high level of depressive symptoms (score > or = 16) using the Center for Epidemiologic Studies-Depression scale (CES-D). The prevalence of high levels of depressive symptoms (CES-D score > or = 16) was lower than in most other population-based samples using an identical CES-D scale. In age-adjusted, sex-specific analyses, increasing income level was associated significantly with lower levels of depressive symptoms, but the nature of the relationship appeared quadratic rather than linear (Men: odds ratio (OR) income .80, 95% confidence interval (CI) .68-.94; income2 OR 1.006, 95% CI 1.001-1.011. Women: OR income .80, 95% CI .69-.91; income2 OR 1.007, 95% CI 1.002-1.011). In multivariate regression analyses including potential confounding risk factors, the magnitude of the association between depressive symptoms and income decreased and was not statistically significant when measures of health conditions, physical disability, and social support were included in the model (Men: OR income .90, 95% CI .75-1.06; income2 OR 1.003, 95% CI .998-1.009. Women: OR income .90, 95% CI .78-1.05; income2 OR 1.003, 95% CI .998-1.008). These findings suggest that poor health, physical disability, and social isolation are the major factors

  13. Safety from Crime and Physical Activity among Older Adults: A Population-Based Study in Brazil

    Directory of Open Access Journals (Sweden)

    Maruí Weber Corseuil

    2012-01-01

    Full Text Available Objective. To evaluate the association between safety from crime and physical activity among older adults. Methods. A population-based survey including 1,656 older adults (60+ years took place in Florianopolis, Brazil, in 2009-2010. Commuting and leisure time physical activity were assessed through the long version of the International Physical Activity Questionnaire. Perception of safety from crime was assessed using the Neighbourhood Environment Walkability Scale. Results. Perceiving the neighbourhood as safe during the day was related to a 25% increased likelihood of being active in leisure time (95% CI 1.02–1.53; general perception of safety was also associated with a 25% increase in the likelihood of being active in leisure time (95% CI 1.01–1.54. Street lighting was related to higher levels of commuting physical activity (prevalence ratio: 1.89; 95% CI 1.28–2.80. Conclusions. Safety investments are essential for promoting physical activity among older adults in Brazil.

  14. Early determinants for the development of undernutrition in an older general population: Longitudinal Aging Study Amsterdam.

    Science.gov (United States)

    Schilp, Janneke; Wijnhoven, Hanneke A H; Deeg, Dorly J H; Visser, Marjolein

    2011-09-01

    Undernutrition may be an important modifiable risk factor for poor clinical outcomes in older individuals. To achieve earlier detection or prevention of undernutrition, more information is needed about risk factors for the development of undernutrition in community-dwelling older individuals. The objective was to identify early determinants of incident undernutrition in a prospective population-based study. Baseline data (1992-3) on socio-economic, psychological, medical, functional, lifestyle and social factors of 1120 participants aged 65-85 years of the Longitudinal Aging Study Amsterdam were used. Undernutrition, defined as a BMI weight loss ≥ 5 % in the last 6 months, was assessed every 3 years during a 9-year follow-up period. Cox proportional-hazards regression analysis was used to investigate the association between early determinants at baseline and incident undernutrition. In 9 years, 156 participants (13·9 %) developed undernutrition. In univariate analyses, female sex, depressive symptoms, anxiety symptoms, multiple chronic diseases, high medication use (women), poor appetite, no alcohol use v. light alcohol use, loneliness, not having a partner, limitations in performing normal activities due to a health problem, low physical performance (participants aged stairs (participants aged stairs (participants aged < 75 years) remained early determinants. The results of the present study can be used to identify subgroups of older individuals with increased risk of undernutrition and to identify modifiable determinants for the purpose of prevention of undernutrition.

  15. Risk factors for mortality during antiretroviral therapy in older populations in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Daniel O’Brien

    2016-01-01

    Full Text Available Introduction: An increasing proportion of adult patients initiating antiretroviral therapy (ART in resource-limited settings are aged >50 years. Older populations on ART appear to have heightened risk of death, but little is known about factors influencing mortality in this population. Methods: We performed a retrospective observational multisite cohort study including all adult patients (≥15 years initiating ART between 2003 and 2013 in programmes supported by Médecins Sans Frontières across 12 countries in Asia, Africa and Europe. Patients were stratified into two age groups, >50 years and 15 to 50 years. A Cox proportional hazards model was used to explore factors associated with mortality. Results: The study included 41,088 patients: 2591 (6.3% were aged >50 years and 38,497 (93.7% were aged 15 to 50 years. The mortality rate was significantly higher in the age group >50 years [367 (14.2% deaths; mortality rate 7.67 deaths per 100 person-years (95% confidence interval, CI: 6.93 to 8.50] compared to the age group 15 to 50 years [3788 (9.8% deaths; mortality rate 4.18 deaths per 100 person-years (95% CI: 4.05 to 4.31], p50 age group. WHO Stage 4 conditions were more strongly associated with increased mortality rates in the 15 to 50 age group compared to populations >50 years. WHO Stage 3 conditions were associated with an increased mortality rate in the 15 to 50 age group but not in the >50 age group. Programme region did not affect mortality rates in the >50 age group; however being in an Asian programme was associated with a 36% reduced mortality rate in populations aged 15 to 50 years compared to being in an African programme. There was a higher overall incidence of Stage 3 WHO conditions in people >50 years (12.8/100 person-years compared to those 15 to 50 years (8.1/100 person-years (p50 age groups. Conclusions: Older patients on ART in resource-limited settings have increased mortality rates, but compared to younger populations this

  16. Construct Validity of Four Frailty Measures in an Older Australian Population: A Rasch Analysis.

    Science.gov (United States)

    Widagdo, I S; Pratt, N; Russell, M; Roughead, E E

    2016-01-01

    Individuals identified as frail have been shown to be at an increased risk of adverse health outcomes. However, there is no gold standard frailty measure and frailty status can vary depending on the measure used, suggesting the measures perform differently. Construct validity can be used to assess a measure's performance. This study aimed to examine the construct validity of four frailty measures in an Australian older population using Rasch analysis. Frailty status among the 2087 participants aged 65 years and above from the Australian Longitudinal Study of Ageing (ALSA) was assessed using: frailty phenotype--FP, simplified frailty phenotype--SFP, frailty index--FI, and prognostic frailty score--PFS. Rasch analysis was used to assess the unidimensionality of the measures, which is the extent to which the underlying characteristic of frailty is assessed. The criteria for unidimensionality from principal component analysis of the residuals was when 50% or more of the raw variance was explained by the measures, and less than 5% was unexplained variance. Only FI meet the unidimensionality criteria with 74% of explained variance and 2.1% of unexplained variance. SFP did not show a unidimensional construct with 13.3% of explained variance and 47.1% of unexplained variance. FP and PFS had 39.6%, 18.1% and 46.5%, 8.7% of explained and unexplained variance, respectively. Our findings showed that FI has better construct validity than the other three measures in assessing frailty among the Australian older population.

  17. Sociopolitical context and depressive symptoms in an older Mexican-origin population

    Science.gov (United States)

    Miranda, Patricia Yvonne

    A large proportion of older adult Latinos have at least one chronic physical health condition; those same individuals who also exhibit depressive symptoms experience higher mortality rates. Given their projected population growth of 500% by 2050, it is important to disentangle the factors influencing the health status of Latinos aged 65 and older, specifically those who also experience depressive symptoms. Prior studies of depressive symptoms among Latino populations have often failed to consider the role of sociopolitical context---that is, the social, economic, political and historical circumstances that shape an individual's lived experience---and its contribution to understanding within-group differences for health outcomes. This study explores the relationships between sociopolitical context and number of depressive symptoms among an older Mexican-origin population in the U.S., and seeks to disentangle the importance of sociopolitical context from other widely used group stratifications for capturing U.S.-Mexican experiences, including nativity status, length of residence in the U.S., and place of residence during formative years. Study findings do not support rejecting the null hypothesis that there were differences in number of depressive symptoms by nativity status, length of residence in the U.S., or place of residence during formative years. Rather, findings suggest that the interaction of sociopolitical context and the age at which individuals arrive in the U.S. has a significant association with number of depressive symptoms among immigrants. This study takes a novel approach to examine the relationships between sociopolitical context at time of entry in the U.S. and symptoms of depression in later life. The implications of its findings for immigration as well as other social policies are discussed. The significant relationship between the interaction of sociopolitical context during time of entry into the U.S. and age of arrival into the U.S. suggests

  18. Ecological specialization and population size in a biodiversity hotspot: How rare species avoid extinction

    OpenAIRE

    S. E. Williams; Y. M. Williams; Vanderwal, J.; Isaac, J. L.; L. P. Shoo; Johnson, C. N.

    2009-01-01

    Species with narrow environmental niches typically have small geographic ranges. Small range size is, in turn, often associated with low local abundance. Together, these factors should mean that ecological specialists have very small total populations, putting them at high risk of extinction. But some specialized and geographically restricted species are ancient, and some ecological communities have high proportions of rare and specialized endemics. We studied niche characteristics and patter...

  19. 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, ...

  20. NINE-YEAR FOLLOW-UP OF SPECIFIC PHOBIA IN A POPULATION SAMPLE OF OLDER PEOPLE.

    Science.gov (United States)

    Sigström, Robert; Skoog, Ingmar; Karlsson, Björn; Nilsson, Johan; Östling, Svante

    2016-04-01

    Little is known about the long-term course of specific phobia (SP) in the general population. We examined the prevalence and course of SP and subthreshold fears in an older population followed over 9 years. A psychiatric examination was performed in a population-based sample of 558 70-year-olds, among whom 303 dementia-free survivors were followed up at both ages 75 and 79. Fears were rated with respect to level of anxiety and social or other consequences. DSM-IV SP was diagnosed when fears were associated with prominent anxiety and had social or other consequences. All other fears were labeled subthreshold fears. The prevalence of SP declined from 9.9% at age 70 to 4.0% at age 79. The reason was that the prevalence of fears associated with prominent anxiety (mandatory in the diagnosis) decreased whereas the prevalence of fears that gave social or other consequences remained stable. A total of 14.5% of the population had SP at least once during the study. Among these, 11.4% had SP and 65.9% had specific fear at all three examinations. The prevalence of fears associated with prominent anxiety decreased with age, resulting in an overall decline in the prevalence of SP. SP seems to be a fluctuating disorder, and in most cases an exacerbation of chronic subthreshold fears. © 2015 Wiley Periodicals, Inc.

  1. Levels of Acculturation of Chinese Older Adults in the Greater Chicago Area - The Population Study of Chinese Elderly in Chicago.

    Science.gov (United States)

    Dong, XinQi; Bergren, Stephanie M; Chang, E-Shien

    2015-09-01

    Acculturation is a difficult process for minority older adults for a variety of reasons, including access and exposure to mainstream culture, competing ethnic identities, and linguistic ability and preference. There is a paucity of research regarding overall level of acculturation for Chinese older adults in the United States. This study aimed to provide an overall estimate of level of acculturation of Chinese older adults in the United States and to examine correlations between sociodemographic characteristics, self-reported health measures, and level of acculturation. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study. This community-based participatory research study surveyed 3,159 Chinese older adults aged 60 and older. The PINE Study Acculturation Scale was used to assess level of acculturation in three dimensions: language preference, media use, and ethnic social relations. Mean acculturation level for all items was 15.3 ± 5.1, indicating low levels of acculturation. Older age, more offspring, lower income, fewer years living in the United States, lower overall health status, and lower quality of life were associated with lower levels of acculturation. Level of acculturation was low in Chinese older adults, and certain subsets of the population were more likely to have a lower level of acculturation. Future research should investigate causality and effects of level of acculturation.

  2. Incidence and related factors of traffic accidents among the older population in a rapidly aging society.

    Science.gov (United States)

    Hong, Kimyong; Lee, Kyoung-Mu; Jang, Soong-nang

    2015-01-01

    To estimate the incidence of traffic accidents and find related factors among the older population. We used the cross-sectional data from the Korean Community Health Survey (KCHS), which was conducted between 2008 and 2010 and completed by 680,202 adults aged 19 years or more. And we used individuals aged 60 years or above (n=210,914). The incidence of traffic accidents was estimated as number of traffic accidents experienced per thousand per year by a number of factors including age, sex, residential area, education, employment status, and diagnosis with chronic diseases. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each potential risk factor adjusted for the others. Incidence of traffic accidents was estimated as 11.74/1,000 per year for men, and 7.65/1,000 per year for women. It tended to decline as age increased among women; compared to the youngest old age group (60-64), the older old groups (70-74 and 80+) were at lower risk for traffic accidents. Depressive symptom was the strongest predictor for both men (OR=1.83, 95% CI=1.28-2.61) and women (1.70, 1.23-2.35). Risk of traffic accident was greater in employed men (1.76, 1.40-2.22) and women diagnosis with arthritis (1.36, 1.06-1.75). Given that the incidence of and factors associated with traffic accidents differ between men and women, preventive strategies, such as driver education and traffic safety counseling for older adults, should be modified in accordance with these differences. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Examining Contextual Influences on Fall-Related Injuries Among Older Adults for Population Health Management.

    Science.gov (United States)

    Hoffman, Geoffrey J; Rodriguez, Hector P

    2015-12-01

    The objectives were to assess the associations between fall-related injuries (FRIs) treated in the emergency department (ED) among older adults in California and contextual county-level physical, social, and economic characteristics, and to assess how county-level economic conditions are associated with FRIs when controlling for other county-level factors. Data from 2008 California ED discharge, Medicare Impact File, and County Health Rankings were used. Random effects logistic regression models estimated contextual associations between county-level factors representing economic conditions, the built environment, community safety, access to care, and obesity with patient-level FRI treatment among 1,712,409 older adults, controlling for patient-level and hospital-level characteristics. Patient-level predictors of FRI treatment were consistent with previous studies not accounting for contextual associations. Larger and rural hospitals had higher odds of FRI treatment, while teaching and safety net hospitals had lower odds. Better county economic conditions were associated with greater odds (ß=0.73, P=0.001) and higher county-level obesity were associated with lower odds (ß=-0.37, P=0.004), but safer built environments (ß=-0.31, P=0.38) were not associated with FRI treatment. The magnitude of association between county-level economic conditions and FRI treatment attenuated with the inclusion of county-level obesity rates. FRI treatment was most strongly and consistently related to more favorable county economic conditions, suggesting differences in treatment or preferences for treatment for FRIs among older individuals in communities of varying resource levels. Using population health data on FRIs, policy makers may be able to remove barriers unique to local contexts when implementing falls prevention educational programs and built environment modifications.

  4. Trends in diet quality among adolescents, adults and older adults: A population-based study

    Directory of Open Access Journals (Sweden)

    Samantha Caesar de Andrade, PhD

    2016-12-01

    Full Text Available This study aimed to monitor diet quality and associated factors in adolescents, adults and older adults from the city of São Paulo, Brazil. We conducted a cross-sectional population-based study involving 2376 individuals surveyed in 2003, and 1662 individuals in 2008 (Health Survey of São Paulo, ISA-Capital. Participants were of both sexes and aged 12 to 19 years old (adolescents, 20 to 59 years old (adults and 60 years old or over (older adults. Food intake was assessed using the 24-h dietary recall method while diet quality was determined by the Brazilian Healthy Eating Index (BHEI-R. The prevalence of descriptive variables for 2003 and 2008 was compared adopting a confidence interval of 95%. The means of total BHEI-R score and its components for 2003 and 2008 were compared for each age group. Associations between the BHEI-R and independent variables were evaluated for each survey year using multiple linear regression analysis. Results showed that the mean BHEI-R increased (54.9 vs. 56.4 points over the five-year period. However, the age group evaluation showed a deterioration in diet quality of adolescents, influenced by a decrease in scores for dark-green and orange vegetables and legumes, total grains, oils and SoFAAS (solid fat, alcohol and added sugar components. In the 2008 survey, adults had a higher BHEI-R score, by 6.1 points on average, compared to adolescents. Compared to older adults, this difference was 10.7 points. The diet quality remains a concern, especially among adolescents, that had the worst results compared to the other age groups.

  5. [Immunogenicity and safety of the influenza vaccine, in a population older than 55-years in Mexico].

    Science.gov (United States)

    Ayala-Montiel, Octavio; Mascareñas, César; García-Hernández, Delfino; Rendón-Muñiz, Jorge; López, Irma; Felipe Montaño, Luis; Zenteno, I; Franco-Paredes, C

    2005-01-01

    To confirm the immunogenicity and tolerance of the inactivated, fractionated, and purified influenza vaccine, in a Mexican adult population aged 55 and older, medically served at a Petróleos Mexicanos Hospital (Pemex, Mexican Oil Company). The study was conducted between November and December, 2000, among ninety adult subjects aged 55 years and older who were seen at the Hospital Central Sur Pemex. The primary endpoints regarding immunogenicity were the percentage of individuals with protective antibodies targeting hemagglutinins higher than or equal to 1:40, and the percentage of subjects who seroconverted as measured by a four-fold increase in protective antibody production. Secondary endpoints included the frequency of local and systemic reactions to the vaccine. An additional criterion that was evaluated included antigen-antibody affinity assays to measure the polyclonal antibody response to the vaccine and the specific generation of high-affinity antibodies to viral proteins, before and after vaccination. The antibody protection rate was 95.6% against the HINI strain, 98.9% against the H3N2 strain, and a 100% against the B/Yamanashi strain. Seroconversion to the HINI strain was elicited in 74.4% of subjects, to the H3N2 strain in 88.9%, and to the B/Yamanashi strain in 82.2%. Eighteen (20%) subjects developed local reactions; 17 (18.8%) developed a systemic reaction post vaccination at day 5 and nine subjects (10%) at day 28. Local reactions consisted of pain in 10 (11.1%) subjects, redness in 8 (8.8%), and induration in 6 (6.6%). General malaise, headache, and fever were identified in 10, 8.8, and 0% of subjects, respectively, at day 5, and in 4.4, 6.6, and 0%, respectively, at day 28. Influenza vaccine was highly immunogenic in a healthy Mexican adult population aged 55 years and older. The generation of high-affinity antibodies to the virus after vaccination was also demonstrated. Local and systemic adverse reactions to the vaccine identified in our study

  6. Care of Special Populations in an Observation Unit: Pediatrics and Geriatrics.

    Science.gov (United States)

    Mace, Sharon E

    2017-08-01

    Infants and children and the elderly comprise a large and growing (especially the elderly) segment of the US population. The benefits of observation medicine have been documented in these two age groups: Based on the success of observation medicine, and recognizing the growth of these special populations, it is likely that observation medicine will be expanding in the future, especially within the pediatric and geriatric populations. Future studies should be able to provide further evidence regarding the value of observation medicine in these two diverse population age groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Primary unilateral and bilateral cleft lip and nose in an older population.

    Science.gov (United States)

    Rai, Kimit

    2005-01-01

    A one-stage procedure to reconstruct complete and incomplete unilateral/bilateral cleft lip and nose deformities is presented. Emphasis was made on closure of the lip muscles, correction of the nostril floor, correction of the alveolar cleft as well as reconstruction of the nose through an intranasal approach, with a supported suture technique for nasal correction. No dental or orthodontic treatment was available or performed in this older population. Emphasis was on primary closure of the muscles, using the rotation advancement principle. The repair that was performed was near anatomical, reconstructing the labial sulcus, the nostril floor, the alveolar cleft and the nasal deformity all in one stage. There was a high level of satisfaction both from the patient's and surgeon's point of view.

  8. Effectiveness of Chemoradiation for Head and Neck Cancer in an Older Patient Population

    Energy Technology Data Exchange (ETDEWEB)

    VanderWalde, Noam A. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Meyer, Anne Marie; Deal, Allison M. [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Layton, J. Bradley [Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Liu, Huan [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Carpenter, William R. [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Weissler, Mark C. [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Hayes, David N. [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Department of Medicine, Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Fleming, Mary E. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); and others

    2014-05-01

    Purpose: The purpose of this study was to compare chemoradiation therapy (CRT) with radiation therapy (RT) only in an older patient population with head and neck squamous cell carcinoma (HNSCC). Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database (1992-2007), we identified a retrospective cohort of nonmetastatic HNSCC patients and divided them into treatment groups. Comparisons were made between CRT and RT cohorts. Propensity scores for CRT were estimated from covariates associated with receipt of treatment using multivariable logistic regression. Standardized mortality ratio weights (SMRW) were created from the propensity scores and used to balance groups on measured confounders. Multivariable and SMR-weighted Cox proportional hazard models were used to estimate the hazard ratio (HR) of death for receipt of CRT versus RT among the whole group and for separate patient and tumor categories. Results: The final cohort of 10,599 patients was 68% male and 89% white. Median age was 74 years. Seventy-four percent were treated with RT, 26% were treated with CRT. Median follow-up points for CRT and RT survivors were 4.6 and 6.3 years, respectively. On multivariable analysis, HR for death with CRT was 1.13 (95% confidence interval [CI]: 1.07-1.20; P<.01). Using the SMRW model, the HR for death with CRT was 1.08 (95% CI: 1.02-1.15; P=.01). Conclusions: Although the addition of chemotherapy to radiation has proven efficacious in many randomized controlled trials, it may be less effective in an older patient population treated outside of a controlled trial setting.

  9. Characteristics of physical measurement consent in a population-based survey of older adults.

    Science.gov (United States)

    Sakshaug, Joseph W; Couper, Mick P; Ofstedal, Mary Beth

    2010-01-01

    Collecting physical measurements in population-based health surveys has increased in recent years, yet little is known about the characteristics of those who consent to these measurements. To examine the characteristics of persons who consent to physical measurements across several domains, including one's demographic background, health status, resistance behavior toward the survey interview, and interviewer characteristics. We conducted a secondary data analysis of the 2006 Health and Retirement Study, a nationally-representative panel survey of older adults aged 51 and older. We performed multilevel logistic regressions on a sample of 7457 respondents who were eligible for physical measurements. The primary outcome measure was consent to all physical measurements. Seventy-nine percent (unweighted) of eligible respondents consented to all physical measurements. In weighted multilevel logistic regressions controlling for respondent demographics, current health status, survey resistance indicators, and interviewer characteristics, the propensity to consent was significantly greater among Hispanic respondents matched with bilingual Hispanic interviewers, patients with diabetes, and those who visited a doctor in the past 2 years. The propensity to consent was significantly lower among younger respondents, those who have several Nagi functional limitations and infrequently participate in "mildly vigorous" activities, and those interviewed by black interviewers. Survey resistance indicators, such as number of contact attempts and interviewer observations of resistant behavior in prior wave iterations of the Health and Retirement Study were also negatively associated with physical measurement consent. The propensity to consent was unrelated to prior medical diagnoses, including high blood pressure, cancer (excluding skin), lung disease, heart abnormalities, stroke, and arthritis, and matching of interviewer and respondent on race and gender. Physical measurement consent

  10. Managing Chronic Pain in Special Populations with Emphasis on Pediatric, Geriatric, and Drug Abuser Populations.

    Science.gov (United States)

    Baumbauer, Kyle M; Young, Erin E; Starkweather, Angela R; Guite, Jessica W; Russell, Beth S; Manworren, Renee C B

    2016-01-01

    In the adult population chronic pain can lead to loss of productivity and earning potential, and decreased quality of life. There are distinct groups with increased vulnerability for the emergence of chronic pain. These groups may be defined by developmental status and/or life circumstances. Within the pediatric, geriatric, and drug abuser populations, chronic pain represents a significant health issue. This article focuses on known anatomic, physiologic, and genetic mechanisms underlying chronic pain in these populations, and highlights the need for a multimodal approach from multiple health care professionals for management of chronic pain in those with the most risk.

  11. Introduction: Special issue on genetic research of alcohol use disorder in diverse racial/ethnic populations.

    Science.gov (United States)

    Chartier, Karen G; Hesselbrock, Michie N; Hesselbrock, Victor M

    2017-08-01

    This special issue of The American Journal on Addictions is an extension of a workshop held at the Research Society on Alcoholism (2015) highlighting several important issues related to studies of the genetic bases of alcohol use disorder among racially/ethnically diverse populations. While not exhaustive in their coverage, the papers in this special issue focus on three important topics: (1) the importance of considering the social and environmental context in genetic analyses; (2) social and cultural considerations for engaging diverse communities in genetic research; and (3) methodologies related to phenotype development for use with racially/ethnically diverse populations. A brief overview of each paper included in these three sections is presented. The issue concludes with additional considerations for genetic research with racially/ethnically diverse population groups along with a commentary. (Am J Addict 2017;26:422-423). © 2017 American Academy of Addiction Psychiatry.

  12. Trends in Obesity and Abdominal Obesity in the Older Adult Population of Spain (2000-2010

    Directory of Open Access Journals (Sweden)

    Juan Luis Gutiérrez-Fisac

    2013-02-01

    Full Text Available Objective: This work examines the trend in obesity and abdominal obesity in the Spanish population aged 60 years and over during the first decade of the 21st century. Methods: We analyze data from a representative study of the Spanish population aged 60 years and older conducted in 2000-2001 and from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA conducted in 2008-2010. Results: In men, the distribution of BMI did not vary in the period 2000-2010. In contrast, in women there was a reduction in both mean BMI - from 29.3 to 28.8 kg/m2 - and the prevalence of obesity - from 40.8 to 36.3%. This decline was greatest in women aged 60-69 years. In men, no significant changes were observed in mean waist circumference (WC or in the prevalence of abdominal obesity. In contrast, WC decreased by 3.6 cm and abdominal obesity prevalence by 12.7% in women. The decline was greatest in women aged 60-69 years, in whom mean WC decreased by 5.1 cm and abdominal obesity prevalence by 18.6%. Conclusion: These findings show that the frequency of obesity has begun to decline in Spanish women aged 60 and over. The causes of this decline are unclear.

  13. Health supplement consumption behavior in older adults population: An exploratory study

    Directory of Open Access Journals (Sweden)

    Mimi M.Y. eTSE

    2014-02-01

    Full Text Available Health supplement consumption behavior is important to maintain health status. The purpose of the study was to explore the spending pattern on health supplement consumption behavior in Hong Kong older adults population. The present study was a cross-sectional survey study; and was collected from via a street-intercept interview. Participants were approached and invited to response to a questionnaire. The location for data collection was evenly distributed in Hong Kong, Kowloon and New Territories. The questionnaire included demographic data and source of income source, spending habits on health supplement products and whether they performed regular health check. There were 982 participants interviewed; and 46% was male and 54% was female. The participants are divided into young-old (age 50-69 and old-old group (age 70 or above. The mean age is 67.93±10.386. Most of the participants have regular body check; the major reason is to maintain health. Less than half of the participants spent money on health supplement products; the major reason for such purchase was to maintain health; while for not buying is they did not think that would have any effect in their health. Also, more young-old participants have regular body check and spend more money on health supplement products; while old-old group participants were less likely to concern their health, and they were less likely to perform regular body check and purchase health supplement products. The present research reveals the pattern of the health supplement consumption behavior of young-old and old-old. Young-old group and old-old group have difference pattern according to their difference age-related health condition and the amount of spare money. Different educational programme concern health consciousness and promotion strategy of regular body check and health supplement products need be tailor-made for older adults, and for young old and old-old groups.

  14. Statin Safety in Chinese: A Population-Based Study of Older Adults.

    Directory of Open Access Journals (Sweden)

    Daniel Q Li

    Full Text Available Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients.We conducted a population-based retrospective cohort study of older adults (mean age, 74 years newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm were matched (1:3 by propensity score to 57,099 non-Chinese. This study used linked healthcare databases.The follow-up observation period (mean 1.1, maximum 10.8 years was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation. Forty-seven percent (47% of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR 0.61 (95% CI 0.28 to 1.34, incident diabetes HR 1.02 (95% CI 0.80 to 1.30, acute kidney injury HR 0.90 (95% CI 0.72 to 1.13, or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05]. Similar results were observed in subgroups defined by statin type and dose.We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted.

  15. Statin Safety in Chinese: A Population-Based Study of Older Adults

    Science.gov (United States)

    Li, Daniel Q.; Kim, Richard B.; McArthur, Eric; Fleet, Jamie L.; Hegele, Robert A.; Shah, Baiju R.; Weir, Matthew A.; Molnar, Amber O.; Dixon, Stephanie; Tu, Jack V.; Anand, Sonia; Garg, Amit X.

    2016-01-01

    Background Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients. Methods We conducted a population-based retrospective cohort study of older adults (mean age, 74 years) newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm) were matched (1:3) by propensity score to 57,099 non-Chinese. This study used linked healthcare databases. Findings The follow-up observation period (mean 1.1, maximum 10.8 years) was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation). Forty-seven percent (47%) of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR) 0.61 (95% CI 0.28 to 1.34), incident diabetes HR 1.02 (95% CI 0.80 to 1.30), acute kidney injury HR 0.90 (95% CI 0.72 to 1.13), or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05)]. Similar results were observed in subgroups defined by statin type and dose. Conclusions We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted. PMID:26954681

  16. Low blood pressure and depressive symptoms among Chinese older subjects: a population-based study.

    Science.gov (United States)

    Ng, Tze-Pin; Feng, Liang; Niti, Mathew; Yap, Keng-Bee

    2010-04-01

    The relationships between blood pressure and depression are unclear. There are inconsistent reports of an association between low blood pressure and depressive symptoms. In a population-based sample of 2611 Chinese older adults aged 55 years and above, including participants with treated (n=1088), untreated (n=545), or no hypertension (n=978), depressive symptoms were determined by the 15-item Geriatric Depression Scale (> or =5), and current systolic blood pressure and diastolic blood pressure measurements were used to classify participants into high, normal, and low blood pressure groups. Estimates of association were adjusted for confounding by use of antihypertensive and depressogenic drugs and other covariables in hierarchical regression analyses. Systolic blood pressure and diastolic blood pressure were negatively associated with Geriatric Depression Scale scores, independent of other variables. Low systolic blood pressure (odds ratio [OR] 1.54; 95% confidence interval [CI], 1.07-2.22), low diastolic blood pressure (OR 1.67; 95% CI, 0.98-2.85), and low systolic blood pressure or diastolic blood pressure (or both) (OR 1.55; 95% CI, 1.10-2.19) were independently associated with depressive symptoms. The associations with depressive symptoms were particularly observed for low systolic blood pressure (OR 2.13; 95% CI, 1.13-4.03) among treated hypertensive participants, and low diastolic blood pressure (OR 2.42; 95% CI, 1.26-4.68) among untreated or nonhypertensive participants. Low blood pressure was independently associated with depressive symptoms in both older subjects who were treated for hypertension and those who were not.

  17. Assessing and Measuring Chronic Multimorbidity in the Older Population: A Proposal for Its Operationalization.

    Science.gov (United States)

    Calderón-Larrañaga, Amaia; Vetrano, Davide L; Onder, Graziano; Gimeno-Feliu, Luis A; Coscollar-Santaliestra, Carlos; Carfí, Angelo; Pisciotta, Maria S; Angleman, Sara; Melis, René J F; Santoni, Giola; Mangialasche, Francesca; Rizzuto, Debora; Welmer, Anna-Karin; Bernabei, Roberto; Prados-Torres, Alexandra; Marengoni, Alessandra; Fratiglioni, Laura

    2016-12-21

    Although the definition of multimorbidity as "the simultaneous presence of two or more chronic diseases" is well established, its operationalization is not yet agreed. This study aims to provide a clinically driven comprehensive list of chronic conditions to be included when measuring multimorbidity. Based on a consensus definition of chronic disease, all four-digit level codes from the International Classification of Diseases, 10th revision (ICD-10) were classified as chronic or not by an international and multidisciplinary team. Chronic ICD-10 codes were subsequently grouped into broader categories according to clinical criteria. Last, we showed proof of concept by applying the classification to older adults from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K) using also inpatient data from the Swedish National Patient Register. A disease or condition was considered to be chronic if it had a prolonged duration and either (a) left residual disability or worsening quality of life or (b) required a long period of care, treatment, or rehabilitation. After applying this definition in relation to populations of older adults, 918 chronic ICD-10 codes were identified and grouped into 60 chronic disease categories. In SNAC-K, 88.6% had ≥2 of these 60 disease categories, 73.2% had ≥3, and 55.8% had ≥4. This operational measure of multimorbidity, which can be implemented using either or both clinical and administrative data, may facilitate its monitoring and international comparison. Once validated, it may enable the advancement and evolution of conceptual and theoretical aspects of multimorbidity that will eventually lead to better care. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.

  18. Statin Safety in Chinese: A Population-Based Study of Older Adults.

    Science.gov (United States)

    Li, Daniel Q; Kim, Richard B; McArthur, Eric; Fleet, Jamie L; Hegele, Robert A; Shah, Baiju R; Weir, Matthew A; Molnar, Amber O; Dixon, Stephanie; Tu, Jack V; Anand, Sonia; Garg, Amit X

    2016-01-01

    Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients. We conducted a population-based retrospective cohort study of older adults (mean age, 74 years) newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm) were matched (1:3) by propensity score to 57,099 non-Chinese. This study used linked healthcare databases. The follow-up observation period (mean 1.1, maximum 10.8 years) was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation). Forty-seven percent (47%) of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR) 0.61 (95% CI 0.28 to 1.34), incident diabetes HR 1.02 (95% CI 0.80 to 1.30), acute kidney injury HR 0.90 (95% CI 0.72 to 1.13), or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05)]. Similar results were observed in subgroups defined by statin type and dose. We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted.

  19. Rehabilitation needs for older adults with stroke living at home: perceptions of four populations

    Directory of Open Access Journals (Sweden)

    Viscogliosi Chantal

    2007-08-01

    Full Text Available Abstract Background Many people who have suffered a stroke require rehabilitation to help them resume their previous activities and roles in their own environment, but only some of them receive inpatient or even outpatient rehabilitation services. Partial and unmet rehabilitation needs may ultimately lead to a loss of functional autonomy, which increases utilization of health services, number of hospitalizations and early institutionalization, leading to a significant psychological and financial burden on the patients, their families and the health care system. The aim of this study was to explore partially met and unmet rehabilitation needs of older adults who had suffered a stroke and who live in the community. The emphasis was put on needs that act as obstacles to social participation in terms of personal factors, environmental factors and life habits, from the point of view of four target populations. Methods Using the focus group technique, we met four types of experts living in three geographic areas of the province of Québec (Canada: older people with stroke, caregivers, health professionals and health care managers, for a total of 12 groups and 72 participants. The audio recordings of the meetings were transcribed and NVivo software was used to manage the data. The process of reducing, categorizing and analyzing the data was conducted using themes from the Disability Creation Process model. Results Rehabilitation needs persist for nine capabilities (e.g. related to behaviour or motor activities, nine factors related to the environment (e.g. type of teaching, adaptation and rehabilitation and 11 life habits (e.g. nutrition, interpersonal relationships. The caregivers and health professionals identified more unmet needs and insisted on an individualized rehabilitation. Older people with stroke and the health care managers had a more global view of rehabilitation needs and emphasized the availability of resources. Conclusion Better

  20. Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

    Directory of Open Access Journals (Sweden)

    Lindberg T

    2016-08-01

    Full Text Available Terese Lindberg,1,2 Doris M Bohman,1 Sölve Elmståhl,2 Claes Jogréus,1 Johan Sanmartin Berglund1 1Department of Health, Blekinge Institute of Technology, Karlskrona, 2Department of Health Sciences, Lund University, Lund, Sweden Purpose: With longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR using the ECG-BodyKom®.Methods: Two hundred elderly persons aged 66–93 years were recruited from the Swedish National Study on Aging and Care in 2010–2013, and data were collected via wireless LTR ECG-BodyKom.Results: Screening with the LTR ECG revealed that persistent atrial fibrillation (AF occurred in 10% of the outpatient population aged ≥66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60–80 years and older (>80 years elderly participants. Furthermore, all patients with paroxysmal AF had a CHA2DS2VASc score of ≥2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it.Conclusion: The increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment. Keywords: arrhythmia, older people, prevalence, wireless long-term ECG

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  2. Heart Score Estimation by Specialized Nurses in a Greek Urban Population.

    Science.gov (United States)

    Papadopoulou, Evaggelia; Meidani, Maria; Boutsikou, Maria; Papaspiropoulou, Pinelopi; Kelaiditou, Theodosia; Koukouzli, Afedia; Tapola, Anastasia; Voudoufianaki, Ioanna; Mavrogeni, Sophie; Katsiki, Niki; Kolovou, Genovefa; Lekakis, Ioannis

    2017-01-01

    Specialized nurses estimated the HeartScore in an urban Greek population by recognizing cardiovascular disease (CVD) risk factors in the setting of the Onassis Cardiovascular Prevention Program (OCPP). They also provided nursing consultation and assessed the clinical and biochemical characteristics of the studied population. Individuals were recruited through TV announcements and via the website of the Onassis Cardiac Surgery Centre. All participants visited the Onassis Cardiac Centre from 20 September to 30 October 2011. Overall, 2,145 individuals were included in the study. CVD risk was calculated by the HeartScore and serum total cholesterol was measured (mean: 193±43 mg/dl). Although 33% of the participants reported dyslipidaemia, only 17% were on hypolipidaemic treatment. Hypertension and dyslipidaemia frequency increased with age. In the present study, specialized nurses estimated the HeartScore in a Greek urban population. The majority of the studied population was undiagnosed and untreated. These results highlight the necessity for both primary and secondary prevention programs that can be carried out by specialized nurses. Such programs may improve the diagnosis and treatment of CVD risk factors; early initiation and optimization of therapy as well as management of drug intolerance (e.g. statins) can contribute to CVD risk reduction.

  3. [How educating students in depression among older people can affect their motivation to work with this population].

    Science.gov (United States)

    Favier, S; Izaute, M; Teissèdre, F

    2017-04-01

    Negative representations of ageing are conveyed in our society. We see that people frequently avoid working with older people, due to a lack of motivation. Depressive signs in older people are more frequently associated with normal ageing, rather than a pathology, giving health professionals the feeling that therapeutic efforts are likely to be unproductive. Yet, depression is a major public health problem, particularly among older people. It is a real pathology, affecting 20% of people aged 65 and older. In retirement homes the percentage can be as high as 45%. To study and evaluate how theoretical knowledge about older people and depression affects the motivation of 2nd year psychology students to work with this population. The study involves two groups. One of the groups (experimental group) followed an 8hour course on depression in older people, whereas the other (control group) followed an 8hour course on a different topic. The study was conducted in two parts. First, the two groups answered an initial questionnaire which measured how motivated they were to work with older people and what they knew about depression in older people. Then, after the experimental phase, all of the students answered the same questionnaire a second time. The comparison shows a significant decline in knowledge between T1 and T2 for the control group (Pstudents are more motivated to work with older people. Moreover, we observe that the more knowledge students have in this field, the more motivated they will be to work with older people. Whereas there were no differences in knowledge before the course, we observed that the knowledge of the group who took part in the course about older people improved. Also, the evaluation showed that students who took the course were significantly more knowledgeable. Regarding motivation, our results vary according to the type of motivation. Overall, as regards intrinsic motivation, we observed an increase in motivation, insofar as the students who

  4. Exercise prescription for the older population: The interactions between physical activity, sedentary time, and adequate nutrition in maintaining musculoskeletal health.

    Science.gov (United States)

    Shad, Brandon J; Wallis, Gareth; van Loon, Luc J C; Thompson, Janice L

    2016-11-01

    Regular physical activity (PA) promotes musculoskeletal health in older adults. However, the majority of older individuals do not meet current PA guidelines and are also highly sedentary. Emerging evidence indicates that large amounts of sedentary time accelerate the loss of skeletal muscle mass (i.e., sarcopenia) and physical function with advancing age. However, current PA recommendations for sedentary time are non-specific (i.e., keep sedentary time to a minimum). Research indicates that physical inactivity and large amounts of sedentary time accelerate sarcopenic muscle loss by inducing skeletal muscle 'anabolic resistance'. These findings suggest a critical interaction between engaging in 'sufficient' levels of PA, minimising sedentary time, and consuming 'adequate' nutrition to promote optimal musculoskeletal health in older adults. However, current PA recommendations do not take into account the important role that nutrition plays in ensuring older adults can maximise the benefits from the PA in which they engage. The aim of this narrative review is: (1) to briefly summarise the evidence used to inform current public health recommendations for PA and sedentary time in older adults; and (2) to discuss the presence of 'anabolic resistance' in older adults, highlighting the importance of regular PA and minimising sedentary behaviour. It is imperative that the synergy between PA, minimising sedentary behaviour and adequate nutrition is integrated into future PA guidelines to promote optimal musculoskeletal health and metabolic responses in the growing ageing population.

  5. Ecological specialization and population size in a biodiversity hotspot: how rare species avoid extinction.

    Science.gov (United States)

    Williams, S E; Williams, Y M; VanDerWal, J; Isaac, J L; Shoo, L P; Johnson, C N

    2009-11-17

    Species with narrow environmental niches typically have small geographic ranges. Small range size is, in turn, often associated with low local abundance. Together, these factors should mean that ecological specialists have very small total populations, putting them at high risk of extinction. But some specialized and geographically restricted species are ancient, and some ecological communities have high proportions of rare and specialized endemics. We studied niche characteristics and patterns of distribution and abundance of terrestrial vertebrates in the rainforests of the Australian Wet Tropics (AWT) to identify mechanisms by which rare species might resist extinction. We show that species with narrow environmental niches and small geographic ranges tend to have high and uniform local abundances. The compensation of geographic rarity by local abundance is exact, such that total population size in the rainforest vertebrates of the AWT is independent of environmental specialization. This effect would tend to help equalize extinction risk for specialists and generalists. Phylogenetic analysis suggests that environmental specialists have been gradually accumulating in this fauna, indicating that small range size/environmental specialization can be a successful trait as long as it is compensated for by demographic commonness. These results provide an explanation of how range-restricted specialists can persist for long periods, so that they now form a major component of high-diversity assemblages such as the AWT.

  6. Differential effectiveness of two anxiety induction procedures in youth and older adult populations

    OpenAIRE

    Ignacio Montorio; Roberto Nuevo; Isabel Cabrera; María Márquez; María Izal

    2015-01-01

    In this study, we tested in older and younger adults the efficacy of two well-known procedures to experimentally induce anxiety: a) Velten self-statements combined with music; b) film scenes. We extended the previous findings in this field to the understudied area of mood induction in older adults. Fifty-seven older adults and 94 college students were randomly assigned to one of the experimental conditions or to a control group. Results indicated that both procedures were effective, according...

  7. Extending decision making competence to special populations: a pilot study of persons on the autism spectrum

    OpenAIRE

    Levin, Irwin P; Gary J Gaeth; Foley-Nicpon, Megan; Yegorova, Vitaliya; Cederberg, Charles; Yan, Haoyang

    2015-01-01

    The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from “theory of mind” to predict key components of decision making in high-functioning y...

  8. Exercise and social support are associated with psychological distress outcomes in a population of community-dwelling older adults.

    Science.gov (United States)

    McHugh, Joanna E; Lawlor, Brian A

    2012-09-01

    Exercise reduces the likelihood of psychological distress, but this may be due to incidental socializing. We gathered information on exercise, social support and three aspects of psychological distress from 583 community-dwelling older adults. Exercise and social support from friends were both associated with lower scores of depression, anxiety and perceived stress. For infrequent exercisers, having a low level of social support indicated higher levels of depression, whereas for frequent exercisers, having a low level of social support did not affect depression levels. Both exercise and social support have roles in regulating psychological well-being in older populations and exercisers are less susceptible to effects of low social support on depression.

  9. Physical Activity, Adiposity, and Diabetes Risk in Middle-Aged and Older Chinese Population

    Science.gov (United States)

    Qin, Li; Corpeleijn, Eva; Jiang, Chaoqiang; Thomas, G. Neil; Schooling, C. Mary; Zhang, Weisen; Cheng, Kar Keung; Leung, Gabriel M.; Stolk, Ronald P.; Lam, Tai Hing

    2010-01-01

    OBJECTIVE Physical activity may modify the association of adiposity with type 2 diabetes. We investigated the independent and joint association of adiposity and physical activity with fasting plasma glucose, impaired fasting glucose, and type 2 diabetes in a Chinese population. RESEARCH DESIGN AND METHODS Middle-aged and older Chinese (n = 28,946, ≥50 years, 72.4%women) from the Guangzhou Biobank Cohort Study were examined in 2003–2008. Multivariable regression was used in a cross-sectional analysis. RESULTS BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with type 2 diabetes after multiple adjustment, most strongly for WHR with odds ratio (OR) of 3.99 (95% CI 3.60–4.42) for highest compared with lowest tertile. Lack of moderate-to-vigorous physical activity, but not walking, was associated with diabetes with an OR of 1.29 (1.17–1.41). The association of moderate-to-vigorous activity with fasting glucose varied with WHR tertiles (P = 0.01 for interaction). Within the high WHR tertile, participants who had a lack of moderate-to-vigorous activity had an OR of 3.87 (3.22–4.65) for diabetes, whereas those who were active had an OR of 2.94 (2.41–3.59). CONCLUSIONS In this population, WHR was a better measure of adiposity-related diabetes risk than BMI or waist circumference. Higher moderate-to-vigorous activity was associated with lower diabetes risk, especially in abdominally obese individuals. PMID:20713687

  10. Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population

    DEFF Research Database (Denmark)

    McDonald, Cameron Keith; Ankarfeldt, Mikkel Z.; Capra, Sandra

    2016-01-01

    over 6 years (for trend: β=0·434, P=0·03). Sensitivity analysis indicated no effect modification of sex or the presence of CVD. Greater leucine intake in conjunction with adequate total protein intake was associated with long-term LBM retention in a healthy older Danish population. This study......Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older...... adult Danes. Dietary leucine intake was assessed at baseline and after 6 years in men and women, aged 35-65 years, participating in the Danish cohort of the WHO-MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) study (n 368). Changes in LBM over the 6 years were...

  11. Biofeedback for training balance and mobility tasks in older populations : a systematic review

    NARCIS (Netherlands)

    Zijlstra, Agnes; Mancini, Martina; Chiari, Lorenzo; Zijlstra, Wiebren

    2010-01-01

    Context: An effective application of biofeedback for interventions in older adults with balance and mobility disorders may be compromised due to co-morbidity. Objective: To evaluate the feasibility and the effectiveness of biofeedback-based training of balance and/or mobility in older adults. Data S

  12. Biofeedback for training balance and mobility tasks in older populations : a systematic review

    NARCIS (Netherlands)

    Zijlstra, Agnes; Mancini, Martina; Chiari, Lorenzo; Zijlstra, Wiebren

    2010-01-01

    Context: An effective application of biofeedback for interventions in older adults with balance and mobility disorders may be compromised due to co-morbidity. Objective: To evaluate the feasibility and the effectiveness of biofeedback-based training of balance and/or mobility in older adults. Data

  13. Falls and Drugs in the Older Population: medical and societal consequences

    NARCIS (Netherlands)

    K.A. Hartholt (Klaas)

    2011-01-01

    textabstractFalls represent a major public health problem among older persons in western countries, since approximately a third of all persons aged 65 years and older experience at least one fall per year. This thesis provides insights in the epidemiology, injury patterns, healthcare costs,

  14. Ranging of older male elephants introduced to an existing small population without older males: Pilanesberg National Park

    Directory of Open Access Journals (Sweden)

    R. Slotow

    2004-12-01

    Full Text Available The African elephant Loxodonta africana is one of the key components of African savanna. Not only do they play a crucial role in the ecosystem (Dublin et al. 1990; Van de Vijver et al. 1999, but they also provide one of the integral parts of sustainable conservation through ecotourism (e.g. Brown 1993 and consumptive utilisation (Taylor 1993. The ever-expanding transformation of savanna land-use through human settlement is resulting in the isolation of elephants into small populations. Furthermore, in South Africa, the reclamation of ranch land as game areas has resulted in the reintroduction of elephant to a large number of small, isolated, fenced reserves.

  15. Insomnia in special populations: effects of aging, menopause, chronic pain, and depression.

    Science.gov (United States)

    Ancoli-Israel, Sonia; Soares, Cláudio N; Gaeta, Raymond; Benca, Ruth M

    2004-12-01

    Chronic insomnia is highly common in adults, and certain population groups are particularly prone to sleep disturbances, including the elderly, women in menopausal transition, persons with chronic pain, and those with depression. Diagnosis and treatment of insomnia in such patients may be problematic because of (1) the presence of one or more comorbid medical illnesses, as in the elderly or patients with a chronic pain syndrome, (2) the presence of depressive symptoms, or (3) the patient's underlying physiologic status (eg, hormone fluctuations due to perimenopause). Effective management of sleep disturbances in these special populations requires an integrative approach to evaluation in the context of the underlying condition and to concurrent treatment of the sleep disturbance and any coexisting medical condition or associated symptom. The contributors to this article discuss insomnia as it is experienced by each of these populations and present representative case examples and proposed treatment plans for each.

  16. Trend of cardiovascular risk factors in the older Iranian population: 2002-2014.

    Science.gov (United States)

    Eslami, Ali; Lotfaliany, Mojtaba; Akbarpour, Samaneh; Azizi, Fereidoun; Hadaegh, Farzad

    2017-08-31

    Current study aimed to investigate the sex-stratified secular trend of cardiovascular disease risk factors among an older population in Iran during a median follow-up period of 8.76 years. A total of 1490 participants (733 women) aged ≥60 years were evaluated in four study phases of 2002-2005, 2005-2008, 2008-2011 and 2011-2014. The trends of cardiovascular disease risk factors for each sex were estimated using generalized estimating equations. The age-adjusted prevalence of diabetes, hypertension, central obesity, and chronic kidney disease at the baseline was 24%, 43%, 55%, and 32% in men and 31%, 57%, 60% and 53% in women, respectively, and had noticeable upward trend during the study period to reach 35%, 56%, 61% and 51% in men, and 42%, 71%, 74% and 67% in women, respectively. However, lipid profile parameters showed favorable trends. Despite the increasing trend in drug consumption, approximately 27% of women with diabetes and 37% of men with diabetes did not use antidiabetic medication, respectively; the results were 23% and 35% for hypertensive women and men, respectively. Among men, there was a decreasing trend towards low physical activity, from 40% at baseline to 26% at the most recent follow up. The prevalence of smoking remained steady throughout follow up. Despite the benefits of lipid lowering, the status of other risk factor profiles are often suboptimal in both sexes. There remains much room for improvement in risk factors management, particularly for hypertension, smoking and adiposity status, and a need for an intervention. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  17. Nutritional status and quality of life in different populations of older people in Poland.

    Science.gov (United States)

    Kostka, J; Borowiak, E; Kostka, T

    2014-11-01

    To estimate the potential association of three distinct nutritional status measures (body mass index (BMI), calf circumference (CC) and the Mini Nutritional Assessment (MNA)) with health-related quality of life (HRQL) assessed with Euroqol 5D questionnaire in different populations of elderly people in Poland. The study group was comprised of 1003 community-dwelling subjects from the urban environment, 890 subjects from the rural environment and 879 subjects from an institutional environment (nursing homes). Bivariate and multivariate associations were identified between nutritional status measures and HRQL adjusted for demographic and social variables, health status, physical function and mental status. Nutrition status indices (BMI, CC and MNA) were generally higher in the urban than in the rural environment and clearly worse in institutionalised elderly. In both community-dwelling groups, BMI and CC were negatively related to several Euroqol scores. In institutional residents, of opposite relationships were observed: higher values of these variables were connected with less frequent reporting of problems in Euroqol. In all the three groups, associations between HRQL scores and MNA were very similar: higher values of MNA were significantly connected with less frequent reporting of problems in Euroqol. BMI and CC, as overweight/obesity measures, are independent predictors of lower HRQL in urban and rural community-dwelling seniors and higher HRQL in institutionalised elderly. Poor nutritional state as measured by MNA is a similar determinant of well-being in all the three environments. This different relationship of popular overweight/obesity measures to HRQL should be taken into account while designing care for older people.

  18. The Health Literacy Status and Influencing Factors of Older Population in Xinjiang

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    Yongbing LIU

    2015-10-01

    Full Text Available Background: This study was to investigate the health literacy and influencing factors of older population in pension institution of Xinjiang, China.Methods: Elderly people were selected from 44 pension institutions in Urumqi, Changji, Karamay and Shihezi and from September 2011 to June 2012 using random layer sampling method. The investigation was carried out by Chi-nese citizen health literacy questionnaire prepared by the China Health Education Center. Data were analyzed by One-way ANOVA, multiple linear regression and Pearson correlation analysis.Results: A total of 1396 elderly people met the inclusion criteria and their average age was (77.37 ± 8.48 years. Their average health literacy score was (77.37 ± 8.48 points, which was at a low level. There was significant difference in health literacy score among the factors of age, gender, race, education, household income, marital status and occupa-tion (P<0.05. The independent influencing factors of health literacy were education, race, occupation, household in-come, age and marital status (P < 0.05. Correlation analysis was conducted between the scores of health knowledge, health belief, health behavior, health skill and total scores of health literacy. Health knowledge scores and total scores had highest correlation (r=0.95, followed by health belief scores and total scores (r=0.81.Conclusion: The correlation between health behavior scores and health skill scores was the lowest (r=0.33. The ma-jor factors that lead to low health literacy in elderly people are femininity, minority and low levels of education.

  19. Online data collection with special populations over the World Wide Web.

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    Marcell, M M; Falls, A L

    2001-10-01

    The quick ascendance of the World Wide Web as the dominant vehicle for internet communication has recently made experimentation in a multimedia environment feasible on the Internet. Although web sites containing online psychology demonstrations and experiments for non-handicapped individuals have appeared in recent years (especially in the areas of cognitive and social psychology), there appear to have been few attempts to conduct online experimentation with special populations. We recently completed two online pilot studies of families with Down syndrome or Williams syndrome members: a) A survey that asks (via Likert rating scales, adjective checklists, multiple-choice style questions, and text-entry boxes) about family background, computer use, and temperament of the special needs family member; and b) An experiment (completed by an individual with special needs) that includes auditory and visual digit span tasks and a memory-for-orientation task in which responses are entered via mouse clicks. Recruiting began with e-mail announcements to representative Down syndrome and Williams syndrome discussion groups, listserves, and bulletin boards, and submission of the project's URL (http://www.cofc.edu/~marcellm/testaw.htm) and key indexing terms to selected search engines. This paper reviews technical aspects of developing the online programmes as well as the strengths and weaknesses of online vs. traditional laboratory-based research in relation to issues such as experimental control, delivery of instructions, experimenter bias, participant recruitment, sample heterogeneity, generalization, attrition, privacy, financial costs, data integrity, and ethics. We conclude by offering our thoughts on two ways of implementing online experimentation with special populations: a) Using a remote parent 'helper' as a proxy to work with the target individual; and b) Collaborating with professional colleagues in Web-based projects conducted in traditional laboratory settings.

  20. Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

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    Juliana Saboia Fontenele e Silva

    2013-12-01

    Full Text Available We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed, EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients: pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows: nursing mothers and children (meglumine antimoniate or pentamidine, patients with renal disease (amphotericin B or miltefosine, patients with heart disease (amphotericin B, miltefosine or pentamidine, immunosuppressed patients (liposomal amphotericin, the elderly (meglumine antimoniate, pregnant women (amphotericin B and patients with liver disease (no evidence available. The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fill in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.

  1. Multimorbidity and health-related quality of life in the older population: results from the German KORA-Age study

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    Peters Annette

    2011-07-01

    Full Text Available Abstract Background Multimorbidity in the older population is well acknowledged to negatively affect health-related quality of life (HRQL. Several studies have examined the independent effects of single diseases; however, little research has focused on interaction between diseases. The purpose of this study was to assess the impact of six self-reported major conditions and their combinations on HRQL measured by the EQ-5D. Methods The EQ-5D was administered in the population-based KORA-Age study of 4,565 Germans aged 65 years or older. A generalised additive regression model was used to assess the effects of chronic conditions on HRQL and to account for the nonlinear associations with age and body mass index (BMI. Disease interactions were identified by a forward variable selection method. Results The conditions with the greatest negative impact on the EQ-5D index were the history of a stroke (regression coefficient -11.3, p 2. Conclusions There are important interactions between coronary problems, diabetes mellitus, and the history of a stroke that negatively affect HRQL in the older German population. Not only high but also low BMI is associated with impairments in health status.

  2. [Thought on several problems of post-marketing herbs clinical evaluation in special populations].

    Science.gov (United States)

    Zhou, Ai; Lian, Fengmei

    2011-10-01

    The re-evaluation of clinical post-marketing herbs in special populations, such as children, the aged, pregnant women, lactating women, has attracted attention in our country. The media is drug adverse reaction reports and package insert. The safety of combined administration in aged and children's growth should have been taken long-term follow-up study. Perfecting traditional chinese medicine FDA system will be beneficial to the re-evaluation of clinical postmarketing herbs in pregnant women. Dose-effect study in children also should cause the concern of researchers.

  3. Differences in management of older women influence breast cancer survival: results from a population-based database in Sweden.

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    Sonja Eaker

    2006-03-01

    Full Text Available BACKGROUND: Several reports have shown that less aggressive patterns of diagnostic activity and care are provided to elderly breast carcinoma patients. We sought to investigate whether differences in the management of older women with breast cancer are associated with survival. METHODS AND FINDINGS: In an observational study using a population-based clinical breast cancer register of one health-care region in Sweden, we identified 9,059 women aged 50-84 y diagnosed with primary breast cancer between 1992 and 2002. The 5-y relative survival ratio was estimated for patients classified by age group, diagnostic activity, tumor characteristics, and treatment. The 5-y relative survival for breast cancer patients was lower (up to 13% in women 70-84 y of age compared to women aged 50-69 y, and the difference was most pronounced in stage IIB-III and in the unstaged. Significant differences in disease management were found, as older women had larger tumors, had fewer nodes examined, and did not receive treatment by radiotherapy or by chemotherapy as often as the younger women. Adjustment for diagnostic activity, tumor characteristics, and treatment diminished the relative excess mortality in stages III and in the unstaged, whereas the excess mortality was only marginally affected in stage IIB. CONCLUSIONS: Less diagnostic activity, less aggressive treatment, and later diagnosis in older women are associated with poorer survival. The large differences in treatment of older women are difficult to explain by co-morbidity alone.

  4. The fate of small-size pericardial heart valve prostheses in an older patient population.

    Science.gov (United States)

    De Paulis, Ruggero; D'Aleo, Salvatore; Bellisario, Alessandro; Salica, Andrea; Weltert, Luca P; Scaffa, Raffaele; Wolf, Lorenzo Guerrieri; Maselli, Daniele; Di Mauro, Michele

    2017-01-01

    Structural valve deterioration (SVD) is the Achilles' heel of bioprostheses. Its correlation with younger age is well known. In recent years we exclusively reserved use of small-size Mitroflow valve prostheses (LivaNova, London, United Kingdom) to an older patient population with small aortic annuli. This study aimed to assess the incidence of SVD and its effect on patient survival and need for reoperation. Two hundred five patients (aged 75.9 ± 5.3 years; range, 62-92 years) underwent aortic valve replacement with a 19-mm or 21-mm Mitroflow valve prosthesis between 2005 and 2011. The great majority was female (n = 170; 83%). In half of patients it was an isolated procedure. All valve prostheses were implanted in a supra-annular position using pledgeted sutures. A 19-mm valve was implanted in 93 patients (45.3%), whereas in 112 patients (54.6%) a 21-mm valve was used. Twenty-three patients (11.2%) were diagnosed with early SVD by echocardiography. Average time from surgery to diagnosis of SVD was 64.3 ± 26.8 months. Ten patients needed a reoperation for SVD. Average time from surgery to a second operation was 45.7 ± 35.7 months. Overall survival was 64.5% and 42.3% at 5 and 9 years, respectively. Cumulative freedom from SVD at 5 and 9 years was 94.8% ± 1.6% and 77.4% ± 5.4%, respectively. In 4 patients death was linked to the presence of SVD. There were no differences in mortality, reoperation, or SVD between the 2 Mitroflow valve sizes. Small-size Mitroflow pericardial valve prostheses have shown a worrisome incidence of SVD even in patients aged >70 years. Based on this experience we have discontinued their use. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  5. Self-perception of oral health in older adults from an urban population in Lisbon, Portugal.

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    Carvalho, Catarina; Manso, Ana Cristina; Escoval, Ana; Salvado, Francisco; Nunes, Carla

    2016-08-22

    To analyze if the self-perception of oral health in the urban context is associated with sociodemographic factors that interfere in the life quality of oral health. Cross-sectional study with convenience sample of older individuals (65 years old or more) enrolled in the Agrupamento de Centros de Saúde de Lisboa Norte (ACES Lisboa Norte - Health Centers Groupings North Lisbon). The self-perception of oral health and associated life quality was evaluated by the Geriatric Oral Health Assessment Index and the individuals were classified according to sociodemographic characteristics. The internal consistency of the questionnaire was evaluated by Cronbach's alpha (α). Later, we used binary logistic regression models to characterize the factors associated with the self-perception of oral health, considering the sociodemographic variables and the older adults' clinical conditions of oral health and establishing the crude and adjusted (to age) odds ratios and their 90% confidence intervals. A total of 369 older adults participated in this study, with an average age of 74.2 years (SD = 6.75); 62.9% were female. On average, the index was moderated, with tendency to be high: 32.9 (SD = 3.6; 12-36 interval). The Cronbach's alpha was high: 0.805. Age, marital status, and the last dental appointment were the factors significantly associated with self-perception of oral health. The study shows that these individuals have a moderate, with tendency to high, self-perception of oral health. The self-perception of oral health assessment allowed us to identify the main associated sociodemographic factors. This instrument can help guiding planning strategies and oral health promotion directed toward a better life quality for this population group. Analisar se a autopercepção de saúde bucal em contexto urbano está associada aos factores sociodemográficos que interferem na qualidade de vida da saúde bucal. Estudo transversal com amostra de conveniência de indivíduos idosos (65

  6. Dental care and children with special health care needs: a population-based perspective.

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    Lewis, Charlotte W

    2009-01-01

    This paper grew out of a project reviewing progress in children's oral health after Oral Health in America: A Report of the Surgeon General was published in 2000. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006 National Survey of Children with Special Health Care Needs to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to children without special health care needs, and to results from the previous iteration of this survey. Dental care remains the most frequently cited unmet health need for CSHCN. More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. In summary, CSHCN are more likely to be insured and to receive preventive dental care at equal or higher rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely affected, are more likely to report unmet dental care need compared with unaffected children. Despite advances in knowledge about dental care among CSHCN, unanswered questions remain. Recommendations are provided toward obtaining additional data and facilitating dental care access for this vulnerable population.

  7. Gender differences: examination of the 12-item bem sex role inventory (BSRI-12) in an older Brazilian population.

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    Carver, Lisa F; Vafaei, Afshin; Guerra, Ricardo; Freire, Aline; Phillips, Susan P

    2013-01-01

    Although gender is often acknowledged as a determinant of health, measuring its components, other than biological sex, is uncommon. The Bem Sex Role Inventory (BSRI) quantifies self-attribution of traits, indicative of gender roles. The BSRI has been used with participants across cultures and countries, but rarely in an older population in Brazil, as we have done in this study. Our primary objective was to determine whether the BSRI-12 can be used to explore gender in an older Brazilian population. The BSRI was completed by volunteer participants, all community dwelling adults aged 65+ living in Natal, Brazil. Exploratory factor analysis was performed, followed by a varimax rotation (orthogonal solution) for iteration to examine the underlying gender roles of feminine, masculine, androgynous and undifferentiated, and to validate the BSRI in older adults in Brazil. The 278 participants, (80 men, 198 women) were 65-99 years old (average 73.6 for men, 74.7 for women). Age difference between sexes was not significant (p = 0.22). A 12 item version of the BSRI (BSRI-12) previously validated among Spanish seniors was used and showed validity with 5 BSRI-12 items (Cronbach=0.66) loading as feminine, 6 items (Cronbach=0.51) loading onto masculine roles and neither overlapping with the category of biological sex of respondent. Although the BSRI-12 appears to be a valid indicator of gender among elderly Brazilians, the gender role status identified with the BSRI-12 was not correlated with being male or female.

  8. Disability and chronic disease among older adults in India: detecting vulnerable populations through the WHO SAGE Study.

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    Basu, Sanjay; King, Abby C

    2013-12-01

    Chronic noncommunicable diseases (NCDs) are now prevalent in many low- and middle-income countries and confer a heightened risk of disability. It is unclear how public health programs can identify the older adults at highest risk of disability related to NCDs within diverse developing country populations. We studied nationally representative survey data from 7,150 Indian adults older than 50 years of age who participated in the World Health Organization Study on Global Aging and Adult Health (2007-2010) to identify population subgroups who are highly disabled. Using machine-learning algorithms, we identified sociodemographic correlates of disability. Although having 2 or more symptomatic NCDs was a key correlate of disability, the prevalence of symptomatic, undiagnosed NCDs was highest among the lowest 2 wealth quintiles of Indian adults, contrary to prior hypotheses of increased NCDs with wealth. Women and persons from rural populations were also disproportionately affected by nondiagnosed NCDs, with high out-of-pocket health care expenditures increasing the probability of remaining symptomatic from NCDs. These findings also indicate that NCD prevalence surveillance studies in low- and middle-income countries should expand beyond self-reported diagnoses to include more extensive symptom- and examination-based surveys, given the likely high rate of surveillance bias due to barriers to diagnosis among vulnerable populations.

  9. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa

    Science.gov (United States)

    Gómez-Olivé, Francesc X.; Rohr, Julia K.; Houle, Brian C.; Kabudula, Chodziwadziwa W.; Wagner, Ryan G.; Salomon, Joshua A.; Kahn, Kathleen; Berkman, Lisa F.; Tollman, Stephen M.; Bärnighausen, Till

    2017-01-01

    Objective: To identify the unmet needs for HIV prevention among older adults in rural South Africa. Methods: We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age–sex standardization. Results: HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age–sex standardization. Conclusions: Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa. PMID:27926667

  10. Behavioural and psychological symptoms in the older population without dementia - relationship with socio-demographics, health and cognition

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    Brayne Carol

    2010-11-01

    Full Text Available Abstract Background Behavioural and psychological symptoms are associated with dementia, but are also present in a significant number of the older population without dementia. Here we explore the distribution of behavioural and psychological symptoms in the population without dementia, and their relationship with domains and severity of health and cognitive impairment. Methods The Medical Research Council Cognitive Function and Ageing Study is a two-phase longitudinal study of ageing representative of the population aged 65 and over of England and Wales. A subsample of 1781 participants without a study diagnosis of dementia was included in this study. Information on symptoms including depression, apathy, anxiety, feelings of persecution, hallucination, agitated behaviour, elation, irritability, sleep problems, wandering, confabulation and misidentification, cognitive function, health related factors and socio-demographic information was extracted from interviews with participants and knowledgeable informants. Participants were classified according to the Mini-Mental State Examination and by criteria for subtypes of mild cognitive impairment (MCI. The prevalence of behavioural and psychological symptoms and associations with cognitive function, health and socio-demographics was examined. Co-occurrence of symptoms was tested using factor analysis. Results Most symptoms were reported more frequently in those with more severe cognitive impairment. Subjective memory complaints were the strongest independent predictor of reported symptoms, and most were reported more often in those classified as having MCI than in those with cognitive impairments that did not meet the MCI criteria. The pattern of co-occurrence of symptoms is similar to that seen in dementia. Conclusions Our results highlight that behavioural and psychological symptoms are prevalent in the cognitively impaired older population, and partly explain the variation observed in previous

  11. Effect of Fish Oil Supplementation on Quality of Life in a General Population of Older Dutch Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial.

    NARCIS (Netherlands)

    Rest, van de O.; Geleijnse, J.M.; Kok, F.J.; Staveren, van W.A.; OldeRikkert, M.G.M.; Beekman, A.T.F.; Groot, de C.P.G.M.

    2009-01-01

    OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Independently living individuals from the general older Dutch population. PARTICIPANTS:

  12. Effect of fish oil supplementation on quality of life in a general population of older Dutch subjects: a randomized, double-blind, placebo-controlled trial.

    NARCIS (Netherlands)

    Rest, O. van de; Geleijnse, J.M.; Kok, F.J.; Staveren, W.A. van; Olde Rikkert, M.G.M.; Beekman, A.T.; Groot, L.C. de

    2009-01-01

    OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Independently living individuals from the general older Dutch population. PARTICIPANTS:

  13. Effect of fish oil supplementation on quality of life in a general population of older Dutch subjects: a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Rest, van de O.; Geleijnse, J.M.; Kok, F.; Staveren, van W.A.; Olderikkert, M.G.M.; Beekman, A.T.F.; Groot, de L.C.P.G.M.

    2009-01-01

    OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Independently living individuals from the general older Dutch population. PARTICIPANTS:

  14. Tracking an Elusive Population: Family Carers of Older Adults with Intellectual Disabilities in Romandy (Switzerland)

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    Jecker-Parvex, Maurice; Breitenbach, Nancy

    2012-01-01

    Despite a long-standing tradition of institutional placement in Switzerland, many older adults with intellectual disabilities continue to be supported by aging parents and siblings. For various reasons, these carers and the adults concerned have been overlooked up to now. To find out how many such families are providing housing and care of this…

  15. Physical and Leisure Activity in Older Community-Dwelling Canadians Who Use Wheelchairs: A Population Study

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    Krista L. Best

    2011-01-01

    Full Text Available Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR=44.71 and leisure activity (OR=10.83. Wheelchair use was a risk factor for poor perceived health (OR=10.56 and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.

  16. Declined guideline adherence in older breast cancer patients: a population-based study in the Netherlands.

    NARCIS (Netherlands)

    Weggelaar, I.; Aben, K.K.H.; Warle, M.C.; Strobbe, L.J.; Spronsen, D.J. van

    2011-01-01

    Older women with primary operable breast cancer might receive suboptimal care due to their advanced age. Although several studies reported age as an independent determinant for receiving none or less treatment according to accepted standards, prospective data are lacking. This study evaluates the

  17. Differential effectiveness of two anxiety induction procedures in youth and older adult populations

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    Ignacio Montorio

    2015-01-01

    Full Text Available In this study, we tested in older and younger adults the efficacy of two well-known procedures to experimentally induce anxiety: a Velten self-statements combined with music; b film scenes. We extended the previous findings in this field to the understudied area of mood induction in older adults. Fifty-seven older adults and 94 college students were randomly assigned to one of the experimental conditions or to a control group. Results indicated that both procedures were effective, according to a series of ANOVAs for several self-report, physiological, and behavioral measures. Likewise, the highest effect sizes were observed for the Velten procedure (g = .81 vs. g = .71, and the effects were significantly higher in younger (g = 1.0 in the Velten condition than in older adults (g = .62, Q = 4.25, χ2(1, P = .0392. Both procedures were effective to induce inducting anxiety in both age groups, especially the Velten procedure in younger adults. Therefore, Velten self-statements combined with music may be very useful anxiety induction procedure for further research in controlled situations of emotions across the life-span.

  18. Dental fear in a special needs clinic population of persons with disabilities.

    Science.gov (United States)

    Martin, Michael D; Kinoshita-Byrne, Jamie; Getz, Tracy

    2002-01-01

    This study reports findings from a survey of dental fear in a special needs dental clinic population. Subjects were recruited from the University of Washington's Dental Education in Care of Persons With Disabilities (DECOD) clinical program (n = 132). Dental fears were assessed using the Kleinknecht Dental Report. Fear levels were examined among patients with differing categories of primary disabilities and between genders, races and educational levels. Some level of dental fear was reported by 43.2% of the respondents, indicating that dental fear may be an important factor in dental care for this population. Gender and educational level were significantly associated with fear levels (both p caregivers also were interviewed (n = 72) to allow for a comparison of patient and caregiver perceptions. Both patient and caregiver were interviewed whenever possible to create paired reports. Generally, caregivers significantly overestimated fear levels compared with patients (p caregiver-patient analyses, the fear scores were not significantly different, indicating that caregivers accurately estimated their client's level of dental fear. A regression model including disability group, gender, and years of education was significant for predicting fear level as measured by the Kleinknecht survey (p = 0.02). We conclude that dental fear may be a significant, though little understood problem for a population of persons with disabilities as well as for their oral care providers, and that further investigation is needed.

  19. Prevalence of Frailty Indicators and Association with Socioeconomic Status in Middle-Aged and Older Adults in a Swiss Region with Universal Health Insurance Coverage: A Population-Based Cross-Sectional Study

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    Idris Guessous

    2014-01-01

    Full Text Available Frailty prevalence in older adults has been reported but is largely unknown in middle-aged adults. We determined the prevalence of frailty indicators among middle-aged and older adults from a general Swiss population characterized by universal health insurance coverage and assessed the determinants of frailty with a special focus on socioeconomic status. Participants aged 50 and more from the population-based 2006–2010 Bus Santé study were included (N = 2,930. Four frailty indicators (weakness, shrinking, exhaustion, and low activity were measured according to standard definitions. Multivariate logistic regressions were used to determine associations. Overall, 63.5%, 28.7%, and 7.8% participants presented no frailty indicators, one frailty indicator, and two or more frailty indicators, respectively. Among middle-aged participants (50–65 years, 75.1%, 22.2%, and 2.7% presented 0, 1, and 2 or more frailty indicators. The number of frailty indicators was positively associated with age, hypertension, and current smoking and negatively associated with male gender, body mass index, waist-to-hip ratio, and serum total cholesterol level. Lower income level but not education was associated with higher number of frailty indicators. Frailty indicators are frequently encountered in both older and middle-aged adults from the Swiss general population. Despite universal health insurance coverage, household income is independently associated with frailty.

  20. Prevalence of frailty indicators and association with socioeconomic status in middle-aged and older adults in a swiss region with universal health insurance coverage: a population-based cross-sectional study.

    Science.gov (United States)

    Guessous, Idris; Luthi, Jean-Christophe; Bowling, Christopher Barrett; Theler, Jean-Marc; Paccaud, Fred; Gaspoz, Jean-Michel; McClellan, William

    2014-01-01

    Frailty prevalence in older adults has been reported but is largely unknown in middle-aged adults. We determined the prevalence of frailty indicators among middle-aged and older adults from a general Swiss population characterized by universal health insurance coverage and assessed the determinants of frailty with a special focus on socioeconomic status. Participants aged 50 and more from the population-based 2006-2010 Bus Santé study were included (N = 2,930). Four frailty indicators (weakness, shrinking, exhaustion, and low activity) were measured according to standard definitions. Multivariate logistic regressions were used to determine associations. Overall, 63.5%, 28.7%, and 7.8% participants presented no frailty indicators, one frailty indicator, and two or more frailty indicators, respectively. Among middle-aged participants (50-65 years), 75.1%, 22.2%, and 2.7% presented 0, 1, and 2 or more frailty indicators. The number of frailty indicators was positively associated with age, hypertension, and current smoking and negatively associated with male gender, body mass index, waist-to-hip ratio, and serum total cholesterol level. Lower income level but not education was associated with higher number of frailty indicators. Frailty indicators are frequently encountered in both older and middle-aged adults from the Swiss general population. Despite universal health insurance coverage, household income is independently associated with frailty.

  1. Nutritional status among older residents with dementia in open versus special care units in municipal nursing homes: an observational study

    Science.gov (United States)

    2013-01-01

    Background Undernutrition is widespread among institutionalised elderly, and people suffering from dementia are at particularly high risk. Many elderly with dementia live in open units or in special care units in nursing homes. It is not known whether special care units have an effect on the nutritional status of the residents. The aim of this study was therefore to examine the nutritional status of residents with dementia in both open units and in special care units. Methods Among Oslo’s 29 municipal nursing homes, 21 participated with 358 residents with dementia or cognitive impairment, of which 46% lived in special care units. Nutritional status was assessed using the Malnutrition Universal Screening Tool and anthropometry. Results We found no differences (p > 0.05) in risk of undernutrition, body mass index, mid-upper arm muscle circumference or triceps skinfold thickness between residents in open units and those in special care units. Residents in special care units were significantly younger and stronger when measured with a hand-grip test. Conclusions We found no difference in nutritional status between nursing home residents with dementia/cognitive impairment in open units versus in special care units. PMID:23496975

  2. Perceptions of Direct-to-Consumer Advertising and the Older Adult Population.

    Science.gov (United States)

    Bailey, Trista Askins; Fenney, Megan

    2016-04-01

    Direct-to-consumer advertising (DTCA) has become a prominent feature of our society and reaches many consumers through their televisions, radios, and computer screens. In 2004, the average United States citizen was exposed to more than 16 hours of DTCA per year, and the number of hours has steadily increased. Drug advertising is a multi-billion dollar business for pharmaceutical manufacturers and affects public perception of medications, both prescription and over-the counter. Studies have shown advertisements can have both positive and negative effects, including educating consumers, but can harm the patient-physician relationship. This article addresses the perceptions older adults have toward DTCA and discusses how pharmacists can play a role in helping older adults understand and effectively use DTCA.

  3. Early Life Exposures and the Occurrence and Timing of Heart Disease Among the Older Adult Puerto Rican Population

    OpenAIRE

    McEniry, Mary; Palloni, Alberto

    2010-01-01

    Few studies have examined the effects of early life conditions on the timing of the onset of heart disease. We use the remarkable example of a representative sample of the population of older Puerto Ricans aged 60–74 who lived in the countryside during childhood (n = 1,438) to examine the effects of seasonal exposures to poor nutrition and infectious diseases during late gestation on the timing of the onset and the probability of ever experiencing adult heart disease. Cox and log logistic haz...

  4. Identifying Falls Efficacy and Number of F alls in Older Adults of Turkish Population

    OpenAIRE

    Gönül BABAYİĞİTİREZ

    2014-01-01

    The aim of the study was to investigate the fear of falls in older adults while conducting the reliability analyzes of Falls Efficacy Scale - I for Turkish version living in Mugla and secondary aim was to study relations hip between fear of falls (FES - I Scor e), gender and number of falls. All participants were living in the community and aged 65 years or over (N=100) included as voluntarily to...

  5. Insomnia medication use and the probability of an accidental event in an older adult population

    Directory of Open Access Journals (Sweden)

    Alon Y Avidan

    2010-11-01

    Full Text Available Alon Y Avidan1, Liisa A Palmer2, Justin F Doan3, Robert W Baran31UCLA Department of Neurology, Los Angeles, CA, USA; 2Thomson Reuters, Washington, DC, USA; 3Takeda Global Research and Development Center, Deerfield, IL, USAObjective: This study examined the risk of accidental events in older adults prescribed a sedating antidepressant, long-acting benzodiazepine, short-acting benzodiazepine, and nonbenzodiazepine, relative to a reference group (selective melatonin receptor agonist.Methods: This was a retrospective cohort analysis of older adults (≥65 years with newly initiated pharmacological treatment of insomnia. Data were collected from the Thomson MarketScan® Medicare Supplemental and Coordination of Benefits databases (January 1, 2000, through June 30, 2006. Probit models were used to evaluate the probability of an accidental event.Results: Data were analyzed for 445,329 patients. Patients taking a long-acting benzodiazepine (1.21 odds ratio [OR], short-acting benzodiazepine (1.16 OR, or nonbenzodiazepine (1.12 OR had a significantly higher probability of experiencing an accidental event during the first month following treatment initiation compared with patients taking the reference medication (P < 0.05 for all. A significantly higher probability of experiencing an accidental event was also observed during the 3-month period following the initiation of treatment (1.62 long-acting benzodiazepine, 1.60 short-acting benzodiazepine, 1.48 nonbenzodiazepine, and 1.56 sedating antidepressant; P < 0.05.Conclusions: Older adults taking an SAD or any of the benzodiazepine receptor agonists appear to have a greater risk of an accidental event compared with a reference group taking an MR.Keywords: insomnia, accidental events, benzodiazepine receptor agonist, melatonin receptor agonist, older adults

  6. Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study

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    Caroline A. Smith

    2016-01-01

    Full Text Available Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of “trust” and “try and see” provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills.

  7. Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study.

    Science.gov (United States)

    Smith, Caroline A; Chang, Esther; Brownhill, Suzanne; Barr, Kylie

    2016-01-01

    Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of "trust" and "try and see" provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills.

  8. Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study

    Science.gov (United States)

    Chang, Esther; Brownhill, Suzanne; Barr, Kylie

    2016-01-01

    Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of “trust” and “try and see” provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills. PMID:27429638

  9. Use of statins and reduced risk of recurrence of VTE in an older population. A population-based cohort study.

    Science.gov (United States)

    Tagalakis, Vicky; Eberg, Maria; Kahn, Susan; Azoulay, Laurent

    2016-06-02

    We aimed to determine whether statin use is associated with a decreased risk of recurrent venous thromboembolism (VTE) in older patients. We used a pre-assembled cohort of patients at least 65 years of age diagnosed with incident VTE between January 1, 1994 and December 31, 2004 in the province of Québec, Canada and followed until December 31, 2005. Time-dependent Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) of recurrent VTE associated with current and past use of statins, compared with non-use. The cohort included 25,681 patients with incident VTE. During a mean follow-up of 3.0 years, there were 2343 recurrent VTE events (rate: 3.1 per 100 person-years). Compared with non-use, current use of statins was associated with a decreased risk of VTE recurrence (rates: 1.55 vs 3.47 per 100 per year, respectively; HR: 0.74, 95 % CI: 0.61-0.89), while no association was observed with past use (HR: 0.98, 95 % CI: 0.76-1.25). In a secondary analysis, longer durations of statin use were associated with greater risk reductions (0-6 months, HR 0.82, 95 % CI: 0.67-1.01; 6-12 months, HR 0.62, 95 % CI: 0.43-0.90; ≥ 12 months, HR: 0.50, 95 % CI: 0.33-0.74; p-value for trend ≤ 0.001). The use of statin was associated with a decreased risk of recurrent VTE in older patients. This study supports the need for randomised controlled trials to assess the efficacy and safety of statins in the long-term treatment of VTE.

  10. Prevalence, types, risk factors and clinical correlates of anaemia in older people in a rural Ugandan population.

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    Joseph O Mugisha

    Full Text Available BACKGROUND: Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. METHODS: Participants were aged (≥ 50 years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. RESULTS: In total, 1449 people participated (response rate 72.3%. The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%, and this was higher for males (24.1%, 95% CI=20.7-27.7% than females (17.5%, 95% CI=15.0-20.1%. In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001. Unexplained anaemia was responsible for more than half of all cases (59.7%. Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82, HIV (OR 2.17, 1.32-3.57 heavy hookworm infection (OR 3.45, 1.73-6.91, low fruit consumption (OR 1.55, 1.05-2.29 and being unmarried (OR 1.37 , 95% CI 1.01-1.89. However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77. CONCLUSION: Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict

  11. Prevalence, Types, Risk Factors and Clinical Correlates of Anaemia in Older People in a Rural Ugandan Population

    Science.gov (United States)

    Mugisha, Joseph O.; Baisley, Kathy; Asiki, Gershim; Seeley, Janet; Kuper, Hannah

    2013-01-01

    Background Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. Methods Participants were aged (≥ 50) years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. Results In total, 1449 people participated (response rate 72.3%). The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%), and this was higher for males (24.1%, 95% CI=20.7-27.7%) than females (17.5%, 95% CI=15.0-20.1%). In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trendanaemia was responsible for more than half of all cases (59.7%). Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82), HIV (OR 2.17, 1.32-3.57) heavy hookworm infection (OR 3.45, 1.73-6.91), low fruit consumption (OR 1.55, 1.05-2.29) and being unmarried (OR 1.37 , 95% CI 1.01-1.89). However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77). Conclusion Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict iron deficiency anaemia in older

  12. Voices of Special Educators in Sweden: A Total-Population Study

    Science.gov (United States)

    Göransson, Kerstin; Lindqvist, Gunilla; Nilholm, Claes

    2015-01-01

    Background: There are two occupational groups in Sweden that are expected to have significant impact on educational work related to children in need of special support. These two groups are special educational needs coordinators (SENCOs) and special education teachers. In this paper, we use the collective name "special educators" to…

  13. FMR1 alleles in Tasmania: a screening study of the special educational needs population.

    Science.gov (United States)

    Mitchell, R J; Holden, J J A; Zhang, C; Curlis, Y; Slater, H R; Burgess, T; Kirkby, K C; Carmichael, A; Heading, K D; Loesch, D Z

    2005-01-01

    The distribution of fragile X mental retardation-1 (FMR1) allele categories, classified by the number of CGG repeats, in the population of Tasmania was investigated in 1253 males with special educational needs (SEN). The frequencies of these FMR1 categories were compared with those seen in controls as represented by 578 consecutive male births. The initial screening was based on polymerase chain reaction analysis of dried blood spots. Inconclusive results were verified by Southern analysis of a venous blood sample. The frequencies of common FMR1 alleles in both samples, and of grey zone alleles in the controls, were similar to those in other Caucasian populations. Consistent with earlier reports, we found some (although insignificant) increase of grey zone alleles in SEN subjects compared with controls. The frequencies of predisposing flanking haplotypes among grey zone males FMR1 alleles were similar to those seen in other Caucasian SEN samples. Contrary to expectation, given the normal frequency of grey zone alleles, no premutation (PM) or full mutation (FM) allele was detected in either sample, with only 15 fragile X families diagnosed through routine clinical admissions registered in Tasmania up to 2002. An explanation of this discrepancy could be that the C19th founders of Tasmania carried few PM or FM alleles. The eight to ten generations since white settlement of Tasmania has been insufficient time for susceptible grey zone alleles to evolve into the larger expansions.

  14. Psychometric properties of the OLQ-13 scale to measure Sense of Coherence in a community-dwelling older population

    Directory of Open Access Journals (Sweden)

    van den Esker Franciska

    2011-05-01

    Full Text Available Abstract Background With the ongoing demographic shift, the quality of life and health promotion among older individuals are becoming increasingly important. Recent research suggests that Sense of Coherence positively affects quality of life. Hence, a valid and reliable measurement of Sense of Coherence is pivotal. The 13-item Orientation to Life Questionnaire (OLQ-13 can be used to measure Sense of Coherence. The purpose of the present study is to assess the psychometric properties, validity, and reliability, of the OLQ-13 in community-dwelling individuals, aged 65 and older. Methods The OLQ-13 scale was administered as part of a healthy aging project for non-institutionalized people aged 65 years and older. Internal consistency and reliability were assessed by means of inter-item and test-halves correlations and Cronbach's alpha. Construct validity was explored using cluster analysis and exploratory factor analysis (n = 703 and tested using confirmatory factor analysis on a separate subset of individuals (n = 658. Item face validity was investigated by means of 12 semi-structured interviews. Results The reliability and the validity of the OLQ-13 in this population of non-institutionalized individuals aged 65 years and older was ambiguous, at least partly due to the poor performance of two items (b and d, which was confirmed by results from the qualitative part of this study. The psychometric properties of the proposed OLQ-11, obtained by deleting the two items, were better. In particular, the interpretation of exploratory factor solution improved. Whereas the underlying theoretical constructs could not be linked to the exploratory analyses of OLQ-13, this was to some extent possible in OLQ-11. The superior validity of OLQ-11 over OLQ-13 was supported by the better model fit in the confirmatory factor analysis. Conclusions The present mixed-method study suggests the proposed OLQ-11 as a more suitable instrument for measuring Sense of Coherence

  15. Disparity in Dental Attendance Among Older Adult Populations: A Comparative Analysis Across Selected European Countries and the United States

    Science.gov (United States)

    Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Listl, Stefan

    2015-01-01

    Background The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the United States and selected European countries. Method The analyses relied on 2006/2007 data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and 2004–2006 data from of the Health and Retirement Study (HRS) in the United States for respondents aged 51 years and older. Logistic regression models were estimated to identify impacts of dental care coverage and oral as well as general health status on dental care use. Results We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified by social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified by welfare state regime or by presence or absence of social health insurance. Conclusions Findings of this study suggest that income and education have stronger and more persistent correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that (1) higher overall rates of coverage in most European countries, compared to relatively lower rates in the USA, contribute to this finding and that (2) policies targeted to improving the income of older persons and their awareness of the importance of oral health care in both Europe and the USA can contribute to improving the use of dental services. PMID:26465093

  16. Why Are Native Hawaiians Underrepresented in Hawai‘i's Older Adult Population? Exploring Social and Behavioral Factors of Longevity

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    Lana Sue Ka‘opua

    2011-01-01

    Full Text Available Native Hawaiians comprise 24.3% of Hawai‘i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and social-behavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100–199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity.

  17. Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population.

    Science.gov (United States)

    Cox, Katherine H M; Pipingas, Andrew; Scholey, Andrew B

    2015-05-01

    Curcumin possesses many properties which may prevent or ameliorate pathological processes underlying age-related cognitive decline, dementia or mood disorders. These benefits in preclinical studies have not been established in humans. This randomized, double-blind, placebo-controlled trial examined the acute (1 and 3 h after a single dose), chronic (4 weeks) and acute-on-chronic (1 and 3 h after single dose following chronic treatment) effects of solid lipid curcumin formulation (400 mg as Longvida®) on cognitive function, mood and blood biomarkers in 60 healthy adults aged 60-85. One hour after administration curcumin significantly improved performance on sustained attention and working memory tasks, compared with placebo. Working memory and mood (general fatigue and change in state calmness, contentedness and fatigue induced by psychological stress) were significantly better following chronic treatment. A significant acute-on-chronic treatment effect on alertness and contentedness was also observed. Curcumin was associated with significantly reduced total and LDL cholesterol and had no effect on hematological safety measures. To our knowledge this is the first study to examine the effects of curcumin on cognition and mood in a healthy older population or to examine any acute behavioral effects in humans. Results highlight the need for further investigation of the potential psychological and cognitive benefits of curcumin in an older population.

  18. Early life exposures and the occurrence and timing of heart disease among the older adult Puerto Rican population.

    Science.gov (United States)

    McEnry, Mry; Palloni, Alberto

    2010-02-01

    Few studies have examined the effects of early life conditions on the timing of the onset of heart disease. We use the remarkable example of a representative sample of the population of older Puerto Ricans aged 60-74 who lived in the countryside during childhood (n = 1,438) to examine the effects ofseasonal exposures to poor nutrition and infectious diseases during late gestation on the timing of the onset and the probability of ever experiencing adult heart disease. Cox and log logistic hazard models controlling for childhood conditions (self-reported childhood health status and socioeconomic status [SES], rheumatic fever, and knee height) and adult risk factors (adult SES, obesity, smoking, exercise, and self-reported diabetes) showed that the risk of onset of heart disease was 65% higher among those born during high-exposure periods compared with unexposed individuals. However, there were no significant differences in median time of onset for those ever experiencing heart disease. As a comparison, we found that there were no significant seasonality effects for those who lived in urban areas during childhood. We conclude that early exposures in utero have important ramifications for adult heart disease among the older Puerto Rican population. We show, however, that while exposure is associated with the probability of ever experiencing adult heart disease, it is not associated with the timing of onset among those who do experience it.

  19. The transition from good to poor health: an econometric study of the older population.

    Science.gov (United States)

    Buckley, Neil J; Denton, Frank T; Robb, A Leslie; Spencer, Byron G

    2004-09-01

    This is a study of the influence of socioeconomic factors on the state of health of older Canadians. Three years of panel data from the Survey of Labour and Income Dynamics are used to model the transition probabilities between good and poor health. Care is taken to avoid the problem of endogeneity of income in modelling its effects, and to adjust reported income to free it from its strong association with age at the time of the survey. Of particular note are the significant effects found for income, in spite of universal public health care coverage. Significant effects are found also for age, education, and other variables.

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

    NARCIS (Netherlands)

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

    2017-01-01

    BACKGROUND: Self-management is an important asset in helping older adults remain independent and in control for as long as possible. There is no reliable and valid measurement instrument to evaluate self-management behaviour of older adults. OBJECTIVE: This study aims to design a measurement instrum

  1. Identifying Falls Efficacy and Number of F alls in Older Adults of Turkish Population

    Directory of Open Access Journals (Sweden)

    Gönül BABAYİĞİTİREZ

    2014-09-01

    Full Text Available The aim of the study was to investigate the fear of falls in older adults while conducting the reliability analyzes of Falls Efficacy Scale - I for Turkish version living in Mugla and secondary aim was to study relations hip between fear of falls (FES - I Scor e, gender and number of falls. All participants were living in the community and aged 65 years or over (N=100 included as voluntarily to this study . The FES - I questionnaire which is a self - report questionnaire, providing information on level of concern a bout falls for a range of activities of daily living , contains 16 items scored on four point scale of 1 - 4, was used for research aim. Internal reliability of the FES - I was evaluated by calculating the Cronbach’s alpha coefficient for the whole scale . Independent sample test and correlation tests were used for statistical analysis. There were relationship between falls self efficacy, gender and number of falls. Therefore, there was significant differences between genders in FES - I scores and number of f alls. In conclusion, Identifying fear of falling may be important to decrease inactivity in older age. Some exercise promotions may help to this people who are seeking be active by decreasing fear of falling and number of falls.

  2. Application of PACE Principles for Population Health Management of Frail Older Adults.

    Science.gov (United States)

    Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

    2015-10-01

    To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

  3. Factor Structure and Psychometric Properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in Older Populations with and without Cognitive Impairment

    Science.gov (United States)

    Ros, L.; Latorre, J. M.; Aguilar, M. J.; Serrano, J. P.; Navarro, B.; Ricarte, J. J.

    2011-01-01

    The CES-D is widely used for the assessment of depressive symptoms in the adult population. However, few studies have been performed to assess the utility of this scale in an older population with cognitive impairment. The factor structure of the Spanish version of the CES-D was examined in an observational, cross sectional study in 623 older…

  4. Effects of Degree of Urbanization and Lifetime Longest-Held Occupation on Cognitive Impairment Prevalence in an Older Spanish Population

    Science.gov (United States)

    Lorenzo-López, Laura; Millán-Calenti, José C.; López-López, Rocío; Diego-Diez, Clara; Laffon, Blanca; Pásaro, Eduardo; Valdiglesias, Vanessa; Maseda, Ana

    2017-01-01

    Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia.

  5. Effects of Degree of Urbanization and Lifetime Longest-Held Occupation on Cognitive Impairment Prevalence in an Older Spanish Population.

    Science.gov (United States)

    Lorenzo-López, Laura; Millán-Calenti, José C; López-López, Rocío; Diego-Diez, Clara; Laffon, Blanca; Pásaro, Eduardo; Valdiglesias, Vanessa; Maseda, Ana

    2017-01-01

    Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia.

  6. CO-PRESENCE OF MULTIMORBIDITY AND DISABILITY WITH FRAILTY: AN EXAMINATION OF HETEROGENEITY IN THE FRAIL OLDER POPULATION

    Science.gov (United States)

    AARTS, S.; PATEL, K.V.; Garcia, M. E.; VAN DEN AKKER, M.; VERHEY, F.R.J.; METSEMAKERS, J.F.M.; VAN BOXTEL, M.P.J.; GUDNASON, V.; JONSDOTTIR, M.K.; SIGGEIRSDOTTIR, K.; JONSSON, P.V.; HARRIS, T. B.; LAUNER, L.J.

    2017-01-01

    Background Frailty is often associated with multimorbidity and disability. Objectives We investigated heterogeneity in the frail older population by characterizing five subpopulations according to quantitative biological markers, multimorbidity and disability, and examined their association with mortality and nursing home admission. Design Observational study. Participants Participants (n=4,414) were from the population-based Age Gene/Environment Susceptibility Reykjavik Study. Measurements Frailty was defined by ≥ 3 of five characteristics: weight loss, weakness, reduced energy levels, slowness and physical inactivity. Multimorbidity was assessed using a simple disease count, based on 13 prevalent conditions. Disability was assessed by five activities of daily living; participants who had difficulty with one or more tasks were considered disabled. Differences among frail subpopulations were based on the co-presence of multimorbidity and disability. Differences among the following subpopulations were examined: 1) Non-frail (reference group); 2) Frail only; 3) Frail with disability; 4) Frailty with multimorbidity; 5) Frail with disability and multimorbidity. Results Frailty was present in 10.7% (n=473). Frailty was associated with increased risk for mortality (OR 1.40; 95% CI 1.15–1.69) and nursing home admission (OR 1.50; 95% CI 1.16–1.93); risks differed by subpopulations. Compared to the non-frail, the frail only group had poorer cognition and increased inflammation levels but did not have increased risk for mortality (OR 1.40; 95% CI 0.84–2.33) or nursing home admission (OR 1.01; 95% CI 0.46–2.21). Compared to the non-frail, the other frail subpopulations had significantly poorer cognition, increased inflammation levels, more white matter lesions, higher levels of calcium, glucose and red cell distribution width and increased risk for mortality and nursing home admission. Conclusions The adverse health risks associated with frailty in the general older

  7. Gait patterns in a community-dwelling population aged 50 years and older.

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    Verlinden, V J A; van der Geest, J N; Hoogendam, Y Y; Hofman, A; Breteler, M M B; Ikram, M A

    2013-04-01

    Poor gait is an important risk factor for falls and associated with higher morbidity and mortality. It is well established that older age is associated with worse gait, but it remains unclear at what age this association is first seen. Moreover, previous studies focused mainly on normal walking, but gait also encompasses turning and tandem walking. In a large study of community-dwelling middle-aged and elderly persons we investigated the association of age with gait, focusing on normal walking, turning and tandem walking. In 1500 persons aged 50 years and over, we measured gait using an electronic walkway. Participants performed normal walks, turning and a tandem walk. With principal components analysis of 30 variables we summarized gait into five known gait factors: Rhythm, Variability, Phases, Pace and Base of Support; and uncovered two novel gait factors: Tandem and Turning. The strongest associations with age were found for Variability (difference in Z-score -0.29 per 10 years increase (95% confidence interval: -0.34; -0.24)), Phases (-0.31 per 10 years (-0.36; -0.27)) and Tandem (-0.25 per 10 years (-0.30; -0.20)). Additionally, these factors already showed association with the youngest age groups, from 55 to 60 years of age and older. Our study shows that Variability, Phases and Tandem have the strongest association with age and are the earliest to demonstrate a poorer gait pattern with higher age. Future research should further investigate how these gait factors relate with gait-related diseases in their earliest stages.

  8. Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS).

    Science.gov (United States)

    Vafaei, Afshin; Ahmed, Tamer; Freire, Aline do N Falcão; Zunzunegui, Maria Victoria; Guerra, Ricardo O

    2016-01-01

    To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression. International cross-sectional study of adults between 65 and 74 years old (n = 1,967). Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). A validated 12-item Bem Sex Role Inventory (BSRI) was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR) of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions. Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16) were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93). In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated. Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

  9. Mild cognitive impairment predicts institutionalization among older men: a population-based cohort study.

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    Danijela Gnjidic

    Full Text Available BACKGROUND: There is a lack of evidence on the contribution of mild cognitive impairment (MCI to institutionalization in older adults. This study aimed to evaluate a range of risk factors including MCI of institutionalization in older men. METHODS: Men aged ≥70 years (n = 1705, participating in the Concord Health and Ageing in Men Project, Sydney, Australia were studied. Participants completed self-reported questionnaires and underwent comprehensive clinical assessments during 2005-2007. Institutionalization was defined as entry into a nursing home facility or hostel at any time over an average of 5 years of follow-up. Cox regression analysis was conducted to generate hazard ratios (HR with 95% confidence intervals (CI. RESULTS: A total of 125 (7.3% participants were institutionalized. Piecewise Cox proportional models were generated and divided at 3.4 years (1250 days of follow-up due to violation of the proportional hazards assumption for the association between MCI and institutionalization (χ(2 = 6.44, p = 0.01. Dementia, disability in Activities of Daily Living (ADL and Instrumental Activities of Daily Living (IADL, poor grip strength, few social interactions, being a Non-English speaking immigrant and age were predictive of institutionalization during both time periods, whereas MCI (HR = 4.39, 95%CI 2.17-8.87 only predicted institutionalization in the period beyond 3.4 years of follow-up. Being married (HR = 0.42, 95%CI: 0.24-0.72 was protective only during the period after 3.4 years of follow-up. DISCUSSION: In this study, the strongest predictors of institutionalization were dementia, MCI, ADL and IADL disability. MCI was not a predictor of early institutionalization but became a significant predictor beyond 3.4 years of follow-up.

  10. Home healthcare services in Taiwan: a nationwide study among the older population

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    Lai Hsiu-Yun

    2010-09-01

    Full Text Available Abstract Background Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan. Methods Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored. Results Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9% patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%. More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%. Conclusions Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.

  11. Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS.

    Directory of Open Access Journals (Sweden)

    Afshin Vafaei

    Full Text Available To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression.International cross-sectional study of adults between 65 and 74 years old (n = 1,967. Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D. A validated 12-item Bem Sex Role Inventory (BSRI was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions.Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16 were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93. In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated.Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

  12. Extending decision making competence to special populations: a pilot study of persons on the autism spectrum.

    Science.gov (United States)

    Levin, Irwin P; Gaeth, Gary J; Foley-Nicpon, Megan; Yegorova, Vitaliya; Cederberg, Charles; Yan, Haoyang

    2015-01-01

    The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from "theory of mind" to predict key components of decision making in high-functioning young adults on the autism spectrum. A battery of tests was administered to 15 high-functioning college students with autism spectrum disorder (ASD), focusing on decision making competence (DMC) and other aspects of decision making related to known deficits associated with autism. Data from this group were compared to data from unselected college students receiving the same measures. First, as a test of a key social deficit associated with autism, the target group scored much lower on the Empathy Quotient scale. Traditional elements of decision making competency such as Numeracy and application of decision rules were comparable across groups. However, there were differences in thinking style, with the ASD group showing lesser ability and engagement in intuitive thinking, and they showed lower levels of risk taking. For comparisons within the ASD group, autobiographical reports concerning individual lifestyles and outcomes were used to derive a scale of Social Functioning. The lowest scoring individuals showed the lowest levels of intuitive thinking, the lowest perceived levels of others' endorsement of socially undesirable behaviors, and the lowest ability to discriminate between "good" and "bad" risks. Results are discussed in terms of interventions that might aid high-functioning young adults with ASD in their everyday decision making.

  13. Risk of Stroke and Myocardial Infarction After Herpes Zoster in Older Adults in a US Community Population.

    Science.gov (United States)

    Yawn, Barbara P; Wollan, Peter C; Nagel, Maria A; Gilden, Don

    2016-01-01

    To assess the risk of stroke and myocardial infarction (MI) after herpes zoster in a US community population of older adults. We performed a community cohort study (January 1, 1986, to October 1, 2011) comparing the risk of stroke and MI in 4862 adult residents of Olmsted County, Minnesota, 50 years and older with and without herpes zoster and 19,433 sex- and age-matched individuals with no history of herpes zoster. Odds ratios are presented for MI and stroke at 3, 6, 12, and 36 months after index herpes zoster plus hazard ratios for long-term risk (up to 28.6 years). Individuals with herpes zoster had more risk or confounding factors for MI and stroke, suggesting that they had worse health status overall. When controlling for the multiple risk factors, those with herpes zoster were at increased risk for stroke at 3 months after herpes zoster compared with those without a history of herpes zoster (odds ratio, 1.53; 95% CI, 1.10-2.33; P=.04). The association between herpes zoster and MI at 3 months was not robust across analytic methods. Herpes zoster was not associated with an increased risk of stroke or MI at any point beyond 3 months. Herpes zoster was associated with only a short-term increased risk of stroke, which may be preventable with the prevention of herpes zoster. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. Recruiting and Retaining Underrepresented Groups and Special Populations in Nursing Programs. Napa Valley College, October 1991-June 1992.

    Science.gov (United States)

    Zylinski, Doris; Metson, Elena

    In 1991-92, Napa Valley College participated in a statewide project to develop and publish this guide for recruiting and retaining underrepresented groups and special populations in vocational nursing. Among the highlighted recommendations presented in the guide are the following: (1) disseminate information on nursing education and job…

  15. Sociodemographic and socioeconomic patterns of chronic non-communicable disease among the older adult population in Ghana

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    Nadia Minicuci

    2014-04-01

    Full Text Available Background: In Ghana, the older adult population is projected to increase from 5.3% of the total population in 2015 to 8.9% by 2050. National and local governments will need information about non-communicable diseases (NCDs in this population in order to allocate health system resources and respond to the health needs of older adults. Design: The 2007/08 Study on global AGEing and adult health (SAGE Wave 1 in Ghana used face-to-face interviews in a nationally representative sample of persons aged 50-plus years. Individual respondents were asked about their overall health, diagnosis of 10 chronic non-communicable conditions, and common health risk factors. A number of anthropometric and health measurements were also taken in all respondents, including height, weight, waist and hip circumferences, and blood pressure (BP. Results: This paper includes 4,724 adults aged 50-plus years. The highest prevalence of self-reported chronic conditions was for hypertension [14.2% (95% CI 12.8–15.6] and osteoarthritis [13.8%, (95% CI 11.7–15.9]. The figure for hypertension reached 51.1% (95% CI 48.9–53.4 when based on BP measurement. The prevalence of current smokers was 8.1% (95% CI 7.0–9.2, while 2.0 (95% CI 1.5–2.5 were infrequent/frequent heavy drinkers, 67.9% (95% CI 65.2–70.5 consume insufficient fruits and vegetables, and 25.7% (95% CI 23.1–28.3 had a low level of physical activity. Almost 10% (95% CI 8.3–11.1 of adults were obese and 77.6% (95% CI 76.0–79.2 had a high-risk waist-to-hip ratio (WHR. Risks from tobacco and alcohol consumption continued into older age, while insufficient fruit and vegetable intake, low physical activity and obesity increased with increasing age. The patterns of risk factors varied by income quintile, with higher prevalence of obesity and low physical activity in wealthier respondents, and higher prevalence of insufficient fruit and vegetable intake and smoking in lower-income respondents. The multivariate

  16. Physical Activity, Adiposity, and Diabetes Risk in Middle-Aged and Older Chinese Population

    NARCIS (Netherlands)

    Qin, Li; Corpeleijn, Eva; Jiang, Chaoqiang; Thomas, G. Neil; Schooling, C. Mary; Zhang, Weisen; Cheng, Kar Keung; Leung, Gabriel M.; Stolk, Ronald P.; Lam, Tai Hing

    2010-01-01

    OBJECTIVE- Physical activity may modify the association of adiposity with type 2 diabetes. We investigated the independent and joint association of adiposity and physical activity with fasting plasma glucose, impaired fasting glucose, and type 2 diabetes in a Chinese population. RESEARCH DESIGN AND

  17. Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

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    de Moraes Suzana Albuquerque

    2013-01-01

    Full Text Available Abstract Background Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. Methods This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults, with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. Results The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004. The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35, perceived fatigue (OR = 1.93; 95% CI 1.21-3.10, recurring falls (OR = 2.01; 95% CI 1.11-3.62 and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29. The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727 (p Conclusions The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our

  18. Leisure activities, education, and cognitive impairment in Chinese older adults: a population-based longitudinal study.

    Science.gov (United States)

    Zhu, Xinyi; Qiu, Chengxuan; Zeng, Yi; Li, Juan

    2017-05-01

    We examine the association between leisure-time activities and the risk of developing cognitive impairment among Chinese older people, and further investigate whether the association varies by educational level. This follow-up study included 6,586 participants (aged 79.5 ± 9.8 years, range 65-105 years, 51.7% female) of the Chinese Longitudinal Healthy Longevity Survey who were aged ≥65 years and were free of cognitive impairment in 2002. Incident cognitive impairment was defined at the 2005 or 2008/2009 survey following an education-based cut-off on the adapted Chinese version of Mini-Mental State Examination (MMSE). Participation in cognitive activities (e.g. reading) and non-exercise physical activity (e.g. housework) was assessed by a self-reported scale. Cox proportional hazard models were employed to examine the association of leisure activities with incident cognitive impairment while controlling for age, gender, education, occupation, residence, physical exercise, smoking, drinking, cardiovascular diseases and risk factors, negative well-being, and physical functioning, and baseline MMSE score. During a five-year follow-up, 1,448 participants developed incident cognitive impairment. Overall, a high level of participation in leisure activities was associated with a 41% decreased risk of cognitive impairment compared to low-level engagement in leisure activities after controlling for age, gender, education, and other confounders. Moreover, there was a significant interaction between leisure activity and educational level, such that the beneficial effect of leisure activities on cognitive function was larger in educated elderly than their uneducated counterparts, and only educated elderly benefited from cognitive activities. Late-life leisure activities protect against cognitive impairment among elderly Chinese people, and the protective effects are more profound for educated elderly.

  19. Vitamin B12 deficiency is associated with geographical latitude and solar radiation in the older population.

    Science.gov (United States)

    Cabrera, Sebastián; Benavente, David; Alvo, Miriam; de Pablo, Paola; Ferro, Charles J

    2014-11-01

    Vitamin B12 and folic acid deficiency are common in the older and are associated with several conditions including anaemia, cardiovascular disease, cognitive impairment and cancer. Evidence from in vitro studies suggests that solar radiation can degrade both vitamins in the skin. Chile is the longest country in the world running perfectly North-South making it an ideal place to study potential associations of latitude and solar radiation on vitamin B12 and folic acid deficiency. The objective was to examine the association between vitamin B12 and folic acid deficiencies and latitude. Plasma samples were collected from Chileans aged 65+ years (n=1013) living across the whole country and assayed for vitamin B12 and folic acid concentrations as part of the Chilean Health Survey 2009-2010, which is a national representative sample study. Overall, the prevalence of vitamin B12 deficiency was 11.3%, with the prevalence in the North of the country being significantly greater than in the Central and South zones (19.1%,10.5%, and 5.7%, respectively; Pvitamin B12 deficiency was significantly associated with geographical latitude (OR 0.910 [95% confidence intervals 0.890-0.940], Pvitamin B12 deficiency is associated with living closer to the Equator and solar radiation. Although degradation by solar radiation might explain this observation, further work is required to establish the potential mechanisms. In countries that routinely fortify food with folic acid, efforts to identify vitamin B12 deficiency might be more cost-efficiently targeted in areas closest to the Equator. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Diet specialization in a generalist population: the case of breeding great tits Parus major in the Mediterranean area.

    Science.gov (United States)

    Pagani-Núñez, E; Valls, M; Senar, J C

    2015-11-01

    The analysis of diet specialization provides key information on how different individuals deal with similar food and habitat constraints within populations. Characterizing parental diet specialization at the moment of breeding, and the consistency of these preferences under different levels of effort, may help us to understand why parents exploit alternative resources. We investigated these questions in a species commonly considered a generalist: a breeding population of Mediterranean great tits Parus major. Our aim was to determine whether they are specialists or generalists at the pair level, and the consistency of this behaviour under different levels of effort. Using proportional similarity and mean pairwise overlap indices, we found that parents showed great variability in prey selection between territories. That is, they displayed a small niche overlap. Interestingly, the most specialized breeding pairs showed a tendency to have larger broods. Additionally, we experimentally manipulated brood size and found that parents showed high short-term consistency in their foraging behaviour. They precisely adjusted the number of provisioning trips to the number of nestlings, while they were unable to modify prey proportions or prey size after brood size was changed. We can therefore characterize their foraging strategies as highly consistent. Our results suggest that although the great tit may be considered a generalist at the species or population level, there was a tendency for trophic specialization among breeding pairs. This high inter- and intrapopulation plasticity could account for their great success and wide distribution.

  1. DSM-IV and DSM-5 Prevalence of Social Anxiety Disorder in a Population Sample of Older People.

    Science.gov (United States)

    Karlsson, Björn; Sigström, Robert; Östling, Svante; Waern, Margda; Börjesson-Hanson, Anne; Skoog, Ingmar

    2016-12-01

    To examine the prevalence of social anxiety disorders (SAD) with (DSM-IV) and without (DSM-5) the person's own assessment that the fear was unreasonable, in a population sample of older adults. Further, to determine whether clinical and sociodemographic correlates of SAD differ depending on the criteria applied. Cross-sectional. General population in Gothenburg, Sweden. A random population-based sample of 75- and 85-year olds (N = 1200) without dementia. Psychiatric research nurses carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. DSM-IV SAD was diagnosed with the Mini International Neuropsychiatric Interview. SAD was diagnosed according to DSM-IV and DSM-5 criteria. The 6-month duration criterion in DSM-5 was not applied because of lack of information. Other assessments included the Global Assessment of Functioning (GAF), the Brief Scale for Anxiety (BSA), and the Montgomery Åsberg Depression Rating Scale (MADRS). The 1-month prevalence of SAD was 2.5% (N = 30) when the unreasonable fear criterion was defined in accordance with DSM-IV and 5.1% (N = 61) when the DSM-5 criterion was applied. Clinical correlates (GAF, MADRS, and BSA) were worse in SAD cases identified by either procedure compared with all others, and ratings for those reporting unreasonable fear suggested greater (albeit nonsignificant) overall psychopathology. Shifting the judgment of how reasonable the fear was, from the individual to the clinician, doubled the prevalence of SAD. This indicates that the DSM-5 version might increase prevalence rates of SAD in the general population. Further studies strictly applying all DSM-5 criteria are needed in order to confirm these findings. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study.

    Science.gov (United States)

    Vinnard, Christopher; Gopal, Anand; Linkin, Darren R; Maslow, Joel

    2013-01-01

    our objective was to determine the incidence of toxicity among veterans initiating isoniazid therapy for latent tuberculosis infection (LTBI) and determine whether advancing age was a risk factor for toxicity. we performed a retrospective cohort study among all adults initiating isoniazid treatment for LTBI at a Veterans Medical Center from 1999 to 2005. We collected data on patient demographics, co-morbidities, site of initiation, and treatment outcome. 219 patients initiated isoniazid therapy for LTBI during the period of observation, and the completion of therapy was confirmed in 100 patients (46%). Among 18/219 patients (8%) that discontinued therapy due to a documented suspected toxicity, the median time to onset was 3 months (IQR 1-5 months). In an adjusted Cox regression model, there was no association between discontinuation due to suspected toxicity and advancing age (HR 1.03, 95% CI 0.99, 1.07). In contrast, hepatitis C infection was a significant predictor of cessation due to toxicity in the adjusted analysis (HR 3.03, 95% CI 1.08, 8.52). cessation of isoniazid therapy due to suspected toxicity was infrequently observed among a veteran population and was not associated with advancing age. Alternative LTBI treatment approaches should be further examined in the veteran population.

  3. Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study

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    Christopher Vinnard

    2013-01-01

    Full Text Available Background: our objective was to determine the incidence of toxicity among veterans initiating isoniazid therapy for latent tuberculosis infection (LTBI and determine whether advancing age was a risk factor for toxicity. Methods: we performed a retrospective cohort study among all adults initiating isoniazid treatment for LTBI at a Veterans Medical Center from 1999 to 2005. We collected data on patient demographics, co-morbidities, site of initiation, and treatment outcome. Results: 219 patients initiated isoniazid therapy for LTBI during the period of observation, and the completion of therapy was confirmed in 100 patients (46%. Among 18/219 patients (8% that discontinued therapy due to a documented suspected toxicity, the median time to onset was 3 months (IQR 1–5 months. In an adjusted Cox regression model, there was no association between discontinuation due to suspected toxicity and advancing age (HR 1.03, 95% CI 0.99, 1.07. In contrast, hepatitis C infection was a significant predictor of cessation due to toxicity in the adjusted analysis (HR 3.03, 95% CI 1.08, 8.52. Conclusions: cessation of isoniazid therapy due to suspected toxicity was infrequently observed among a veteran population and was not associated with advancing age. Alternative LTBI treatment approaches should be further examined in the veteran population.

  4. [Use of health services by a population of 60-year olds and older in Mexico].

    Science.gov (United States)

    Borges-Yáñez, S A; Gómez-Dantés, H

    1998-01-01

    To describe the sociodemographic characteristics and determinants of health services utilization by the Mexican population of 60 years of age or more. Information obtained from the National Health Survey II (ENSA-II) allowed analysis of 4,628 elderly people. Prevalence of chronic diseases was analyzed and the determinants of individuals who had used the health services in the two weeks prior to the interview. The chronic diseases most frequently reported were: hypertension, diabetes and heart disease. The utilization and hospitalization rates of that age group were 11.4 and 5.5%, respectively. The services most frequently used were: the private physician, social security (IMSS, ISSSTE) welfare services (Ministry of Health--SSA- and IMSS-Solidaridad). Interestingly, 25 to 45% of social security insurance holders did not use the services, instead they consulted a private physician. The most important explanatory variables for health services utilization were: the perceived illness, not having worked for the previous week and being a social security insurance holder. Gender, area of residence and level of education were not significant in the explanation of health services utilization. This study demonstrates the need to strengthen preventive and support programs for the elderly population, since they only demand health services when they feel sick.

  5. Physical activity, adiposity, and diabetes risk in middle-aged and older Chinese population: the Guangzhou Biobank Cohort Study.

    Science.gov (United States)

    Qin, Li; Corpeleijn, Eva; Jiang, Chaoqiang; Thomas, G Neil; Schooling, C Mary; Zhang, Weisen; Cheng, Kar Keung; Leung, Gabriel M; Stolk, Ronald P; Lam, Tai Hing

    2010-11-01

    Physical activity may modify the association of adiposity with type 2 diabetes. We investigated the independent and joint association of adiposity and physical activity with fasting plasma glucose, impaired fasting glucose, and type 2 diabetes in a Chinese population. Middle-aged and older Chinese (n=28,946, ≥50 years, 72.4%women) from the Guangzhou Biobank Cohort Study were examined in 2003-2008. Multivariable regression was used in a cross-sectional analysis. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with type 2 diabetes after multiple adjustment, most strongly for WHR with odds ratio (OR) of 3.99 (95% CI 3.60-4.42) for highest compared with lowest tertile. Lack of moderate-to-vigorous physical activity, but not walking, was associated with diabetes with an OR of 1.29 (1.17-1.41). The association of moderate-to-vigorous activity with fasting glucose varied with WHR tertiles (P=0.01 for interaction). Within the high WHR tertile, participants who had a lack of moderate-to-vigorous activity had an OR of 3.87 (3.22-4.65) for diabetes, whereas those who were active had an OR of 2.94 (2.41-3.59). In this population, WHR was a better measure of adiposity-related diabetes risk than BMI or waist circumference. Higher moderate-to-vigorous activity was associated with lower diabetes risk, especially in abdominally obese individuals.

  6. A prospective population-based study of differences in elder self-neglect and mortality between black and white older adults.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A; Fulmer, Terry; Mendes de Leon, Carlos F; Hebert, Liesi E; Beck, Todd; Scherr, Paul A; Evans, Denis A

    2011-06-01

    Self-neglect is the behavior of an elderly person that threatens his or her own health and safety, and it is associated with increased morbidity and mortality. Although report of self-neglect is more common among black older adults, the racial/ethnic differences in mortality remain unclear. The Chicago Healthy Aging Project is a population-based cohort study conducted from 1993 to 2005. A subset of these participants were suspected to self-neglect and were reported to a social services agency. Mortality was ascertained during follow-up and from the National Death Index. Cox proportional hazards models were used to assess the mortality risk. In the total cohort, there were 5,963 black and 3,475 white older adults, and of these, 1,479 were reported for self-neglect (21.7% in black and 5.3% in white older adults). In multivariable analyses with extensive adjustments, the interaction term indicated that impact of self-neglect on mortality was significantly stronger in black than in white older adults (parameter estimate, 0.54, SE, 0.14, p self-neglect, the hazard ratio for black older adults was 5.00 (95% confidence interval, 4.47-5.59) and for white older adults was 2.75 (95% confidence interval, 2.19-3.44). At 3 years after report, the hazard ratios were 2.61 (95% confidence interval, 2.25-3.04) and 1.47 (95% confidence interval, 1.10-1.96) for black older adults and white older adults, respectively. Future studies are needed to qualify the casual mechanisms between self-neglect and mortality in black and white older adults in order to devise targeted prevention and intervention strategies.

  7. Use of Information and Communication Technologies Among Older People With and Without Frailty: A Population-Based Survey

    Science.gov (United States)

    Kangas, Maarit; Immonen, Milla; Similä, Heidi; Enwald, Heidi; Korpelainen, Raija; Jämsä, Timo

    2017-01-01

    Background Use of information and communication technologies (ICT) among seniors is increasing; however, studies on the use of ICT by seniors at the highest risk of health impairment are lacking. Frail and prefrail seniors are a group that would likely benefit from preventive nutrition and exercise interventions, both of which can take advantage of ICT. Objective The objective of the study was to quantify the differences in ICT use, attitudes, and reasons for nonuse among physically frail, prefrail, and nonfrail home-dwelling seniors. Methods This was a population-based questionnaire study on people aged 65-98 years living in Northern Finland. A total of 794 eligible individuals responded out of a contacted random sample of 1500. Results In this study, 29.8% (237/794) of the respondents were classified as frail or prefrail. The ICT use of frail persons was lower than that of the nonfrail ones. In multivariable logistic regression analysis, age and education level were associated with both the use of Internet and advanced mobile ICT such as smartphones or tablets. Controlling for age and education, frailty or prefrailty was independently related to the nonuse of advanced mobile ICT (odds ratio, OR=0.61, P=.01), and frailty with use of the Internet (OR=0.45, P=.03). The frail or prefrail ICT nonusers also held the most negative opinions on the usefulness or usability of mobile ICT. When opinion variables were included in the model, frailty status remained a significant predictor of ICT use. Conclusions Physical frailty status is associated with older peoples’ ICT use independent of age, education, and opinions on ICT use. This should be taken into consideration when designing preventive and assistive technologies and interventions for older people at risk of health impairment. PMID:28196791

  8. Driving with pets and motor vehicle collision involvement among older drivers: a prospective population-based study

    Science.gov (United States)

    Huisingh, Carrie; Levitan, Emily B.; Irvin, Marguerite R.; Owsley, Cynthia; McGwin, Gerald

    2016-01-01

    Objective Distracted driving is a major cause of motor vehicle collision (MVC) involvement. Pets have been identified as potential distraction to drivers, particularly in the front. This type of distraction could be worse for those with impairment in the cognitive aspects of visual processing. The purpose of this study is to evaluate the association between driving with pets and rates of motor vehicle collision involvementin a cohort of older drivers. Methods A three-year prospective was conducted in a population-based sample of 2000 licensed drivers aged 70 years and older. At the baseline visit, a trained interviewer asked participants about pet ownership, whether they drive with pets, how frequently, and where the pet sits in the vehicle. Motor vehicle collision (MVC) involvement during the three-year study period was obtained from the Alabama Department of Public Safety. At-fault status was determined by the police officer who arrived on the scene. Participants were followed until the earliest of death, driving cessation, or end of the study period. Poisson regression was used to calculate crude and adjusted rate ratios (RR) examining the association between pet ownership, presence of a pet in a vehicle, frequency of driving with a pet, and location of the pet inside with vehicle with any and at-fault MVC involvement. We examined whether the associations differed by higher order visual processing impairment status, as measured by Useful Field Of View, Trails B, and Motor-free Visual Perception Test. Results Rates of crash involvement were similar for older adults who have ever driven with a pet compared to those who never drove with their pet (RR=1.15, 95% CI 0.76-1.75). Drivers who reported always or sometimes driving with their pet had higherMVC rates compared topet owners who never drive with a pet, but this association was not statistically significant (RR=1.39, 95% CI 0.86-2.24). In terms of location, those reporting having a pet frequently ride in the

  9. Availability and readability of emergency preparedness materials for deaf and hard-of-hearing and older adult populations: issues and assessments.

    Science.gov (United States)

    Neuhauser, Linda; Ivey, Susan L; Huang, Debbie; Engelman, Alina; Tseng, Winston; Dahrouge, Donna; Gurung, Sidhanta; Kealey, Melissa

    2013-01-01

    A major public health challenge is to communicate effectively with vulnerable populations about preparing for disasters and other health emergencies. People who are Deaf or Hard of Hearing (Deaf/HH) and older adults are particularly vulnerable during health emergencies and require communications that are accessible and understandable. Although health literacy studies indicate that the readability of health communication materials often exceeds people's literacy levels, we could find no research about the readability of emergency preparedness materials (EPM) intended for Deaf/HH and older adult populations. The objective of this study was to explore issues related to EPM for Deaf/HH and older adult populations, to assess the availability and readability of materials for these populations, and to recommend improvements. In two California counties, we interviewed staff at 14 community-based organizations (CBOs) serving Deaf/HH clients and 20 CBOs serving older adults selected from a stratified, random sample of 227 CBOs. We collected 40 EPM from 10 CBOs and 2 public health departments and 40 EPM from 14 local and national websites with EPM for the public. We used computerized assessments to test the U.S. grade reading levels of the 16 eligible CBO and health department EPM, and the 18 eligible website materials. Results showed that less than half of CBOs had EPM for their clients. All EPM intended for clients of Deaf/HH-serving CBOs tested above the recommended 4(th) grade reading level, and 91% of the materials intended for clients of older adult-serving CBOs scored above the recommended 6(th) grade level. EPM for these populations should be widely available through CBOs and public health departments, adhere to health literacy principles, and be accessible in alternative formats including American Sign Language. Developers should engage the intended users of EPM as co-designers and testers. This study adds to the limited literature about EPM for these populations.

  10. Long terms trends of multimorbidity and association with physical activity in older English population.

    Science.gov (United States)

    Dhalwani, Nafeesa N; O'Donovan, Gary; Zaccardi, Francesco; Hamer, Mark; Yates, Thomas; Davies, Melanie; Khunti, Kamlesh

    2016-01-19

    Multimorbidity has become one of the main challenges in the recent years for patients, health care providers and the health care systems globally. However, literature describing the burden of multimorbidity in the elderly population, especially longitudinal trends is very limited. Physical activity is recommended as one of the main lifestyle changes in the prevention and management of multiple chronic diseases worldwide; however, the evidence on its association with multimorbidity remains inconclusive. Therefore, we aimed to assess the longitudinal trends of multimorbidity and the association between multimorbidity and physical activity in a nationally representative cohort of the English population aged ≥50 years between 2002 and 2013. We used data on 15,688 core participants from six waves of the English Longitudinal Study of Ageing, with complete information on physical activity. Self-reported physical activity was categorised as inactive, mild, moderate and vigorous levels of physical activity. We calculated the number of morbidities and the prevalence of multimorbidity (more than 2 chronic conditions) between 2002 and 2013 overall and by levels of self-reported physical activity. We estimated the odds ratio (OR) and 95% confidence intervals (CI) for multimorbidity by each category of physical activity, adjusting for potential confounders. There was a progressive decrease over time in the proportion of participants without any chronic conditions (33.9% in 2002/2003 vs. 26.8% in 2012/2013). In contrast, the prevalence of multimorbidity steadily increased over time (31.7% in 2002/2003 vs. 43.1% in 2012/2013). Compared to the physically inactive group, the OR for multimorbidity was 0.84 (95% CI 0.78 to 0.91) in mild, 0.61 (95% CI 0.56 to 0.66) in moderate and 0.45 (95% CI 0.41 to 0.49) in the vigorous physical activity group. This study demonstrated an inverse dose-response association between levels of physical activity and multimorbidity, however, given the

  11. Prevention and exercise therapy of osteoporosis for older population%老年性骨质疏松的预防与运动疗法

    Institute of Scientific and Technical Information of China (English)

    李宏伟; 段宝林

    2003-01-01

    @@ INTRODUCTION Osteoporosis of older populations is known as retrogressive osteo-porosis which is the result of aging of bones and belongs to the pri-mary osteoporosis Ⅱ. With the pass of time, reduction of material andmatrix of bones, bone becomes thin, decrease of number of bonetrabecula, risks of fracture and fragility will increase.

  12. 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

  13. A "Suicide Pill" for Older People: Attitudes of Physicians, the General Population, and Relatives of Patients Who Died after Euthanasia or Physician-Assisted Suicide in the Netherlands

    Science.gov (United States)

    Rurup, Mette L.; Onwuteaka-Philipsen, Bregje D.; van der Wal, Gerrit; van der Heide, Agnes; van Der Maas, Paul J.

    2005-01-01

    In the Netherlands there has been ongoing debate in the past 10 years about the availability of a hypothetical "suicide pill", with which older people could end their life in a dignified way if they so wished. Data on attitudes to the suicide pill were collected in the Netherlands from 410 physicians, 1,379 members of the general population, and…

  14. Birth weight and special educational needs: results of a population-based study in Berlin.

    Science.gov (United States)

    Bettge, Susanne; Oberwöhrmann, Sylke; Brockstedt, Matthias; Bührer, Christoph

    2014-05-09

    Preterm infants are at higher risk for developmental problems. The aim of this study is to quantify the relation between birth weight and special educational needs. We analyzed data from the pre-school examinations of 134 313 children in Berlin aged 5 to 6 who were examined between 2007 and 2011. Special educational needs were diagnosed in 8058 children (6.0%), 4943 (61%) of whom had weighed 3000 g or more at birth. The percentage of children with special educational needs rose steadily with decreasing birth weight (2250-2499 g, 9.2%; 1250-1499 g, 21.1%; less than 750 g, 35.6%). Logistic regression analysis yielded odds ratios and 99% confidence intervals for special educational needs that ranged from 1.32 [1.17-1.47] for birth weight 2750-2999 g to 12.83 [7.48-22.03] for birth weight less than 750 g. Further risk factors were male sex (1.88 [1.75-2.03]), low social status (5.96 [5.21-6.82]), an immigrant background associated with poor German language skills in the family (1.63 [1.43-1.86]), and being raised by a single parent (1.21 [1.12-1.31]). On the other hand, nursery school and/or kindergarten enrollment for at least two years before entering school (0.82 [0.73-0.91]) and an immigrant background with good German skills in the family (0.39 [0.34-0.45]) were associated with lower rates of special educational needs. The risk of special educational needs increases already with moderately decreased birth weight. The most important factor other than birth weight is the family's social status. Although children of very low birth weight have a much higher rate of special educational needs than other children, they still make up only a small percentage of all children with special educational needs.

  15. Special needs hurricane shelters and the ageing population: development of a methodology and a case study application.

    Science.gov (United States)

    Horner, Mark W; Ozguven, Eren Erman; Marcelin, Jean Michael; Kocatepe, Ayberk

    2017-04-28

    Recent experience of hurricanes, particularly in the southeast United States, has heightened awareness of the multifaceted nature of and the challenges to effective disaster relief planning. One key element of this planning is providing adequate shelter at secure locations for people who evacuate. Some of these individuals will have 'special needs', yet there is little research on the relationship with shelter space. This study designed a geographic information systems-based network optimisation methodology for the siting of special needs hurricane relief shelters, with a focus on the transportation component. It sought to find new locations for shelters that maximise accessibility by vulnerable populations, given capacity constraints, concentrating on the ageing population. The framework was implemented in a medium-sized metropolitan statistical area in the state of Florida where data suggest a possible deficit in special needs shelter space. The study analysed options for increasing special needs shelter capacity, while considering potential uncertainties in transportation network availability. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  16. Older workers

    NARCIS (Netherlands)

    Ybema,J.F.; Giesen, F.

    2014-01-01

    Due to an ageing population and global economic competition, there is a societal need for people to extend their working lives while maintaining high work productivity. This article presents an overview of the labour participation, job performance, and job characteristics of older workers in the Eur

  17. Extending the study of decision making competence to special populations: A case study of persons on the autism spectrum

    OpenAIRE

    Irwin eLevin; Gary eGaeth; Megan eFoley-Nicpon; Vita eYegorova; Charles eCederberg; Haoyang eYan

    2015-01-01

    The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from theory of mind to predict key components of decision making in high-functioning you...

  18. Levels of disability in the older population of England: Comparing binary and ordinal classifications.

    Science.gov (United States)

    Pongiglione, Benedetta; Ploubidis, George B; De Stavola, Bianca L

    2017-10-01

    Recent studies suggest the importance of distinguishing severity levels of disability. Nevertheless, there is not yet a consensus with regards to an optimal classification. Our study seeks to advance the existing binary definitions towards categorical/ordinal manifestations of disability. We define disability according to the WHO's International Classification of Functioning, Disability and Health (ICF) using data collected at the baseline wave of the English Longitudinal Study of Aging, a longitudinal study of the non-institutionalized population, living in England. First, we identify cut-off points in the continuous disability score derived from ICF to distinguish disabled from no-disabled participants. Then, we fit latent class models to the same data to find the optimal number of disability classes according to: (i) model fit indicators; (ii) estimated probabilities of each disability item; (iii) association of the predicted disability classes with observed health and mortality. According to the binary classification criteria, about 32% of both men and women are classified disabled. No optimal number of classes emerged from the latent class models according to model fit indicators. However, the other two criteria suggest that the best-fitting model of disability severity has four classes. Our findings contribute to the debate on the usefulness and relevance of adopting a finer categorization of disability, by showing that binary indicators of disability averaged the burden of disability and masked the very strong effect experienced by individuals having severe disability, and were not informative for low levels of disability. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Perceptions of disaster preparedness among older people in South Korea.

    Science.gov (United States)

    Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy

    2016-03-01

    Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy.

  20. Unusual trend in the prevalence of trisomy 13 in mothers aged 35 and older: A population based study of national congenital anomaly data.

    Science.gov (United States)

    Nair, Deepa Balachandran; Tucker, David; Hughes, Rhian; Greenacre, Judith; Morgan, Margery

    2015-07-01

    Trisomy 13 is one of the three autosomal trisomies compatible with viability. It is associated with structural anomalies, learning disability and poor survival. Advanced maternal age is the most frequently suggested risk factor. This is a population based register study to investigate the temporal trends of trisomy 13. Chromosomal trisomies were reviewed by the Welsh Congenital Anomaly Register using data from 1998-2012. All pregnancy outcomes were included. Prevalence rates and trends for all cases and for cases with mothers aged below 35 years and those aged 35 years and older were plotted for trisomy 13, 18 and 21. Possible risk factors contributing to the trend in older mothers were compared in the early and late period of the study. There were 124 cases of trisomy 13 over the 15 year period with 55 mothers aged 35 years and older. Overall prevalence was 2.5 per 10,000 total births. A significant declining trend in the prevalence of trisomy 13 in mothers aged 35 and older (χ(2) trend = 4.98, p=0.026) was noted. Rates for younger mothers were lower and remained stable. Prevalence of trisomy 18 and 21 in older mothers remained stable. The unexpected declining trend in trisomy 13 in older mothers could not be explained by the risk factors examined in this study. There have been no other reports of trends in the prevalence of trisomy 13 in older mothers in recent years. There is further need for surveillance of trends in future and in other populations. © 2015 Wiley Periodicals, Inc.

  1. "In the mood for ageing": determinants of subjective well-being in older men and women of the population-based KORA-Age study.

    Science.gov (United States)

    Lukaschek, Karoline; Vanajan, Anushiya; Johar, Hamimatunnisa; Weiland, Nina; Ladwig, Karl-Heinz

    2017-06-16

    To investigate risk factors associated with low subjective well-being (SWB) in men and women (≥65 years) separately with a special focus on emotional distress. A cross-sectional analysis was conducted among 3602 participants (50.6% women) aged 65-90 years (mean age 72.8 years, SD ± 5.8) from the population-based KORA-Age study conducted in 2008/2009. SWB was assessed using the WHO-5 well-being index (score range: 0 to 100). SWB was dichotomized into "low" (score ≤ 50) and "high" (score > 50) SWB. The association between potential risk factors and SWB was assessed by logistic regressions analyses. Population-attributable risks (PARs) were calculated. Low SWB was significantly higher in women than in men (23.8% versus 18.2%; p < 0.0001). The logistic regressions analyses revealed low income, physical inactivity, multimorbidity, depression, anxiety and sleeping problems to be associated with low SWB in both sexes. Living alone increased the odds of having low SWB in women, but not in men. Depression and anxiety were the strongest risk factors of low SWB among men (depression: OR: 4.19, 95% CI: 1.33-13.17, p < 0.05; anxiety: 8.45, 5.14-13.87, p < 0.0001) and women (depression: 6.83, 2.49-18.75 p < 0.05; anxiety: 7.31, 5.14-10.39, p < 0.0001). In both sexes, anxiety had the highest population-attributable risk (men: 27%, women: 41%). Our results call out for an increased focus on mental health interventions among older adults, especially for women living alone. Further research is needed to understand the paradoxical pattern of discrepant subjective well-being versus objective health in age.

  2. A short report on tooth replacement in an older suburban population in Nigeria.

    Science.gov (United States)

    Ibiyemi, Olushola; Lawal, Folake B

    2017-09-20

    To determine: the knowledge of the participants about removable dentures, importance of tooth replacement; prevalence of tooth loss and denture use; and factors associated with its non-use among an elderly population in Nigeria. Tooth loss without replacement can impact negatively on the quality of life of the elders, thus making use of denture a basic requirement for those with partial or complete edentulous arches in developed countries. It is, however, not known if this is the case among elders in suburban Nigeria. A cross-section of 392 consenting elderly participants aged ≥65 years residing at Idikan, Ibadan, Nigeria, were interviewed on their biodata, knowledge of removable denture and importance of tooth replacement, history of use of denture and reasons for non-use where applicable. Oral examinations for the presence of missing teeth and denture were conducted by an examiner. Data were analysed with SPSS and P value set at ˂.05. The mean age of the participants was 73 (SD = 9.2) years. About 39% of the participants believed that it was important to replace missing teeth, 56.0% had poor knowledge about tooth replacement options, and 47.7% had at least a missing tooth. Only 7.1% of those with missing teeth had them replaced and all were using removable acrylic partial dentures. Financial constraint was the main reason for non-replacement of missing teeth (80.1%). Age, gender, occupation before retirement, income, level of education and presence of physical impairment were associated with non-use of denture (P ˂ .05). Many elderly individuals had poor knowledge about removable dentures and the importance of tooth replacement. About half of the participants had full complement of teeth and only 7.1% of those with tooth loss reported denture wear. Major reasons for non-use of dentures were due to economic reasons. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  3. Alcohol consumption and chronic atrophic gastritis: population-based study among 9,444 older adults from Germany.

    Science.gov (United States)

    Gao, Lei; Weck, Melanie N; Stegmaier, Christa; Rothenbacher, Dietrich; Brenner, Hermann

    2009-12-15

    Moderate alcohol consumption has been suggested to facilitate elimination of Helicobacter pylori infection which is a key risk factor for chronic atrophic gastritis (CAG) and gastric cancer. The aim of our study was to assess the association of alcohol consumption with CAG among older adults from Germany. In the baseline examination of ESTHER, a population-based study conducted in Saarland, serological measurements of pepsinogen I and II (for CAG definition) and H. pylori antibodies were taken in 9,444 subjects aged 50-74 years. Moderate current (<60 g/week) and lifetime (

  4. Effect of age, education, and bilingualism on confrontation naming in older illiterate and low-educated populations.

    Science.gov (United States)

    Ashaie, Sameer; Obler, Loraine

    2014-01-01

    We investigated the effects of age as well as the linked factors of education and bilingualism on confrontation naming in rural Kashmir by creating a culturally appropriate naming test with pictures of 60 objects. We recruited 48 cognitively normal participants whose ages ranged from 18 to 28 and from 60 to 85. Participants in our study were illiterate monolinguals (N = 18) and educated Kashmiri-Urdu bilinguals (N = 30). Hierarchical multiple regression revealed that younger adults performed better than older adults (P < 0.01) and the age effect was quadratic (age(2)). It also showed Age X Education and Age X L2 Speaking interactions predicted naming performance. The Age X Education interaction indicated that the advantages of greater education increased with advancing age. Since education is in the second language (L2) in our population, this finding is no doubt linked to the Age X L2 Speaking interaction. This suggests that L2 speaking proficiency contributed more to first language (L1) naming with advancing age.

  5. Effect of Age, Education, and Bilingualism on Confrontation Naming in Older Illiterate and Low-Educated Populations

    Directory of Open Access Journals (Sweden)

    Sameer Ashaie

    2014-01-01

    Full Text Available We investigated the effects of age as well as the linked factors of education and bilingualism on confrontation naming in rural Kashmir by creating a culturally appropriate naming test with pictures of 60 objects. We recruited 48 cognitively normal participants whose ages ranged from 18 to 28 and from 60 to 85. Participants in our study were illiterate monolinguals (N=18 and educated Kashmiri-Urdu bilinguals (N=30. Hierarchical multiple regression revealed that younger adults performed better than older adults (P<0.01 and the age effect was quadratic (age2. It also showed Age X Education and Age X L2 Speaking interactions predicted naming performance. The Age X Education interaction indicated that the advantages of greater education increased with advancing age. Since education is in the second language (L2 in our population, this finding is no doubt linked to the Age X L2 Speaking interaction. This suggests that L2 speaking proficiency contributed more to first language (L1 naming with advancing age.

  6. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    Science.gov (United States)

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  7. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    Science.gov (United States)

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  8. An investigation to identify potential risk factors associated with common chronic diseases among the older population in India

    Directory of Open Access Journals (Sweden)

    Enemona Emmanuel Adaji

    2017-01-01

    Full Text Available Background: In India, chronic diseases are the leading cause of death and their prevalence has constantly increased over the last decade. Objective: This study aimed to identify risk factors associated with common chronic diseases among people aged 50 years and over in India. Materials and Methods: Data from Wave 1 of the 2007/2008 Indian Study on Global Ageing and Adult Health (SAGE was used to investigate the association between lifestyle choices and chronic diseases using logistic regression. Result: The fully adjusted model showed that significant independent risk factors for angina included area of residence, being diagnosed with diabetes, chronic lung disease (CLD [highest odds ratio (OR 4.77, 95% confidence interval (CI: 2.95-7.70] and arthritis. For arthritis, risk factors included having underlying diabetes, CLD diagnosis, or angina (highest OR 2.32, 95% CI: 1.63-3.31. Risk factors associated with CLD included arthritis, angina (highest OR 4.76, 95% CI: 2.94-7.72, alcohol use, and tobacco use. Risk factors associated with diabetes included level of education, area of residence, socioeconomic status, angina (highest OR 3.59, 95% CI: 2.44-5.29, CLD, arthritis, stroke, and vegetable consumption. Finally, risk factors associated with stroke included diabetes and angina (highest OR 3.34, 95% CI: 1.72-6.50. The presence of any other comorbidity was significantly associated with all five chronic diseases studied. Conclusion: The results show that within the older population, the contribution of lifestyle risk factors to the common chronic diseases investigated in this study was limited. Our findings showed that the major health issue within the study population was multimorbidity.

  9. Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study.

    Science.gov (United States)

    Tinetti, Mary E; McAvay, Gail; Trentalange, Mark; Cohen, Andrew B; Allore, Heather G

    2015-10-02

    To estimate the association between guideline recommended drugs and death in older adults with multiple chronic conditions. Population based cohort study. Medicare Current Beneficiary Survey cohort, a nationally representative sample of Americans aged 65 years or more. 8578 older adults with two or more study chronic conditions (atrial fibrillation, coronary artery disease, chronic kidney disease, depression, diabetes, heart failure, hyperlipidemia, hypertension, and thromboembolic disease), followed through 2011. Drugs included β blockers, calcium channel blockers, clopidogrel, metformin, renin-angiotensin system (RAS) blockers; selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs); statins; thiazides; and warfarin. Adjusted hazard ratios for death among participants with a condition and taking a guideline recommended drug relative to participants with the condition not taking the drug and among participants with the most common combinations of four conditions. Over 50% of participants with each condition received the recommended drugs regardless of coexisting conditions; 1287/8578 (15%) participants died during the three years of follow-up. Among cardiovascular drugs, β blockers, calcium channel blockers, RAS blockers, and statins were associated with reduced mortality for indicated conditions. For example, the adjusted hazard ratio for β blockers was 0.59 (95% confidence interval 0.48 to 0.72) for people with atrial fibrillation and 0.68 (0.57 to 0.81) for those with heart failure. The adjusted hazard ratios for cardiovascular drugs were similar to those with common combinations of four coexisting conditions, with trends toward variable effects for β blockers. None of clopidogrel, metformin, or SSRIs/SNRIs was associated with reduced mortality. Warfarin was associated with a reduced risk of death among those with atrial fibrillation (adjusted hazard ratio 0.69, 95% confidence interval 0.56 to 0.85) and

  10. Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population

    DEFF Research Database (Denmark)

    McDonald, Cameron Keith; Ankarfeldt, Mikkel Z; Capra, Sandra

    2016-01-01

    Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older...

  11. Advances in Psychotherapy for Depressed Older Adults.

    Science.gov (United States)

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

    2017-09-01

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

  12. [Prevalence of polypharmacy among the population older than 65 years in Spain: Analysis of the 2006 and 2011/12 National Health Surveys].

    Science.gov (United States)

    Martin-Pérez, Mar; López de Andrés, Ana; Hernández-Barrera, Valentín; Jiménez-García, Rodrigo; Jiménez-Trujillo, Isabel; Palacios-Ceña, Domingo; Carrasco-Garrido, Pilar

    Polypharmacy in older people is the result of several inter-connected factors, and is very common despite the associated risks. Not many population-based studies have been conducted in Spain to ascertain the magnitude of polypharmacy in this population. A descriptive, cross-sectional study was conducted with individualised data for non-institutionalised older people (65 or older) of both sexes from the Spanish National Health Surveys (SNHS) 2006 (N=7,835) and 2011/12 (N=5,896). The prevalence of polypharmacy (use of 4 or more drugs within the 2 weeks preceding the survey) was ascertained for the 2 surveys used, as well as by sex and age groups. The prevalence of use of the different drug groups was also estimated in the elderly who used polypharmacy. Polypharmacy occurred in about a third of the older people in the 2006 SNHS (32.54%), and was significantly higher in the 2011/12 SNHS (36.37%) (P<.05). In both surveys, the prevalence of polypharmacy was higher in women than men and among the older individuals (≥85 years) compared to the less old. The type of drugs most commonly used were analgesics (2006 SNHS: 71.93%, 2011/12 SNHS: 76.27%; P<.05), and antihypertensive drugs 2006 SNHS: 70.26%, 2011/12 SNHS: 78.10%; P<.05). The magnitude of polypharmacy is considerable in older people and increasing over time. Further research on this issue is needed to identify those individuals who are at higher risk of using multiple drugs concomitantly. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Prevalence and determinant factors of malocclusion in population with special needs in South India

    OpenAIRE

    R Muppa; P Bhupathiraju; M K Duddu; A Dandempally; D L Karre

    2013-01-01

    Objectives: Malocclusion plays an important role in the overall oral health of an individual because it is associated with periodontal disease, temporomandibular disorders and may be complicated by an individual′s disparity. Careful attention to malocclusion in children with special needs leads to a considerable improvement in the quality-of-life. The objective of the present study was to analyze the prevalence of malocclusion and its association with determinant factors in individuals with s...

  14. Prevalence and determinant factors of malocclusion in population with special needs in South India

    Directory of Open Access Journals (Sweden)

    R Muppa

    2013-01-01

    Full Text Available Objectives: Malocclusion plays an important role in the overall oral health of an individual because it is associated with periodontal disease, temporomandibular disorders and may be complicated by an individual′s disparity. Careful attention to malocclusion in children with special needs leads to a considerable improvement in the quality-of-life. The objective of the present study was to analyze the prevalence of malocclusion and its association with determinant factors in individuals with special needs in South India. Materials and Methods: A cross-sectional study was carried out that included 844 individuals with special needs and their mothers at eleven institutions in South India. Data were collected based on the questionnaire given to the mothers and dental examination carried out on the children. The nutritive and non-nutritive oral habits were obtained from the reports of the mothers. Clinical examination recorded the following: Class I, Class II, Class III, anterior crowding, anterior spacing, deep bite, open bite, and anterior cross bite. Statistical analyses of data were performed using Chi-square test. Results: Results at the end of the study revealed anterior crowding in 27.37% of the total sample size, deep bite in 20.5%, Class I in 14.34%, anterior spacing in 12.9%, Class II in 9.95%, Class III in 5.33%, anterior cross bite in 4.98% and open bite in 4.62%. Conclusion: The prevalence of malocclusion in individuals with special needs is associated with the type of disability and it is more in males than females. Mentally disabled individuals had higher frequencies of all types the malocclusion. Prevalence of anterior crowding was higher compared to other types of malocclusion followed by deep bite.

  15. International Conference on Harmonisation; Guidance on E7 Studies in Support of Special Populations; Geriatrics; Questions and Answers; availability. Notice.

    Science.gov (United States)

    2012-02-21

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled ``E7 Studies in Support of Special Populations: Geriatrics; Questions and Answers.'' The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The questions and answers (Q&A) guidance addresses special considerations for the design and conduct of clinical trials of drugs likely to have significant use in the elderly. The Q&As are intended to provide guidance on the use of geriatric data to adequately characterize and represent the safety and efficacy of a drug for a marketing application, including data collected postmarketing.

  16. Depression symptoms and cognitive-deficit in a population aged 60 years and older in a medium-sized city in São Paulo state, Brazil

    Directory of Open Access Journals (Sweden)

    José Evandro Marques Gomes

    2011-05-01

    Full Text Available Introduction: the world population is ageing, and Brazil follows this tendency, which requires the reorganization of society for care provision to older people. In such tendency, an increasing number of cases of depression and dementia is observed in addition to their association with other chronic-degenerative diseases. Objective: to estimate the prevalence of depression and cognitive-deficit symptoms in a population aged 60 years and older, residing in a middle-sized city in São Paulo state and to associate the population with other more prevalent chronic degenerative diseases. Methods: cross-sectional study on 364 older people using the following instruments: socio-demographic and morbidity, Mini Mental State Examination, Yesavage Scale, the Activities of Daily Living Scale, and the Instrumental Activities of Daily Living (IADL Scale. The following were performed: statistical analyses of the instruments’ score frequencies; presentation and summarization of the variables; and the possible associations between depression/dementia by applying the X2 test followed by fitting of a logistic regression model for ordinal data. Results: the suspected depression was found in 44% (160, and cognitive deficit was observed in 38.7% (141 aged. About 75% of the individuals with suspicion of depression or cognitive deficit had at least another chronic pathology. It was possible to establish statistically significant associations between suspected depression and IADL (p<0.0001; OR=7.59; CI=3.361-7.139 and cognitive deficit and IADL (p=0.0007; OR=3.967; CI=1.788-8.799. No associations were found between age, marital status, schooling, placement in the work market, retirement or income. Conclusion: male and female older individuals are vulnerable to diseases, such as depression and dementia. On the other hand, depression symptoms and cognitive deficit were associated with the score of compromised older individuals, according to IADL.

  17. The epidemiology of invasive pneumococcal disease in older adults from 2007 to 2014 in Ontario, Canada: a population-based study

    Science.gov (United States)

    Desai, Shalini; Policarpio, Michelle E.; Wong, Kenney; Gubbay, Jonathan; Fediurek, Jill; Deeks, Shelley

    2016-01-01

    Background: In Ontario, pneumococcal conjugate vaccines (PCVs) have been sequentially introduced into the publicly funded childhood vaccination program since 2005. A 23-valent polysaccharide pneumococcal vaccine (PPV23) has been routinely recommended for adults aged 65 years and older since 1996. To determine the effect of herd immunity, we examined the epidemiology of invasive pneumococcal disease in adults aged 65 years and older. Methods: Invasive pneumococcal disease is a provincially reportable disease. We were therefore able to conduct a descriptive epidemiologic analysis that included assessing time trends for patients aged 65 years and older using surveillance data from 2007 to 2014. Using serotype information within the surveillance data, cases were grouped into categories according to vaccine type and periods and then compared using Poisson regression. Results: A total of 3825 cases of invasive pneumococcal disease were reported among adults aged 65 years and older, for an overall annualized incidence of 25.4 cases per 100 000 population. There was a decrease in incidence due to serotypes included in 7-valent PCV (3.0 to 0.7 cases per 100 000 population) (p herd immunity from the childhood program. A burden of illness due to unique PPV23 serotypes and those that are not covered by a vaccine exists and has increased over time. PMID:27730119

  18. Waterfowl population and habitat study, Kenai National Moose Range, Kenai, Alaska: Special report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — During the period between May 27 and August 28, 1961, a waterfowl population and habitat study was conducted on the Kenai National Moose Range by personnel of the...

  19. Death penalty support for special offender populations of legally convicted murderers: juveniles, the mentally retarded, and the mentally incompetent.

    Science.gov (United States)

    Boots, Denise Paquette; Heide, Kathleen M; Cochran, John K

    2004-01-01

    The U.S. Supreme Court recently re-examined the constitutionality of the death penalty in the context of two of three special offender populations of murderers (juveniles, mentally retarded, and mentally incompetent). The Court reaffirmed the imposition of the death penalty for juveniles 16 and 17, while reversing itself on the mentally retarded. In reaching its decision, the Court relied on society's "evolving standards of decency." Using Likert-type items, this study is the first to have prospective jurors assess support for the death penalty for these specific offender groups. The public's support for the execution of each of the groups is then compared with existing case law. Descriptive statistics and regression analyses indicate that, as expected, the levels of support for the applicability of capital punishment to the various special offender populations are much lower than that for the general adult offender. Moreover, these findings are congruent with the holdings of the Court with one notable exception: a slight majority of respondents supported executing the mentally incompetent. Reasons for the public's apparent departure from the Supreme Court holding prohibiting the execution of mentally incompetent convicted murderers are discussed. The Court's continued role in protecting marginalized populations from "cruel and unusual punishment" is explored in the context of strong public sentiment demanding justice and finality despite changes in offenders' mental capacity.

  20. Evaluation of plasma Aβ as predictor of Alzheimer's disease in older individuals without dementia: a population-based study.

    Science.gov (United States)

    Hansson, Oskar; Stomrud, Erik; Vanmechelen, Eugeen; Östling, Svante; Gustafson, Deborah R; Zetterberg, Henrik; Blennow, Kaj; Skoog, Ingmar

    2012-01-01

    Amyloid-β (Aβ) pathology is a major component in the mechanisms behind Alzheimer's disease (AD). Measurement of Aβ(42) in cerebrospinal fluid predicts cognitive decline in patients with mild cognitive impairment and identifies AD in patients with dementia. However, studies on Aβ in plasma are contradictory. In this prospective population-based study, plasma Aβ(42) and Aβ(40) were measured at baseline in 730 adults aged 70 years or older and without dementia. After five years, plasma levels were analyzed again and participants were assessed for development of dementia. During follow-up, 53 individuals (7%) developed dementia of which 37 (5%) were classified as AD. No difference in baseline plasma Aβ(42), Aβ(40), or Aβ(42)/Aβ(40) ratio levels were observed between converters to dementia or AD compared to the cognitively stable individuals. However, individuals with plasma Aβ(40) levels above the median level for the group at baseline had an increased risk of developing dementia and AD during the follow-up, even after adjustment for age, gender, APOE genotype, and educational level (odds ratio = 2.2, 95% confidence interval = 1.0-4.7, p < 0.05). Neither plasma Aβ(42) nor the Aβ(42)/Aβ(40) ratio influenced the risk of developing dementia or AD. Moreover, Aβ(42) and Aβ(40) levels increased over the 5 years, whereas the Aβ(42)/Aβ(40) ratio decreased (p < 0.001). In conclusion, this study suggests that measurement of plasma Aβ should not be used clinically to predict dementia or AD. However, plasma Aβ(40) may possibly be regarded as a moderate risk marker comparable to other risk markers for AD such as first-degree family history of dementia.

  1. Association between Polyphenol Intake and Hypertension in Adults and Older Adults: A Population-Based Study in Brazil

    Science.gov (United States)

    Miranda, Andreia Machado; Steluti, Josiane; Fisberg, Regina Mara; Marchioni, Dirce Maria

    2016-01-01

    Background/Objective Hypertension is an important risk factor for cardiovascular disease, and diet has been identified as a modifiable factor for preventing and controlling hypertension. Besides, epidemiological studies have suggested an inverse association between polyphenol intake and cardiovascular diseases. The aim of this study was to evaluate the association between the intake of polyphenols and hypertension in a general population of Sao Paulo. Methods Data came from the ‘Health Survey of Sao Paulo (ISA-Capital)’ among 550 adults and older adults in Sao Paulo, Brazil. Diet was assessed by two 24-hour dietary recalls (24HR). Usual intakes were calculated using the Multiple Source Method. Polyphenol intake was calculated by matching food consumption data from the 24HR with the Phenol-Explorer database. The associations between the hypertension and tertiles of the total and classes of polyphenols intake were tested by multivariate logistic regression analysis. Results After multivariate adjustment for potential confounding factors the findings showed an inverse and linearly association between the hypertension and highest tertiles of tyrosols (OR = 0.33; 95%CI 0.18, 0.64), alkylphenols (OR = 0.45; 95%CI 0.23, 0.87), lignans (OR = 0.49; 95%CI 0.25, 0.98), as well as stilbenes (OR = 0.60; 95%CI 0.36, 0.98), and other polyphenols (OR = 0.33; 95%CI 0.14, 0.74). However, total polyphenol intake, and phenolic acids were significantly associated only in the middle tertile with hypertension and flavonoids were not significant associated. Conclusion There is an inverse and linearly association between the highest tertile of some classes of polyphenols, such as, tyrosols, alkylphenols, lignans, stilbenes, other polyphenols and hypertension. PMID:27792767

  2. Association between Polyphenol Intake and Hypertension in Adults and Older Adults: A Population-Based Study in Brazil.

    Science.gov (United States)

    Miranda, Andreia Machado; Steluti, Josiane; Fisberg, Regina Mara; Marchioni, Dirce Maria

    2016-01-01

    Hypertension is an important risk factor for cardiovascular disease, and diet has been identified as a modifiable factor for preventing and controlling hypertension. Besides, epidemiological studies have suggested an inverse association between polyphenol intake and cardiovascular diseases. The aim of this study was to evaluate the association between the intake of polyphenols and hypertension in a general population of Sao Paulo. Data came from the 'Health Survey of Sao Paulo (ISA-Capital)' among 550 adults and older adults in Sao Paulo, Brazil. Diet was assessed by two 24-hour dietary recalls (24HR). Usual intakes were calculated using the Multiple Source Method. Polyphenol intake was calculated by matching food consumption data from the 24HR with the Phenol-Explorer database. The associations between the hypertension and tertiles of the total and classes of polyphenols intake were tested by multivariate logistic regression analysis. After multivariate adjustment for potential confounding factors the findings showed an inverse and linearly association between the hypertension and highest tertiles of tyrosols (OR = 0.33; 95%CI 0.18, 0.64), alkylphenols (OR = 0.45; 95%CI 0.23, 0.87), lignans (OR = 0.49; 95%CI 0.25, 0.98), as well as stilbenes (OR = 0.60; 95%CI 0.36, 0.98), and other polyphenols (OR = 0.33; 95%CI 0.14, 0.74). However, total polyphenol intake, and phenolic acids were significantly associated only in the middle tertile with hypertension and flavonoids were not significant associated. There is an inverse and linearly association between the highest tertile of some classes of polyphenols, such as, tyrosols, alkylphenols, lignans, stilbenes, other polyphenols and hypertension.

  3. Differences in health status of older people aged 65 and above after total hip replacement compared with the normal population: a cross-sectional study

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2009-01-01

    The aim of the study was to describe the health status of older patients with osteoarthrosis following total hip replacement and to compare their health status with population norms in order to analyse the need for a rehabilitation programme after total hip replacement. Background.  Total hip...... replacement is a very efficient operation in terms of pain relief and improvement of walking ability. However, after the operation some patients still report low health status. Method.  A cross-sectional study including 287 older patients aged 65-74 and 75+ years who had had total hip replacement within...... reported significantly lower scores than the age specific norm population. Conclusion.  Our results indicate that health status is scored lower for patients after total hip replacement. This implies that there might be a need for further postoperative rehabilitation based on the identification of problems...

  4. Genetic Evidence for Contrasting Wetland and Savannah Habitat Specializations in Different Populations of Lions (Panthera leo).

    Science.gov (United States)

    Moore, Andy E; Cotterill, Fenton P D Woody; Winterbach, Christiaan W; Winterbach, Hanlie E K; Antunes, Agostinho; O'Brien, Stephen J

    2016-03-01

    South-central Africa is characterized by an archipelago of wetlands, which has evolved in time and space since at least the Miocene, providing refugia for animal species during Pleistocene arid episodes. Their importance for biodiversity in the region is reflected in the evolution of a variety of specialist mammal and bird species, adapted to exploit these wetland habitats. Populations of lions (Panthera leo) across south-central and east Africa have contrasting signatures of mitochondrial DNA haplotypes and biparental nuclear DNA in wetland and savannah habitats, respectively, pointing to the evolution of distinct habitat preferences. This explains the absence of genetic admixture of populations from the Kalahari savannah of southwest Botswana and the Okavango wetland of northern Botswana, despite separation by only 500 km. We postulate that ancestral lions were wetland specialists and that the savannah lions evolved from populations that were isolated during arid Pleistocene episodes. Expansion of grasslands and the resultant increase in herbivore populations during mesic Pleistocene climatic episodes provided the stimulus for the rapid population expansion and diversification of the highly successful savannah lion specialists. Our model has important implications for lion conservation.

  5. DENTAL CARE AND CHILDREN WITH SPECIAL HEALTH CARE NEEDS: A POPULATION-BASED PERSPECTIVE

    OpenAIRE

    Lewis, Charlotte W.

    2009-01-01

    This paper grew out of a project reviewing progress in children's oral health since the Surgeon General's Report (SGR) on Oral Health. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006-National Survey of CSHCN to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to ...

  6. Reassessing the HAROLD model: is the hemispheric asymmetry reduction in older adults a special case of compensatory-related utilisation of neural circuits?

    Science.gov (United States)

    Berlingeri, Manuela; Danelli, Laura; Bottini, Gabriella; Sberna, Maurizio; Paulesu, Eraldo

    2013-02-01

    The HAROLD (hemispheric asymmetry reduction in older adults) model, proposed by Cabeza in 2002, suggests that age-related neurofunctional changes are characterised by a significant reduction in the functional hemispheric lateralisation in the prefrontal cortex (PFC). The supporting evidence, however, has been derived from qualitative explorations of the data rather than from explicit statistical assessments of functional lateralisation. In contrast, the CRUNCH (compensation-related utilisation of neural circuits hypothesis) model posits that elderly subjects recruit additional brain regions that do not necessarily belong to the contralateral hemisphere as much as they rely on additional strategies to solve cognitive problems. To better assess the validity and generalisability of the HAROLD model, we analysed the fMRI patterns of twenty-four young subjects (age range: 18-30 years) and twenty-four healthy elderly subjects (age range: 50-80 years) collected during the performance of two linguistic/semantic tasks (a picture-naming task and a sentence judgment task) and two episodic long-term memory (eLTM) recognition tasks for the same materials. The functional hemispheric lateralisation in each group and the ensuing between-group differences were quantitatively assessed using statistical lateralisation maps (SLMs). The number of clusters showing a genuine HAROLD effect was proportional to the level of task demand. In addition, when quantitatively significant, these effects were not restricted to the PFC. We conclude that, in its original version, the HAROLD model captures only some of the age-related brain patterns observed in graceful ageing. The results observed in our study are compatible with the more general CRUNCH model, suggesting that the former patterns can be considered a special manifestation of age-related compensatory processes.

  7. Thermal specialization across large geographical scales predicts the resilience of mangrove crab populations to global warming

    KAUST Repository

    Fusi, Marco

    2014-11-18

    The broad prediction that ectotherms will be more vulnerable to climate change in the tropics than in temperate regions includes assumptions about centre/edge population effects that can only be tested by within-species comparisons across wide latitudinal gradients. Here, we investigated the thermal vulnerability of two mangrove crab species, comparing populations at the centre (Kenya) and edge (South Africa) of their distributions. At the same time, we investigated the role of respiratory mode (water- versus air-breathing) in determining the thermal tolerance in amphibious organisms. To do this, we compared the vulnerability to acute temperature fluctuations of two sympatric species with two different lifestyle adaptations: the free living Perisesarma guttatum and the burrowing Uca urvillei, both pivotal to the ecosystem functioning of mangroves. The results revealed the air-breathing U. urvillei to be a thermal generalist with much higher thermal tolerances than P. guttatum. Importantly, however, we found that, while U. urvillei showed little difference between edge and centre populations, P. guttatum showed adaptation to local conditions. Equatorial populations had elevated tolerances to acute heat stress and mechanisms of partial thermoregulation, which make them less vulnerable to global warming than temperate conspecifics. The results reveal both the importance of respiratory mode to thermal tolerance and the unexpected potential for low latitude populations/species to endure a warming climate. The results also contribute to a conceptual model on the latitudinal thermal tolerance of these key species. This highlights the need for an integrated population-level approach to predict the consequences of climate change. © 2014 The Authors.

  8. Urinary tract infections in special populations: diabetes, renal transplant, HIV infection, and spinal cord injury.

    Science.gov (United States)

    Nicolle, Lindsay E

    2014-03-01

    Some populations have unique considerations relevant to complicated urinary tract infection. For patients with diabetes, renal transplant, HIV infection, and spinal cord injuries, approaches to management, including diagnosis and treatment, are generally similar to other patients with complicated urinary tract infection. In addition, there is no evidence that treatment of asymptomatic bacteriuria leads to improved outcomes.

  9. Herpes zoster correlates with increased risk of Parkinson's disease in older people: A population-based cohort study in Taiwan.

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Chih-Hsueh; Lin, Hsien-Feng; Lin, Cheng-Li; Lin, Cheng-Chieh; Liao, Kuan-Fu

    2017-02-01

    Little is known on the relationship between herpes zoster and Parkinson's disease in older people. This study aimed to explore whether herpes zoster could be associated with Parkinson's disease in older people in Taiwan.We conducted a retrospective cohort study using the claim data of the Taiwan National Health Insurance Program. There were 10,296 subjects aged 65 years and older with newly diagnosed herpes zoster as the herpes zoster group and 39,405 randomly selected subjects aged 65 years and older without a diagnosis of herpes zoster as the nonherpes zoster group from 1998 to 2010. Both groups were followed up until subjects received a diagnosis of Parkinson's disease. This follow-up design would explore whether subjects with herpes zoster were at an increased risk of Parkinson's disease. Relative risks were estimated by adjusted hazard ratio (HR) and 95% confidence interval (CI) using the multivariable Cox proportional hazards regression model.The incidence of Parkinson's disease was higher in the herpes zoster group than that in the nonherpes zoster group (4.86 vs 4.00 per 1000 person-years, 95% CI 1.14, 1.29). After adjustment for confounding factors, the multivariable Cox proportional hazards regression model revealed that the adjusted HR of Parkinson's disease was 1.17 for the herpes zoster group (95% CI 1.10, 1.25), compared with the nonherpes zoster group.Older people with herpes zoster confer a slightly increased hazard of developing Parkinson's disease when compared to those without herpes zoster. We think that herpes zoster correlates with increased risk of Parkinson's disease in older people. When older people with herpes zoster seek help, clinicians should pay more attention to the development of the cardinal symptoms of Parkinson's disease.

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

    Science.gov (United States)

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

    2017-08-01

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

  11. Genetic population structure of the white sifaka (Propithecus verreauxi verreauxi) at Beza Mahafaly Special Reserve, southwest Madagascar (1992-2001).

    Science.gov (United States)

    Lawler, Richard R; Richard, Alison F; Riley, Margaret A

    2003-09-01

    Gene flow within and between social groups is contingent on behaviourally mediated patterns of mating and dispersal. To understand how these patterns affect the genetic structure of primate populations, long-term data are required. In this study, we analyse 10 years of demographic and genetic data from a wild lemur population (Propithecus verreauxi verreauxi) at Beza Mahafaly Special Reserve, southwest Madagascar. Our goal is to specify how patterns of mating and dispersal determine kinship and genetic diversity among animals in the population. Specifically, we use microsatellite, parentage, and census data to obtain estimates of genetic subdivision (FST), within group homozygosity (FIS), and relatedness (r) within and among social groups in the population. We analyse different classes of individuals (i.e. adults, offspring, males, females) separately in order to discern which classes most strongly influence aspects of population structure. Microsatellite data reveal that, across years, offspring are consistently more heterozygous than expected within social groups (FIS mean = -0.068) while adults show both positive and negative deviations from expected genotypic frequencies within groups (FIS mean = 0.003). Offspring cohorts are more genetically subdivided than adults (FST mean = 0.108 vs. 0.052) and adult females are more genetically subdivided than adult males (FST mean = 0.098 vs. 0.046). As the proportion of females in social groups increases, the proportion of offspring sired by resident males decreases. Offspring are characterized by a heterozygote excess as resident males (vs. nonresident males) sire the majority of offspring within groups. We link these genetic data to patterns of female philopatry, male dispersal, exogamy, and offspring sex-ratio. Overall, these data reveal how mating and dispersal tactics influence the genetic population structure in this species.

  12. Association between perceived social stigma against mental disorders and use of health services for psychological distress symptoms in the older adult population: validity of the STIG scale.

    Science.gov (United States)

    Préville, Michel; Mechakra Tahiri, Samia Djemaa; Vasiliadis, Helen-Maria; Quesnel, Louise; Gontijo-Guerra, Samantha; Lamoureux-Lamarche, Catherine; Berbiche, Djamal

    2015-01-01

    To document the reliability, construct and nomological validity of the perceived Social Stigmatisation (STIG) scale in the older adult population. Cross-sectional survey. Primary medical health services clinics. Probabilistic sample of older adults aged 65 years and over waiting for medical services in the general medical sector (n = 1765). Perceived social stigma against people with a mental health problem was measured using the STIG scale composed of seven indicators. A second-order measurement model of perceived social stigma fitted adequately the observed data. The reliability of the STIG scale was 0.83. According to our results, 39.6% of older adults had a significant level of perceived social stigma against people with a mental health problem. RESULTS showed that the perception of social stigma against mental health problems was not significantly associated with a respondent gender and age. RESULTS also showed that the perception of social stigma against the mental health problems was directly associated with the respondents' need for improved mental health (b = -0.10) and indirectly associated with their use of primary medical health services for psychological distress symptoms (b = -0.07). RESULTS lead us to conclude that social stigma against mental disorders perceived by older adults may limit help-seeking behaviours and warrants greater public health and public policy attention. Also, results lead us to conclude that physicians should pay greater attention to their patients' attitudes against mental disorders in order to identify possible hidden mental health problems.

  13. Association Between Depressive Symptoms, Multiple Dimensions of Depression, and Elder Abuse: A Cross-Sectional, Population-Based Analysis of Older Adults in Urban Chicago.

    Science.gov (United States)

    Roepke-Buehler, Susan K; Simon, Melissa; Dong, XinQi

    2015-09-01

    Depression is conceptualized as both a risk factor for and a consequence of elder abuse; however, current research is equivocal. This study examined associations between elder abuse and dimensions of depressive symptoms in older adults. Participants were 10,419 older adults enrolled in theChicago Health and Aging Project (CHAP), a population-based study of older adults. Regression was used to determine the relationships between depressive symptoms, depression dimensions, and abuse variables. Depressive symptoms were consistently associated with elder abuse. Participants in the highest tertile of depressive symptoms were twice as likely to have confirmed abuse with a perpetrator (odds ratio = 2.07, 95% confidence interval = [1.21, 3.52], p = .008). Elder abuse subtypes and depression dimensions were differentially associated. These findings highlight the importance of routine depression screening in older adults as a component of abuse prevention and intervention. They also provide profiles of depressive symptoms that may more accurately characterize risk for specific types of abuse. © The Author(s) 2015.

  14. Visual Impairment, Hearing Loss and Cognitive Function in an Older Population: Longitudinal Findings from the Blue Mountains Eye Study.

    Directory of Open Access Journals (Sweden)

    Thomas Hong

    Full Text Available The presence of visual impairment (VI and hearing loss (HL with may be a marker for subsequent cognitive decline over time in older people. A prospective, longitudinal population-based study of the 3654 participants of the Blue Mountains Eye Study were assessed for the associations between VI and HL and a decline in mini-mental state examination (MMSE scores over a duration of 10 years from the 5-year (baseline of this report to the 15-year follow-up visits. MMSE was assessed at the 5-, 10- and 15-year follow-up visits. A decline ≥3 scores from 5-year to 10- or 15-year visits indicated possible cognitive decline. VI was defined as best-corrected visual acuity 40 decibels in the worse-ear and dual sensory impairment (DSI was defined by the co-presence of VI and HL, detected at 5-year follow-up (baseline of this report. Participants with no VI and HL over the same 5- or 10-year corresponding period were controls. Associations of VI, HL and DSI with possible cognitive decline were assessed using logistic regression models adjusting for age and sex after excluding subjects with a stroke history. The presence of VI, HL or DSI was not associated with possible cognitive decline over 5 years (odds ratio (OR 0.84, 95% confidence-intervals (CI 0.40-1.79, OR 1.02, 95% CI 0.61-1.70 and 1.41, 95% CI 0.54-3.72, respectively or 10 years (OR 1.09, 95% CI 0.52-2.30, OR 1.09, 95% CI 0.65-1.82 and 1.15, 95% CI 0.28-4.73, respectively. There were no changes to these findings after adjustment for other potential confounders. Age was significantly associated with possible cognitive decline (OR 1.07, 95% CI 1.04-1.10 for both periods. Neither visual impairment, hearing loss nor dual sensory impairment was independently associated with subsequent decline in cognition.

  15. The management of hip fracture in the older population. Joint position statement by Gruppo Italiano Ortogeriatria (GIOG).

    Science.gov (United States)

    Pioli, Giulio; Barone, A; Mussi, C; Tafaro, L; Bellelli, G; Falaschi, P; Trabucchi, M; Paolisso, G

    2014-10-01

    This document is a Joint Position Statement by Gruppo Italiano di OrtoGeriatria (GIOG) supported by Società Italiana di Gerontologia e Geriatria (SIGG), and Associazione Italiana Psicogeriatria (AIP) on management of hip fracture older patients. Orthogeriatric care is at present the best model of care to improve results in older patients after hip fracture. The implementation of orthogeriatric model of care, based on the collaboration between orthopaedic surgeons and geriatricians, must take into account the local availability of resources and facilities and should be integrated into the local context. At the same time the programme must be based on the best available evidences and planned following accepted quality standards that ensure the efficacy of the intervention. The position paper focused on eight quality standards for the management of hip fracture older patients in orthogeriatric model of care. The GIOG promotes the development of a clinic database with the aim of obtaining a qualitative improvement in the management of hip fracture.

  16. Achieving glycemic control in special populations in hospital: perspectives in practice.

    Science.gov (United States)

    Cheng, Alice Y Y

    2014-04-01

    Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly.

  17. Mobile Applications for Diabetics: A Systematic Review and Expert-Based Usability Evaluation Considering the Special Requirements of Diabetes Patients Age 50 Years or Older

    Science.gov (United States)

    Quade, Mandy; Kirch, Wilhelm

    2014-01-01

    Background A multitude of mhealth (mobile health) apps have been developed in recent years to support effective self-management of patients with diabetes mellitus type 1 or 2. Objective We carried out a systematic review of all currently available diabetes apps for the operating systems iOS and Android. We considered the number of newly released diabetes apps, range of functions, target user groups, languages, acquisition costs, user ratings, available interfaces, and the connection between acquisition costs and user ratings. Additionally, we examined whether the available applications serve the special needs of diabetes patients aged 50 or older by performing an expert-based usability evaluation. Methods We identified relevant keywords, comparative categories, and their specifications. Subsequently, we performed the app review based on the information given in the Google Play Store, the Apple App Store, and the apps themselves. In addition, we carried out an expert-based usability evaluation based on a representative 10% sample of diabetes apps. Results In total, we analyzed 656 apps finding that 355 (54.1%) offered just one function and 348 (53.0%) provided a documentation function. The dominating app language was English (85.4%, 560/656), patients represented the main user group (96.0%, 630/656), and the analysis of the costs revealed a trend toward free apps (53.7%, 352/656). The median price of paid apps was €1.90. The average user rating was 3.6 stars (maximum 5). Our analyses indicated no clear differences in the user rating between free and paid apps. Only 30 (4.6%) of the 656 available diabetes apps offered an interface to a measurement device. We evaluated 66 apps within the usability evaluation. On average, apps were rated best regarding the criterion “comprehensibility” (4.0 out of 5.0), while showing a lack of “fault tolerance” (2.8 out of 5.0). Of the 66 apps, 48 (72.7%) offered the ability to read the screen content aloud. The number of

  18. Association among measures of mobility-related disability and self-perceived fatigue among older people: a population-based study

    Directory of Open Access Journals (Sweden)

    Wuber J. S. Soares

    2015-06-01

    Full Text Available Objective: To investigate the relationship between self-perceived fatigue with different physical functioning tests and functional performance scales used for evaluating mobility-related disability among community-dwelling older persons. Method: This is a cross-sectional, population-based study. The sample was composed of older persons with 65 years of age or more living in Cuiabá, MT, and Barueri, SP, Brazil. The data for this study is from the FIBRA Network Study. The presence of self-perceived fatigue was assessed using self-reports based on the Center for Epidemiologic Studies-Depression Scale. The Lawton instrumental activities of daily living scale (IADL and the advanced activities of daily living scale (AADL were used to assess performance and participation restriction. The following physical functioning tests were used: five-step test (FST, the Short Physical Performance Battery (SPPB, and usual gait speed (UGS. Three models of logistic regression analysis were conducted, and a significance level of α<0.05 was adopted. Results: The sample was composed of 776 older adults with a mean age (SD of 71.9 (5.9 years, of whom the majority were women (74%. The prevalence of self-perceived fatigue within the participants was 20%. After adjusting for covariates, SPPB, UGS, IADL, and AADL remained associated with self-perceived fatigue in the final multivariate regression model. Conclusion: Our results suggest that there is an association between self-perceived fatigue and lower extremity function, usual gait speed and activity limitation and participation restriction in older adults. Further cohort studies are needed to investigate which physical performance measure may be able to predict the negative impact of fatigue in older adults.

  19. Challenges in Special Populations: HIV/HCV Coinfection, Liver Transplantation and Patients with End-Stage Renal Disease.

    Science.gov (United States)

    Bonacci, Martín; Lens, Sabela; Mariño, Zoe; Forns, Xavier

    Until recently, the combination of PEG-interferon and ribavirin (RBV) was the main treatment for all genotypes of chronic hepatitis C virus (HCV) infection. Sustained virological response (SVR) rates varied signixFB01;cantly across patient subgroups and the concept of 'special populations' emerged. Now, in the era of direct acting antivirals, with a better safety profile and higher efficacy rates, those patients with comorbidities or conditions that limited IFN-based antiviral treatment but with unmet medical needs have been considered for therapy again. With the currently approved all-oral antivirals, patients coinfected with human immunodeficiency virus and HCV have SVR rates similar to patients with HCV monoinfection. However, drug-drug interactions (DDIs) with antiretroviral drugs are still challenging. In the setting of liver transplantation, with an accelerated course of hepatitis C, previous IFN-RBV treatments were poorly tolerated and attained low SVR rates. Today, all-oral therapies have proven to be efficacious and safe in this population. Nevertheless, questions such as the optimal treatment duration or the need for RBV still remain opened. In this population as well, DDIs are an issue, as some regimens require adjustments and monitoring of immunosuppressive drugs during therapy. Finally, preliminary data show promising results in terms of efficacy and safety in patients with end-stage renal disease. However, there is clear need for more clinical studies since treatment options are still very limited.

  20. Cognitive and Functional Decline among Individuals 50 Years of Age or Older in Cambé, Paraná, Brazil: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    Marcos Aparecido Sarria Cabrera

    2016-05-01

    Full Text Available Aims: To identify the frequency of cognitive and functional decline (CFD among adults 50 years of age and older by a population-based study. Methods: Cognitive function was analyzed by the Mini-Mental State Examination, and the functional conditions were based on instrumental activities of daily living (IADL. Cases of CFD included individuals with cognitive decline and 2 or more compromised IADL. Results: A total of 693 individuals were studied. The frequency of CFD was 16.3%. A low socioeconomic profile was associated with greater CFD independent of gender, age, education, and presence of depression (OR = 2.46; 95% CI: 1.53-3.97. Conclusions: These data show a high frequency of CFD among adults 50 years and older. Individuals with less education and a lower socioeconomic level exhibited poorer cognitive and functional conditions.

  1. The 37 item Version of the Mini-Mental State Examination: Normative Data in a Population-Based Cohort of Older Spanish Adults (NEDICES).

    Science.gov (United States)

    Contador, I; Bermejo-Pareja, F; Fernández-Calvo, B; Boycheva, E; Tapias, E; Llamas, S; Benito-León, J

    2016-05-01

    The 37-item version of the Mini-Mental State Examination (MMSE-37) is an extended version of the original test for individuals with low education, which was adapted for different cultures. Despite its favorable psychometric properties, there is a lack of normative data for this instrument. We provide normative data for the MMSE-37 stratified by age, sex, and education in a large population-based cohort of older Spanish adults. The sample consisted of 3,777 participants without dementia (age range: 65-97 years) from different socioeconomic areas of central Spain. Normative data are presented in percentile ranks and divided into nine overlapping age tables with different midpoints, using the overlapping cell procedure. A hierarchical regression was performed to evaluate the effects of sociodemographic variables on MMSE-37 performance. Results showed that age, sex, and education affect test score. The norms presented herein are important for the correct interpretation of MMSE-37 scores when assessing older adults in Spain.

  2. Performance of an Abbreviated Version of the Lubben Social Network Scale among Three European Community-Dwelling Older Adult Populations

    Science.gov (United States)

    Lubben, James; Blozik, Eva; Gillmann, Gerhard; Iliffe, Steve; von Renteln-Kruse, Wolfgang; Beck, John C.; Stuck, Andreas E.

    2006-01-01

    Purpose: There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. Design and Methods: The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale…

  3. Does social capital affect the incidence of functional disability in older Japanese? A prospective population-based cohort study.

    Science.gov (United States)

    Aida, Jun; Kondo, Katsunori; Kawachi, Ichiro; Subramanian, S V; Ichida, Yukinobu; Hirai, Hiroshi; Kondo, Naoki; Osaka, Ken; Sheiham, Aubrey; Tsakos, Georgios; Watt, Richard G

    2013-01-01

    Recent increases in numbers of older people have been accompanied by increases in those with functional disability. No study has examined the association between community social capital and the onset of functional disability. The association between community social capital and the onset of functional disability was examined using data from the Aichi Gerontological Evaluation Study, a prospective cohort established in 2003 in Japan. Perceptions of community social capital (indicators of social cohesion such as trust of others and extent of social participation) in 6953 men and 7636 women aged 65 years or older were surveyed. Multilevel survival analysis using the discrete-time hazard model was applied. During 4-year follow-up, onset of functional disability occurred in 759 men and 1146 women. Women living in communities with higher mistrust had 1.68 (95% CI 1.14 to 2.49) times higher OR of onset of disability, even after adjusting for covariates. Mediators did not substantially change this association. Lack of social participation seemed to affect the health of women, though the effect was marginal (OR for covariates adjusted model =1.12 (95% CI 0.96 to 1.31)). There were no significant ORs among men. Lower community social capital was associated with higher incidence of onset of functional disability among older women but not among men. Community-based interventions to promote social capital may be useful for preventing functional disability of older Japanese women.

  4. Psychometric properties of the OLQ-13 scale to measure Sense of Coherence in a community-dwelling older population

    NARCIS (Netherlands)

    Naaldenberg, J.; Tobi, H.; Hartog-van den Esker, den F.G.; Vaandrager, L.

    2011-01-01

    Background - With the ongoing demographic shift, the quality of life and health promotion among older individuals are becoming increasingly important. Recent research suggests that Sense of Coherence positively affects quality of life. Hence, a valid and reliable measurement of Sense of Coherence is

  5. Psychometric properties of the OLQ-13 scale to measure Sense of Coherence in a community-dwelling older population

    NARCIS (Netherlands)

    Naaldenberg, J.; Tobi, H.; Hartog-van den Esker, den F.G.; Vaandrager, L.

    2011-01-01

    Background - With the ongoing demographic shift, the quality of life and health promotion among older individuals are becoming increasingly important. Recent research suggests that Sense of Coherence positively affects quality of life. Hence, a valid and reliable measurement of Sense of Coherence is

  6. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2011-11-01

    Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe.

  7. Stroke awareness in the general population: knowledge of stroke risk factors and warning signs in older adults.

    LENUS (Irish Health Repository)

    Hickey, Anne

    2009-01-01

    BACKGROUND: Stroke is a leading cause of death and functional impairment. While older people are particularly vulnerable to stroke, research suggests that they have the poorest awareness of stroke warning signs and risk factors. This study examined knowledge of stroke warning signs and risk factors among community-dwelling older adults. METHODS: Randomly selected community-dwelling older people (aged 65+) in Ireland (n = 2,033; 68% response rate). Participants completed home interviews. Questions assessed knowledge of stroke warning signs and risk factors, and personal risk factors for stroke. RESULTS: Of the overall sample, 6% had previously experienced a stroke or transient ischaemic attack. When asked to identify stroke risk factors from a provided list, less than half of the overall sample identified established risk factors (e.g., smoking, hypercholesterolaemia), hypertension being the only exception (identified by 74%). Similarly, less than half identified established warning signs (e.g., weakness, headache), with slurred speech (54%) as the exception. Overall, there were considerable gaps in awareness with poorest levels evident in those with primary level education only and in those living in Northern Ireland (compared with Republic of Ireland). CONCLUSION: Knowledge deficits in this study suggest that most of the common early symptoms or signs of stroke were recognized as such by less than half of the older adults surveyed. As such, many older adults may not recognise early symptoms of stroke in themselves or others. Thus, they may lose vital time in presenting for medical attention. Lack of public awareness about stroke warning signs and risk factors must be addressed as one important contribution to reducing mortality and morbidity from stroke.

  8. Stroke awareness in the general population: knowledge of stroke risk factors and warning signs in older adults

    Directory of Open Access Journals (Sweden)

    Shelley Emer

    2009-08-01

    Full Text Available Abstract Background Stroke is a leading cause of death and functional impairment. While older people are particularly vulnerable to stroke, research suggests that they have the poorest awareness of stroke warning signs and risk factors. This study examined knowledge of stroke warning signs and risk factors among community-dwelling older adults. Methods Randomly selected community-dwelling older people (aged 65+ in Ireland (n = 2,033; 68% response rate. Participants completed home interviews. Questions assessed knowledge of stroke warning signs and risk factors, and personal risk factors for stroke. Results Of the overall sample, 6% had previously experienced a stroke or transient ischaemic attack. When asked to identify stroke risk factors from a provided list, less than half of the overall sample identified established risk factors (e.g., smoking, hypercholesterolaemia, hypertension being the only exception (identified by 74%. Similarly, less than half identified established warning signs (e.g., weakness, headache, with slurred speech (54% as the exception. Overall, there were considerable gaps in awareness with poorest levels evident in those with primary level education only and in those living in Northern Ireland (compared with Republic of Ireland. Conclusion Knowledge deficits in this study suggest that most of the common early symptoms or signs of stroke were recognized as such by less than half of the older adults surveyed. As such, many older adults may not recognise early symptoms of stroke in themselves or others. Thus, they may lose vital time in presenting for medical attention. Lack of public awareness about stroke warning signs and risk factors must be addressed as one important contribution to reducing mortality and morbidity from stroke.

  9. Research training of students in minority and international settings: lessons learned from cancer epidemiology education in special populations.

    Science.gov (United States)

    Soliman, Amr S; Mullan, Patricia B; Chamberlain, Robert M

    2010-06-01

    This article describes the development and evaluation of an NCI-sponsored short-term summer cancer research education program. The study questions examined: the feasibility of conducting a cancer education program in special populations at multiple US and international field sites for masters students; the merit and worth that students and faculty attribute to the program; and students' scholarly and cancer-related career outcomes. Developing a new curriculum, increasing the pool of mentors, utilizing and increasing the number of field sites, and program dissemination were also evaluated. Evidence of the program's success included students' completion of field experiences at multiple sites and their subsequent 70% project-related publication rate, with 79% of trainees reporting themselves as likely to pursue future cancer-related careers. Evaluation-guided future plans for the program include implementing faculty development to further enhance the program outcomes.

  10. Attitudes Toward Breast Cancer Genetic Testing in Five Special Population Groups.

    Science.gov (United States)

    Ramirez, Amelie G; Chalela, Patricia; Gallion, Kipling J; Muñoz, Edgar; Holden, Alan E; Burhansstipanov, Linda; Smith, Selina A; Wong-Kim, Evaon; Wyatt, Stephen W; Suarez, Lucina

    2015-01-01

    This study examined interest in and attitudes toward genetic testing in 5 different population groups. The survey included African American, Asian American, Latina, Native American, and Appalachian women with varying familial histories of breast cancer. A total of 49 women were interviewed in person. Descriptive and nonparametric statistical techniques were used to assess ethnic group differences. Overall, interest in testing was high. All groups endorsed more benefits than risks. There were group differences regarding endorsement of specific benefits and risks: testing to "follow doctor recommendations" (p=0.017), "concern for effects on family" (p=0.044), "distrust of modern medicine" (p=0.036), "cost" (p=0.025), and "concerns about communication of results to others" (p=0.032). There was a significant inverse relationship between interest and genetic testing cost (p<0.050), with the exception of Latinas, who showed the highest level of interest regardless of increasing cost. Cost may be an important barrier to obtaining genetic testing services, and participants would benefit by genetic counseling that incorporates the unique cultural values and beliefs of each group to create an individualized, culturally competent program. Further research about attitudes toward genetic testing is needed among Asian Americans, Native Americans, and Appalachians for whom data are severely lacking. Future study of the different Latina perceptions toward genetic testing are encouraged.

  11. Non-Vitamin K Oral Anticoagulants for Stroke Prevention in Special Populations with Atrial Fibrillation.

    Science.gov (United States)

    Bisson, Arnaud; Angoulvant, Denis; Philippart, Raphael; Clementy, Nicolas; Babuty, Dominique; Fauchier, Laurent

    2017-06-01

    Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke or systemic embolism compared with normal sinus rhythm. These strokes may efficiently be prevented in patients with risk factors using oral anticoagulant therapy, with either vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) (i.e., direct thrombin inhibitors or direct factor Xa inhibitors). Owing to their specific risk profiles, some AF populations may have increased risks of both thromboembolic and bleeding events. These AF patients may be denied oral anticoagulants, whilst evidence shows that the absolute benefits of oral anticoagulants are greatest in patients at highest risk. NOACs are an alternative to VKAs to prevent stroke in patients with "non-valvular AF", and NOACs may offer a greater net clinical benefit compared with VKAs, particularly in these high-risk patients. Physicians have to learn how to use these drugs optimally in specific settings. We review concrete clinical scenarios for which practical answers are currently proposed for use of NOACs based on available evidence for patients with kidney disease, elderly patients, women, patients with diabetes, patients with low or high body weight, and those with valve disease.

  12. Patterns of ecological specialization among microbial populations in the Red Sea and diverse oligotrophic marine environments

    KAUST Repository

    Thompson, Luke R

    2013-05-11

    Large swaths of the nutrient-poor surface ocean are dominated numerically by cyanobacteria (Prochlorococcus), cyanobacterial viruses (cyanophage), and alphaproteobacteria (SAR11). How these groups thrive in the diverse physicochemical environments of different oceanic regions remains poorly understood. Comparative metagenomics can reveal adaptive responses linked to ecosystem-specific selective pressures. The Red Sea is well-suited for studying adaptation of pelagic-microbes, with salinities, temperatures, and light levels at the extreme end for the surface ocean, and low nutrient concentrations, yet no metagenomic studies have been done there. The Red Sea (high salinity, high light, low N and P) compares favorably with the Mediterranean Sea (high salinity, low P), Sargasso Sea (low P), and North Pacific Subtropical Gyre (high light, low N). We quantified the relative abundance of genetic functions among Prochlorococcus, cyanophage, and SAR11 from these four regions. Gene frequencies indicate selection for phosphorus acquisition (Mediterranean/Sargasso), DNA repair and high-light responses (Red Sea/Pacific Prochlorococcus), and osmolyte C1 oxidation (Red Sea/Mediterranean SAR11). The unexpected connection between salinity-dependent osmolyte production and SAR11 C1 metabolism represents a potentially major coevolutionary adaptation and biogeochemical flux. Among Prochlorococcus and cyanophage, genes enriched in specific environments had ecotype distributions similar to nonenriched genes, suggesting that inter-ecotype gene transfer is not a major source of environment-specific adaptation. Clustering of metagenomes using gene frequencies shows similarities in populations (Red Sea with Pacific, Mediterranean with Sargasso) that belie their geographic distances. Taken together, the genetic functions enriched in specific environments indicate competitive strategies for maintaining carrying capacity in the face of physical stressors and low nutrient availability. 2013 The

  13. Patterns of ecological specialization among microbial populations in the Red Sea and diverse oligotrophic marine environments.

    Science.gov (United States)

    Thompson, Luke R; Field, Chris; Romanuk, Tamara; Ngugi, David; Siam, Rania; El Dorry, Hamza; Stingl, Ulrich

    2013-06-01

    Large swaths of the nutrient-poor surface ocean are dominated numerically by cyanobacteria (Prochlorococcus), cyanobacterial viruses (cyanophage), and alphaproteobacteria (SAR11). How these groups thrive in the diverse physicochemical environments of different oceanic regions remains poorly understood. Comparative metagenomics can reveal adaptive responses linked to ecosystem-specific selective pressures. The Red Sea is well-suited for studying adaptation of pelagic-microbes, with salinities, temperatures, and light levels at the extreme end for the surface ocean, and low nutrient concentrations, yet no metagenomic studies have been done there. The Red Sea (high salinity, high light, low N and P) compares favorably with the Mediterranean Sea (high salinity, low P), Sargasso Sea (low P), and North Pacific Subtropical Gyre (high light, low N). We quantified the relative abundance of genetic functions among Prochlorococcus, cyanophage, and SAR11 from these four regions. Gene frequencies indicate selection for phosphorus acquisition (Mediterranean/Sargasso), DNA repair and high-light responses (Red Sea/Pacific Prochlorococcus), and osmolyte C1 oxidation (Red Sea/Mediterranean SAR11). The unexpected connection between salinity-dependent osmolyte production and SAR11 C1 metabolism represents a potentially major coevolutionary adaptation and biogeochemical flux. Among Prochlorococcus and cyanophage, genes enriched in specific environments had ecotype distributions similar to nonenriched genes, suggesting that inter-ecotype gene transfer is not a major source of environment-specific adaptation. Clustering of metagenomes using gene frequencies shows similarities in populations (Red Sea with Pacific, Mediterranean with Sargasso) that belie their geographic distances. Taken together, the genetic functions enriched in specific environments indicate competitive strategies for maintaining carrying capacity in the face of physical stressors and low nutrient availability.

  14. Testosterone replacement therapy for older men

    Directory of Open Access Journals (Sweden)

    Stephen E Borst

    2008-01-01

    Full Text Available Stephen E Borst, Thomas MulliganGeriatrics Research, Education, and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USAAbstract: Despite intensive research on testosterone therapy for older men, important questions remain unanswered. The evidence clearly indicates that many older men display a partial androgen deficiency. In older men, low circulating testosterone is correlated with low muscle strength, with high adiposity, with insulin resistance and with poor cognitive performance. Testosterone replacement in older men has produced benefits, but not consistently so. The inconsistency may arise from differences in the dose and duration of testosterone treatment, as well as selection of the target population. Generally, studies reporting anabolic responses to testosterone have employed higher doses of testosterone for longer treatment periods and have targeted older men whose baseline circulating bioavailable testosterone levels were low. Most studies of testosterone replacement have reported anabolic that are modest compared to what can be achieved with resistance exercise training. However, several strategies currently under evaluation have the potential to produce greater anabolic effects and to do so in a safe manner. At this time, testosterone therapy can not be recommended for the general population of older men. Older men who are hypogonadal are at greater risk for the catabolic effects associated with a number of acute and chronic medical conditions. Future research is likely to reveal benefits of testosterone therapy for some of these special populations. Testosterone therapy produces a number of adverse effects, including worsening of sleep apnea, gynecomastia, polycythemia and elevation of PSA. Efficacy and adverse effects should be assessed frequently throughout the course of therapy.Keywords: aging, testosterone, hypogonadism, physical function

  15. Predictive value of a profile of routine blood measurements on mortality in older persons in the general population: the Leiden 85-plus Study.

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    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.

  16. Older People and Their Attitude to the Use of Information and Communication Technologies--A Review Study with Special Focus on the Czech Republic (Older People and Their Attitude to ICT)

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    Klimova, Blanka; Simonova, Ivana; Poulova, Petra; Truhlarova, Zuzana; Kuca, Kamil

    2016-01-01

    Rising standards of living and good quality health care have contributed to people living longer. According to the Eurostat agency (Benácová & Valenta, 2009), in the next 50 years there will be twice as many older people worldwide. The aging process, however, brings about new economic and social issues. Therefore, there is constant effort to…

  17. Sodium intake of special populations in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study.

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    Cotugna, Nancy; Fanelli-Kuczmarski, Marie; Fanelli-Kuczmarksi, Marie; Clymer, Julie; Hotchkiss, Lawrence; Zonderman, Alan B; Evans, Michele K

    2013-10-01

    The sodium intake of participants of the Healthy Aging in Neighborhoods of Diversity across the Life Span study who were in three of the special population groups identified by the Dietary Guidelines for Americans, 2010 (those with hypertension, African Americans, and those ≥51years) was analyzed to determine if they met sodium recommendations. The sample included 2152 African American and White subjects, aged 30-64years. Major dietary sources of sodium for each group were determined from two 24-hour dietary recalls, and dietary intakes were compared with sodium recommendations. Dietary potassium was also evaluated. The intakes of the groups studied exceeded 1500mg of sodium while their potassium intakes were lower than the Adequate Intake of 4700mg. The major contributors of sodium included "cold cuts, sausage, and franks," "protein foods," and yeast breads. Excessive sodium intake characterized the diet of an urban, socioeconomically diverse population who are hypertensive or at risk for having hypertension. These findings have implications for health professionals and the food industry. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Associations Between Resilience, Community Belonging, and Social Participation Among Community-Dwelling Older Adults: Results From the Eastern Townships Population Health Survey.

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    Levasseur, Mélanie; Roy, Mathieu; Michallet, Bernard; St-Hilaire, France; Maltais, Danielle; Généreux, Mélissa

    2017-04-26

    To examine the associations between resilience, community belonging, and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. Community. A sample (N=4541) of women (n=2485) and men (n=2056) aged ≥60 years was randomly selected according to area. Most participants had resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in 8 community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to the local community. Social participation and sense of belonging questions came from Statistics Canada surveys. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale, capturing the ability to cope with adversity. Controlling for age, education, and psychological distress, greater resilience and community belonging were associated with greater social participation among women (R(2)=.13; Presilience, especially in men. Greater community belonging further enhanced social participation, especially among women (P=.03) and men (Presilience (moderator effect). Resilience moderates the association between community belonging and social participation among community-dwelling older women and, especially, men. Interventions targeting social participation should consider the potential impact of resilience on improving community belonging. Future studies should investigate why resilience moderates associations between community belonging and social participation, and how to enhance resilience among older adults. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  19. Ready-to-Eat Cereal Consumption Patterns: The Relationship to Nutrient Intake, Whole Grain Intake, and Body Mass Index in an Older American Population

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    Ann M. Albertson

    2012-01-01

    Full Text Available Objective. To investigate the relationship between ready-to-eat (RTE breakfast cereal consumption patterns and body mass index (BMI, nutrient intake, and whole grain intake in an older American population. Design. A cross-sectional survey of US households, collected by the NPD Group via the National Eating Trends (NET survey. Main outcome measures include BMI, nutrient intake, and whole grain intake. Subjects/Setting. The sample included 1759 participants age 55 and older, which was divided into approximate quartiles based on intake of RTE breakfast cereal for the 2-week period (0 servings, 1–3 servings, 4–7 servings, and ≥8 servings. Results. In the multivariate linear regression analysis adjusted for energy and age; intake of dietary fiber, whole grains, and the majority of micronutrients examined were found to be positively associated with frequent RTE cereal consumption. The proportion of participants consuming less than the Estimated Average Requirement (EAR was lower for the highest quartile of RTE cereal consumers compared to nonconsumers, for the majority of vitamins and minerals examined. Significant differences in BMI between RTE breakfast cereal intake groups were found for men. Conclusion. Results suggest that ready-to-eat breakfast cereals may contribute to the nutritional quality of the diets of older Americans. Prospective studies and experimental trials are needed to better evaluate the role of RTE cereal consumption in energy balance.

  20. Association of New-Onset Diabetes Mellitus in Older People and Mortality in Taiwan: A 10-Year Nationwide Population-Based Study.

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    Chi, M-J; Liang, C-K; Lee, W-J; Peng, L-N; Chou, M-Y; Chen, L-K

    2017-01-01

    Older patients with diabetes mellitus are at a higher risk of developing diabetic macro- and micro-vascular complications and cardiovascular diseases than younger diabetes mellitus patients. However, older diabetes mellitus patients are very heterogeneous in their clinical characteristics, diabetes mellitus-related complications and age at disease onset. This study aimed to evaluate the all-cause mortality rates and adverse health outcomes among older adults with new-onset diabetes mellitus through a nationwide population-based study. A retrospective cohort study. 2001-2011 data of the National Health Insurance database. Nationally representative sample of Taiwanese adults aged 65 years and older with propensity score-matched controls. All-cause mortality and adverse health outcomes. During the study period, 45.3% of patients in the diabetes mellitus cohort and 38.8% in the non-diabetes mellitus cohort died. The adjusted relative risk for mortality in the diabetes mellitus cohort compared to the non-diabetes mellitus cohort was 1.23 (95% Confidence Interval [CI]=1.16-1.30) for males and 1.27 (95%CI=1.19-1.35) for females. During the follow-up period, 8.9% of the diabetes mellitus cohort and 5.8% of the non-diabetes mellitus cohort developed cardiovascular diseases; the diabetes mellitus cohort had an adjusted relative risk of cardiovascular complications compared to the non-diabetes mellitus cohort of 1.54 (95%CI=1.36-1.75) for men and 1.70 (95%CI=1.43-2.02) for women. The adjusted relative risk of mortality in the patients with hypoglycemia compared to non-hypoglycemia patients in the diabetes mellitus cohort was 2.33 (95%CI=1.81-3.01) for men and 2.73 (95%CI=2.10-3.52) for women after adjustment for age, Charlson comorbidity index, acute coronary syndrome, respiratory disease, cancer, infectious disease and nervous system disease at baseline. New-onset diabetes in older adults is associated with an increased risk of mortality, and hypoglycemia is an important

  1. Nutritional Status and Falls in Community-Dwelling Older People: A Longitudinal Study of a Population-Based Random Sample

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    Chien, Ming-Hung; Guo, How-Ran

    2014-01-01

    Background Falls are common in older people and may lead to functional decline, disability, and death. Many risk factors have been identified, but studies evaluating effects of nutritional status are limited. To determine whether nutritional status is a predictor of falls in older people living in the community, we analyzed data collected through the Survey of Health and Living Status of the Elderly in Taiwan (SHLSET). Methods SHLSET include a series of interview surveys conducted by the government on a random sample of people living in community dwellings in the nation. We included participants who received nutritional status assessment using the Mini Nutritional Assessment Taiwan Version 2 (MNA-T2) in the 1999 survey when they were 53 years or older and followed up on the cumulative incidence of falls in the one-year period before the interview in the 2003 survey. Results At the beginning of follow-up, the 4440 participants had a mean age of 69.5 (standard deviation  = 9.1) years, and 467 participants were “not well-nourished,” which was defined as having an MNA-T2 score of 23 or less. In the one-year study period, 659 participants reported having at least one fall. After adjusting for other risk factors, we found the associated odds ratio for falls was 1.73 (95% confidence interval, 1.23, 2.42) for “not well-nourished,” 1.57 (1.30, 1.90) for female gender, 1.03 (1.02, 1.04) for one-year older, 1.55 (1.22, 1.98) for history of falls, 1.34 (1.05, 1.72) for hospital stay during the past 12 months, 1.66 (1.07, 2.58) for difficulties in activities of daily living, and 1.53 (1.23, 1.91) for difficulties in instrumental activities of daily living. Conclusion Nutritional status is an independent predictor of falls in older people living in the community. Further studies are warranted to identify nutritional interventions that can help prevent falls in the elderly. PMID:24614184

  2. Gender-specific associations of vision and hearing impairments with adverse health outcomes in older Japanese: a population-based cohort study

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    Saito Hideyuki

    2009-11-01

    Full Text Available Abstract Background Several epidemiological studies have shown that self-reported vision and hearing impairments are associated with adverse health outcomes (AHOs in older populations; however, few studies have used objective sensory measurements or investigated the role of gender in this association. Therefore, we examined the association of vision and hearing impairments (as measured by objective methods with AHOs (dependence in activities of daily living or death, and whether this association differed by gender. Methods From 2005 to 2006, a total of 801 residents (337 men and 464 women aged 65 years or older of Kurabuchi Town, Gunma, Japan, participated in a baseline examination that included vision and hearing assessments; they were followed up through September 2008. Vision impairment was defined as a corrected visual acuity of worse than 0.5 (logMAR = 0.3 in the better eye, and hearing impairment was defined as a failure to hear a 30 dB hearing level signal at 1 kHz in the better ear. Information on outcomes was obtained from the town hall and through face-to-face home visit interviews. We calculated the risk ratios (RRs of AHOs for vision and hearing impairments according to gender. Results During a mean follow-up period of 3 years, 34 men (10.1% and 52 women (11.3% had AHOs. In both genders, vision impairment was related to an elevated risk of AHOs (multi-adjusted RR for men and women together = 1.60, 95% CI = 1.05-2.44, with no statistically significant interaction between the genders. In contrast, a significant association between hearing impairment and AHOs (multi-adjusted RR = 3.10, 95% CI = 1.43-6.72 was found only in the men. Conclusion In this older Japanese population, sensory impairments were clearly associated with AHOs, and the association appeared to vary according to gender. Gender-specific associations between sensory impairments and AHOs warrant further investigation.

  3. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

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    Aquiles Salas

    Full Text Available Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria.Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L.Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116, Puerto Rico (43.4%, 197, and urban (27.0%, 125, and rural Mexico (23.7%, 111 already exceeds that in the USA, while that in Venezuela (20.9%, 100 is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%, rural India (6.6% and Nigeria (6.0%. and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes.Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

  4. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey

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    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P.; Guerra, Mariella; Huang, Yueqin; Jacob, K. S.; Jimenez-Velazquez, Ivonne Z.; Llibre Rodriguez, Juan J.; Sosa, Ana L.; Uwakwe, Richard; Williams, Joseph D.; Jotheeswaran, A. T.; Liu, Zhaorui; Lopez Medina, A. M.; Salinas-Contreras, Rosa Maria; Prince, Martin J.

    2016-01-01

    Background Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Methods Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7mmol/L). Results Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Conclusions Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control

  5. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

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    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velazquez, Ivonne Z; Llibre Rodriguez, Juan J; Sosa, Ana L; Uwakwe, Richard; Williams, Joseph D; Jotheeswaran, A T; Liu, Zhaorui; Lopez Medina, A M; Salinas-Contreras, Rosa Maria; Prince, Martin J

    2016-01-01

    Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L). Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

  6. The effect of three different exercise training modalities on cognitive and physical function in a healthy older population.

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    Coetsee, Carla; Terblanche, Elmarie

    2017-01-01

    Older adults are encouraged to participate in regular physical activity to counter the age-related declines in physical and cognitive health. Literature on the effect of different exercise training modalities (aerobic vs resistance) on these health-related outcomes is not only sparse, but results are inconsistent. In general, it is believed that exercise has a positive effect on executive cognitive function, possibly because of the physiological adaptations through increases in fitness. Indications are that high-intensity interval training is a potent stimulus to improve cardiovascular fitness, even in older adults; however, its effect on cognitive function has not been studied before. Therefore, the purpose of this study was to compare the effects of resistance training, high-intensity aerobic interval training and moderate continuous aerobic training on the cognitive and physical functioning of healthy older adults. Sixty-seven inactive individuals (55 to 75 years) were randomly assigned to a resistance training (RT) group (n = 22), high-intensity aerobic interval training (HIIT) group (n = 13), moderate continuous aerobic training (MCT) group (n = 13) and a control (CON) group (n = 19) for a period of 16 weeks. Cognitive function was assessed with a Stroop task and physical function with the Timed-Up-and-Go (TUG) and submaximal Bruce treadmill tests. No significant GROUP x TIME interaction was found for Stroop reaction time (P > .05). The HIIT group showed the greatest practical significant improvement in reaction time on the information processing task, i.e. Stroop Neutral (ES = 1.11). MCT group participants had very large practical significant improvements in reaction time on the executive cognitive tasks, i.e. Stroop Incongruent and Interference (ES = 1.28 and 1.31, respectively). The HIIT group showed the largest practically significant increase in measures of physical function, i.e. walking endurance (ES = 0.91) and functional mobility

  7. Rural Older Americans: Unanswered Questions. Hearing Before the Special Committee on Aging. United States Senate, Ninety-Seventh Congress, Second Session.

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    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    The hearing's purpose was to begin building a record, from a national perspective, regarding older Americans who live in smaller towns and rural areas. It is not fully known what the real impact is of such matters as lack of transportation, nutritional deficiencies, distance to and shortage of health care, non-availability of adult education…

  8. Cervical screening and cervical cancer death among older women: a population-based, case-control study.

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    Rustagi, Alison S; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D; Newcomb, Polly; Weiss, Noel S

    2014-05-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55-79 years who died of cervical cancer during 1980-2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5-7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55-79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening-a more sensitive test-to reduce cervical cancer death among older women.

  9. Regional and Gender Differences in Years with and without Mobility Limitation in the Older Population of Thailand.

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    Benjawan Apinonkul

    Full Text Available To examine gender and regional differences in health expectancies based on the measure of mobility.Health expectancies by gender and region were computed by Sullivan's method from the fourth Thai National Health Examination Survey (2009. A total of 9,210 older persons aged 60 years and older were included. Mobility limitation was defined as self-reporting of ability to perform only with assistances/aids at least one of: walking at least 400 metres; or going up or down a flight of 10 stairs. Severe limitation was defined as complete inability to do at least one of these two functions, even with assistances or aids.At age 60, females compared to males, spent significantly fewer years without mobility limitation (male-female = 3.2 years and more years with any limitation (female-male = 6.7 years and with severe limitation (female-male = 3.2 years. For both genders, years lived with severe limitation were remarkably constant across age. Significant regional inequalities in years lived without and with limitation were evident, with a consistent pattern by gender in years free of mobility limitation (Central ranked the best and the North East ranked the worst. Finally, both males and females in the South had the longest life expectancy and the most years of life with severe mobility limitation.This study identifies inequalities in years without and with mobility limitations with important policy implication.

  10. Anion gap as a predictor of trauma outcomes in the older trauma population: correlations with injury severity and mortality.

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    Leskovan, John J; Justiniano, Carla F; Bach, John A; Cook, Charles H; Lindsey, David E; Eiferman, Daniel S; Papadimos, Thomas J; Steinberg, Steven M; Bergese, Sergio D; Stawicki, Stanislaw P A; Evans, David C

    2013-11-01

    The relationship among traumatic injury, the associated metabolic/physiologic responses, and mortality is well established. Tissue hypoperfusion and metabolic derangement may not universally correlate with initial clinical presentation. We hypothesized that anion gap (AG) could be a useful gauge of trauma-related physiologic response and mortality in older patients with relatively lower injury acuity. We retrospectively analyzed data from 711 trauma patients older than 45 years. Parameters examined included demographics, injury characteristics, laboratories, morbidity, and mortality. Univariate and survival analyses were performed using PASW 18. A stepwise correlation exists between increasing Injury Severity Score and AG. Although AG less than 8 to 15 was not associated with a significant increase in mortality, greater mortality was seen for AG greater than 16 with further stepwise increases for AGs greater than 22. Anion gap correlated moderately with serum lactate and poorly with base excess. Increasing AG also correlated with morbidity and greater incidence of intensive care admissions. The presence of any complication increased from 28.6 per cent for patients with AG 12 or less to 45.5 per cent for patients with AG 22 or greater (P < 0.04). These findings support the contention that "low acuity" trauma patients with high AGs may not appear acutely ill but may harbor significant underlying metabolic and physiologic disturbances that could contribute to morbidity and mortality. Higher AG values (i.e., greater than 16) may be associated with worse clinical outcomes.

  11. Extending the study of decision making competence to special populations: A case study of persons on the autism spectrum

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    Irwin eLevin

    2015-04-01

    Full Text Available The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from theory of mind to predict key components of decision making in high-functioning young adults on the autism spectrum. A battery of tests was administered to 15 high-functioning college students with autism spectrum disorder (ASD, focusing on Decision Making Competence (DMC and other aspects of decision making related to known deficits associated with autism. Data from this group were compared to data from unselected college students receiving the same measures. First, as a test of a key social deficit associated with autism, the target group scored much lower on the Empathy Quotient scale. Traditional elements of decision making competency such as Numeracy and application of decision rules were comparable across groups. However, there were differences in thinking style, with the ASD group showing lesser ability and engagement in intuitive thinking, and they showed lower levels of risk taking. For comparisons within the ASD group, autobiographical reports concerning individual lifestyles and outcomes were used to derive a scale of Social Functioning. The lowest scoring individuals showed the lowest levels of intuitive thinking, the lowest perceived levels of others' endorsement of socially undesirable behaviors, and the lowest ability to discriminate between good and bad risks. Results are discussed in terms of interventions that might aid high-functioning young adults with ASD in their everyday decision making.

  12. Rib fracture fixation in the 65 years and older population: A paradigm shift in management strategy at a Level I trauma center.

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    Fitzgerald, Michael T; Ashley, Dennis W; Abukhdeir, Hesham; Christie, D Benjamin

    2017-03-01

    Rib fractures after chest wall trauma are a common injury; however, they carry a significant morbidity and mortality risk. The impact of rib fractures in the 65-year and older patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients 65 years and older receiving rib plating (RP) have decreased mortality, complication rates, and an accelerated return to normal functional states when compared with controls. With institutional review board approval, a retrospective review analyzed patients 65 years and older with rib fractures admitted from 2009 to 2015 receiving RP (RP group) (n = 23) compared to nonoperative, injury-matched controls admitted from 2003 to 2008 (NO group) (n = 50). Patients were followed prospectively with regard to lifestyle and functional satisfaction. Independent variables analyzed included Injury Severity Score (ISS), number of rib fractures, mortalities, hospital days, intensive care unit days, pneumonia development, respiratory complications, readmission rates, need for and length of rehabilitation stay time. Comparisons were by χ tests/Fisher's exact tests, Student's t tests and Wilcoxon rank sum tests. From 2003 to 2008, 50 NO patients were admitted with ages ranging 65 to 97 years, average ISS of 18.47 (14.28-22.66) versus ages ranging from 63 to 89 years, average ISS of 20.71 (15.7-25.73) for the RP group (n = 23). Average hospital days were 16.76 (10.35-23.18) and 18.36 (13.61-23.11) in the NO and RP groups, respectively. Average intensive care unit days were 11.65 (6.45-16.85) and 8.29 (5.31-11.26) days in the NO and RP groups, respectively. Four respiratory readmissions, two deaths, seven pneumonias, seven pleural-effusions, and 19 recurrent pneumothoraces were encountered in the NO group versus 0 in the RP group (p < 0.001). An equal percentage of patients in both groups entered rehabilitation facilities with average stay time of 18.5 and 28.53 days for the RP and NO groups

  13. Different populations of vasoactive intestinal polypeptide-immunoreactive interneurons are specialized to control pyramidal cells or interneurons in the hippocampus.

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    Acsády, L; Görcs, T J; Freund, T F

    1996-07-01

    The postsynaptic targets of three vasoactive intestinal polypeptide-containing GABAergic interneuron types were examined in the rat hippocampus. Two of them showed remarkable target selectivity for other GABAergic neurons, while the third contacted the somata and proximal dendrites of pyramidal cells. Vasoactive intestinal polypeptide-positive interneurons innervating the stratum oriens/alveus border in the CA1 region were shown to establish multiple contacts with horizontal GABAergic interneurons immunoreactive for type 1 metabotropic glutamate receptor. Similarly, identified axons of vasoactive intestinal polypeptide-positive interneurons projecting to stratum radiatum were found to establish symmetrical synapses largely on GABAergic dendrites. The majority of these postsynaptic GABAergic neurons were shown to contain calbindin or vasoactive intestinal polypeptide. In contrast to the first two vasoactive intestinal polypeptide-containing cell populations, vasoactive intestinal polypeptide-positive interneurons arborizing in stratum pyramidale formed baskets around pyramidal cells. These results revealed a new element in cortical microcircuits, interneurons which are specialized to innervate other GABAergic interneurons. The role of this new component may be the synchronization of dendritic inhibition, or an input-specific disinhibition of pyramidal cells in various dendritic domains. In contrast, vasoactive intestinal polypeptide-containing basket cells are likely to be involved in perisomatic inhibition of pyramidal neurons, and represents a new basket cell type different from that containing parvalbumin.

  14. Cardiovascular risk factor profiles for peripheral artery disease and carotid atherosclerosis among Chinese older people: a population-based study.

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    Yajun Liang

    Full Text Available OBJECTIVES: Epidemiological data concerning atherosclerotic disease among older people in rural China are sparse. We seek to determine prevalence and cardiovascular risk factor profiles for peripheral artery disease (PAD and carotid atherosclerosis (CAS among Chinese older people living in a rural community. METHODS: This cross-sectional study included 1499 participants (age ≥60 years, 59.0% women of the Confucius Hometown Aging Project in Shandong, China. From June 2010-July 2011, data were collected through interviews, clinical examinations, and laboratory tests. PAD was defined as an ankle-brachial index ≤0.9. Carotid intima-media thickness (cIMT and carotid artery stenosis were assessed by ultrasonography. We defined moderate stenosis as carotid stenosis ≥50%, and severe stenosis as carotid stenosis ≥70%. cIMT≥1.81 mm was considered as an increased cIMT (a measure of CAS. Data were analyzed with multiple logistic models. RESULTS: The prevalence was 5.7% for PAD, 8.9% for moderate stenosis, 1.8% for severe stenosis, and 11.2% for increased cIMT. After controlling for multiple potential confounders, diabetes, an increased low-density lipoprotein cholesterol (LDL-C/high-density lipoprotein cholesterol (HDL-C ratio, and hypertension were significantly or marginally associated with PAD. Ever smoking, hypertension, and an increased LDL-C/HDL-C ratio were significantly associated with an increased likelihood of increased cIMT. An increasing number of those cardiovascular risk factors were significantly associated with an increasing odds ratio of PAD and increased cIMT, respectively (p for linear trend <0.001. CONCLUSION: Among Chinese older people living in a rural community, PAD, carotid artery stenosis, and an increased cIMT are relatively uncommon. Cardiovascular risk factor profiles for PAD and CAS are slightly different, with hypertension and an increased LDL-C/HDL-C ratio being associated with an increased likelihood of both PAD and

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

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    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

  16. Care needs and clinical outcomes of older people with dementia: a population-based propensity score-matched cohort study.

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    Fei-Yuan Hsiao

    Full Text Available To explore the healthcare resource utilization, psychotropic drug use and mortality of older people with dementia.A nationwide propensity score-matched cohort study.National Health Insurance Research database.A total of 32,649 elderly people with dementia and their propensity-score matched controls (n=32,649.Outpatient visits, inpatient care, psychotropic drug use, in-hospital mortality and all-cause mortality at 90 and 365 days.Compared to the non-dementia group, a higher proportion of patients with dementia used inpatient services (1 year after index date: 20.91% vs. 9.55%, and the dementia group had more outpatient visits (median [standard deviation]: 7.00 [8.87] vs. 3.00 [8.30]. Furthermore, dementia cases with acute admission had the highest psychotropic drug utilization both at baseline and at the post-index dates (difference-in-differences: all <0.001. Dementia was associated with an increased risk of all-cause mortality (90 days, Odds ratio (OR=1.85 [95%CI 1.67-2.05], p<0.001; 365 days, OR=1.59 [1.50-1.69], p<0.001 and in-hospital mortality (90 days, OR=1.97 [1.71-2.27], p<0.001; 365 days, OR=1.82 [1.61-2.05], p<0.001 compared to matched controls.When older people with dementia are admitted for acute illnesses, they may increase their use of psychotropic agents and their risk of death, particularly in-hospital mortality.

  17. Association of AKAP6 and MIR2113 with cognitive performance in a population-based sample of older adults.

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    Andrews, S J; Das, D; Anstey, K J; Easteal, S

    2017-04-01

    Genetic factors make a substantial contribution to inter-individual variability in cognitive function. A recent meta-analysis of genome-wide association studies identified two loci, AKAP6 and MIR2113, that are associated with general cognitive function. Here, we extend this previous research by investigating the association of MIR2113 and AKAP6 with baseline and longitudinal non-linear change across a broad spectrum of cognitive domains in a community-based cohort of older adults without dementia. Two single nucleotide polymorphisms (SNPs), MIR211-rs10457441 and AKAP6-rs17522122 were genotyped in 1570 non-demented older Australians of European ancestry, who were examined up to 4 times over 12 years. Linear mixed effects models were used to examine the association between AKAP6 and MIR2113 with cognitive performance in episodic memory, working memory, vocabulary, perceptual speed and reaction time at baseline and with linear and quadratic rates of change. AKAP6-rs17522122*T was associated with worse baseline performance in episodic memory, working memory, vocabulary and perceptual speed, but it was not associated with cognitive change in any domain. MIR2113-rs10457441*T was associated with accelerated decline in episodic memory. No other associations with baseline cognitive performance or with linear or quadratic rate or cognitive changes were observed for this SNP. These results confirm the previous finding that AKAP6 is associated with performance across multiple cognitive domains at baseline but not with cognitive decline, while MIR2113 primarily affects the rate at which memory declines over time.

  18. Risk of myeloid neoplasms after radiotherapy among older women with localized breast cancer: A population-based study

    Science.gov (United States)

    Long, Jessica B.; Wang, Rong; Hu, Xin; Yu, James B.; Huntington, Scott F.; Abel, Gregory A.; Mougalian, Sarah S.; Podoltsev, Nikolai A.; Gore, Steven D.; Gross, Cary P.; Ma, Xiaomei; Davidoff, Amy J.

    2017-01-01

    Background There are inconsistent and limited data regarding the risk of myeloid neoplasms (MN) among breast cancer survivors who received radiotherapy (RT) in the absence of chemotherapy. Concern about subsequent MN might influence the decision to use adjuvant RT for women with localized disease. As patients with therapy-related MN have generally poor outcomes, the presumption of subsequent MN being therapy-related could affect treatment recommendations. Methods We used the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database to study older women with in-situ or stage 1–3 breast cancer diagnosed 2001–2009 who received surgery. Chemotherapy and RT were ascertained using Medicare claims, and new MN diagnoses were captured using both SEER registry and Medicare claims. We excluded women who received chemotherapy for initial treatment, and censored at receipt of subsequent chemotherapy. Competing-risk survival analysis was used to assess the association between RT and risk of subsequent MN adjusting for relevant characteristics. Results Median follow-up for 60,426 eligible patients was 68 months (interquartile range, 46 to 92 months), with 47.6% receiving RT. In total, 316 patients (0.52%) were diagnosed with MN; the cumulative incidence per 10,000 person-years was 10.6 vs 9.0 among RT-treated vs non-RT-treated women, respectively (p = .004); the increased risk of subsequent MN persisted in the adjusted analysis (hazard ratio = 1.36, 95% confidence interval: 1.03–1.80). The results were consistent in multiple sensitivity analyses. Conclusions Our data suggest that RT is associated with a significant risk of subsequent MN among older breast cancer survivors, though the absolute risk increase is very small. These findings suggest the benefits of RT outweigh the risks of development of subsequent MN. PMID:28902882

  19. A framework for evaluating mHealth tools for Older Patients on Usability.

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    Wildenbos, G A; Peute, L W; Jaspers, M W M

    2015-01-01

    Mobile health (mHealth) apps can play a significant role in supporting older patients. The aging process is yet related to progressive degradation of sensory, physical and cognitive abilities. mHealth apps with touch screen based interfaces thus need to be adapted to the, often impaired, skills and special needs of older patients. However, existing design guidelines for mHealth apps do not address the aging barriers that older users face in working with touch screen based applications. By means of a constructed conceptual framework on cognitive, motivational, physical and visual impairments of older adults, this study revealed possible aging barriers concerning identified usability issues of an mHealth app for older patients. Insights into the aging process barriers that underlie usability issues supports developers in (re)designing mHealth apps that are better attuned to the needs of the older patient population.

  20. The MOBILIZE Boston Study: Design and methods of a prospective cohort study of novel risk factors for falls in an older population

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    Hannan Marian T

    2008-07-01

    Full Text Available Abstract Background Falls are the sixth leading cause of death in elderly people in the U.S. Despite progress in understanding risk factors for falls, many suspected risk factors have not been adequately studied. Putative risk factors for falls such as pain, reductions in cerebral blood flow, somatosensory deficits, and foot disorders are poorly understood, in part because they pose measurement challenges, particularly for large observational studies. Methods The MOBILIZE Boston Study (MBS, an NIA-funded Program Project, is a prospective cohort study of a unique set of risk factors for falls in seniors in the Boston area. Using a door-to-door population-based recruitment, we have enrolled 765 persons aged 70 and older. The baseline assessment was conducted in 2 segments: a 3-hour home interview followed within 4 weeks by a 3-hour clinic examination. Measures included pain, cerebral hemodynamics, and foot disorders as well as established fall risk factors. For the falls follow-up, participants return fall calendar postcards to the research center at the end of each month. Reports of falls are followed-up with a telephone interview to assess circumstances and consequences of each fall. A second assessment is performed 18 months following baseline. Results Of the 2382 who met all eligibility criteria at the door, 1616 (67.8% agreed to participate and were referred to the research center for further screening. The primary reason for ineligibility was inability to communicate in English. Results from the first 600 participants showed that participants are largely representative of seniors in the Boston area in terms of age, sex, race and Hispanic ethnicity. The average age of study participants was 77.9 years (s.d. 5.5 and nearly two-thirds were women. The study cohort was 78% white and 17% black. Many participants (39% reported having fallen at least once in the year before baseline. Conclusion Our results demonstrate the feasibility of conducting

  1. Onset and persistence of person-perceived participation restriction in older adults: a 3-year follow-up study in the general population

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    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

  2. Screening instruments for a population of older adults: The 10-item Kessler Psychological Distress Scale (K10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7).

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    Vasiliadis, Helen-Maria; Chudzinski, Veronica; Gontijo-Guerra, Samantha; Préville, Michel

    2015-07-30

    Screening tools that appropriately detect older adults' mental disorders are of great public health importance. The present study aimed to establish cutoff scores for the 10-item Kessler Psychological Distress (K10) and the 7-item Generalized Anxiety Disorder (GAD-7) scales when screening for depression and anxiety. We used data from participants (n = 1811) in the Enquête sur la Santé des Aînés-Service study. Depression and anxiety were measured using DSM-V and DSM-IV criteria. Receiver operating characteristic (ROC) curve analysis provided an area under the curve (AUC) of 0.767 and 0.833 for minor and for major depression when using K10. A cutoff of 19 was found to balance sensitivity (0.794) and specificity (0.664) for minor depression, whereas a cutoff of 23 was found to balance sensitivity (0.692) and specificity (0.811) for major depression. When screening for an anxiety with GAD-7, ROC analysis yielded an AUC of 0.695; a cutoff of 5 was found to balance sensitivity (0.709) and specificity (0.568). No significant differences were found between subgroups of age and gender. Both K10 and GAD-7 were able to discriminate between cases and non-cases when screening for depression and anxiety in an older adult population of primary care service users. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Hypertension prevalence, awareness, treatment and control among older people in Latin America, India and China: a 10/66 cross-sectional population-based survey.

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    Prince, Martin J; Ebrahim, Shah; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velazquez, Ivonne Z; Rodriguez, Juan L; Salas, Aquiles; Sosa, Ana L; Williams, Joseph D; Gonzalez-Viruet, Maribella; Jotheeswaran, Amuthavilli T; Liu, Zhaorui

    2012-01-01

    To estimate the prevalence, social patterning, treatment and control of hypertension among older people in the 10/66 Dementia Research Group developing country sites. Cross-sectional surveys of SBP, hypertension, and hypertension awareness, treatment and control among 17 014 people aged 65 years and over in eight urban and four rural sites in Latin America, India and China. Hypertension prevalence was higher in urban (range 52.6-79.8%) than rural sites (range 42.6-56.9%), and lower in men than women [pooled prevalence ratio 0.89, 95% confidence interval (CI) 0.85-0.93]. Educational attainment was positively associated with hypertension in rural and least-developed sites. Age-standardized morbidity ratios, compared to USA (100), were higher in urban sites in Cuba (105), Dominican Republic (109), and Venezuela (107), similar in Puerto Rico (105), urban Mexico (99) and urban India (101), and lower in urban (75) and rural (61) Peru, rural Mexico (81), urban (91) and rural (84) China and rural India (65). In most Latin American centres, and urban China just over one-third of those with hypertension were controlled (BP hypertension is common among older people in developing countries, and may rise further during the demographic and health transitions. It is a major determinant of population SBP level. Strengthening primary care to improve hypertension management is necessary for primary prevention.

  4. Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

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    Määttä Mikko

    2012-09-01

    Full Text Available Abstract Background Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period. Methods The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years. Seventy-three percent (n = 1222 participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures. Results During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p  Conclusions Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.

  5. Application of antihistamines in special populations%抗组胺药在特殊人群中的应用

    Institute of Scientific and Technical Information of China (English)

    温禾; 姚煦

    2016-01-01

    抗组胺药物是皮肤科治疗过敏性疾病最常见的药物之一,在大部分人群中有着较好的疗效及耐受性.由于其适用范围广泛,安全性显得尤为重要.对于儿童、孕妇、哺乳期妇女、老年人以及肝、肾功能不全的过敏性疾病患者,应用抗组胺药时应充分考虑每一种药物的药效学、代谢特点以及药物之间的相互作用,权衡用药收益和可能带来的不良反应,选择相应的安全性高的抗组胺药物,或者通过减少常规用药剂量、延长用药间隔时间等方法使安全性达到最大.%Antihistamines,a group of drugs most commonly used for the treatment of allergic diseases in dermatology,exert favorable efficacy and are well tolerated in most people.Due to their wide application,the safety of medication is particularly important.When they are used in some special populations with allergic diseases,such as children,pregnant and lactating women,the elderly and people with hepatic or renal insufficiency,their pharmacodynamics,metabolic characteristics and interactions with other drugs should be fully considered,and profits of medication and potential adverse effects should be well weighed before choosing relatively safe antihistamines.In addition,decreasing the routine dose or prolonging intervals between the administration of antihistamines may also be attempted to achieve maximum safety.

  6. Population Aging at Cross-Roads: Diverging Secular Trends in Average Cognitive Functioning and Physical Health in the Older Population of Germany.

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    Steiber, Nadia

    2015-01-01

    This paper uses individual-level data from the German Socio-Economic Panel to model trends in population health in terms of cognition, physical fitness, and mental health between 2006 and 2012. The focus is on the population aged 50-90. We use a repeated population-based cross-sectional design. As outcome measures, we use SF-12 measures of physical and mental health and the Symbol-Digit Test (SDT) that captures cognitive processing speed. In line with previous research we find a highly significant Flynn effect on cognition; i.e., SDT scores are higher among those who were tested more recently (at the same age). This result holds for men and women, all age groups, and across all levels of education. While we observe a secular improvement in terms of cognitive functioning, at the same time, average physical and mental health has declined. The decline in average physical health is shown to be stronger for men than for women and found to be strongest for low-educated, young-old men aged 50-64: the decline over the 6-year interval in average physical health is estimated to amount to about 0.37 SD, whereas average fluid cognition improved by about 0.29 SD. This pattern of results at the population-level (trends in average population health) stands in interesting contrast to the positive association of physical health and cognitive functioning at the individual-level. The findings underscore the multi-dimensionality of health and the aging process.

  7. Population Aging at Cross-Roads: Diverging Secular Trends in Average Cognitive Functioning and Physical Health in the Older Population of Germany.

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    Nadia Steiber

    Full Text Available This paper uses individual-level data from the German Socio-Economic Panel to model trends in population health in terms of cognition, physical fitness, and mental health between 2006 and 2012. The focus is on the population aged 50-90. We use a repeated population-based cross-sectional design. As outcome measures, we use SF-12 measures of physical and mental health and the Symbol-Digit Test (SDT that captures cognitive processing speed. In line with previous research we find a highly significant Flynn effect on cognition; i.e., SDT scores are higher among those who were tested more recently (at the same age. This result holds for men and women, all age groups, and across all levels of education. While we observe a secular improvement in terms of cognitive functioning, at the same time, average physical and mental health has declined. The decline in average physical health is shown to be stronger for men than for women and found to be strongest for low-educated, young-old men aged 50-64: the decline over the 6-year interval in average physical health is estimated to amount to about 0.37 SD, whereas average fluid cognition improved by about 0.29 SD. This pattern of results at the population-level (trends in average population health stands in interesting contrast to the positive association of physical health and cognitive functioning at the individual-level. The findings underscore the multi-dimensionality of health and the aging process.

  8. Obesity, fat distribution, and risk of frailty in two population-based cohorts of older adults in Spain

    OpenAIRE

    García-Esquinas, Esther; José García-García, Francisco; León-Muñoz, Luz M; Carnicero, José Antonio; Guallar-Castillón, Pilar; Gonzaáez-Colaço Harmand, Magali; López-García, Esther; Alonso-Bouzón, Cristina; Rodríguez-Mañas, Leocadio; Rodríguez-Artalejo, Fernando

    2015-01-01

    OBJECTIVE: To evaluate for the first time the longitudinal relationship between abdominal obesity and the onset of frailty. METHODS: Study based on results from two population-based cohorts, the Seniors-ENRICA, with 1801 individuals aged ≥60, and the Toledo Study for Healthy Ageing (TSHA), with 1289 participants ≥65 years. Incident frailty was assessed with the Fried criteria. RESULTS: During 3.5 years of follow-up, 125 individuals with incident frailty in Seniors-ENRICA and 16...

  9. Improving accuracy of medication identification in an older population using a medication bottle color symbol label system

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    Cardarelli Roberto

    2011-12-01

    Full Text Available Abstract Background The purpose of this pilot study was to evaluate and refine an adjuvant system of color-specific symbols that are added to medication bottles and to assess whether this system would increase the ability of patients 65 years of age or older in matching their medication to the indication for which it was prescribed. Methods This study was conducted in two phases, consisting of three focus groups of patients from a family medicine clinic (n = 25 and a pre-post medication identification test in a second group of patient participants (n = 100. Results of focus group discussions were used to refine the medication label symbols according to themes and messages identified through qualitative triangulation mechanisms and data analysis techniques. A pre-post medication identification test was conducted in the second phase of the study to assess differences between standard labeling alone and the addition of the refined color-specific symbols. The pre-post test examined the impact of the added labels on participants' ability to accurately match their medication to the indication for which it was prescribed when placed in front of participants and then at a distance of two feet. Results Participants appreciated the addition of a visual aid on existing medication labels because it would not be necessary to learn a completely new system of labeling, and generally found the colors and symbols used in the proposed labeling system easy to understand and relevant. Concerns were raised about space constraints on medication bottles, having too much information on the bottle, and having to remember what the colors meant. Symbols and colors were modified if they were found unclear or inappropriate by focus group participants. Pre-post medication identification test results in a second set of participants demonstrated that the addition of the symbol label significantly improved the ability of participants to match their medication to the appropriate

  10. Subjective and objective cognitive function among older adults with a history of traumatic brain injury: A population-based cohort study

    Science.gov (United States)

    Langa, Kenneth M.; Yaffe, Kristine

    2017-01-01

    Background Traumatic brain injury (TBI) is extremely common across the lifespan and is an established risk factor for dementia. The cognitive profile of the large and growing population of older adults with prior TBI who do not have a diagnosis of dementia, however, has not been well described. Our aim was to describe the cognitive profile associated with prior TBI exposure among community-dwelling older adults without dementia—an understudied but potentially vulnerable population. Methods and findings In this population-based cohort study, we studied 984 community-dwelling older adults (age 51 y and older and their spouses) without dementia who had been randomly selected from respondents to the 2014 wave of the Health and Retirement Study to participate in a comprehensive TBI survey and who either reported no prior TBI (n = 737) or prior symptomatic TBI resulting in treatment in a hospital (n = 247). Mean time since first TBI was 38 ± 19 y. Outcomes assessed included measures of global cognitive function, verbal episodic memory, semantic fluency, and calculation as well as a measure of subjective memory (“How would you rate your memory at the present time?”). We compared outcomes between the two TBI groups using regression models adjusting for demographics, medical comorbidities, and depression. Sensitivity analyses were performed stratified by TBI severity (no TBI, TBI without loss of consciousness [LOC], and TBI with LOC). Respondents with TBI were younger (mean age 64 ± 10 y versus 68 ± 11 y), were less likely to be female, and had higher prevalence of medical comorbidities and depression than respondents without TBI. Respondents with TBI did not perform significantly differently from respondents without TBI on any measure of objective cognitive function in either raw or adjusted models (fully adjusted: global cognitive function score 15.4 versus 15.2, p = 0.68; verbal episodic memory score 4.4 versus 4.3, p = 0.79; semantic fluency score 15.7 versus

  11. Markers of low-grade inflammation and endothelial dysfunction are related to reduced information processing speed and executive functioning in an older population - the Hoorn Study.

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    Heringa, S M; van den Berg, E; Reijmer, Y D; Nijpels, G; Stehouwer, C D A; Schalkwijk, C G; Teerlink, T; Scheffer, P G; van den Hurk, K; Kappelle, L J; Dekker, J M; Biessels, G J

    2014-02-01

    Low-grade inflammation and endothelial dysfunction are related to cognitive decline and dementia, in a complex interplay with vascular factors and aging. We investigated, in an older population, low-grade inflammation and endothelial dysfunction in relation to detailed assessment of cognitive functioning. Furthermore, we explored this association within the context of vascular factors. 377 participants (73 ± 6 years) of the population-based Hoorn Study were included. In plasma samples of 2000-2001 (n=363) and/or 2005-2008 (n=323), biomarkers were determined of low-grade inflammation (CRP, TNF-alpha, IL-6, IL-8, SAA, MPO, and sICAM-1) and endothelial dysfunction (vWF, sICAM-1, sVCAM-1, sTM, sE-selectin). In 2005-2008, all participants underwent neuropsychological examination. Composite z-scores were computed for low-grade inflammation and endothelial dysfunction at both time points, and for six domains of cognitive functioning (abstract reasoning, memory, information processing speed, attention and executive functioning, visuoconstruction, and language). The association between low-grade inflammation and endothelial dysfunction, and cognitive functioning was evaluated with linear regression analysis. In secondary analyses, we explored the relation with vascular risk factors and cardiovascular disease. Low-grade inflammation and endothelial dysfunction were associated with worse performance on information processing speed and attention and executive functioning, in prospective and cross-sectional analyses (standardized betas ranging from -0.20 to -0.10). No significant relation with other cognitive domains was observed. Adjusting for vascular factors slightly attenuated the associations. Low-grade inflammation and endothelial dysfunction accounted for only 2.6% explained variance in cognitive functioning, on top of related vascular risk factors and cardiovascular disease. Bootstrapping analyses show that low-grade inflammation and endothelial dysfunction mediate the

  12. Association of alcohol consumption with incident hypertension among middle-aged and older Japanese population: the Ibarakai Prefectural Health Study (IPHS).

    Science.gov (United States)

    Okubo, Yoshiro; Sairenchi, Toshimi; Irie, Fujiko; Yamagishi, Kazumasa; Iso, Hiroyasu; Watanabe, Hiroshi; Muto, Takashi; Tanaka, Kiyoji; Ota, Hitoshi

    2014-01-01

    The objective of this study was to examine the effect of age on the relationship between alcohol consumption and incident hypertension in a general Japanese population. A cohort of Japanese men (n=37 310) and women (n=78 426) aged 40 to 79 years who underwent community-based health checkups from 1993 to 2004 and were free of hypertension were followed up with annual examinations, including the measurement of blood pressure, until the end of 2010. Incident hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or the initiation of treatment for hypertension. Hazard ratios for incident hypertension according to alcohol consumption were estimated using a Cox proportional hazards model adjusted for possible confounding variables. A total of 45 428 participants (39.3%) developed hypertension (16 155 men and 29 273 women) for a mean follow-up time of 3.9 (1-18) years. Significant associations between alcohol consumption and incident hypertension were found in both sexes and age groups (P for trend was hypertension was found in either sex (P for interaction, >0.05). Our results suggest that alcohol consumption is a similar risk factor for incident hypertension in both the middle-aged and the older populations.

  13. Healthcare system and the wealth-health gradient: a comparative study of older populations in six countries.

    Science.gov (United States)

    Maskileyson, Dina

    2014-10-01

    The present study provides a comparative analysis of the association between wealth and health in six healthcare systems (Sweden, the United Kingdom, Germany, the Czech Republic, Israel, the United States). National samples of individuals fifty years and over reveal considerable cross-country variations in health outcomes. In all six countries wealth and health are positively associated. The findings also show that state-based healthcare systems produce better population health outcomes than private-based healthcare systems. The results indicate that in five out of the six countries studied, the wealth-health gradients were remarkably similar, despite significant variations in healthcare system type. Only in the United States was the association between wealth and health substantially different from, and much greater than that in the other five countries. The findings suggest that private-based healthcare system in the U.S. is likely to promote stronger positive associations between wealth and health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Prevalence of DSM-5 Mild Neurocognitive Disorder in Dementia-Free Older Adults: Results of the Population-Based LIFE-Adult-Study.

    Science.gov (United States)

    Luck, Tobias; Then, Francisca S; Schroeter, Matthias L; Witte, Veronica; Engel, Christoph; Loeffler, Markus; Thiery, Joachim; Villringer, Arno; Riedel-Heller, Steffi G

    2017-04-01

    The DSM-5 introduces mild neurocognitive disorder (miNCD) as a syndrome that recognizes the potential clinical importance of acquired cognitive deficits being too mild to qualify for diagnosis of dementia. We provide new empirical data on miNCD including total, age-, and sex-specific prevalence rates; number and types of neurocognitive domains being impaired; and diagnostic overlap with the well-established mild cognitive impairment (MCI) concept. Cross-sectional results of an observational cohort study (LIFE-Adult-Study). General population. A total of 1,080 dementia-free individuals, aged 60-79 years. We calculated weighted point prevalence rates with confidence intervals (95% CI) for miNCD and analyzed diagnostic overlap between miNCD and MCI by calculating overall percentage agreement and Cohen's kappa coefficient. Weighted total prevalence of miNCD was 20.3% (95% CI: 17.8-23.0). Prevalence was similar in both sexes, but significantly higher in older age. Two-thirds (66.2%) of the individuals with miNCD showed impairment restricted to only one out of six possible neurocognitive domains. Learning and memory was the most frequently (38.3%) impaired domain in all miNCD-cases, followed by social cognition (26.1%). Analysis of diagnostic overlap with MCI yielded an overall agreement of 98.6% and a kappa of 0.959. By considering all six predefined neurocognitive domains, our study observed a substantial proportion of dementia-free older adults having miNCD. Provision of information on the underlying etiology/ies may be of prime importance in future studies aiming at evaluating the clinical relevance of the miNCD syndrome. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Genetic structure of Chinese indigenous goats and the special geographical structure in the Southwest China as a geographic barrier driving the fragmentation of a large population.

    Directory of Open Access Journals (Sweden)

    Caihong Wei

    Full Text Available BACKGROUND: China has numerous native domestic goat breeds, however, extensive studies are focused on the genetic diversity within the fewer breeds and limited regions, the population demographic history and origin of Chinese goats are still unclear. The roles of geographical structure have not been analyzed in Chinese goat domestic process. In this study, the genetic relationships of Chinese indigenous goat populations were evaluated using 30 microsatellite markers. METHODOLOGY/PRINCIPAL FINDINGS: Forty Chinese indigenous populations containing 2078 goats were sampled from different geographic regions of China. Moderate genetic diversity at the population level (H(S of 0.644 and high population diversity at the species level (H(T value of 0.737 were estimated. Significant moderate population differentiation was detected (F(ST value of 0.129. Significant excess homozygosity (F(IS of 0.105 and recent population bottlenecks were detected in thirty-six populations. Neighbour-joining tree, principal components analysis and Bayesian clusters all revealed that Chinese goat populations could be subdivided into at least four genetic clusters: Southwest China, South China, Northwest China and East China. It was observed that the genetic diversity of Northern China goats was highest among these clusters. The results here suggested that the goat populations in Southwest China might be the earliest domestic goats in China. CONCLUSIONS/SIGNIFICANCE: Our results suggested that the current genetic structure of Chinese goats were resulted from the special geographical structure, especially in the Western China, and the Western goat populations had been separated by the geographic structure (Hengduan Mountains and Qinling Mountains-Huaihe River Line into two clusters: the Southwest and Northwest. It also indicated that the current genetic structure was caused by the geographical origin mainly, in close accordance with the human's migration history throughout

  16. Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults.

    Science.gov (United States)

    Eramudugolla, Ranmalee; Mortby, Moyra E; Sachdev, Perminder; Meslin, Chantal; Kumar, Rajeev; Anstey, Kaarin J

    2017-03-04

    There is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI. A population-based sample of 1644 adults aged 72-78 years was assessed. Algorithmic diagnostic criteria used detailed neuropsychological data, medical history, longitudinal cognitive performance, and informant interview. Those meeting all criteria for at least one diagnosis had data reviewed by a neurologist (expert diagnosis) who achieved consensus with a psychiatrist for complex cases. The algorithm accurately classified DSM-5 major NCD (area under the curve (AUC) = 0.95, 95% confidence interval (CI) 0.92-0.97), DSM-IV dementia (AUC = 0.91, 95% CI 0.85-0.97), DSM-5 mild NCD (AUC = 0.75, 95% CI 0.70-0.80), and MCI (AUC = 0.76, 95% CI 0.72-0.81) when compared to expert diagnosis. Expert diagnosis of dementia using DSM-5 criteria overlapped with 90% of DSM-IV dementia cases, but resulted in a 127% increase in diagnosis relative to DSM-IV. Additional cases had less severe memory, language impairment, and instrumental activities of daily living (IADL) impairments compared to cases meeting DSM-IV criteria for dementia. DSM-5 mild NCD overlapped with 83% of MCI cases and resulted in a 19% increase in diagnosis. These additional cases had a subtly different neurocognitive profile to MCI cases, including poorer social cognition. DSM-5 NCD criteria can be operationalized in a psychometric algorithm in a population setting. Expert diagnosis using DSM-5 NCD criteria captured most cases with DSM-IV dementia and MCI in our sample, but included many additional cases suggesting that DSM-5

  17. 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…

  18. Clinical instructors' knowledge and perceptions about nursing care of older people: a pilot study.

    Science.gov (United States)

    Baumbusch, Jennifer; Dahlke, Sherry; Phinney, Alison

    2014-08-01

    With an aging population, the majority of nurses will spend their careers working with older people. Currently, there is scant research about clinical instructors' knowledge and perceptions about nursing care of older people despite their instrumental role in preparing nurses for practice. The purpose of this study was to explore clinical instructors' knowledge and perceptions about nursing care of older people. A mixed methods approach was used. Fifteen clinical instructors and 15 nurse educators employed on specialized units for older people completed questionnaires. Independent t-tests were administered. Five of the clinical instructors also participated in semi-structured interviews, which were analyzed using thematic analysis. Findings indicated that clinical instructors had significantly lower scores on knowledge and perceptions about nursing care of older people than practice-based nurse educators. Further, clinical instructors found it difficult to integrate specialized knowledge about nursing care of older people along with other aspects of their teaching. They also reported that it was challenging to support learning about best practices for older people within the current clinical context, which was complex and fast-paced. This study reinforces the need for professional development opportunities for clinical instructors to support their instrumental role in preparing students for practice with older people.

  19. Approaches in methodology for population-based longitudinal study on neuroprotective model for healthy longevity (TUA) among Malaysian Older Adults.

    Science.gov (United States)

    Shahar, Suzana; Omar, Azahadi; Vanoh, Divya; Hamid, Tengku Aizan; Mukari, Siti Zamratol Mai-Sarah; Din, Normah Che; Rajab, Nor Fadilah; Mohammed, Zainora; Ibrahim, Rahimah; Loo, Won Hui; Meramat, Asheila; Kamaruddin, Mohd Zul Amin; Bagat, Mohamad Fazdillah; Razali, Rosdinom

    2016-12-01

    A number of longitudinal studies on aging have been designed to determine the predictors of healthy longevity, including the neuroprotective factors, however, relatively few studies included a wide range of factors and highlighted the challenges faced during data collection. Thus, the longitudinal study on neuroprotective model for healthy longevity (LRGS TUA) has been designed to prospectively investigate the magnitude of cognitive decline and its risk factors through a comprehensive multidimensional assessment comprising of biophysical health, auditory and visual function, nutrition and dietary pattern and psychosocial aspects. At baseline, subjects were interviewed for their status on sociodemographic, health, neuropsychological test, psychosocial and dietary intake. Subjects were also measured for anthropometric and physical function and fitness. Biospecimens including blood, buccal swap, hair and toenail were collected, processed and stored. A subsample was assessed for sensory function, i.e., vision and auditory. During follow-up, at 18 and 36 months, most of the measurements, along with morbidity and mortality outcomes will be collected. The description of mild cognitive impairment, successful aging and usual aging process is presented here. A total 2322 respondents were recruited in the data analysis at baseline. Most of the respondents were categorized as experiencing usual aging (73 %), followed by successful aging (11 %) and mild cognitive impairment (16 %). The LRGS TUA study is the most comprehensive longitudinal study on aging in Malaysia, and will contribute to the understanding of the aging process and factors associated with healthy aging and mental well-being of a multiethnic population in Malaysia.

  20. Urodynamics in a community-dwelling population of females 80 years or older: which motive? Which diagnosis?

    Directory of Open Access Journals (Sweden)

    Françoise A. Valentini

    2010-04-01

    Full Text Available PURPOSE: To determine why community-dwelling women aged 80 years or over were referred for urodynamic evaluation despite their advanced age and which urodynamic diagnosis was made. MATERIALS AND METHODS: One hundred consecutive females (80-93 years were referred to our urodynamics outpatient clinic for evaluation of lower urinary tract symptoms (LUTS between 2005 and 2008. Clinical evaluation comprised of a previous history of LUTS, previous medical history of neurological disease or dementia, pelvic floor dysfunction or prior pelvic surgery. Exclusion criteria were complete retention and severe dementia involving failure to understand simple instructions. Assessed items were results of uroflows (free flow and intubated flow, cystometry and urethral pressure profilometry, and final urodynamic diagnosis. RESULTS: The main complaint evoked by the patients was incontinence (65.0% of which 61.5% was "complicated" and urgency was reported by 70.0%. Interpretable free flow at arrival was very low (44.0%. Prevalence of detrusor overactivity was high, found in 45 patients of whom 16 had detrusor hyperactivity with impaired detrusor contractility. Detrusor overactivity and urgency were strongly associated (p = 0.004. Twenty-five patients had intrinsic sphincteric deficiency alone and 15 detrusor underactivity. CONCLUSION: In this particular community-dwelling with an elderly female population, urodynamics is easily feasible. Incontinence, mainly "complicated" is the more frequent complaint and urgency the more frequent symptom. Urodynamic diagnosis underlines the high incidence of detrusor overactivity as well as impaired detrusor function.

  1. [Arterial hypertension as a medical and social problem in the older urban population. The CINDI WHO Program study].

    Science.gov (United States)

    Kaczmarczyk-Chałas, Krystyna; Kwaśniewska, Magdalena; Pikala, Małgorzata; Drygas, Wojciech

    2008-01-01

    Increasing lifespan and progressive aging of the Polish population results in rising demands on health care. Chronic diseases with a leading position of arterial hypertension (HA) prevail in morbidity rates of adult seniors. The aim of the study is to characterize hypertension in the elderly with regard to other risk factors, complications and therapeutic control. The study was carried out in 2002 within the framework of the CINDI WHO Programme. A total of 1460 persons were randomly selected among residents of Lodz aged > or = 65 years. The response rate was 57%. All participants underwent questionnaire interview, two blood pressure (BP) measurements, anthropometric and physical examination, ECG and laboratory tests. After final verification, we analysed data collected from 828 persons (289 men and 539 women). Mean values of systolic and diastolic BP were 147.6 and 83.6 mmHg, respectively. The increase of systolic BP with age of studied seniors was observed. Hypertension was diagnosed in 669 persons (79% men, 82% women). In most cases there were systolic-diastolic or isolated systolic hypertension. About 60% of seniors with elevated BP declared suffering from HA, while 73% were under antihypertensive treatment. Normalization of BP (obesity, visceral obesity and metabolic syndrome was higher in hypertensive seniors. As a result, incidents of myocardial infarction and morbidity due to coronary artery disease were twice as cantly more often hospitalised and visited family doctors (7 vs 4.6 visits/year) in comparison to normotensive subjects.

  2. A survey of attitudes and factors associated with successful cardiopulmonary resuscitation (CPR knowledge transfer in an older population most likely to witness cardiac arrest: design and methodology

    Directory of Open Access Journals (Sweden)

    Brehaut Jamie C

    2008-11-01

    Full Text Available Abstract Background Overall survival rates for out-of-hospital cardiac arrest rarely exceed 5%. While bystander cardiopulmonary resuscitation (CPR can increase survival for cardiac arrest victims by up to four times, bystander CPR rates remain low in Canada (15%. Most cardiac arrest victims are men in their sixties, they usually collapse in their own home (85% and the event is witnessed 50% of the time. These statistics would appear to support a strategy of targeted CPR training for an older population that is most likely to witness a cardiac arrest event. However, interest in CPR training appears to decrease with advancing age. Behaviour surrounding CPR training and performance has never been studied using well validated behavioural theories. Methods/Design The overall goal of this study is to conduct a survey to better understand the behavioural factors influencing CPR training and performance in men and women 55 years of age and older. The study will proceed in three phases. In phase one, semi-structured qualitative interviews will be conducted and recorded to identify common categories and themes regarding seeking CPR training and providing CPR to a cardiac arrest victim. The themes identified in the first phase will be used in phase two to develop, pilot-test, and refine a survey instrument based upon the Theory of Planned Behaviour. In the third phase of the project, the final survey will be administered to a sample of the study population over the telephone. Analyses will include measures of sampling bias, reliability of the measures, construct validity, as well as multiple regression analyses to identify constructs and beliefs most salient to seniors' decisions about whether to attend CPR classes or perform CPR on a cardiac arrest victim. Discussion The results of this survey will provide valuable insight into factors influencing the interest in CPR training and performance among a targeted group of individuals most susceptible to

  3. Is cancer a good way to die? A population-based survey among middle-aged and older adults in the United Kingdom.

    Science.gov (United States)

    Vrinten, Charlotte; Wardle, Jane

    2016-03-01

    Despite improved outcomes, cancer remains widely feared, often because of its association with a long and protracted death as opposed to the quick death that people associate with that other common cause of adult mortality: heart disease. Former editor-in-chief of the BMJ Richard Smith's view that 'cancer is the best way to die' therefore attracted much criticism. We examined middle-aged and older adults' agreement with this view and compared their attitudes towards dying from cancer versus heart disease in terms of which was a good death. This study was part of an online survey (February 2015) in a United Kingdom (UK) population sample of 50- to 70-year olds (n = 391), with sampling quotas for gender and education. Five characteristics of 'a good death' were selected from the end-of-life literature. Respondents were asked to rate the importance of each characteristic for their own death to ensure their relevance to a population sample and the likelihood of each for death from cancer and heart disease. We also asked whether they agreed with Smith's view. At least 95% of respondents considered the selected five characteristics important for their own death. Death from cancer was rated as more likely to provide control over what happens (p  0.05). Almost half (40%) agreed that cancer is 'the best way to die', with no differences by age (p = 0.40), gender (p = 0.85), or education (p = 0.27). Despite the media commotion, a surprisingly high proportion of middle-aged and older adults viewed cancer as 'the best way to die' and rated cancer death as better than heart disease. Given that one in two of us are likely to be diagnosed with cancer, conversations about a good death from cancer may in a small way mitigate fear of cancer. Future research could explore variations by type of cancer or heart disease and by previous experience of these illnesses in others. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Obesity, fat distribution, and risk of frailty in two population-based cohorts of older adults in Spain.

    Science.gov (United States)

    García-Esquinas, Esther; José García-García, Francisco; León-Muñoz, Luz M; Carnicero, José Antonio; Guallar-Castillón, Pilar; Gonzalez-Colaço Harmand, Magali; López-García, Esther; Alonso-Bouzón, Cristina; Rodríguez-Mañas, Leocadio; Rodríguez-Artalejo, Fernando

    2015-04-01

    To evaluate for the first time the longitudinal relationship between abdominal obesity and the onset of frailty. Study based on results from two population-based cohorts, the Seniors-ENRICA, with 1801 individuals aged ≥60, and the Toledo Study for Healthy Ageing (TSHA), with 1289 participants ≥65 years. Incident frailty was assessed with the Fried criteria. During 3.5 years of follow-up, 125 individuals with incident frailty in Seniors-ENRICA and 162 in TSHA were identified. After adjustment for the main confounders, the pooled odds ratio (pooled OR) for general obesity and risk of frailty was 1.73 (95% confidence interval [CI]: 1.18-2.28). Abdominal obesity was also associated with frailty (pooled OR: 1.67; 95% CI: 1.09-2.25). Compared with individuals with BMI obesity, the risk of frailty was highest among individuals with concurrent general and abdominal obesity (pooled OR: 2.55; 95% CI: 1.23-3.86). General obesity was associated with increased risk of exhaustion (pooled OR: 1.66; 95% CI: 1.11-2.21), low physical activity (pooled OR: 1.57; 95% CI: 1.08-2.05), and weakness (pooled OR: 1.63; 95% CI: 1.12-2.05). For abdominal obesity, results were in the same direction, although they showed statistical significance only for weakness (OR: 1.46; 95% CI: 1.11-1.80). General and abdominal obesity are associated with incident frailty in the elderly. © 2015 The Obesity Society.

  5. Does life course socio-economic position influence chronic disabling pain in older adults? A general population study.

    Science.gov (United States)

    Lacey, Rosie J; Belcher, John; Croft, Peter R

    2013-08-01

    Chronic pain is the leading cause of disability in developed countries. Prevalence is linked with socio-economic position (SEP), but little is known about the influence of SEP on disabling pain over the life course. We have investigated the influence of different life course trajectories of SEP on disabling pain ('pain interference') in postal surveys of adults aged ≥50 years sampled from the general population of adults registered with three UK general practices. Current pain interference was measured using the dichotomized 36-item Short-Form (SF-36) health survey. Three recalled SEP measures (age left school, longest job and current/most recent job) were dichotomized into low SEP (left school at or before minimum school leaving age; reported routine or manual occupations) and high SEP, from which eight life course SEP trajectories were constructed. Associations of (i) eight SEP trajectories and (ii) three individual SEP measures adjusted for each other, with pain interference, adjusted for potential confounders, were calculated using logistic regression. A total of 2533 individuals provided data on all three SEP measures. A consistently low life course SEP trajectory was significantly associated with current pain interference compared with a high trajectory [odds ratio (OR) = 2.76, 95% confidence interval (CI): 2.19-3.47], even after adjustment for age and gender. Further adjustment reduced the association but it remained significant (OR = 2.04; 95% CI: 1.55-2.68). In the model with individual measures, low age left school (OR = 1.45; 95% CI: 1.15-1.82) and manual longest job (OR = 1.47; 95% CI: 1.13-1.91) were independently associated with pain interference. Our results highlight the potential for reducing chronic disabling pain in later life by addressing inequalities in both childhood education and adult occupational opportunities.

  6. Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort.

    Science.gov (United States)

    Gfroerer, Joseph; Penne, Michael; Pemberton, Michael; Folsom, Ralph

    2003-03-01

    There is concern that as the baby boom population ages in the US, there will be a substantial increase in the number of older adults needing treatment for substance abuse problems. To address this concern, projections of future treatment need for older adults (defined as age 50 and older) were made. Using data from the National Household Survey on Drug Abuse, regression models including predictors of treatment need in 2000 and 2001 were developed. Treatment need was defined as having a DSM-IV alcohol or illicit drug use disorder in the past year. Regression parameters from these models were applied to the projected 2020 population to obtain estimates of the number of older adults needing treatment in 2020. The number of older adults in need of substance abuse treatment is estimated to increase from 1.7 million in 2000 and 2001 to 4.4 million in 2020. This is due to a 50 percent increase in the number of older adults and a 70 percent increase in the rate of treatment need among older adults. The aging baby boom cohort will place increasing demands on the substance abuse treatment system in the next two decades, requiring a shift in focus to address the special needs of an older population of substance abusers. There is also a need to develop improved tools for measuring substance use and abuse among older adults. Copyright 2002 Elsevier Science Ireland Ltd.

  7. Ambient UVB Dose and Sun Enjoyment Are Important Predictors of Vitamin D Status in an Older Population.

    Science.gov (United States)

    O'Sullivan, Fiona; Laird, Eamon; Kelly, Dervla; van Geffen, Jos; van Weele, Michiel; McNulty, Helene; Hoey, Leane; Healy, Martin; McCarroll, Kevin; Cunningham, Conal; Casey, Miriam; Ward, Mary; Strain, J J; Molloy, Anne M; Zgaga, Lina

    2017-05-01

    Background: UVB-induced skin synthesis is considered the key source of vitamin D, yet exposure to UVB is poorly accounted for in epidemiological studies.Objectives: The aim of this study was to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentration with accurately measured ambient UVB dose, sun enjoyment, supplements, and other factors.Methods: An all-Irish cohort of community-dwelling participants aged >60 y [median age: 73; 67% female; median 25(OH)D: 54.5 nmol/L] was used. Participants from this large, cross-sectional study completed a questionnaire to provide information on demographic factors and lifestyle (including supplement use and sun enjoyment). The Tropospheric Emission Monitoring Internet Service database was used to extract the daily ambient UVB dose at wavelengths that could induce vitamin D synthesis (D-UVB) over Ireland (latitude: 51°N-55°N). Blood sampling occurred throughout the year. Ambient exposure at the place of residence was calculated for each participant individually. Associations between determinants and serum 25(OH)D concentration were examined in a multivariate model. Random forest analysis was used to establish prediction models of vitamin D deficiency, and area under the curve (AUC) is shown.Results: In total, 5138 individuals were included. Median D-UVB was 63 mJ/cm(2), which varied between seasons and latitudes, despite the small latitude differential. Vitamin D supplementation (β = 27.7; P D-UVB (β = 1.58 per 1000 mJ/cm(2); P D. Those who avoided sunshine were largely at risk of deficiency (D sufficient (≥50 nmol/L). D-UVB and sun enjoyment improved prediction of deficiency in non-supplement-taking individuals; the overall AUC improved by 3.5%.Conclusion: D-UVB and sun enjoyment are important predictors of vitamin D status, even in this elderly population at northern latitudes. Accurate estimation of ambient UVB can help to further clarify the role of other determinants of vitamin D status and inform

  8. Gender differences in the utilization of health-care services among the older adult population of Spain

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    Banegas José

    2006-06-01

    Full Text Available Abstract Background Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly. Methods Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposing factors (age and head-of-family status, need factors (lifestyles, chronic diseases, functional status, cognitive deficit and health-related quality of life (HRQL and enabling factors (educational level, marital status, head-of-family employment status and social network. Relative differences in the use of each service between women and men were summarized using odds ratios (OR, obtained from logistic regression. The contribution of the variables of interest to the gender differences in the use of such services was evaluated by comparing the OR before and after adjustment for such variables. Results As compared to men, a higher percentage of women visited a medical practitioner (OR: 1.24; 95% confidence limits (CL: 1.07–1.44, received home medical visits (OR: 1.67; 95% CL: 1.34–2.10 and took ≥3 medications (OR: 1.54; 95% CL: 1.34–1.79, but there were no gender differences in hospital admission or influenza vaccination. Adjustment for need or enabling factors led to a reduction in the OR of women compared to men for utilization of a number of services studied. On adjusting for the number of chronic diseases, the OR (95% CL of women versus men for ingestion of ≥3 medications was 1.24 (1.06–1.45. After adjustment for HRQL, the OR was 1.03 (0.89–1.21 for visits to medical practitioners, 1.24 (0.98–1.58 for home medical visits, 0.71 (0.58–0.87 for hospitalization, and 1.14 (0.97–1.33 for intake of ≥3 medications. After adjustment for the

  9. [THE DEVELOPMENT OF MEDICAL CARE OF POPULATION IN CONDITIONS OF SPECIALIZED DAY-TIME HOSPITALS OF NEUROLOGICAL PROFILE].

    Science.gov (United States)

    Grishina, N K; Solovieva, N B; Abdulsalamova, Z A

    2015-01-01

    The article considers issues concerning increasing of quality and accessibility of medical care in Moscow neurological profile included at the expense of wide-spread implementation of specialized day-time hospitals in health care practice. The analysis applied was based on average Moscow indicators of functioning of public health institutions and characteristics of clinical course of diseases of the mentioned profile.

  10. 特殊人群骨质疏松症研究进展%Osteoporosis in special populations

    Institute of Scientific and Technical Information of China (English)

    蒲嘉骐; 郝杰

    2015-01-01

    骨质疏松症是老年人常见的一种疾病,其最大的危害是增加了骨折的风险。随着人口的老龄化,骨质疏松性骨折的发病率也显著增高,引起了医学研究者的普遍关注。近年来许多研究表明骨质疏松的发生常与一些慢性疾病相关。本文通过分析强直性脊柱炎、慢性炎症、肾病综合征、精神分裂症及智力障碍这几类人群中骨质疏松症的研究进展,探讨骨质疏松症与这些疾病的关系。在以上几种疾病中,引起骨质疏松的因素包括:①TNF-a和IL-6等炎症因子可通过抑制Wnt/β-catenin信号通路、引起OPG/RANKL/RANK系统平衡失调等途径产生一系列反应从而影响骨代谢,抑制成骨活动,促进破骨活动,加重骨质流失。②由于其他疾病引起的器官功能障碍影响导致钙、维生素D、雌激素等一些骨代谢相关因子的不足,使得成骨活动受到抑制,导致骨质疏松。③糖皮质激素、抗癫痫药物等影响了骨的代谢。④不良生活习惯、缺乏光照、缺少劳动锻炼、营养不良、体质指数下降等因素在骨质疏松的发生中同样扮演了重要的角色。综上所述,骨质疏松症的发生与多种因素相关,对于老年人,尤其是合并其他慢性疾病的老年人,应当加强骨密度的监测,早诊断,早治疗。%Osteoporosis is a common disease in the elderly, and its greatest damage is the increased risk of fractures.Along with the population ageing, the incidence of osteoporotic fracture has increased significantly, which draws general attention by medical researchers.In recent years, many studies show that osteoporosis is often associated with some chronic diseases.In this paper, the advance in the research of osteoporosis in special population, who are with ankylosing spondylitis, chronic inflammation, nephrotic syndrome, schizophrenia, and dysgnosia, are summarized in order to further clarify the

  11. Association between APOE genotype and change in physical function in a population-based Swedish cohort of older individuals followed over four years.

    Directory of Open Access Journals (Sweden)

    Ingmar Skoog

    2016-10-01

    Full Text Available The association between decline in physical function and age-related conditions, such as reduced cognitive performance and vascular disease, may be explained by genetic influence on shared biological pathways of importance for aging. The apolipoprotein E (APOE gene is well-known for its association with Alzheimer’s disease (AD, but has also been related to other disorders of importance for aging. The aim of this study was to investigate possible associations between APOE allele status and physical function in a population-based longitudinal study of older individuals. In 2005, at the age of 75, 622 individuals underwent neuropsychiatric and physical examinations, including tests of physical function, and APOE-genotyping. Follow-up examinations were performed at age 79. A significantly larger decline in grip strength (p=0.015 between age 75 and 79 was found when comparing APOE ɛ4 allele carriers with non-carriers (10.3 (±10.8 kg versus 7.8 (±10.1 kg. No association was seen with decline in gait speed, chair-stand or balance. The association with grip strength remained after correction for cognitive and educational level, depression, cardiovascular disease, stroke, and BMI. This result supports the theory that APOE ɛ4 is an allele of importance for age-related phenotypes in general.

  12. Medication Regimen Complexity and Polypharmacy as Factors Associated With All-Cause Mortality in Older People: A Population-Based Cohort Study.

    Science.gov (United States)

    Wimmer, Barbara C; Bell, J Simon; Fastbom, Johan; Wiese, Michael D; Johnell, Kristina

    2016-02-01

    To investigate whether medication regimen complexity and/or polypharmacy are associated with all-cause mortality in older people. This was a population-based cohort study among community-dwelling and institutionalized people ≥60 years old (n = 3348). Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI) in 10-unit steps. Polypharmacy was assessed as a continuous variable (number of medications). Mortality data were obtained from the Swedish National Cause of Death Register. Cox proportional hazard models were used to compute unadjusted and adjusted hazard ratios (HRs) and 95% CIs for the association between regimen complexity and polypharmacy with all-cause mortality over a 3-year period. Subanalyses were performed stratifying by age (≤80 and>80 years), sex, and cognition (Mini-Mental State Examination [MMSE] Polypharmacy was not associated with mortality (adjusted HR = 1.03; 95% CI = 0.99-1.06). When stratifying by sex, both MRCI and polypharmacy were associated with mortality in men but not in women. MRCI was associated with mortality in participants ≤80 years old and in participants with MMSE ≥26 but not in participants >80 years old or with MMSE polypharmacy. However, regimen complexity was not predictive of mortality in women, in participants >80 years old, or in those with MMSE<26. These different associations with mortality deserve further investigation. © The Author(s) 2015.

  13. Post-ischemic stroke rehabilitation is associated with a higher risk of fractures in older women: A population-based cohort study.

    Science.gov (United States)

    Huang, Huei Kai; Lin, Shu Man; Yang, Clement Shih Hsien; Liang, Chung Chao; Cheng, Hung Yu

    2017-01-01

    Rehabilitation can improve physical activity after stroke. However, patients may be more prone to falls and fractures because of balance and gait deficits. Few reports have studied the relationship between rehabilitation and subsequent fractures after ischemic stroke. To investigate whether post-stroke rehabilitation affects fracture risk. We conducted a population-based retrospective cohort study based on the Taiwan National Health Insurance Research Database. Patients with a newly diagnosed ischemic stroke between 2000 and 2012 were included. After propensity score matching, a total of 8,384 patients were enrolled. Half of the patients (4,192) received post-stroke rehabilitation within 1 month; the other half did not receive any post-stroke rehabilitation. Cox proportional hazards regression model was used to calculate hazard ratios (HRs) for fractures among patients with and without rehabilitation within 1 year after ischemic stroke. Patients were further stratified by sex and age (20-64 and ≥65 years). Patients receiving post-stroke rehabilitation had a higher incidence of fracture (6.2 per 100 person-years) than those who did not (4.1 per 100 person-years) after adjustment for sociodemographic and coexisting medical conditions [HR = 1.53, 95% confidence interval (CI) = 1.25-1.87, p rehabilitation had a significantly higher risk of fracture (HR = 1.62, 95% CI = 1.21-2.17, p = 0.001). Rehabilitation after ischemic stroke is associated with an increased fracture risk in older women.

  14. Psychometric Properties of the Physical Activity Questionnaire for Older Children in Italy: Testing the Validity among a General and Clinical Pediatric Population.

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    Erica Gobbi

    Full Text Available The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It. Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170 examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA and construct validity with enjoyment perception during physical activity. Study 2 (n = 59 reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry over the span of seven consecutive days. Study 3 (n = 58 examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD. In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83. Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36, with BMI (r = -.30 and -.79 for CHD simple form, and with the VO2max (r = .55 for CHD simple form. Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p < .05. Findings of the EFA suggested a two-factor structure for the PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe.

  15. Psychometric Properties of the Physical Activity Questionnaire for Older Children in Italy: Testing the Validity among a General and Clinical Pediatric Population.

    Science.gov (United States)

    Gobbi, Erica; Elliot, Catherine; Varnier, Maurizio; Carraro, Attilio

    2016-01-01

    The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It). Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170) examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA) and construct validity with enjoyment perception during physical activity. Study 2 (n = 59) reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry) over the span of seven consecutive days. Study 3 (n = 58) examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD). In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83). Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36), with BMI (r = -.30 and -.79 for CHD simple form), and with the VO2max (r = .55 for CHD simple form). Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe.

  16. Morphological differentiation of seven parthenogenetic Artemia (Crustacea: Branchiopoda) populations from China, with special emphasis on ploidy degrees.

    Science.gov (United States)

    Asem, Alireza; Sun, Shi-Chun

    2016-04-01

    Parthenogenetic Artemia from seven Chinese locations with different elevations and various ploidies are characterized by phenotypic and morphometric analyses. Our findings show that the studied populations exhibit dissimilar patterns of ovisac. Four phenotypic patterns of furca are qualified and one of them is shared among di-, tetra- and pentaploid Artemia. Results of discriminant analysis based on morphometric data reveal that tetra- and pentaploid populations are grouped together, but the Aqqikkol Lake population is clearly differentiated. Previous hypothesis/conclusion that polyploid Artemia are larger than diploids is only partly supported by the present results, which show that pentaploid and tetraploid populations are larger than the mostly diploid populations in terms of the total length, but the body size of the Aibi Lake triploids has not significant difference with the sympatric diploids and the mostly diploid Aqqikkol population that inhabit in very high altitude has the largest body size among all parthenogenetic populations. The founding confirms that body size of Artemia is following with Bergmann's rule.

  17. Treatment of depression in older adults beyond fluoxetine

    Directory of Open Access Journals (Sweden)

    Gabriela Arantes Wagner

    2015-01-01

    Full Text Available This review aimed to discuss the importance of the comprehensive treatment of depression among older adults in Brazil. The abuse of selective serotonin reuptake inhibitors, including fluoxetine hydrochloride, as antidepressants has been considered a serious public health problem, particularly among older adults. Despite the consensus on the need for a comprehensive treatment of depression in this population, Brazil is still unprepared. The interface between pharmacotherapy and psychotherapy is limited due to the lack of healthcare services, specialized professionals, and effective healthcare planning. Fluoxetine has been used among older adults as an all-purpose drug for the treatment of depressive disorders because of psychosocial adversities, lack of social support, and limited access to adequate healthcare services for the treatment of this disorder. Preparing health professionals is a sine qua non for the reversal of the age pyramid, but this is not happening yet.

  18. Treatment of depression in older adults beyond fluoxetine

    Science.gov (United States)

    Wagner, Gabriela Arantes

    2015-01-01

    This review aimed to discuss the importance of the comprehensive treatment of depression among older adults in Brazil. The abuse of selective serotonin reuptake inhibitors, including fluoxetine hydrochloride, as antidepressants has been considered a serious public health problem, particularly among older adults. Despite the consensus on the need for a comprehensive treatment of depression in this population, Brazil is still unprepared. The interface between pharmacotherapy and psychotherapy is limited due to the lack of healthcare services, specialized professionals, and effective healthcare planning. Fluoxetine has been used among older adults as an all-purpose drug for the treatment of depressive disorders because of psychosocial adversities, lack of social support, and limited access to adequate healthcare services for the treatment of this disorder. Preparing health professionals is a sine qua non for the reversal of the age pyramid, but this is not happening yet. PMID:25830872

  19. The Activities of UN Specialized Agencies in the Area of Disaster Relief of Population and Territories against Disasters in the beginning of the XXI century

    Directory of Open Access Journals (Sweden)

    Aleksey Vladimirovich Kuvshinov

    2016-12-01

    Full Text Available The article deals with the analysis of the structure and main directions of the activities of UN specialized agencies as well as other international organizations and entities such as ICDO aimed at the organization of the measures for disaster relief and civil defence. The urgency of the article is in the fact that it is for the first time in Russian academic literature devoted to this topic with the specific examples of conducting of such measures. The main conclusions of the article stresses that the specialized U.N. agencies and other international and national entities have already demonstrated the urgent nature and efficiency of providing disaster relief to affected countries and population in the beginning of the XXI century but they should upgrade their potential in that regard in the coming years.

  20. Quality of life and affective well-being in middle-aged and older people with chronic medical illnesses: a cross-sectional population based study.

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    Anna Wikman

    Full Text Available BACKGROUND: There has been considerable research into the impact of chronic illness on health-related quality of life. However, few studies have assessed the impact of different chronic conditions on general quality of life (QOL. The objective of this paper was to compare general (rather than health-related QOL and affective well-being in middle aged and older people across eight chronic illnesses. METHODS AND FINDINGS: This population-based, cross-sectional study involved 11,523 individuals aged 50 years and older, taking part in wave 1 of the English Longitudinal Study of Ageing. General QOL was assessed using the CASP-19, happiness was evaluated using two items drawn from the GHQ-12, and depression was measured with the CES-D. Analysis of covariance and logistic regression, adjusting for age, gender and wealth, were performed. General QOL was most impaired in people with stroke (mean 37.56, CI 36.73-38.39, and least in those reporting cancer (mean 41.78, CI 41.12-42.44, respectively, compared with no illness (mean 44.15, CI 43.92-44.39. Stroke (mean 3.65, CI 3.58-3.73 was also associated with the greatest reduction in positive well-being whereas diabetes (mean 3.81, CI 3.76-3.86 and cancer were least affected (3.85, CI 3.79-3.91, compared with no illness (mean 3.97, CI 3.95-4.00. Depression was significantly elevated in all conditions, but was most common in chronic lung disease (OR 3.04, CI 2.56-3.61, with more modest elevations in those with osteoarthritis (OR 2.08, CI 1.84-2.34 or cancer (OR 2.07, CI 1.69-2.54. Multiple co-morbidities were associated with greater decrements in QOL and affective well-being. CONCLUSION: The presence of chronic illness is associated with impairments in broader aspects of QOL and affective well-being, but different conditions vary in their impact. Further longitudinal work is needed to establish the temporal links between chronic illness and impairments in QOL and affective well-being.

  1. Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study

    Science.gov (United States)

    Langan, Sinéad M.; Smeeth, Liam; Margolis, David J.; Thomas, Sara L.

    2013-01-01

    Background Herpes zoster is common and has serious consequences, notably post-herpetic neuralgia (PHN). Vaccine efficacy against incident zoster and PHN has been demonstrated in clinical trials, but effectiveness has not been studied in unselected general populations unrestricted by region, full health insurance coverage, or immune status. Our objective was to assess zoster vaccine effectiveness (VE) against incident zoster and PHN in a general population-based setting. Methods and Findings A cohort study of 766,330 fully eligible individuals aged ≥65 years was undertaken in a 5% random sample of Medicare who received and did not receive zoster vaccination between 1st January 2007 and 31st December 2009. Incidence rates and hazard ratios for zoster and PHN were determined in vaccinated and unvaccinated individuals. Analyses were adjusted for age, gender, race, low income, immunosuppression, and important comorbidities associated with zoster, and then stratified by immunosuppression status. Adjusted hazard ratios were estimated using time-updated Cox proportional hazards models. Vaccine uptake was low (3.9%) particularly among black people (0.3%) and those with evidence of low income (0.6%). 13,112 US Medicare beneficiaries developed incident zoster; the overall zoster incidence rate was 10.0 (9.8–10.2) per 1,000 person-years in the unvaccinated group and 5.4 (95% CI 4.6–6.4) per 1,000 person-years in vaccinees, giving an adjusted VE against incident zoster of 0.48 (95% CI 0.39–0.56). In immunosuppressed individuals, VE against zoster was 0.37 (95% CI 0.06–0.58). VE against PHN was 0.59 (95% CI 0.21–0.79). Conclusions Vaccine uptake was low with variation in specific patient groups. In a general population cohort of older individuals, zoster vaccination was associated with reduction in incident zoster, including among those with immunosuppression. Importantly, this study demonstrates that zoster vaccination is associated with a reduction in PHN. Please

  2. Measurements of benzene and formaldehyde in a medium sized urban environment. Indoor/outdoor health risk implications on special population groups.

    Science.gov (United States)

    Pilidis, Georgios A; Karakitsios, Spyros P; Kassomenos, Pavlos A; Kazos, Elias A; Stalikas, Constantine D

    2009-03-01

    In the present study, the results of a measurement campaign aiming to assess cancer risk among two special groups of population: policemen and laboratory technicians exposed to the toxic substances, benzene and formaldehyde are presented. The exposure is compared to general population risk. The results show that policemen working outdoor (traffic regulation, patrol on foot or in vehicles, etc.) are exposed at a significantly higher benzene concentration (3-5 times) than the general population, while the exposure to carbonyls is in general lower. The laboratory technicians appear to be highly exposed to formaldehyde while no significant variation of benzene exposure in comparison to the general population is recorded. The assessment revealed that laboratory technicians and policemen run a 20% and 1% higher cancer risk respectively compared to the general population. Indoor working place air quality is more significant in assessing cancer risk in these two categories of professionals, due to the higher Inhalation Unit Risk (IUR) of formaldehyde compared to benzene. Since the origin of the danger to laboratory technicians is clear (use of chemicals necessary for the experiments), in policemen the presence of carbonyls in indoor air concentrations due to smoking or used materials constitute a danger equal to the exposure to traffic originated air pollutants.

  3. A voice for older patients.

    Science.gov (United States)

    Horner, Anne

    2016-09-29

    How did you become an older people's nurse? I have never seen it as a specialty, but as part of my job as a nurse. I work in the Bournemouth area, as nurse consultant intermediate care at Dorset HealthCare University NHS Foundation Trust, where we have a large older population.

  4. Back complaints in older adults

    NARCIS (Netherlands)

    J. Scheele (Jantine)

    2013-01-01

    textabstractWith the aging of the Dutch population, the number of older aged back pain patients is also expected to increase. However, information on the course and prognosis of older patients with back pain in general practice is very scarce. Back pain is a common musculoskeletal disorder, also in

  5. Marketing to Older American Consumers.

    Science.gov (United States)

    Mertz, Barbara; Stephens, Nancy

    1986-01-01

    Examined older adults as a potential market for American businesses. Data indicate that in terms of size and income, senior citizens comprise a substantial buying group. Their buying styles, product and service needs, and shopping behavior vary from younger adults and within the older adult population. Strategies for successful marketing are…

  6. Back complaints in older adults

    NARCIS (Netherlands)

    J. Scheele (Jantine)

    2013-01-01

    textabstractWith the aging of the Dutch population, the number of older aged back pain patients is also expected to increase. However, information on the course and prognosis of older patients with back pain in general practice is very scarce. Back pain is a common musculoskeletal disorder, also in

  7. Clinical Interviewing with Older Adults

    Science.gov (United States)

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

    2012-01-01

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

  8. Use of the Medicare database in epidemiologic and health services research: a valuable source of real-world evidence on the older and disabled populations in the US

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    Mues KE

    2017-05-01

    Full Text Available Katherine E Mues,1 Alexander Liede,1 Jiannong Liu,2 James B Wetmore,2 Rebecca Zaha,1 Brian D Bradbury,1 Allan J Collins,2 David T Gilbertson2 1Center for Observational Research, Amgen Inc., Thousand Oaks and San Francisco, CA, 2Chronic Disease Research Group, Minneapolis, MN, USA Abstract: Medicare is the federal health insurance program for individuals in the US who are aged ≥65 years, select individuals with disabilities aged <65 years, and individuals with end-stage renal disease. The Centers for Medicare and Medicaid Services grants researchers access to Medicare administrative claims databases for epidemiologic and health outcomes research. The data cover beneficiaries’ encounters with the health care system and receipt of therapeutic interventions, including medications, procedures, and services. Medicare data have been used to describe patterns of morbidity and mortality, describe burden of disease, compare effectiveness of pharmacologic therapies, examine cost of care, evaluate the effects of provider practices on the delivery of care and patient outcomes, and explore the health impacts of important Medicare policy changes. Considering that the vast majority of US citizens ≥65 years of age have Medicare insurance, analyses of Medicare data are now essential for understanding the provision of health care among older individuals in the US and are critical for providing real-world evidence to guide decision makers. This review is designed to provide researchers with a summary of Medicare data, including the types of data that are captured, and how they may be used in epidemiologic and health outcomes research. We highlight strengths, limitations, and key considerations when designing a study using Medicare data. Additionally, we illustrate the potential impact that Centers for Medicare and Medicaid Services policy changes may have on data collection, coding, and ultimately on findings derived from the data. Keywords: Medicare

  9. Prevalence and determinants of age-related macular degeneration in the 50 years and older population: A hospital based study in Maharashtra, India

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    Sucheta R Kulkarni

    2013-01-01

    Full Text Available Background: We present the magnitude and determinants of age-related macular degeneration (ARMD among the 50 year and older population that visited our hospital. Materials and Methods: This was a cohort of eye patients with ARMD, seen from 2006 to 2009. Optometrist noted the best-corrected vision. Ophthalmologists examined eyes using a slit-lamp bio-microscope. The ARMD was confirmed by fluoresceine angiography and optical coherent tomography. The age, sex, history of smoking, sun exposure, family history of ARMD, diet, body mass index (BMI, hypertension, and diabetes were associated with ARMD. Result: Of the 19,140 persons of ≥ 50 years of age-attending eye clinic in our hospital, 302 persons had ARMD in at least one eye. The proportion of overall ARMD was 1.38% (95% CI 1.21--1.55. The proportion of age-related maculopathy (ARM and late ARMD was 1.14% (95% CI 0.99--1.29 and 0.24% (95% CI 0.21-0.24 respectively. ARM was unilateral and bilateral in 64 (29.2% and 155 (70.8% persons respectively. Dry ARMD was found in 47.8%. On regression analysis, old age (OR = 1.05, male (OR = 0.54, and history of smoking (OR = 2.32 were significant risk factors of ARMD. A total of 4.2% of persons with ARMD were blind (vision <3/60. Only 43% of persons with ARMD had J6 grade of the best-corrected near vision. Conclusion: ARMD does not seem to be of public health magnitude in the study area. Early stages of ARMD were common among patients. ge, being male, and history of smoking were significant risk factors for ARMD.

  10. Factors associated with polypharmacy and excessive polypharmacy in older people with intellectual disability differ from the general population: a cross-sectional observational nationwide study.

    Science.gov (United States)

    O'Dwyer, Máire; Peklar, Jure; McCallion, Philip; McCarron, Mary; Henman, Martin C

    2016-04-04

    (1) To evaluate the prevalence of polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines) and (2) to determine associated demographic and clinical characteristics in an ageing population with intellectual disabilities (IDs). Observational cross-sectional study. Wave One (2009/2010) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). A nationally representative sample of 753 persons with ID, aged between 41 and 90 years. Participants/proxy reported medicines (prescription and over the counter) taken on a regular basis; medication data was available for 736 participants (98%). Participants were divided into those with no polypharmacy (0-4 medicines), polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines). Medication use patterns were analysed according to demographic variables and reported chronic conditions. A multinomial logistic regression model identified factors associated with polypharmacy (5-9 medicines) and excessive polypharmacy (≥10 medicines). Overall, 90% of participants reported use of medicines. Polypharmacy was observed in 31.5% of participants and excessive polypharmacy in 20.1%. Living in a residential institution, and reporting a mental health or neurological condition were strongly associated with polypharmacy and excessive polypharmacy after adjusting for confounders, but age or gender had no significant effect. Polypharmacy was commonplace for older adults with ID and may be partly explained by the high prevalence of multimorbidity reported. Review of appropriateness of medication use is essential, as polypharmacy places ageing people with ID at risk of adverse effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Acceptance and Commitment Therapy with Older Adults: Rationale and Considerations

    Science.gov (United States)

    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…

  12. Acceptance and Commitment Therapy with Older Adults: Rationale and Considerations

    Science.gov (United States)

    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…

  13. Population dynamics of the gyrinid beetle, Gyrinus marinus Gyll. (Coleoptera, Gyrinidae) with special reference to its dispersal activities.

    NARCIS (Netherlands)

    Eijk, van der R.H.

    1987-01-01

    Data concerning reproduction, survival and dispersal of the whirligig water beetle Gyrinus marinus Gyll . were collected between 1974 and 1983 by observations and experiments in the laboratory and in a field area with about 10 populations distributed over 15 pools.The purpose of the study was to ass

  14. What Older Adults Need to Know about Retail Clinics

    Science.gov (United States)

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

  15. Searching for genes involved in hypertension development in special populations: children and pre-eclamptic women. Where are we standing now?

    Science.gov (United States)

    Danese, Elisa; Montagnana, Martina; Fava, Cristiano

    2013-12-01

    Primary hypertension is a very common disorder particularly in the aging population but hypertensive disorders can appear earlier in life, especially when obesity and unhealthy lifestyle are present. Also pregnant women can be at risk of developing gestational hypertension and/or pre-eclampsia, which causes complications in nearly 7% of pregnancies. These "special" populations could be regarded as natural models suited to reveal mechanisms of hypertension development which are either common to other forms of hypertension, including primary hypertension or specific to these populations. Recent studies in the field of genetics of primary hypertension have used new powerful tools, such as genome-wide association studies (GWAS) and sequencing, but studies about hypertension during childhood and in pregnancy have seldom used high-throughput technologies and the knowledge in this field comes mostly from the candidate gene approach. In this review we summarize some interesting results from genetic studies conducted in childhood and adolescence and during pregnancy and underline the need to apply modern technologies in these potentially very fruitful populations.

  16. Coyotes demonstrate how habitat specialization by individuals of a generalist species can diversify populations in a heterogeneous ecoregion.

    Science.gov (United States)

    Sacks, Benjamin N; Bannasch, Danika L; Chomel, Bruno B; Ernest, Holly B

    2008-07-01

    The tendency for individuals to disperse into habitat similar to their natal habitat has been observed in a wide range of species, although its population genetic consequences have received little study. Such behavior could lead to discrete habitat-specific population subdivisions even in the absence of physical dispersal barriers or habitat gaps. Previous studies of coyotes have supported this hypothesis in a small region of California, but its evolutionary significance ultimately depends on the extent and magnitude of habitat-specific subdivision. Here, we investigated these questions using autosomal, Y chromosome, and mitochondrial markers and >2,000 coyotes from a broad region, including 2 adjacent ecoregions with contrasting levels of habitat heterogeneity--the California Floristic Province (CFP) (heterogeneous landscape) and the Desert-Prairie ecoregion (DPE) (homogeneous landscape). Consistent with predictions, we found a close correspondence between population genetic structure and habitat subdivisions throughout the CFP and virtual panmixia over the larger DPE. Conversely, although genetic diversity was similar in these 2 ecoregions overall, it was lower within sites of the CFP, as would be the expected consequence of greater genetic drift within subregions. The magnitude of habitat-specific genetic subdivisions (i.e., genetic distance) in the CFP varied considerably, indicating complexity (e.g., asymmetric gene flow or extinction/recolonization), but, in general, was higher than that due to geographic distance or recent human-related barriers. Because habitat-specific structure can enhance a species' adaptive potential and resilience to changing environments, these findings suggest the CFP may constitute an evolutionarily important portion of the range for coyotes and sympatric species exhibiting habitat-specific population structure.

  17. Interface Design and Engagement with Older People

    Science.gov (United States)

    Hawthorn, D.

    2007-01-01

    The current paper examines the design process that led to an unusually successful interactive tutorial for older people. The paper describes the issues that make designing for older people different. These include differences between the designer and the target population and the difficulty that older people have in interacting with low-fidelity…

  18. Prevalence of stroke and associated risk factors in older adults in Havana City and Matanzas Provinces, Cuba (10/66 population-based study).

    Science.gov (United States)

    de Jesús Llibre, Juan; Valhuerdi, Adolfo; Fernández, Otman; Llibre, Juan Carlos; Porto, Rudbeskia; López, Ana M; Marcheco, Beatriz; Moreno, Carmen

    2010-07-01

    Cerebrovascular disease (CVD) is the third cause of death and second cause of disability and dementia in adults aged>or=65 years worldwide. The few epidemiological studies of stroke in Latin America generally report lower prevalence and different patterns than developed countries. Estimate the prevalence of stroke and associated risk factors in adults aged>or=65 years in Havana City and Matanzas provinces, Cuba. Single phase, cross-sectional, door-to-door study of 3015 adults aged>or=65 years in selected municipalities of Havana City and Matanzas provinces. Variables studied were age, sex, educational level, and self-report and description of chronic disease (stroke, heart attack, angina, and diabetes mellitus), substance use (alcohol, tobacco), and dietary habits. Respondents were given a structured physical and neurological exam, and blood pressure was measured. Laboratory tests comprised complete blood count, fasting glucose, total cholesterol and fractions, triglycerides, and apolipoprotein E (APOE) genotype. Diagnosis of stroke was based on the World Health Organization's definition. Stroke prevalence ratios (crude and adjusted), with 95% confidence intervals (CI), were calculated for the variables studied using a Poisson regression model. Risk association was analyzed using multiple logistic regression for dichotomous responses. Assessments were made of 2944 older adults (97.6% response rate). Prevalence of stroke was 7.8% (95% CI 6.9-8.8), and was higher in men. The risk profile for this population group included history of hypertension (OR 2.8; 95% CI 2.0-4.0), low HDL cholesterol (OR 2.6; 95% CI 1.7-3.9), male sex (OR 1.7; 95% CI 1.2-2.5), anemia (OR 1.6; 95% CI 1.1-2.5), history of ischemic heart disease (OR 1.5; 95% CI 1.0-2.3), carrier of one or two apolipoprotein E4 genotype (APOE E4) alleles (OR 1.4; 95% CI 1.0-2.0), and advanced age (OR 1.3; 95% CI 1.1-1.9). Stroke prevalence in this study is similar to that reported for Europe and North America, and

  19. 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.

  20. The clinical value of HER-2 overexpression and PIK3CA mutations in the older breast cancer population: a FOCUS study analysis.

    Science.gov (United States)

    Engels, Charla C; Kiderlen, Mandy; Bastiaannet, Esther; van Eijk, Ronald; Mooyaart, Antien; Smit, Vincent T H B M; de Craen, Anton J M; Kuppen, Peter J K; Kroep, Judith R; van de Velde, Cornelis J H; Liefers, Gerrit Jan

    2016-04-01

    Studies to confirm the effect of acknowledged prognostic markers in older breast cancer patients are scarce. The aim of this study was to evaluate the prognostic value of HER-2 overexpression and PIK3CA mutations in older breast cancer patients. Female breast cancer patients aged 65 years or older, diagnosed between 1997 and 2004 in a geographical region in The Netherlands, with an invasive, non-metastatic tumour and tumour material available, were included in the study. The primary endpoint was relapse-free period and secondary endpoint was relative survival. Determinants were immunochemical HER-2 scores (0/1+, 2+ or 3+) and PIK3CA as a binary measure. Overall, 1698 patients were included, and 103 had a HER-2 score of 3+. HER-2 overexpression was associated with a higher recurrence risk (5 years recurrence risk 34 % vs. 12 %, adjusted p = 0.005), and a worse relative survival (10 years relative survival 48 % vs. 84 % for HER-2 negative; p = 0.004). PIK3CA mutations had no significant prognostic effect. We showed, in older breast cancer patients, that HER-2 overexpression was significantly associated with a worse outcome, but PIK3CA mutations had no prognostic effect. These results imply that older patients with HER-2 overexpressing breast cancer might benefit from additional targeted anti-HER-2 therapy.

  1. Influence of age and cognitive performance on resting-state brain networks of older adults in a population-based cohort.

    Science.gov (United States)

    Jockwitz, Christiane; Caspers, Svenja; Lux, Silke; Eickhoff, Simon B; Jütten, Kerstin; Lenzen, Stefan; Moebus, Susanne; Pundt, Noreen; Reid, Andrew; Hoffstaedter, Felix; Jöckel, Karl-Heinz; Erbel, Raimund; Cichon, Sven; Nöthen, Markus M; Shah, N Jon; Zilles, Karl; Amunts, Katrin

    2017-04-01

    Aging leads to global changes in brain structure and cognitive performance, with reorganization of functional brain networks. Importantly, these age-related changes show higher inter-individual variability in older subjects. To particularly address this variability is a challenge for studies on lifetime trajectories from early to late adulthood. The present study therefore had a dedicated focus on late adulthood to characterize the functional connectivity in resting-state networks (RSFC) in relation to age and cognitive performance in 711 older adults (55-85 years) from the 1000BRAINS project. The executive, left and right frontoparietal resting-state (RS) networks showed age-related increases in RSFC. However, older adults did not show changes in RSFC in the default mode network (DMN). Furthermore, lower performance in working memory (WM) was associated with higher RSFC in the left frontoparietal RS network. The results suggest age-related compensatory increases in RSFC which might help to maintain cognitive performance. Nevertheless, the negative correlation between RSFC and WM performance hints at limited cognitive reserve capacity in lower performing older adults. Consequently, the current results provide evidence for a functional reorganization of the brain until late adulthood that might additionally explain parts of the variability of cognitive abilities in older adults.

  2. Hepatitis C Virus (HCV Prevalence in Special Populations and Associated Risk Factors: A Report From a Tertiary Hospital

    Directory of Open Access Journals (Sweden)

    Onyekwere

    2016-05-01

    Full Text Available Background With the advent of highly effective anti-hepatitis C virus (HCV drugs, efforts to identify infected cases, high-risk groups, and associated risk factors have become the focus of current control measures. Objectives To determine the prevalence of the HCV antibody among diabetics and patients with lymphoproliferative disorders (LPD who presented to the outpatient clinics of a university hospital and its associated risk factors Patients and Methods Consecutively consenting patients who had been previously diagnosed with diabetes mellitus and LPD at the outpatient department of the Lagos State University teaching hospital were recruited. A case record form was used to extract their demographics and physical examination findings as well as any risk factors for HCV infection; blood was also drawn to run a serological assay for the HCV antibody. All data were collated and analyzed using the Statistical Package for the Social Sciences version 20. Student T-test, Chi square, and logistic regression were some of the inferential statistics used in addition to descriptive statistics. Results In all, 438 patients (405 diabetics and 33 patients with LPD were recruited. Their ages ranged from 17 - 87 years with a mean + Standard deviation of 59.61 + 11.859 years. The prevalence of hepatitis C among the diabetic subgroup was 0.7%, while the antibody was present in 9.1% of the LPD patients. The occurrence of the HCV antibody was, however, not significantly associated with age, sex, educational level, or marital status (P > 0.05. Having multiple sexual partners was identified as the only significant risk factor for hepatitis C (OR = 9.148; P = 0.017. Conclusions This survey suggested that a higher HCV prevalence exists in this population than is currently reported in the general population, and having sex with multiple partners was a risk factor for HCV infection.

  3. Hepatitis C Virus (HCV) Prevalence in Special Populations and Associated Risk Factors: A Report From a Tertiary Hospital

    Science.gov (United States)

    Onyekwere, Charles Asabamaka; O Ogbera, Anthonia; Olusola Dada, Akinola; O Adeleye, Olufunke; O Dosunmu, Adedoyin; Akinbami, Akinsegun A; Osikomaiya, Bodunrin; Hameed, Oladipupo

    2016-01-01

    Background With the advent of highly effective anti-hepatitis C virus (HCV) drugs, efforts to identify infected cases, high-risk groups, and associated risk factors have become the focus of current control measures. Objectives To determine the prevalence of the HCV antibody among diabetics and patients with lymphoproliferative disorders (LPD) who presented to the outpatient clinics of a university hospital and its associated risk factors Patients and Methods Consecutively consenting patients who had been previously diagnosed with diabetes mellitus and LPD at the outpatient department of the Lagos State University teaching hospital were recruited. A case record form was used to extract their demographics and physical examination findings as well as any risk factors for HCV infection; blood was also drawn to run a serological assay for the HCV antibody. All data were collated and analyzed using the Statistical Package for the Social Sciences version 20. Student T-test, Chi square, and logistic regression were some of the inferential statistics used in addition to descriptive statistics. Results In all, 438 patients (405 diabetics and 33 patients with LPD) were recruited. Their ages ranged from 17 - 87 years with a mean + Standard deviation of 59.61 + 11.859 years. The prevalence of hepatitis C among the diabetic subgroup was 0.7%, while the antibody was present in 9.1% of the LPD patients. The occurrence of the HCV antibody was, however, not significantly associated with age, sex, educational level, or marital status (P > 0.05). Having multiple sexual partners was identified as the only significant risk factor for hepatitis C (OR = 9.148; P = 0.017). Conclusions This survey suggested that a higher HCV prevalence exists in this population than is currently reported in the general population, and having sex with multiple partners was a risk factor for HCV infection. PMID:27313634

  4. The JUPITER and AURORA clinical trials for rosuvastatin in special primary prevention populations: perspectives, outcomes, and consequences

    Directory of Open Access Journals (Sweden)

    Venkata Narla

    2009-11-01

    Full Text Available Venkata Narla, Michael J Blaha, Roger S Blumenthal, Erin D MichosThe Ciccarone Preventive Cardiology Center, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Statins have emerged at the forefront of preventive cardiology and have significantly reduced cardiovascular events and mortality. Nonetheless, cardiovascular disease remains the leading cause of death in the United States and in other developed countries, as well as the etiology of significant morbidity and health-care expenditure. In an attempt to reduce potentially missed opportunities for instituting preventive therapy, the JUPITER study (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin and the AURORA study (A Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events examined the effect of statins in two specific patient populations who currently do not meet the guidelines for statin treatment, but nonetheless, are at high cardiovascular risk. This review outlines the JUPITER and AURORA trials, interprets the data and significance of the results, analyses the drawbacks and impact of both trials and delineates the potential for further clinical trials.Keywords: JUPITER, AURORA, rosuvastatin, cardiovascular disease

  5. Specialized dermatological care for marginalized populations and education at the primary care level: is community dermatology a feasible proposal?

    Science.gov (United States)

    Estrada, Roberto; Chavez-Lopez, Guadalupe; Estrada-Chavez, Guadalupe; Paredes-Solis, Sergio

    2012-11-01

    Skin diseases have a very high frequency either in developed as well as in undeveloped countries. Guerrero, Chiapas, and Oaxaca are the most impoverished states in Mexico, where 24% of the population lacks basic health care, and only 15% are estimated to have access to specialists. Community Dermatology program was founded in 1991 with the intention of improving the dermatological health of remote, marginalized inhabitants of the state of Guerrero. The program consists of a two-day visit to a pre-selected community; the first day includes a basic dermatology training course for local providers, and day 2 is a "Jornada",which means a day of free medical consultation and treatment. Pityriasis albus Cloasma, vitiligo, and acne continue to be the most frequent diagnosed primary disorders, as in rural areas occupational obligations include prolonged sun exposure. The experience and success of Community Dermatology over the last 20 years has demonstrated that this model of healthcare delivery and instruction is economically feasible, provides practical and quantifiable benefits for the communities served, and could be emulated by other disciplines within medicine.

  6. Assessing perceived risk and STI prevention behavior: a national population-based study with special reference to HPV.

    Directory of Open Access Journals (Sweden)

    Amy Leval

    Full Text Available INTRODUCTION: To better understand trends in sexually transmitted infection (STI prevention, specifically low prevalence of condom use with temporary partners, the aim of this study was to examine factors associated with condom use and perceptions of STI risk amongst individuals at risk, with the underlying assumption that STI risk perceptions and STI prevention behaviors are correlated. METHODS: A national population-based survey on human papillomavirus (HPV and sexual habits of young adults aged 18-30 was conducted in Sweden in 2007, with 1712 men and 8855 women participating. Regression analyses stratified by gender were performed to measure condom use with temporary partners and STI risk perception. RESULTS: Men's condom use was not associated with STI risk perception while women's was. Awareness of and disease severity perceptions were not associated with either condom use or risk perception though education level correlated with condom use. Women's young age at sexual debut was associated with a higher risk of non-condom use later in life (OR 1.95 95% CI: 1.46-2.60. Women with immigrant mothers were less likely to report seldom/never use of condoms with temporary partners compared to women with Swedish-born mothers (OR 0.53 95% CI: 0.37-0.77. Correlates to STI risk perception differ substantially between sexes. Number of reported temporary partners was the only factor associated for both men and women with condom use and STI risk perception. CONCLUSIONS: Public health interventions advocating condom use with new partners could consider employing tactics besides those which primarily aim to increase knowledge or self-perceived risk if they are to be more effective in STI reduction. Gender-specific prevention strategies could be effective considering the differences found in this study.

  7. The Sex, Age, and Me study: recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population.

    Science.gov (United States)

    Lyons, Anthony; Heywood, Wendy; Fileborn, Bianca; Minichiello, Victor; Barrett, Catherine; Brown, Graham; Hinchliff, Sharron; Malta, Sue; Crameri, Pauline

    2017-02-21

    Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult's understandings and practices relating to sexual health. Data collection took place in 2015, with 2137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study's recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area.

  8. Serious Events in Older Ontario Residents Receiving Bowel Preparations for Outpatient Colonoscopy with Various Comorbidity Profiles: A Descriptive, Population-Based Study

    Directory of Open Access Journals (Sweden)

    Joanne M Ho

    2012-01-01

    Full Text Available BACKGROUND: Polyethylene glycol-based bowel preparations (PEGBPs and sodium picosulfate (NaPS are commonly used for bowel cleansing before colonoscopy. Little is known about adverse events associated with these preparations, particularly in older patients or patients with medical comorbidities.

  9. A "Suicide Pill" for Older People: Attitudes of Physicians, the General Population, and Relatives of Patients Who Died after Euthanasia or Physician-Assisted Suicide in the Netherlands

    Science.gov (United States)

    Rurup, Mette L.; Onwuteaka-Philipsen, Bregje D.; van der Wal, Gerrit; van der Heide, Agnes; van Der Maas, Paul J.

    2005-01-01

    In the Netherlands there has been ongoing debate in the past 10 years about the availability of a hypothetical "suicide pill", with which older people could end their life in a dignified way if they so wished. Data on attitudes to the suicide pill were collected in the Netherlands from 410 physicians, 1,379 members of the general…

  10. A "Suicide Pill" for Older People: Attitudes of Physicians, the General Population, and Relatives of Patients Who Died after Euthanasia or Physician-Assisted Suicide in the Netherlands

    Science.gov (United States)

    Rurup, Mette L.; Onwuteaka-Philipsen, Bregje D.; van der Wal, Gerrit; van der Heide, Agnes; van Der Maas, Paul J.

    2005-01-01

    In the Netherlands there has been ongoing debate in the past 10 years about the availability of a hypothetical "suicide pill", with which older people could end their life in a dignified way if they so wished. Data on attitudes to the suicide pill were collected in the Netherlands from 410 physicians, 1,379 members of the general…

  11. Influence of age and cognitive performance on resting-state brain networks of older adults in a population-based cohort

    NARCIS (Netherlands)

    Jockwitz, C.; Caspers, S.; Lux, S.; Eickhoff, S.B.; Jü tten, K.; Lenzen, S.; Moebus, S.; Pundt, N.; Reid, A.T.; Hoffstaedter, F.; Jö ckel, K.H.; Erbel, R.; Cichon, S.; Nö then, M.M.; Shah, N.J.; Zilles, K.; Amunts, K.

    2017-01-01

    Aging leads to global changes in brain structure and cognitive performance, with reorganization of functional brain networks. Importantly, these age-related changes show higher inter-individual variability in older subjects. To particularly address this variability is a challenge for studies on life

  12. A "suicide pill" for older people: attitudes of physicians, the general population, and relatives of patients who died after euthanasia or physician-assisted suicide in The Netherlands

    NARCIS (Netherlands)

    Rurup, M.L.; Philipsen, B.D.; Wal, van der G.

    2005-01-01

    In the Netherlands there has been ongoing debate in the past 10 years about the availability of a hypothetical "suicide pill", with which older people could end their life in a dignified way if they so wished. Data on attitudes to the suicide pill were collected in the Netherlands from 410 physician

  13. Addressing special populations. Forgotten: a view of the social and political obstacles to the prevention and treatment of AIDS in Kenyan deaf people.

    Science.gov (United States)

    Nyang'aya, D

    1998-05-01

    There are an estimated 87,000 deaf people in Kenya; yet campaigns against HIV/AIDS have failed to address the communication needs of this special segment of the population. This paper examines the communication environment of deaf Kenyans. Though a minor group, the deaf community exists as a distinct cultural entity in the country. The Kenyan deaf culture has evolved from within the deaf communities, mainly in the 38 academic institutions and associations of the deaf. The isolation of these communities helped them to cultivate a unique way of life complete with a language--the Kenya Sign Language (KSL). Greatly bypassed by the information on AIDS, there is danger that the deaf Kenyan community will be wiped out by the epidemic because of the many obstacles. Among these obstacles are the use of the English language in literatures on HIV/AIDS, the lack of KSL interpretation on the television and on many AIDS related programs as well as in local public meetings. In addition, deaf people cannot benefit from the services that are offered by some organizations such as telephone hotline for counseling purposes, as well as for medical counseling services unless there is an interpreter. However, the presence of an interpreter beats the main purpose of these services, which is to offer anonymity and confidentiality. Providing relevant HIV/AIDS information to this forgotten segment of the population is a challenge to the health care community. In this regard, a number of recommendations are discussed.

  14. Vaccine preferences and acceptance of older adults

    NARCIS (Netherlands)

    Eilers, R.; de Melker, H. E.; Veldwijk, J.; Krabbe, P. F. M.

    2017-01-01

    Background: Expanding vaccination programs for the older population might be important as older adults are becoming a larger proportion of the general population. The aim of this study is to determine the relative importance of vaccine and disease specific characteristics and acceptance for Dutch

  15. Impairment in the activities of daily living in older adults with and without osteoporosis, osteoarthritis and chronic back pain: a secondary analysis of population-based health survey data.

    Science.gov (United States)

    Stamm, Tanja Alexandra; Pieber, Karin; Crevenna, Richard; Dorner, Thomas Ernst

    2016-03-28

    Independence in performing activities of daily living (ADLs) is a central aspect of functioning. Older adults frequently experience impairments and limitations in functioning in various life areas. The aim of this survey was to explore the limitations in the ADLs in older adults in a population-based survey in Austria. A population-based cross-sectional study in 3097 subjects aged ≥65 years who were included in the Austrian health interview survey was performed. Descriptive statistics were used to calculate frequencies of problems in the ADLs. A principal component analysis was applied to analyze the main dimensions of 19 ADL items. Binary logistic regression models were used with the ADL dimensions as the dependent variables and osteoarthritis, chronic back pain, osteoporosis, sex, education level, anxiety or depression, age and pain intensity as independent variables. People with musculoskeletal conditions were significantly more often affected by ADL problems than people without these diseases. The ADL domain which caused problems in the highest proportion of people was "doing heavy housework" (43.9 %). It was followed by the ADL domains "bending or kneeling down" (39.3 %), "climbing stairs up and down without walking aids" (23.1 %), and "walking 500 m without walking aids" (22.8 %). The principal components analysis revealed four dimensions of ADLs: (1) intense "heavy burden" ADLs, (2) basic instrumental ADLs, (3) basic ADLs and (3) hand-focused ADLs. The proportion of subjects who had problems with the respective dimensions was 58.2, 29.2, 23.0, and 9.2 %. Anxiety/depression (greatest effect), followed by the chronic musculoskeletal disease itself, female sex, higher age and pain intensity were significant predictors of ADL problems. This population-based survey indicates that older people have considerable ADL problems. More attention should be paid to the high impact of pain intensity, anxiety and depression on ADLs.

  16. Chronic disease in older adults

    OpenAIRE

    Durán, Adriana; Pontificia Universidad Javeriana; Valderrama, Laura; Pontificia Universidad Javeriana; Uribe, Ana Fernanda; Pontificia Universidad Javeriana; González, Angélica; Pontificia Universidad Javeriana; Máximo Molina, Juan; Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA)

    2016-01-01

    Methodology: A sample of 500 older adults was selected, between 60 and 96 years of age. A questionnaire of psychosocial factors in older adults designed by Baca, Gonzalez, and Uribe was used. Results: Hypertension, diabetes and osteoporosis were the most frequent diseases in older adults, although the greater percentage of this population did not refer any pathology. Married and widowers individuals presented more diseases as compared to unmarried, separated and people who live together.Concl...

  17. Investigation of Winter Sports Status of Older People in Harbin under the Background of Population Aging%人口老龄化背景下哈尔滨市老年人冬季体育锻炼现状调查

    Institute of Scientific and Technical Information of China (English)

    韩国纲; 张守信

    2014-01-01

    采用文献资料法、问卷调查法、数理统计法等方法,对人口老龄化背景下哈尔滨市老年人冬季体育锻炼现状进行调查。调查结果显示,哈尔滨市老年人冬季体育锻炼意识并不强;由于受天气、身体状况、器材设施等因素的影响,哈尔滨市老年人体育锻炼还未步入科学化、合理化轨道。建议制定保障老年人体育锻炼的相关政策;加大老年人体育锻炼健康知识的普及;建设和增加适合老年人体育锻炼的场地和设施;完善老年人体育组织机构。为科学指导和干预老年人体育生活提供基础资料。%With the methods of literature,questionnaire survey mathematical statistics,this paper has an investigation on winter sports status of older people in Harbin under the background of population aging. The results show that the consciousness of elder people who do winter sports exercise is not strong;Because of the weather,physical condition,equipment and facilities and other factors,physical exercises of older people in Harbin has not entered the scientific and rational track. Proposal for insurance policies for physical exercise of older people;Increase the popularity of the health knowledge for older people;Construct and increase sports venues and facilities for older people;Improve sports organization of older people. Provide the basic data for scientific guidance and intervention of elderly people's sports life.

  18. Polypharmacy in chronic diseases-Reduction of Inappropriate Medication and Adverse drug events in older populations by electronic Decision Support (PRIMA-eDS): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Sönnichsen, Andreas; Trampisch, Ulrike S; Rieckert, Anja; Piccoliori, Giuliano; Vögele, Anna; Flamm, Maria; Johansson, Tim; Esmail, Aneez; Reeves, David; Löffler, Christin; Höck, Jennifer; Klaassen-Mielke, Renate; Trampisch, Hans Joachim; Kunnamo, Ilkka

    2016-01-29

    Multimorbidity is increasing in aging populations with a corresponding increase in polypharmacy as well as inappropriate prescribing. Depending on definitions, 25-50 % of patients aged 75 years or older are exposed to at least five drugs. Evidence is increasing that polypharmacy, even when guidelines advise the prescribing of each drug individually, can potentially cause more harm than benefit to older patients, due to factors such as drug-drug and drug-disease interactions. Several approaches reducing polypharmacy and inappropriate prescribing have been proposed, but evidence showing a benefit of these measures regarding clinically relevant endpoints is scarce. There is an urgent need to implement more effective strategies. We therefore set out to develop an evidence-based electronic decision support (eDS) tool to aid physicians in reducing inappropriate prescribing and test its effectiveness in a large-scale cluster-randomized controlled trial. The "Polypharmacy in chronic diseases-Reduction of Inappropriate Medication and Adverse drug events in older populations" (PRIMA)-eDS tool is a tool comprising an indication check and recommendations for the reduction of polypharmacy and inappropriate prescribing based on systematic reviews and guidelines, the European list of inappropriate medications for older people, the SFINX-database of interactions, the PHARAO-database on adverse effects, and the RENBASE-database on renal dosing. The tool will be evaluated in a cluster-randomized controlled trial involving 325 general practitioners (GPs) and around 3500 patients across five study centres in the United Kingdom, Germany, Austria and Italy. GP practices will be asked to recruit 11 patients aged 75 years or older who are taking at least eight medications and will be cluster-randomized after completion of patient recruitment. Intervention GPs will have access to the PRIMA-eDS tool, while control GPs will treat their patients according to current guidelines (usual care

  19. Cardiac Rehabilitation in Older Adults.

    Science.gov (United States)

    Schopfer, David W; Forman, Daniel E

    2016-09-01

    The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy.

  20. Characteristics Associated with Psychological, Physical, Sexual Abuse, Caregiver Neglect and Financial Exploitation in U.S. Chinese Older Adults: Findings from the Population-Based Cohort Study in the Greater Chicago Area

    Directory of Open Access Journals (Sweden)

    Xinqi Dong

    2014-12-01

    Full Text Available This study examined the socio-demographic and health related characteristics of elder mistreatment (EM in a community-dwelling older Chinese population. Methods: Guided by a community-based participatory research approach, the PINE study conducted in-person interviews with 3,159 U.S. Chinese older adults aged 60 years and older in the Greater Chicago area from 2011–2013. Participants answered questions regarding psychological, physical and sexual mistreatment, caregiver neglect, and financial exploitation. Definitional approaches for EM subtypes were constructed from least restrictive to most restrictive. Results: The sociodemographic and health-related characteristics associated with EM differed by type of mistreatment and by the operational definition used. Living with fewer people, having been born in countries other than China, poorer health status, and lower quality of life were significantly correlated with physical mistreatment. Only higher education was positively and significantly associated with sexual mistreatment and only poorer health status was consistently correlated with psychological mistreatment among all definitions. Male gender, higher educational levels, higher income, fewer children, and having been in the U.S. for fewer years were significantly correlated with financial exploitation. As for caregiver neglect, older age, having more children, having been in the U.S. for more years, poorer health status, lower quality of life, and worsening health over the past year were consistently correlated with caregiver neglect with different definitions. Conclusions: Prevention and intervention programs on EM should be geared towards specific types of mistreatment. Studies on EM should conduct a thorough analysis to justify the operational definition used.

  1. Relationship between Special Abilities and Autistic-Like Traits in a Large Population-Based Sample of 8-Year-Olds

    Science.gov (United States)

    Vital, Pedro M.; Ronald, Angelica; Wallace, Gregory L.; Happe, Francesca

    2009-01-01

    Background: The raised incidence of special abilities or "savant skills" among individuals with autism spectrum disorders (ASD) relative to other developmental disorders suggests an association between the traits characteristic of ASD and special abilities. The purpose of this study was to investigate the association between special abilities and…

  2. 40 Is the New 65? Older Adults and Niche Targeting Strategies in the Online Dating Industry

    Directory of Open Access Journals (Sweden)

    Derek Blackwell

    2016-10-01

    Full Text Available Niche dating sites have become a popular trend in the online dating industry; yet, little is known about the specialization strategies these sites use to cater to their users’ needs. Moreover, previous research alludes to the idea that many of these sites may be engaging in pseudo-individualization—a deceptive technique that creates an illusion of specialization. This study focuses on niche dating sites for older adults, one of the fastest growing niches in online dating. Through a qualitative content analysis and close reading of older-adult dating sites, I seek to determine how and to what extent online dating sites that target older adults actually customize their services to benefit this population. Three key findings emerge: (1 the use of mass segmentation, a strategy that combines elements of both mass marketing and market segmentation; (2 a strategic broadening of the boundaries of the older-adult niche; and (3 the use of deceptive advertising to attract users. These findings suggest that older-adult dating sites are, in fact, engaging in pseudo-individualization. They also highlight some of the unique aspects of online media that facilitate this practice. Implications for both online daters and site producers are discussed.

  3. Program specialization

    CERN Document Server

    Marlet, Renaud

    2013-01-01

    This book presents the principles and techniques of program specialization - a general method to make programs faster (and possibly smaller) when some inputs can be known in advance. As an illustration, it describes the architecture of Tempo, an offline program specializer for C that can also specialize code at runtime, and provides figures for concrete applications in various domains. Technical details address issues related to program analysis precision, value reification, incomplete program specialization, strategies to exploit specialized program, incremental specialization, and data speci

  4. Is there a clinically significant gender bias in post-myocardial infarction pharmacological management in the older (>60 population of a primary care practice?

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2002-05-01

    Full Text Available Abstract Background Differences in the management of coronary artery disease between men and women have been reported in the literature. There are few studies of potential inequalities of treatment that arise from a primary care context. This study investigated the existence of such inequalities in the medical management of post myocardial infarction in older patients. Methods A comprehensive chart audit was conducted of 142 men and 81 women in an academic primary care practice. Variables were extracted on demographic variables, cardiovascular risk factors, medical and non-medical management of myocardial infarction. Results Women were older than men. The groups were comparable in terms of cardiac risk factors. A statistically significant difference (14.6%: 95% CI 0.048–28.7 p = 0.047 was found between men and women for the prescription of lipid lowering medications. 25.3% (p = 0.0005, CI 11.45, 39.65 more men than women had undergone angiography, and 14.4 % (p = 0.029, CI 2.2, 26.6 more men than women had undergone coronary artery bypass graft surgery. Conclusion Women are less likely than men to receive lipid-lowering medication which may indicate less aggressive secondary prevention in the primary care setting.

  5. Social support network typologies and health outcomes of older people in low and middle income countries--a 10/66 Dementia Research Group population-based study.

    Science.gov (United States)

    Thiyagarajan, Jotheeswaran A; Prince, Martin; Webber, Martin

    2014-08-01

    This study aims to assess the construct validity of the Wenger social support network typology in low and middle income countries. We hypothesize that, in comparison with the integrated network type, the non-integrated network type is associated with loneliness, depression, poor quality of life (less happiness), poor self-reported health, increased disability and higher care needs. Cross-sectional one-phase surveys were conducted of all residents aged 65 and over in catchment areas in eight low and middle income countries (India, China, Cuba, Dominican Republic, Venezuela, Mexico, Peru and Puerto Rico). Wenger's Practitioner Assessment of Network Type (PANT) was used to measure social network type. Family dependent, local self-contained, wider community-focused and private restricted network types were considered non-integrated, in comparison to the locally integrated network type. Overall, 17,031 participants were interviewed. Family dependent and locally integrated network types were the most prevalent. Adjusted pooled estimates across sites showed that loneliness, depression, less happiness, poor health, disability, and need for care were significantly associated with non-integrated network type. The findings of this study support the construct validity of Wenger's network typology in low and middle income countries. However, further research is required to test the criterion validity of Wenger typology using longitudinal data. Identifying older people who are vulnerable could inform the development of social care interventions to support older people and their families in the context of deteriorating health.

  6. Health-Related Quality of Life and Health Behaviors in a Population-Based Sample of Older, Foreign-Born, Chinese American Adults Living in New York City

    Science.gov (United States)

    Wyatt, Laura C.; Trinh-Shevrin, Chau; Islam, Nadia S.; Kwon, Simona C.

    2014-01-01

    Although the New York City Chinese population aged =65 years increased by 50% between 2000 and 2010, the health needs of this population are poorly understood. Approximately 3,001 Chinese individuals from high-density Asian American New York City areas were included in the REACH U.S. Risk Factor Survey; 805 (26.8%) were aged =65 years and…

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  8. Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study

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    Virgílio Garcia Moreira

    2013-07-01

    Full Text Available OBJECTIVE: Frailty syndrome can be defined as a state of vulnerability to stressors resulting from a decrease in functional reserve across multiple systems and compromising an individual's capacity to maintain homeostasis. The purpose of this study was to determine the prevalence of frailty and its association with social and demographic factors, functional capacity, cognitive status and self-reported comorbidities in a sample of community-dwelling older individuals who are clients of a healthcare plan. METHODS: We evaluated 847 individuals aged 65 years or older who lived in the northern area of the city of Rio de Janeiro, Brazil. The subjects were selected by inverse random sampling and stratified by gender and age. To diagnose frailty, we used the scale proposed by the Cardiovascular Health Study, which consisted of the following items: low gait speed, grip strength reduction, feeling of exhaustion, low physical activity and weight loss. The data were collected between 2009 and 2010, and the frailty prevalence was calculated as the proportion of individuals who scored positive for three or more of the five items listed above. To verify the association between frailty and risk factors, we applied a logistic regression analysis. RESULTS: The prevalence of frailty syndrome was 9.1% (95% confidence interval [CI], 7.3-11.3; 43.6% (95% CI, 40.3-47 of the individuals were considered robust, and 47.3% (95% CI 43.8-50.8 were considered pre-frail (p<0.001. The frail individuals tended to be older (odds ratio [OR] 13.2, 95% CI, 8.7-20 and have lower education levels (OR 2.1, 95% CI, 1-4.6, lower cognitive performance (OR 0.76, 95% CI, 0.73-0.79 and reduced health perception (OR 65.8, 95% CI, 39.1-110.8. Frail individuals also had a greater number of comorbidities (OR 6.6, 95% CI, 4.4-9.9 and worse functional capacity (OR 3.8, 95% CI, 2.9-5. CONCLUSION: The prevalence of frailty was similar to that seen in other international studies and was

  9. Performance of the 16-Item Informant Questionnaire on Cognitive Decline for the Elderly (IQCODE) in an Arabic-Speaking Older Population

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Chaaya, Monique; Asmar, Khalil

    2015-01-01

    on Cognitive Decline for the Elderly (A-IQCODE 16) for screening for dementia through an informant. METHODS: 236 Lebanese participants older than 65 years, 143 with normal cognition and 93 with mild-to-moderate dementia according to the DSM-IV criteria, and their informants were recruited. Half...... of the participants had no formal education. Interviewers blinded to the cognitive status of the participants administered the A-IQCODE 16 to the informants. The ability of the A-IQCODE 16 to screen for dementia was evaluated against the DSM-IV diagnoses. RESULTS: The A-IQCODE 16 had excellent overall predictive...... power (area under the receiver operator characteristic curve = 0.96). A cutoff point of >3.34 yielded the best sensitivity (92.5%) and specificity (94.4%) for dementia screening. At this cutoff point, the discriminatory ability of the A-IQCODE 16 was comparable between participants with and those...

  10. Rapid decrease in length of stay in institutional care for older people in Sweden between 2006 and 2012: results from a population-based study.

    Science.gov (United States)

    Schön, Pär; Lagergren, Mårten; Kåreholt, Ingemar

    2016-09-01

    There is limited knowledge about older people's length of stay (time until death) in institutional care and how it has changed over time. The aim of this study was to analyse changes in the length of stay for older people in institutional care between 2006 and 2012. All persons 65+ living in Kungsholmen (an urban area of Stockholm), who moved to an institution between 2006 and 2012, were included (N = 1103). The data source was the care system part of a longitudinal database, the Swedish National Study on Aging and Care. The average length of stay was analysed using Laplace regression for the 10th to the 50th percentile for the years 2006-2012. The regressions showed that in 2006, it took an average of 764 days before 50% of those who had moved into institutional care had died. The corresponding figure for 2012 was 595 days, which amounts to a 22.1% decrease over the period studied (P = 0.078). For the lower percentiles, the decrease was even more rapid, for example for the 30th percentile, the length of stay reduced from 335 days in 2006 to 119 days in 2012, a decrease of 64.3% (P decrease in the length of stay of 90.5% (P = 0.002). In general, there was a significant decrease in the length of stay in institutional care between 2006 and 2012. The most dramatic change over the period studied was an increase in the proportion of people who moved into an institution and died shortly afterwards. © 2015 John Wiley & Sons Ltd.

  11. Effects of aging on the function of the urinary system: longitudinal changes with age in selected urine parameters in a hospitalized population of older adults

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    Chmielewski Piotr

    2016-09-01

    Full Text Available Although normal aging does not have a pernicious effect on the homeostasis of fluids, renal reserve in elderly people can be depleted. The purpose of the present study was to assess the relationship between longitudinal changes with age in basic urine parameters (specific gravity and pH in older men and women, depending on their body height and relative body weight. Longitudinal data on these two quantitative traits of the urine were available for 142 physically healthy individuals, including 68 men and 74 women. All subjects were 45 years of age at the beginning and 70 at the end of the period under investigation. All measurements were taken in accordance with internationally accepted requirements. Specific gravity was assessed using a hydrometer, and pH was measured using a pH meter. ANOVA, t-test, and regression analysis were performed. No significant sex differences in specific gravity or urine pH were observed. In both sexes, urine specific gravity decreased with age according to exponential model of regression. In men, there was a gradual increase in the pH of the urine until age 65, and the best fitting regression model was polynomial. In women, on the other hand, there was an exiguous decrease in urine pH throughout the period under study, and the best fitting regression model proved to be exponential. As the process of renal aging commences relatively early in ontogeny and manifests itself in many structural and functional changes, urinalysis and other more sophisticated methods of diagnosis of renal diseases are essential for proper assessment of health status of adults and older individuals. The rate of age-related changes in the analyzed traits of the urine was commensurate in both sexes, thereby revealing no evidence of significant sex differences in terms of renal aging in the period between 45 and 70 years of age.

  12. Physical activity among older Chinese adults living in urban and rural areas: A review

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    Wenfei Zhu

    2016-09-01

    Full Text Available With an increase in rural-to-urban migration, a rapidly aging population, and the rising risk of developing noncommunicable diseases in China, it is important to understand the epidemiology of physical activity (PA and health in the context of disease prevention and population health. Despite its public health importance, there is a significant lack of knowledge about PA in older Chinese adults that may hamper primary prevention efforts of health promotion in an increasingly aging population. To fill this gap, this article presents a narrative review of PA in the older Chinese adult population with a special focus on residential settings (i.e., urban and rural. Using existing studies, the review examines overall PA patterns and their correlates and discusses public health implications and future research. Although there are some preliminary indications of urban and rural differences in PA in the aging population in China, continued research efforts are needed to facilitate primary prevention efforts aimed at reducing noncommunicable diseases and promoting an active lifestyle among the largest population of older people in the world.

  13. Physical activity among older Chinese adults living in urban and rural areas:A review

    Institute of Scientific and Technical Information of China (English)

    Wenfei Zhu; Aiping Chi; Yuliang Sun

    2016-01-01

    With an increase in rural-to-urban migration, a rapidly aging population, and the rising risk of developing noncommunicable diseases in China, it is important to understand the epidemiology of physical activity (PA) and health in the context of disease prevention and population health. Despite its public health importance, there is a significant lack of knowledge about PA in older Chinese adults that may hamper primary prevention efforts of health promotion in an increasingly aging population. To fill this gap, this article presents a narrative review of PA in the older Chinese adult population with a special focus on residential settings (i.e., urban and rural). Using existing studies, the review examines overall PA patterns and their correlates and discusses public health implications and future research. Although there are some preliminary indications of urban and rural differences in PA in the aging population in China, continued research efforts are needed to facilitate primary prevention efforts aimed at reducing noncommunicable diseases and promoting an active lifestyle among the largest population of older people in the world.

  14. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    Science.gov (United States)

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  15. Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study

    Science.gov (United States)

    Ferri, Cleusa P.; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Llibre-Rodriguez, Juan J.; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Gaona, Ciro; Liu, Zhaorui; Noriega-Fernandez, Lisseth; Jotheeswaran, A. T.; Prince, Martin J.

    2012-01-01

    Background Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. Methods and Findings The vital status of 12,373 people aged 65 y and over was determined 3–5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89–0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. Conclusions Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the

  16. Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Cleusa P Ferri

    2012-02-01

    Full Text Available BACKGROUND: Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. METHODS AND FINDINGS: The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98. Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. CONCLUSIONS: Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older

  17. Specialization Patterns

    DEFF Research Database (Denmark)

    Schultz, Ulrik Pagh; Lawall, Julia Laetitia; Consel, Charles

    2000-01-01

    Design patterns offer many advantages for software development, but can introduce inefficiency into the final program. Program specialization can eliminate such overheads, but is most effective when targeted by the user to specific bottlenecks. Consequently, we propose that these concepts...... are complementary. Program specialization can optimize programs written using design patterns, and design patterns provide information about the program structure that can guide specialization. Concretely, we propose specialization patterns, which describe how to apply program specialization to optimize uses...... of design patterns. In this paper, we analyze the specialization opportunities provided by specific uses of design patterns. Based on the analysis of each design pattern, we define the associated specialization pattern. These specialization opportunities can be declared using the specialization classes...

  18. Association between body size and selected hematological parameters in men and women aged 45 and above from a hospitalized population of older adults: an insight from the Polish Longitudinal Study of Aging (1960–2000

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    Chmielewski Piotr

    2017-06-01

    Full Text Available In elderly people, anemia occurs with increasing frequency with each advancing decade and can be a harbinger of very serious health conditions, including gastrointestinal bleeding, gastric and duodenal ulcers, and cancer. Therefore, age-dependant changes in hematological parameters deserve special attention. Nonetheless, very few longitudinal studies of aging have focused on possible associations between basic anthropometric characteristics and hematological parameters in older people. Here, we present some evidence that body size can be associated with red blood cell count as well as some other selected hematological parameters in adults aged 45 to 70 years. Longitudinal data on anthropometric and hematological parameters have been obtained from physically healthy residents at the Regional Psychiatric Hospital for People with Mental Disorders in Cibórz, Lubuskie Province, Poland (142 individuals, including 68 men and 74 women. The residents who took psychoactive drugs were excluded from the study. To evaluate the studied relationships, three anthropometric traits were used and three dichotomous divisions of the study sample were made. The medians of body height, body weight, and body mass index at the age of 45 years were used to divide the sample into: shorter and taller, lighter and heavier, and slimmer and stouter individuals, respectively. Student’s t-test, Pearson’s correlation, and regression analysis were employed. The results of the present study suggest that the relationship between body size and red blood cell count is slightly more pronounced in men and its strength depends on age. However, the correlations between body size and red blood cell count proved to be weak in both sexes. With aging, the strength of the relation decreased gradually, which might have been caused by the aging-associated changes in the hematopoietic system, anemia, or was an artifact. Further studies are needed to elucidate the unclear association between

  19. Effect of Health Comparisons on Functional Health and Depressive Symptoms - Results of a Population-Based Longitudinal Study of Older Adults in Germany.

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    André Hajek

    Full Text Available To investigate the effect of health comparisons on functional health and depressive symptoms in a longitudinal approach. Gender differences were examined.The German Ageing Survey (DEAS is a nationwide, representative longitudinal study of community dwelling individuals living in Germany aged 40 and older. The surveys in 2008 and 2011 were used, with n = 3,983 respondents taking part in both waves. Health comparisons were quantified by the question "How would you rate your health compared with other people your age" (Much better; somewhat better; the same; somewhat worse, much worse. Functional health was assessed by the subscale "physical functioning" of the 36-Item Short Form Health Survey (SF-36 and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D.Adjusting for sociodemographic factors, self-assessed health, social network, self-efficacy and optimism, and morbidity, fixed effects regressions revealed that functional health decreased significantly and considerably with negative health comparisons in the total sample (transitions from 'the same' to 'much worse': β = -11.8, predominantly in men. The effects of negative health comparisons (transitions from 'the same' to 'much worse': β = 4.8 on depressive symptoms were comparable (in terms of significance to the effects on functional health, with stronger effects in women. Positive comparisons did not affect functional health and depressive symptoms.Our findings underline the relevance of negative health comparisons on functional health (men and depressive symptoms (women. Comparison effects are asymmetric and mostly upwards.

  20. Severe sepsis in older adults.

    Science.gov (United States)

    Umberger, Reba; Callen, Bonnie; Brown, Mary Lynn

    2015-01-01

    Severe sepsis may be underrecognized in older adults. Therefore, the purpose of this article is to review special considerations related to early detection of severe sepsis in older adults. Normal organ changes attributed to aging may delay early detection of sepsis at the time when interventions have the greatest potential to improve patient outcomes. Systems are reviewed for changes. For example, the cardiovascular system may have a limited or absent compensatory response to inflammation after an infectious insult, and the febrile response and recruitment of white blood cells may be blunted because of immunosenescence in aging. Three of the 4 hallmark responses (temperature, heart rate, and white blood cell count) to systemic inflammation may be diminished in older adults as compared with younger adults. It is important to consider that older adults may not always manifest the typical systemic inflammatory response syndrome. Atypical signs such as confusion, decreased appetite, and unsteady gait may occur before sepsis related organ failure. Systemic inflammatory response syndrome criteria and a comparison of organ failure criteria were reviewed. Mortality rates in sepsis and severe sepsis remain high and are often complicated by multiple organ failures. As the numbers of older adults increase, early identification and prompt treatment is crucial in improving patient outcomes.

  1. Do Insect Populations Die at Constant Rates as They Become Older? Contrasting Demographic Failure Kinetics with Respect to Temperature According to the Weibull Model.

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    Petros Damos

    Full Text Available Temperature implies contrasting biological causes of demographic aging in poikilotherms. In this work, we used the reliability theory to describe the consistency of mortality with age in moth populations and to show that differentiation in hazard rates is related to extrinsic environmental causes such as temperature. Moreover, experiments that manipulate extrinsic mortality were used to distinguish temperature-related death rates and the pertinence of the Weibull aging model. The Newton-Raphson optimization method was applied to calculate parameters for small samples of ages at death by estimating the maximum likelihoods surfaces using scored gradient vectors and the Hessian matrix. The study reveals for the first time that the Weibull function is able to describe contrasting biological causes of demographic aging for moth populations maintained at different temperature regimes. We demonstrate that at favourable conditions the insect death rate accelerates as age advances, in contrast to the extreme temperatures in which each individual drifts toward death in a linear fashion and has a constant chance of passing away. Moreover, slope of hazard rates shifts towards a constant initial rate which is a pattern demonstrated by systems which are not wearing out (e.g. non-aging since the failure, or death, is a random event independent of time. This finding may appear surprising, because, traditionally, it was mostly thought as rule that in aging population force of mortality increases exponentially until all individuals have died. Moreover, in relation to other studies, we have not observed any typical decelerating aging patterns at late life (mortality leveling-off, but rather, accelerated hazard rates at optimum temperatures and a stabilized increase at the extremes.In most cases, the increase in aging-related mortality was simulated reasonably well according to the Weibull survivorship model that is applied. Moreover, semi log- probability hazard

  2. Weight Management in Older Adults

    Science.gov (United States)

    Gill, Lydia E.; Bartels, Stephen J.; Batsis, John A.

    2017-01-01

    As the number of older adults increases rapidly, the national epidemic of obesity is also affecting our aging population. This is particularly concerning given the numerous health risks and increased costs associated with this condition. Weight management is extremely important for older adults given the risks associated with abdominal adiposity, which is a typical fat redistribution during aging, and the prevalence of comorbid conditions in this age group. However, approaches to weight loss must be considered critically given the dangers of sarcopenia (a condition that occurs when muscle mass and quality is lost), the increase risk of hip fracture with weight loss, and the association between reduced mortality and increased BMI in older adults. This overview highlights the challenges and implications of measuring adiposity in older adults, the dangers and benefits of weight loss in this population, and provides an overview of the new Medicare Obesity Benefit. In addition we provide a summary of outcomes from successful weight loss interventions for older adults and discuss implications for advancing clinical practice. PMID:26627496

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

    Science.gov (United States)

    Emlet, Charles A

    2016-01-01

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

  4. Investigation and Analysis of Drug Labeling on Special Populations in 132 Package Inserts of TCM%132种中成药说明书中特殊人群用药标注情况的调查分析

    Institute of Scientific and Technical Information of China (English)

    赵丹

    2015-01-01

    目的 调查分析中成药说明书中特殊人群用药标注. 方法 对本院门诊中药房在用的132 份中成药说明书中特殊人群用药信息进行统计、分析. 结果 在用的132份中成药说明书中对妊娠期及哺乳期妇女用药、儿童用药、其他特殊人群用药进行了说明的分别为53.03%,5.30%和40.15%,完全没有特殊人群用药标注为23.48%. 结论 目前中成药说明书对特殊人群用药信息的标注存在信息量不足或过于简单,应进一步完善其说明书管理.%Objective To investigate and annlyze the drug labeling on special populations.Method To analyze each items of information on special populations in 132 package inserts of TCM.Results Drug use information for pregnant and lactating women,children,and other special populations respectively for 53.03%,5.30%and 40.15%,no drug use information for these three types of special populations for 23.48%.Conclusion There are some problems about package inserts of TCM,such as inadequate information and simple.To ensure safe use,the package inserts of TCM should be further improved.

  5. Exercise for older patients with chronic disease.

    Science.gov (United States)

    Petrella, R J

    1999-10-01

    Coronary artery disease, hypertension, congestive heart failure, type 2 diabetes mellitus, osteoarthritis, osteoporosis, and cognitive disorders become more prevalent as people age. Besides delaying the onset of many of these conditions, regular exercise may improve function and delay disability and morbidity in those who have them. Further, exercise may work synergistically with medication to combat the effects of some chronic diseases. Special adaptations for older patients include lower-intensity exercise (eg, fewer repetitions), low-impact exercise (cycling, exercise while sitting), and modified equipment (smaller weights, special shoes, loose clothing). Unresolved issues include development of optimal strategies for motivating older patients to begin and maintain exercise programs.

  6. Prevalence of Electrocardiographic Patterns Associated With Sudden Cardiac Death in the Spanish Population Aged 40 Years or Older. Results of the OFRECE Study.

    Science.gov (United States)

    Awamleh García, Paula; Alonso Martín, Joaquín Jesús; Graupner Abad, Catherine; Jiménez Hernández, Rosa María; Curcio Ruigómez, Alejandro; Talavera Calle, Pedro; Cristóbal Varela, Carmen; Serrano Antolín, José; Muñiz, Javier; Gómez Doblas, Juan José; Roig, Eulalia

    2017-10-01

    Some electrocardiographic patterns are associated with an increased risk of sudden cardiac death due to ventricular arrhythmias. There is no information on the prevalence of these patterns in the general population in Spain. The objective of this study was to analyze the prevalence of these patterns and associated clinical and epidemiological factors. This subanalysis of the OFRECE study selected a representative sample of the Spanish population aged ≥ 40 years. We studied the presence or absence of electrocardiographic patterns of Brugada syndrome and QT interval abnormalities. Clinical data and electrocardiograms were available in all participants. Electrocardiograms were evaluated by 2 cardiologists and a third cardiologist was consulted if there was disagreement in the diagnosis. We calculated the weighted prevalence and clinical factors associated with the presence of Brugada-type patterns or QT segment abnormalities. Overall, 8343 individuals were evaluated (59.2 years, 52.4% female). There were 12 Brugada cases (type 1, 2 cases; type 2, 10 cases; weighted prevalence, 0.13%). For corrected QT (QTc) analysis, we excluded participants with left bundle branch block or without sinus rhythm. Weighted prevalences were as follows: short QTc (< 340ms) 0.18%, borderline QTc (441-469ms) 8.33%, long QTc (≥ 470ms criterion) 1.01% and long QTc (≥ 480 criterion) 0.42%. A total of 0.6% to 1.1% of the Spanish population aged ≥ 40 years has an electrocardiographic pattern associated with a higher risk of sudden death (Brugada syndrome, long QT, or short QT). Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Older adult education in Lithuanian ageing society

    Directory of Open Access Journals (Sweden)

    Zemaitaityte I.

    2016-01-01

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

  8. Cultural Diversity Among Older Adults: Addressing Health Education

    Science.gov (United States)

    Haber, David

    2005-01-01

    The diversity of the older adult population is increasing, and health professionals need to learn new knowledge and skills to improve the adherence of older ethnic clients to their health recommendations. Much of the existing research literature on diversity in gerontology concludes that ethnic older adults are at a health disadvantage. Few if any…

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

    Science.gov (United States)

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

  10. The North Staffordshire Osteoarthritis Project – NorStOP: Prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults

    Directory of Open Access Journals (Sweden)

    Dziedzic Krysia

    2004-01-01

    Full Text Available Abstract Background The clinical syndrome of joint pain and stiffness in older people is the commonest cause of disability and health care consultation in this age group. Yet there have been few prospective studies of its course over time and its impact on personal and social life. We plan a cohort study in the general population aged 50 years and over to determine the course and prognosis of hand, hip, knee and foot pain, and the impact of these syndromes on participation levels and health care use. Methods All patients aged 50 years and over registered with 3 local general practices are to be recruited to a population-based cohort study through the use of a two-stage mailing process. Participants will initially complete a "Health Survey" questionnaire. This will collect information on several areas of life including socio-demographics, general health, physical function, participation, and bodily pain. Those who state that they have experienced any hand problem or any pain in their hands, hips, knees, or feet in the previous 12 months, and also give permission to be re-contacted, will be mailed a "Regional Pains Survey" questionnaire which collects detailed information on the four selected body regions (hand, hips, knees, feet. Follow-up data for the three-year period subsequent to cohort recruitment will be collected through two sources: i general practice medical records and ii repeat mailed survey.

  11. CEPF Western Ghats Special Series Ecology, distribution and population status of Elaeocarpus venustus Bedd. (Oxalidales: Elaeocarpaceae, a threatened tree species from Agasthiyamalai Biosphere Reserve, southern Western Ghats, India

    Directory of Open Access Journals (Sweden)

    S.J. Irwin

    2013-05-01

    Full Text Available This paper deals with the ecology, population size, status of regeneration, habitat degradation and threat status of Elaeocarpus venustus Bedd. An endemic and threatened tree species restricted to Agasthiyamalai Biosphere Reserve, southern Western Ghats, India. The population sites of this species in the study area were recorded using Global Positioning System and mapped using Arc GIS software. The population of this species is highly fragmented due to anthropogenic activities. The total stem count in all population sites from the study area was carried out to understand the population structure. A total of 181 saplings were recorded from the entire study area of which 180 are from a single site. Nearly 64% of the stems recorded in this study are mature stems. Poor regeneration was seen in population sites that were highly disturbed. In spite of good adult population, the low number of saplings shows poor germination of seeds and establishment of seedlings.

  12. Risk prediction for breast, endometrial, and ovarian cancer in white women aged 50 y or older: derivation and validation from population-based cohort studies.

    Directory of Open Access Journals (Sweden)

    Ruth M Pfeiffer

    Full Text Available BACKGROUND: Breast, endometrial, and ovarian cancers share some hormonal and epidemiologic risk factors. While several models predict absolute risk of breast cancer, there are few models for ovarian cancer in the general population, and none for endometrial cancer. METHODS AND FINDINGS: Using data on white, non-Hispanic women aged 50+ y from two large population-based cohorts (the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [PLCO] and the National Institutes of Health-AARP Diet and Health Study [NIH-AARP], we estimated relative and attributable risks and combined them with age-specific US-population incidence and competing mortality rates. All models included parity. The breast cancer model additionally included estrogen and progestin menopausal hormone therapy (MHT use, other MHT use, age at first live birth, menopausal status, age at menopause, family history of breast or ovarian cancer, benign breast disease/biopsies, alcohol consumption, and body mass index (BMI; the endometrial model included menopausal status, age at menopause, BMI, smoking, oral contraceptive use, MHT use, and an interaction term between BMI and MHT use; the ovarian model included oral contraceptive use, MHT use, and family history or breast or ovarian cancer. In independent validation data (Nurses' Health Study cohort the breast and ovarian cancer models were well calibrated; expected to observed cancer ratios were 1.00 (95% confidence interval [CI]: 0.96-1.04 for breast cancer and 1.08 (95% CI: 0.97-1.19 for ovarian cancer. The number of endometrial cancers was significantly overestimated, expected/observed = 1.20 (95% CI: 1.11-1.29. The areas under the receiver operating characteristic curves (AUCs; discriminatory power were 0.58 (95% CI: 0.57-0.59, 0.59 (95% CI: 0.56-0.63, and 0.68 (95% CI: 0.66-0.70 for the breast, ovarian, and endometrial models, respectively. CONCLUSIONS: These models predict absolute risks for breast, endometrial, and ovarian

  13. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study.

    Science.gov (United States)

    Bertolotti, Marco; Franchi, Carlotta; Rocchi, Marco B L; Miceli, Andrea; Libbra, M Vittoria; Nobili, Alessandro; Lancellotti, Giulia; Carulli, Lucia; Mussi, Chiara

    2017-04-01

    Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy. 2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment. In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen.

  14. "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

    Directory of Open Access Journals (Sweden)

    Salas Aquiles

    2010-08-01

    Full Text Available Abstract Background The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. Methods A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India. All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF calculated. Results The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%. Other substantial contributors were limb impairment (9%, 1%-46%, stroke (8%, 2%-17%, and depression (8%, 1%-27%. Conclusion The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in

  15. Mobility Assistance for Older People

    Directory of Open Access Journals (Sweden)

    Daniel Eck

    2012-01-01

    Full Text Available This paper describes the development of a scooter supporting the mobility of older people. The scooter is equipped with a drive assistance system and a special scooter navigation system. The drive assistance system consists of a velocity controller, a steering controller, and a collision avoidance system. In this paper it is demonstrated how the challenging control and steering tasks are modified to increase safety for older people. A special scooter navigation system is presented, to support elderly people in navigating on a safe route through the city using sidewalks, pedestrian lights and crosswalks. For extended positioning requirements a hybrid positioning system was developed combining GPS, WLAN, and inertial sensor data. By combination of these technical improvements it is demonstrated how older people are able to preserve their self-determined and independent life. Usability research was done with focus groups in order to become familiar with global user demands and expectations towards a mobility assistance system. Results show that the system components are expected to assist the user in navigation, steering and speed control rather than to take complete control on the driving situation.

  16. Epidemiological aspects of acquired immunodeficiency syndrome in older Brazilians: a comparative approach

    Directory of Open Access Journals (Sweden)

    Luiz Max Fagundes de Carvalho

    Full Text Available OBJECTIVES: To compare epidemiological aspects of young (15 to 49 years old and older (more than 50 years old AIDS patients. METHODS: We analyzed 511,633 AIDS cases notified to the Brazilian Ministry of Health in the period of 1980-2008 looking at sex, age ranges, educational level and exposure category. Patients were divided into three age groups: under 15, from 15 to 49 and over 50 years old. Using a comparative approach, we analyzed data with regard to category of exposure, education (expressed in years of schooling, and sex ratio among younger (15-49 and older adults (over 50 years old. Time series data were log-transformed and normalized, and the temporal trend was evaluated. RESULTS: AIDS incidence is increasing among people over 50 years old in Brazil, with those older than 50 being responsible for 9.64 % of AIDS cases. There was no significant difference between educational level and gender (p = 0.468, but there was a significant difference in exposure category with a lower proportion of injecting drug users amongst the older group. CONCLUSION: Based on this analysis over the last 10 years, the percentage of AIDS cases has increased almost three times among people over 50 years old when compared with the 15-49 year-old group. Our findings suggest that public campaigns have to be specially targeted to the older segment of the population, aiming at heterosexual transmission.

  17. Epidemiological aspects of acquired immunodeficiency syndrome in older Brazilians: a comparative approach

    Directory of Open Access Journals (Sweden)

    Luiz Max Fagundes de Carvalho

    2012-02-01

    Full Text Available OBJECTIVES: To compare epidemiological aspects of young (15 to 49 years old and older (more than 50 years old AIDS patients. METHODS: We analyzed 511,633 AIDS cases notified to the Brazilian Ministry of Health in the period of 1980-2008 looking at sex, age ranges, educational level and exposure category. Patients were divided into three age groups: under 15, from 15 to 49 and over 50 years old. Using a comparative approach, we analyzed data with regard to category of exposure, education (expressed in years of schooling, and sex ratio among younger (15-49 and older adults (over 50 years old. Time series data were log-transformed and normalized, and the temporal trend was evaluated. RESULTS: AIDS incidence is increasing among people over 50 years old in Brazil, with those older than 50 being responsible for 9.64 % of AIDS cases. There was no significant difference between educational level and gender (p = 0.468, but there was a significant difference in exposure category with a lower proportion of injecting drug users amongst the older group. CONCLUSION: Based on this analysis over the last 10 years, the percentage of AIDS cases has increased almost three times among people over 50 years old when compared with the 15-49 year-old group. Our findings suggest that public campaigns have to be specially targeted to the older segment of the population, aiming at heterosexual transmission.

  18. The Effect of Intra- and Intergenerational Caregiving on Subjective Well-Being--Evidence of a Population Based Longitudinal Study among Older Adults in Germany.

    Directory of Open Access Journals (Sweden)

    André Hajek

    Full Text Available To examine whether intra- and intergenerational caregiving affect subjective well-being (SWB of the caregivers longitudinally.Data were drawn from the German Ageing Survey (DEAS, which is a population-based longitudinal study of individuals living in Germany aged 40 and over. The waves in 2002, 2008 and 2011 were used (with 10,434 observations. SWB was examined in a broad sense, covering affective (AWB and cognitive well-being (CWB, positive (PA and negative affect (NA as well as functional and mental health. While intragenerational caregiving was defined as providing care for spouse/partner, intergenerational caregiving was defined as providing care for mother, father, mother-in-law, father-in-law, partner's mother or partner's father.Fixed effects regressions adjusting for sociodemographic factors, social network, self-efficacy and morbidity showed that intergenerational informal care did not affect the various SWB outcome measures. Intragenerational caregiving affected CWB (women and mental health (total sample and men, whereas it did not affect the other outcome variables.Our findings highlight the importance of intragenerational caregiving for mental health (men and cognitive well-being (women. Consequently, interventions to avoid mental illness due to intragenerational caregiving are urgently needed.

  19. Special Weapons

    Data.gov (United States)

    Federal Laboratory Consortium — Supporting Navy special weapons, the division provides an array of engineering services, technical publication support services, logistics support services, safety...

  20. The association of cancer survival with four socioeconomic indicators: a longitudinal study of the older population of England and Wales 1981–2000

    Directory of Open Access Journals (Sweden)

    Young Harriet

    2007-01-01

    Full Text Available Abstract Background Many studies have found socioeconomic differentials in cancer survival. Previous studies have generally demonstrated poorer cancer survival with decreasing socioeconomic status but mostly used only ecological measures of status and analytical methods estimating simple survival. This study investigate socio-economic differentials in cancer survival using four indicators of socioeconomic status; three individual and one ecological. It uses a relative survival method which gives a measure of excess mortality due to cancer. Methods This study uses prospective record linkage data from The Office for National Statistics Longitudinal Study for England and Wales. The participants are Longitudinal Study members, recorded at census in 1971 and 1981 and with a primary malignant cancer diagnosed at age 45 or above, between 1981 and 1997, with follow-up until end 2000. The outcome measure is relative survival/excess mortality, compared with age and sex adjusted survival of the general population. Relative survival and Poisson regression analyses are presented, giving models of relative excess mortality, adjusted for covariates. Results Different socioeconomic indicators detect survival differentials of varying magnitude and definition. For all cancers combined, the four indicators show similar effects. For individual cancers there are differences between indicators. Where there is an association, all indicators show poorer survival with lower socioeconomic status. Conclusion Cancer survival differs markedly by socio-economic status. The commonly used ecological measure, the Carstairs Index, is adequate at demonstrating socioeconomic differentials in survival for combined cancers and some individual cancers. A combination of car access and housing tenure is more sensitive than the ecological Carstairs measure at detecting socioeconomic effects on survival – confirming Carstairs effects where they occur but additionally identifying

  1. Education for Older People: Another View of Mainstreaming. Fastback 181.

    Science.gov (United States)

    Heinrich, June Sark

    There is a strong case to be made for mainstreaming older people into regular classes and schools rather than segregating them in special, separate groups on the basis of age. Many older Americans are in need of elementary-secondary level training in order to become functionally literate. Similarly, the continually changing nature of work has…

  2. Older adults, mealtime-related emotions, and functionalities

    NARCIS (Netherlands)

    Uijl, den Louise C.

    2016-01-01

    Background and aim    Dietary proteins are of special interest for the heterogeneous group of older adults, since these people do not always have an adequate protein intake. When protein-rich products are better aligned with the requirements of older persons, an adequ

  3. Emergency Preparedness Concerns for Older Adults

    Centers for Disease Control (CDC) Podcasts

    2009-01-26

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

  4. Specialized languages

    DEFF Research Database (Denmark)

    Mousten, Birthe; Laursen, Anne Lise

    2016-01-01

    -disciplinarily, because they work with both derivative and contributory approaches. Derivative, because specialized language retrieves its philosophy of science as well as methods from both the natural sciences, social sciences and humanistic sciences. Contributory because language results support the communication......Across different fields of research, one feature is often overlooked: the use of language for specialized purposes (LSP) as a cross-discipline. Mastering cross-disciplinarity is the precondition for communicating detailed results within any field. Researchers in specialized languages work cross...... science fields communicate their findings. With this article, we want to create awareness of the work in this special area of language studies and of the inherent cross-disciplinarity that makes LSP special compared to common-core language. An acknowledgement of the importance of this field both in terms...

  5. Inter- and intra-specific genetic divergence of Asian tiger frogs (genus Hoplobatrachus), with special reference to the population structure of H. tigerinus in Bangladesh.

    Science.gov (United States)

    Sultana, Nasrin; Igawa, Takeshi; Islam, Mohammed Mafizul; Hasan, Mahmudul; Alam, Mohammad Shafiqul; Komaki, Shohei; Kawamura, Kensuke; Khan, Md Mukhlesur Rahman; Sumida, Masayuki

    2017-03-17

    The five frog species of the genus Hoplobatrachus are widely distributed in Asia and Africa, with Asia being considered the genus' origin. However, the evolutionary relationships of Asian Hoplobatrachus species remain ambiguous. Additionally, genetic diversity and fundamental differentiation processes within species have not been studied. We conducted molecular phylogenetic analysis on Asian Hoplobatrachus frogs and population genetic analysis on H. tigerinus in Bangladesh using the mitochondrial CYTB gene and 21 microsatellite markers. The resultant phylogenetic tree revealed monophyly in each species, notwithstanding the involvement of cryptic species in H. chinensis and H. tigerinus, which are evident from the higher genetic divergence between populations. Bayesian inference of population structure revealed genetic divergence between western and eastern H. tigerinus populations in Bangladesh, suggesting restricted gene flow caused by barriers posed by major rivers. However, genetic distances among populations were generally low. A discrete population is located in the low riverine delta region, which likely reflects long-distance dispersal. These results strongly suggest that the environment specific to this river system has maintained the population structure of H. tigerinus in this region.

  6. Cochlear implant rehabilitation in older adults: literature review and proposal of a conceptual framework.

    Science.gov (United States)

    Clark, James H; Yeagle, Jennifer; Arbaje, Alicia I; Lin, Frank R; Niparko, John K; Francis, Howard W

    2012-10-01

    To review studies investigating cochlear implant (CI) outcomes in older adults, and to develop a conceptual framework demonstrating important interactions between characteristics of hearing disability, aging, and the CI intervention. Review of English literature with titles containing the words "cochlear implant" and generic term referring to older adults or numerical value for age greater than 65. Hearing loss is a prevalent consequence of aging and poses special challenges for older adults. Particularly when superimposed on other age-related conditions, presbycusis (age-related hearing loss) places older adults at risk for social isolation and associated psychological and general health sequelae. The increasing cognitive demand of verbal communication and the diminished sense of social and physical connectedness can contribute to a feeling of vulnerability and poor health that worsens with advancing presbycusis. This cascade of downstream effects of hearing loss has implications for the self-assessment of health-related quality of life (HRQoL) and resulting estimates of associated costs. There is accumulating evidence of a potential role for CI in older adults with poor word understanding despite conventional hearing aid use. This review of the literature provides strong evidence of the benefits of restoring communication capacity in the deaf and hard-of-hearing geriatric population. There is, however, a lack of attention to communication performance in the real world and HRQoL outcomes, and significant gaps in knowledge regarding how CI rehabilitation interacts with changing psychosocial and functional status with aging. A broader conceptual framework than is currently available for the role of CI rehabilitation in the management of severe-to-profound hearing loss in older adults is proposed. It is posited that the use of such a model in future investigations is needed to guide multidisciplinary investigations into the unique challenges of hearing loss in older

  7. Dual diagnosis in older adults: a review.

    Science.gov (United States)

    Searby, Adam; Maude, Phil; McGrath, Ian

    2015-02-01

    Dual diagnosis is associated with frequent relapse, poor treatment engagement and overall unsatisfactory treatment outcomes. A comprehensive review of the contemporary literature examining this issue was conducted, finding a paucity of literature concerning dual diagnosis in older adults. Of the literature appraised for this review, a number of studies examined US Veteran's Affairs populations, which were largely male. Studies concerning older mental health populations were scarce. During the literature search, a number of background studies that influenced contemporary research regarding dual diagnosis in older adults were found; these studies were examined regarding their contribution to contemporary paradigms concerning older adults with co-occurring mental illness and substance use disorders. This review presents the results of the contemporary literature concerning dual diagnosis in older adults. Several recurring themes emerge from the literature, including the notion of a statistically small population that, in absolute terms, represents a sizeable number of individuals coming to the attention of aged mental health services in the future. Additionally, the potential for under-diagnosis in this cohort is highlighted, potentially creating a hidden population of older adults with dual diagnosis.

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

    Directory of Open Access Journals (Sweden)

    Mayra dos Santos Silva

    2015-04-01

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

  9. Measuring disability across cultures — the psychometric properties of the WHODAS II in older people from seven low- and middle-income countries. The 10/66 Dementia Research Group population-based survey

    Science.gov (United States)

    Sousa, Renata M; Dewey, Michael E; Acosta, Daisy; Jotheeswaran, AT; Castro-Costa, Erico; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Pichardo, Juana Guillermina Rodriguez; Ramírez, Nayeli Garcia; Rodriguez, Juan Llibre; Rodriguez, Marina Calvo; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Prince, Martin J

    2010-01-01

    We evaluated the psychometric properties of the 12-item interviewer-administered screener version of the World Health Organization Disability Assessment Schedule – version II (WHODAS II) among older people living in seven low- and middle-income countries. Principal component analysis (PCA), confirmatory factor analysis (CFA) and Mokken analyses were carried out to test for unidimensionality, hierarchical structure, and measurement invariance across 10/66 Dementia Research Group sites. PCA generated a one-factor solution in most sites. In CFA, the two-factor solution generated in Dominican Republic fitted better for all sites other than rural China. The two factors were not easily interpretable, and may have been an artefact of differing item difficulties. Strong internal consistency and high factor loadings for the one-factor solution supported unidimensionality. Furthermore, the WHODAS II was found to be a ‘strong’ Mokken scale. Measurement invariance was supported by the similarity of factor loadings across sites, and by the high between-site correlations in item difficulties. The Mokken results strongly support that the WHODAS II 12-item screener is a unidimensional and hierarchical scale confirming to item response theory (IRT) principles, at least at the monotone homogeneity model level. More work is needed to assess the generalizability of our findings to different populations. Copyright © 2010 John Wiley & Sons, Ltd. PMID:20104493

  10. Active Strategies for Older Workers

    DEFF Research Database (Denmark)

    Hansen, Hans

    This report is also to be published by ETUI (Euruopean Trade Unions' Institute) in a book on Active Strategies for Older Workers. It is the National report for Denmark and contains a short section on characteristics of the Danish labour market, with a special focus on the situation of the elderly......, followed by a section on early retirement schemes in Denmark. These are very popular and it has been and, maybe, still is a problem to reduce the participation in these schemes. More ''positive'' measures than just reducing the attractiveness of the early retirement schemes are also necessary to keep...

  11. Older People as a Developing Market for Cultural Heritage Sites

    Science.gov (United States)

    Hansen, Anna; Zipsane, Henrik

    2014-01-01

    Is it morally acceptable for the heritage sector to see the growing population of senior citizens as a developing market? Jamtli is an open air museum in the north of Sweden. The main target group is families with children, but an increasing number of activities for older adults are being offered. The growing population of older people is a…

  12. Geriatric dermatology: optimising care in frail older adults

    NARCIS (Netherlands)

    Lubeek, S.F.K.

    2017-01-01

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

  13. Older Workers and VET. At a Glance

    Science.gov (United States)

    Dawe, Susan

    2009-01-01

    Australia, in common with many industrialised countries, must adjust in the coming years to an ageing population. The labour force participation rate is projected to fall and there will be a record number of older people who have retired from work. Thus, there will be fewer workers as a share of the population to generate the income needed to…

  14. Understanding how lake populations of arctic char are structured and function with special consideration of the potential effects of climate change: a multi-faceted approach.

    Science.gov (United States)

    Budy, Phaedra; Luecke, Chris

    2014-09-01

    Size dimorphism in fish populations, both its causes and consequences, has been an area of considerable focus; however, uncertainty remains whether size dimorphism is dynamic or stabilizing and about the role of exogenous factors. Here, we explored patterns among empirical vital rates, population structure, abundance and trend, and predicted the effects of climate change on populations of arctic char (Salvelinus alpinus) in two lakes. Both populations cycle dramatically between dominance by small (≤300 mm) and large (>300 mm) char. Apparent survival (Φ) and specific growth rates (SGR) were relatively high (40-96%; SGR range 0.03-1.5%) and comparable to those of conspecifics at lower latitudes. Climate change scenarios mimicked observed patterns of warming and resulted in temperatures closer to optimal for char growth (15.15 °C) and a longer growing season. An increase in consumption rates (28-34%) under climate change scenarios led to much greater growth rates (23-34%). Higher growth rates predicted under climate change resulted in an even greater predicted amplitude of cycles in population structure as well as an increase in reproductive output (Ro) and decrease in generation time (Go). Collectively, these results indicate arctic char populations (not just individuals) are extremely sensitive to small changes in the number of ice-free days. We hypothesize years with a longer growing season, predicted to occur more often under climate change, produce elevated growth rates of small char and act in a manner similar to a "resource pulse," allowing a sub-set of small char to "break through," thus setting the cycle in population structure.

  15. Understanding how lake populations of arctic char are structured and function with special consideration of the potential effects of climate change: A multi-faceted approach.

    Science.gov (United States)

    Budy, Phaedra; Luecke, Chris

    2014-01-01

    Size dimorphism in fish populations, both its causes and consequences, has been an area of considerable focus; however, uncertainty remains whether size dimorphism is dynamic or stabilizing and about the role of exogenous factors. Here, we explored patterns among empirical vital rates, population structure, abundance and trend, and predicted the effects of climate change on populations of arctic char (Salvelinus alpinus) in two lakes. Both populations cycle dramatically between dominance by small (≤300 mm) and large (>300 mm) char. Apparent survival (Φ) and specific growth rates (SGR) were relatively high (40–96 %; SGR range 0.03–1.5 %) and comparable to those of conspecifics at lower latitudes. Climate change scenarios mimicked observed patterns of warming and resulted in temperatures closer to optimal for char growth (15.15 °C) and a longer growing season. An increase in consumption rates (28–34 %) under climate change scenarios led to much greater growth rates (23–34 %). Higher growth rates predicted under climate change resulted in an even greater predicted amplitude of cycles in population structure as well as an increase in reproductive output (Ro) and decrease in generation time (Go). Collectively, these results indicate arctic char populations (not just individuals) are extremely sensitive to small changes in the number of ice-free days. We hypothesize years with a longer growing season, predicted to occur more often under climate change, produce elevated growth rates of small char and act in a manner similar to a “resource pulse,” allowing a sub-set of small char to “break through,” thus setting the cycle in population structure.

  16. Older People's Mobility: Segments, Factors, Trends

    DEFF Research Database (Denmark)

    Haustein, Sonja; Siren, Anu

    2015-01-01

    demographic, health-related, or transport-related factors. This paper reviews these studies and compares the segments of older people that different studies have identified. First, as a result of a systematic comparison, we identified four generic segments: (1) an active car-oriented segment; (2) a car......The expanding older population is increasingly diverse with regard to, for example, age, income, location, and health. Within transport research, this diversity has recently been addressed in studies that segment the older population into homogeneous groups based on combinations of various......-dependent segment, restricted in mobility; (3) a mobile multimodal segment; (4) and a segment depending on public transport and other services. Second, we examined the single factors used in the reviewed segmentation studies, with focus on whether there is evidence in the literature for the factors’ effect on older...

  17. New, Occasional, and Frequent Use of Zolpidem or Zopiclone (Alone and in Combination) and the Risk of Injurious Road Traffic Crashes in Older Adult Drivers: A Population-Based Case-Control and Case-Crossover Study.

    Science.gov (United States)

    Nevriana, Alicia; Möller, Jette; Laflamme, Lucie; Monárrez-Espino, Joel

    2017-08-01

    Previous studies on the effect of zolpidem or zopiclone use on the risk of road traffic crashes (RTCs) have shown mixed results. Our objective was to determine the association between zolpidem or zopiclone use (as separate drugs or combined) and the occurrence of injurious RTCs among older adult drivers. This was a population-based matched case-control and case-crossover study based on secondary data linked together from Swedish national registers. Cases were drivers aged 50-80 years involved in a vehicle crash resulting in injuries between January 2006 and December 2009 for the case-control study (n = 27,096) and from February 2006 to December 2009 for the case-crossover study (n = 26,586). For the first design, four controls were matched to each case by sex, age, and residential area, and exposure was categorized into new, occasional, and frequent use of zolpidem only, zopiclone only, and combined zolpidem and zopiclone. For the case-crossover study, newly dispensed zolpidem or zopiclone users were assessed during the 28 days prior to the crash and compared with an equally long control period using a 12-week washout period. Matched adjusted odds ratios (OR) were computed using conditional logistic regression. Increased ORs for all users were observed. In the case-control study, the highest odds were seen among newly initiated zolpidem-only users involved in single-vehicle crashes (adjusted OR 2.27; 95% confidence interval [CI] 1.21-4.24), followed by frequent combined zolpidem and zopiclone users [adjusted OR 2.20; CI 1.21-4.00]. In the case-crossover, newly initiated treatment with zolpidem or zopiclone showed an increased risk that was highest in the 2 weeks after the start of the treatment (OR 2.66; 95% CI 1.04-6.81). These results provide more compelling evidence for the role of zolpidem or zopiclone in the occurrence of RTCs among older adults, not only in frequent users, but also at the beginning of treatment.

  18. Ethical Concerns in Usability Testing Involving Older Adults

    DEFF Research Database (Denmark)

    Møller, Margrethe Hansen

    Based on experience from the research project “User Manuals for Older Adults”, this paper discusses whether there are special ethical concerns with older adults as test persons in a usability test involving the think-aloud method. In this context, older adults are defined as individuals with normal...... cognitive and physical problems of ageing. The paper concludes that usability testing is necessary as a part of the design cycle, but that special care can be taken to ensure that test persons do not feel disempowered during the test....

  19. Valoración biopsicosocial del adulto mayor desde un enfoque bioético en una población cubana Biopsychosocial assessment of the older adult from a bioethical approach in a Cuban population section

    Directory of Open Access Journals (Sweden)

    Germán Brito Sosa

    2012-12-01

    Full Text Available Objetivo: explorar la situación biopsicosocial del adulto mayor en una población del municipio Arroyo Naranjo. Métodos: estudio de tipo observacional, descriptivo longitudinal y prospectivo. El instrumento utilizado fue una encuesta original elaborada por los autores y validada por un comité de expertos, representados por psicólogos, y geriatras y que se les aplicó a 400 personas mayores de 60 años entre enero y diciembre de 2007. Se confeccionó una base de datos con la información de las entrevistas y se obtuvieron los porcentajes de las variables seleccionadas. Resultados: el 88,2 % (353 abuelos de los encuestados padecían al menos de una enfermedad crónica. Se sintieron maltratados en el consultorio del médico y enfermera de la familia, los policlínicos, las clínicas estomatológicas y hospitales, en un 14,7, 9,2, 11,5 y 9,5 % respectivamente. El 19,8 % de los adultos mayores considera que sus familiares no le brindan el apoyo que necesitan. El 44,2 % representado por 177 ancianos de los tres grupos, plantea que sí existe discriminación con el adulto mayor. Conclusiones: la asistencia médica es buena, pero en un pequeño porcentaje no fue la mejor, se violaron los principios de beneficencia, no maleficencia, justicia y autonomía. Los círculos de abuelos y la casa de abuelos, ayudan al adulto mayor a mantenerse integrado a la sociedad.Objective: to assess the biological, psychological and social situation of the older people in a population living in Arroyo Naranjo municipality. Methods: prospective, observational and descriptive study was conducted in which an original survey prepared by the authors of the paper and validated by an expert committee of psychologists and geriatricians was used. Four hundred people over 60 years were surveyed from January to December, 2007. They were divided in three groups based on their participation in the grandparent's clubs, the homes for grandparents and those not involved in neither of

  20. Special Education Finance in California

    Science.gov (United States)

    Hill, Laura; Warren, Paul; Murphy, Patrick; Ugo, Iwunze; Pathak, Aditi

    2016-01-01

    California's system of special education served about 718,000 students in 2014-15, or about 11.5 percent of the K-12 population. It is expensive, consuming some $12 billion in federal, state, and local dollars annually. Special education operates within a legal framework that sets it apart from the rest of the K-12 system. The state's enactment of…

  1. Fruit and vegetable intake among older adults: a scoping review.

    Science.gov (United States)

    Nicklett, Emily J; Kadell, Andria R

    2013-08-01

    Older adults are the fastest growing segment of the world population. Older adults are also at heightened risk of chronic conditions (such as diabetes, heart disease, and cancer) and specific geriatric conditions (such as cognitive impairment, frailty, and falls). Research studies have examined the relationship between fruit and vegetable intake and subsequent health outcomes and the correlates of fruit and vegetable intake in the U.S. population. However, relatively few studies have specifically examined health impacts and correlates of fruit and vegetable intake among older adults, who have unique biophysical and socioeconomic circumstances. Evidence is reviewed to (1) describe findings related to consumption and chronic, geriatric, and other health outcomes among older adults and (2) describe patterns in fruit and vegetable consumption among older adults and how these patterns vary within and among populations. This review addresses specific barriers faced by older adults in obtaining and consuming fruits and vegetables in community settings. Recommendations for practice and policy are discussed.

  2. [Polypharmacy issues in older adults].

    Science.gov (United States)

    Chiang-Hanisko, Lenny; Tan, Jung-Ying; Chiang, Ling-Chun

    2014-06-01

    Polypharmacy is a major concern in the care of older adults. People over 65 years of age frequently have multiple medical conditions and may have cancer, which requires multiple medications for treatment. The use of multiple medications increases the risk of drug-drug interactions, non-adherence, and adverse drug reactions. Polypharmacy is a term that refers to a high number of prescribed medications, usually five and above, or the use of more medications than is clinically justified. Although medications are an important factor in improving and maintaining the quality of life of older adults, polypharmacy increases the risks of morbidity and mortality, loss of functional independence, and a multiplicity of cognitive and physical problems in this population. This article examines issues related to polypharmacy in older adults and identifies nursing strategies and interventions to detect and prevent polypharmacy. Nursing strategies discussed include: (1) increasing patient knowledge of pharmacological issues, (2) increasing patient medication management competency, (3) promoting safe patient medication practices, and (4) enhancing patient education. Nurses must be familiar with medicine regimens, understand the primary factors that affect adherence, and participate in continuing education to enhance their ability to safeguard older adult patients.

  3. Estimating Glomerular Filtration Rate in Older People

    Directory of Open Access Journals (Sweden)

    Sabrina Garasto

    2014-01-01

    Full Text Available We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.

  4. Job Redesign for Older Workers: Pilot Study and Survey in Eight Member Countries.

    Science.gov (United States)

    Marbach, G.

    Transfer of an older worker to a less demanding job not only creates a shortage of skilled labor, but causes the person to lose vitality and self confidence, leading to possible mental deterioration. Retraining of the older worker, moreover, can take five to ten times as long as that of a young worker. A special workshop for older or handicapped…

  5. An Analysis of the Population Dynamics of Selected Avian Species--With Special References to Changes During the Modern Pesticide Era

    Science.gov (United States)

    Henny, C.J.

    1972-01-01

    The impact of pesticides on the mortality rates and recruitment rates of nongame birds during the last 25 years was evaluated by studying the population dynamics of 16 species. A mathematical model showing the relations between population parameters that yielded stable populations was developed. The information needed for the model included (1) mortality rate schedule (obtained from recoveries of banded birds), (2) recruitment rates, and (3) the age of sexual maturity. The rate of recruitment necessary for a stable population and/or the annual rate of change (increase or decrease) in population levels were estimated. Population parameters were compared to determine whether changes had occurred between time periods (i.e., 1925-45 vs. 1946-65). The great horned owl, red-shouldered hawk, sparrow hawk, osprey, barn owl, Cooper's hawk, red-tailed hawk, great blue heron, blackcrowned night heron, brown pelican, barn swallow, chimney swift, blue jay, blackcapped chickadee, cardinal, and robin were subjected to this analysis. No increase in postfledging mortality rates in any of the species was detected during the last 25 years (since 1945). Since there was no evidence of increased mortality rates it was concluded that accelerated declines in several of the species studied resulted from lowered reproductive success. Mortality rates were found to have decreased in the Cooper's hawk, sparrow hawk, great blue heron, and brown pelican and this was associated with a decrease in shooting pressure. Evidence of lower recruitment rates was found in the brown pelican, osprey, Cooper's hawk, red-shouldered hawk, and sparrow hawk. No changes in recruitment rates were noted in the red-tailed hawk, great horned owl, great blue heron, or barn owl. Information on recruitment rates was not available for comparison with the other species although rates of recruitment essential for a stable population were estimated. This work will provide the basis for making comparisons in future studies

  6. Proportion of Population Aged 65 or Older

    Data.gov (United States)

    U.S. Environmental Protection Agency — Variable was created as part of a set of indicators that demonstrate links between the condition of natural areas and human concerns and that quantify dependencies...

  7. mtDNA and Y-chromosome diversity in Aymaras and Quechuas from Bolivia: different stories and special genetic traits of the Andean Altiplano populations.

    Science.gov (United States)

    Gayà-Vidal, Magdalena; Moral, Pedro; Saenz-Ruales, Nancy; Gerbault, Pascale; Tonasso, Laure; Villena, Mercedes; Vasquez, René; Bravi, Claudio M; Dugoujon, Jean-Michel

    2011-06-01

    Two Bolivian samples belonging to the two main Andean linguistic groups (Aymaras and Quechuas) were studied for mtDNA and Y-chromosome uniparental markers to evaluate sex-specific differences and give new insights into the demographic processes of the Andean region. mtDNA-coding polymorphisms, HVI-HVII control regions, 17 Y-STRs, and three SNPs were typed in two well-defined populations with adequate size samples. The two Bolivian samples showed more genetic differences for the mtDNA than for the Y-chromosome. For the mtDNA, 81% of Aymaras and 61% of Quechuas presented haplogroup B2. Native American Y-chromosomes were found in 97% of Aymaras (89% hg Q1a3a and 11% hg Q1a3*) and 78% of Quechuas (100% hg Q1a3a). Our data revealed high diversity values in the two populations, in agreement with other Andean studies. The comparisons with the available literature for both sets of markers indicated that the central Andean area is relatively homogeneous. For mtDNA, the Aymaras seemed to have been more isolated throughout time, maintaining their genetic characteristics, while the Quechuas have been more permeable to the incorporation of female foreigners and Peruvian influences. On the other hand, male mobility would have been widespread across the Andean region according to the homogeneity found in the area. Particular genetic characteristics presented by both samples support a past common origin of the Altiplano populations in the ancient Aymara territory, with independent, although related histories, with Peruvian (Quechuas) populations.

  8. The Evolution of the Population of the City of Zagreb with Special Emphasis on Immigration in the Period 1991−2001

    Directory of Open Access Journals (Sweden)

    Nada Antić

    2001-12-01

    Full Text Available The paper describes the evolution of Zagreb's population and its geographical distribution in the city during the last ten years. Emphasis is placed on the role of migration (involving essentially the settling in of new inhabitants and on the influence of the armed conflict in the 1990s. The author also outlines some predictions regarding future developments. The paper uses primarily the results of the last censuses, including those of the recent census of 2001, as well as statistical data on the current population, on displaced persons and refugees, information in the possession of the municipality, etc. As to migration, since the last census was lacking in regard to migration indicators and there is no population registry, vital-statistical methods were applied to obtain a net migration balance. In the past, especially after WWII, Zagreb experienced considerable demographical growth, owing to its attractiveness for migration flows from other regions in Croatia and in neighbouring Bosnia and Herzegovina. The natural component in the evolution of the population was equally positive, yet a tendency towards reduction appeared in the 1980s. The first part of the paper reviews the demographic expansion of Zagreb in the earlier period (1857−1991, which was accompanied by an extension of the city. The results of the last census (2001 indicate a notable slowing down of population growth in Zagreb (arriving at a growth rate of 0.39%, for although war-induced migrations in the period 1991−1995 did direct the majority of the refugees and displaced persons to Zagreb, this flow was not accompanied by permanent settlement. Most migrants originated from Bosnia and Herzegovina (mainly refugees, after which followed migrants from regions in Croatia. Studies also show that during the most recent period there was a clear increase of out-migration from Zagreb to the outer suburbs and of emigration abroad. The second part of the paper offers indicators on the

  9. Inmunogenicidad y tolerancia de una vacuna contra influenza, en una población mexicana mayor de 55 años de edad Immunogenicity and safety of the influenza vaccine, in a population older than 55-years in Mexico

    Directory of Open Access Journals (Sweden)

    Octavio Ayala-Montiel

    2005-04-01

    ños de edad. Se demostró también la producción de anticuerpos de alta afinidad contra el virus, posterior a la vacunación. Además, se identificó una frecuencia de reacciones locales y sistémicas similares a las previamente reportadas. Estos resultados pueden ser extensivos a instituciones de salud que atienden principalmente a adultos mayores de 55 años de edad, para incrementar las tasas anuales de cobertura de vacunación contra influenza.OBJECTIVE: To confirm the immunogenicity and tolerance of the inactivated, fractionated, and purified influenza vaccine, in a Mexican adult population aged 55 and older, medically served at a Petróleos Mexicanos Hospital (Pemex, Mexican Oil Company. MATERIAL AND METHODS: The study was conducted between November and December, 2000, among ninety adult subjects aged 55 years and older who were seen at the Hospital Central Sur Pemex. The primary endpoints regarding immunogenicity were the percentage of individuals with protective antibodies targeting hemagglutinins higher than or equal to 1:40, and the percentage of subjects who seroconverted as measured by a four-fold increase in protective antibody production. Secondary endpoints included the frequency of local and systemic reactions to the vaccine. An additional criterion that was evaluated included antigen-antibody affinity assays to measure the polyclonal antibody response to the vaccine and the specific generation of high-affinity antibodies to viral proteins, before and after vaccination. RESULTS: The antibody protection rate was 95.6% against the H1N1 strain, 98.9% against the H3N2 strain, and a 100% against the B/Yamanashi strain. Seroconversion to the H1N1 strain was elicited in 74.4% of subjects, to the H3N2 strain in 88.9%, and to the B / Yamanashi strain in 82.2%. Eighteen (20% subjects developed local reactions; 17 (18.8% developed a systemic reaction post vaccination at day 5 and nine subjects (10% at day 28. Local reactions consisted of pain in 10 (11.1% subjects

  10. Ageing, Leisure, and Social Connectedness: How could Leisure Help Reduce Social Isolation of Older People?

    Science.gov (United States)

    Toepoel, Vera

    2013-08-01

    This study investigates the relation between leisure activities and the social status of the elderly based on a heterogeneous sample of the Dutch population. Close relationships are also analyzed to identify which people could serve as successful stimulators of leisure participation. The social profile confirms that older people have fewer social contacts and often feel lonely. This study shows that leisure activities explain a significant part of older people's social connectedness. Voluntary work, cultural activities, holiday, sports, reading books, hobbies and shopping are found to be successful predictors for social connectedness of older people. Watching TV, listening to the radio, and spending time behind the computer (passive activities) were not associated with social connectedness. Friends correlate positively to participation in leisure activities. Partners play a role in participation in cultural activities and sports; parents play a role in participation in voluntary work and holidays; siblings play a role in voluntary work and sports; and children play a role in cultural activities, reading books, and shopping. Local communities can use these close relationships and develop special programs to increase social connectedness and hence improve quality of life for older adults.

  11. Social care networks and older LGBT adults: challenges for the future.

    Science.gov (United States)

    Brennan-Ing, Mark; Seidel, Liz; Larson, Britta; Karpiak, Stephen E

    2014-01-01

    Research on service needs among older adults rarely addresses the special circumstances of lesbian, gay, bisexual, and transgender (LGBT) individuals, such as their reliance on friend-centered social networks or the experience of discrimination from service providers. Limited data suggests that older LGBT adults underutilize health and social services that are important in maintaining independence and quality of life. This study explored the social care networks of this population using a mixed-methods approach. Data were obtained from 210 LGBT older adults. The average age was 60 years, and 71% were men, 24% were women, and 5% were transgender or intersex. One-third was Black, and 62% were Caucasian. Quantitative assessments found high levels of morbidity and friend-centered support networks. Need for and use of services was frequently reported. Content analysis revealed unmet needs for basic supports, including housing, economic supports, and help with entitlements. Limited opportunities for socialization were strongly expressed, particularly among older lesbians. Implications for senior programs and policies are discussed.

  12. Acute care management of older people with dementia: a qualitative perspective.

    Science.gov (United States)

    Moyle, Wendy; Borbasi, Sally; Wallis, Marianne; Olorenshaw, Rachel; Gracia, Natalie

    2011-02-01

    This Australian study explored management for older people with dementia in an acute hospital setting. As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the unique needs of confused older people. Current nursing and medical literature provides some direction in relation to best practice management; however, few studies have examined this management from the perspective of hospital staff. A descriptive qualitative approach was used. Data were collected using semi-structured audio-taped interviews with a cross section of thirteen staff that worked in acute medical or surgical wards in a large South East Queensland, Australia Hospital. Analysis of data revealed five subthemes with the overarching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well-being and dignity. A risk management approach was used rather than one that incorporated injury prevention as one facet of an overall strategy. Using untrained staff to sit and observe people with dementia as a risk management strategy does not encourage an evidence-based approach. Staff education and environmental resources may improve the current situation so that people with dementia receive care that takes into account their individual needs and human dignity. Nurses can assist older people with dementia by encouraging evidence-based care practices to become the part of hospital policy. © 2010 Blackwell Publishing Ltd.

  13. Special health care needs among children in the child welfare system.

    Science.gov (United States)

    Ringeisen, Heather; Casanueva, Cecilia; Urato, Mathew; Cross, Theodore

    2008-07-01

    The aim of this study was to determine levels of special health care need among children in the child welfare system and how these needs may affect children's functioning. Data were from the National Survey of Child and Adolescent Well-being, a national probability study of children investigated for child maltreatment. The sample consisted of 5496 children aged 0 to 15 years at baseline. For analysis, we used descriptive statistics to determine special health care needs and children's functioning from baseline to 3-year follow-up. Logistic regression was used to examine correlates of special health care needs. At any point in the study period, approximately one third of the children were identified as having special health care needs. Overall, across 3 years of follow-up data, 50.3% of the children were identified as having special health care needs. Boys were significantly more likely than girls to have had special health care needs, and children aged 0 to 2 years at baseline were significantly less likely to have had special health care needs than older children. Adopted and foster children were significantly more likely to have had special health care needs than children never placed out of the home. The most commonly reported type of chronic health condition was asthma. The most commonly reported type of special need was a learning disability. Special health care needs are prevalent among children in the child welfare system. Many children with special health care needs have cognitive, language, adaptive, social, or behavioral functional impairments. Mechanisms are needed to ensure that this vulnerable population has access to and receives coordinated health and related social services.

  14. Older men and older women remand prisoners: mental illness, physical illness, offending patterns and needs.

    Science.gov (United States)

    Davoren, Mary; Fitzpatrick, Mary; Caddow, Fintan; Caddow, Martin; O'Neill, Conor; O'Neill, Helen; Kennedy, Harry G

    2015-05-01

    Older prisoners are the fastest growing group of prisoners in most countries. They have high rates of physical and psychiatric co-morbidity, compared to community dwelling older persons and also compared with other prisoner groups. Very high rates of mental illness have been found in remand (pre-trial) prisoners when compared with other prisoner groups; however to date there have been no studies examining older male and female remand prisoners. A retrospective chart review was conducted of all remands, to a male and a female prison, over a six and half-year period. Demographic data were collected pertaining to psychiatric and medical diagnoses and seriousness of offending. We found rising numbers of older prisoners amongst male remand prisoners. Older remand prisoners had very high rates of affective disorder and alcohol misuse. They had rates of psychotic illnesses and deliberate self-harm comparable to younger remand prisoners. High rates of vulnerability were found among older prisoners and older prisoners had a greater need for general medical and psychiatric services than younger prisoners. We also found comparable offending patterns with younger prisoners and high rates of sexual offending among the older male prisoner group. Given the ageing population of many countries it is likely the numbers of older prisoners will continue to grow and given their high levels of both physical and psychiatric illness this will have implications for future service delivery.

  15. Scoping review report: obesity in older adults.

    Science.gov (United States)

    Decaria, J E; Sharp, C; Petrella, R J

    2012-09-01

    Obesity is associated with an increased risk for early death, heart disease and stroke, disability and several other comorbidities. Although there is concern about the potential burden on health-care services with the aging demographic and the increasing trend of obesity prevalence in older adults, evidence on which to base management strategies is conflicting for various reasons. The analytic framework for this review is based on a scoping review methodology, and was conducted to examine what is known about the diagnosis, treatment and management of obesity in older adults. A total of 492 relevant research articles were identified using PubMed, Scirus, EBSCO, Clinicaltrials.gov, Cochrane Reviews and Google Scholar. The findings of this review indicate that the current WHO (World Health Organization)-recommended body mass index, waist circumference and waist-to-hip ratio obesity thresholds for the general adult population may not be appropriate for older adults. Alternatively, weight change or physical fitness may be more useful measures of mortality and health risk in obese older adults. Furthermore, although obesity in older adults is associated with several disorders that increase functional disability, epidemiological evidence suggests that obesity is protective against mortality in seniors. Consequently, the trend toward increasing prevalence of obesity in older adults will lead to an increase in unhealthy life years and health-care costs. The findings from this review also suggest that treatment strategies for obese older adults should focus on maintaining body weight and improving physical fitness and function rather than weight loss, and that a combination of aerobic and resistance exercise appears to be the most effective strategy. In conclusion, this review demonstrates the need for more research to clarify the definition of obesity in older adults, to establish criteria for evaluating when to treat older adults for obesity, and to develop effective

  16. Targeted Therapy for Older Patients with Uncontrolled Severe Asthma: Current and Future Prospects.

    Science.gov (United States)

    de Roos, E W; In 't Veen, J C C M; Braunstahl, G-J; Lahousse, L; Brusselle, G G O

    2016-09-01

    Severe asthma in the elderly places a high burden on affected individuals and society. Emerging therapies target specific phenotypes of the asthma disease spectrum, and can be beneficial for older asthmatics, albeit their response might be altered due to age-related characteristics. Paradoxically, these characteristics are often ground for exclusion from clinical trials. The question thus arises how the senior asthmatic population can successfully enter the era of targeted therapy. Therefore, we highlight characteristics of this population relevant to effective treatment, and review the evidence for targeted therapy in elderly patients. For targeted therapy it is important to account for aging, as this affects the distribution of phenotypes (e.g. late-onset asthma, non-eosinophilic asthma) and may alter biomarkers and drug metabolism. Elderly asthmatics suffer from age-related comorbidities and subsequent polypharmacy. A systematic search into targeted asthma therapy yielded no randomized clinical trials dedicated to older asthmatics. Post hoc analyses of the anti-immunoglobulin E agent omalizumab indicate similar efficacy in both younger and older adults. Conference abstracts on anti-interleukin-5 and anti-interleukin-13 therapy suggest even more pronounced effects of targeted treatments in late-onset disease and in asthmatic patients 65 years or older, but full reports are lacking. For non-eosinophilic asthma in the elderly, there is not yet high-level evidence for targeted therapy, but macrolides may offer a viable option. In conclusion, there is a gap in knowledge regarding the effect of older age on the safety and efficacy of targeted asthma therapy. Further investigations in the elderly are needed, with special emphasis on both late-onset asthma and therapeutics for non-eosinophilic asthma.

  17. Pediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications.

    Science.gov (United States)

    Lyman, Amanda; Wenger, Daniel; Landin, Lennart

    2016-09-01

    This study aims to describe the epidemiology of pediatric diaphyseal forearm fractures in an urban population and the complications of titanium elastic nailing. The medical records of 456 consecutive fractures were reviewed. The annual incidence was 0.7/1000 children. Eighty-six (19%) fractures in 83 children were titanium elastic nailed. The complication rate was 24%. Dorsal entry to the radius was associated with extensor pollicis longus rupture and radial entry was associated with sensory nerve deficit in three cases each. Seventy-eight (94%) of the operated patients recovered completely. Titanium elastic nailing is effective, but associated with a high rate of complications, most of which resolve spontaneously.

  18. "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

    OpenAIRE

    Salas Aquiles; de Rodriguez Juan; Pichardo Guillermina; Liu Zhaorui; Hernandez Milagros; Jacob KS; AT, Jotheeswaran; Huang Yueqin; Guerra Mariella; Acosta Daisy; Ferri Cleusa P; Sousa Renata M; Sosa Ana; Williams Joseph; Zuniga Tirso

    2010-01-01

    Abstract Background The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. Methods A one-phase cross-sectional survey was ...

  19. The relationship between stigma and self-reported willingness to use mental health services among rural and urban older adults.

    Science.gov (United States)

    Stewart, Hannah; Jameson, John Paul; Curtin, Lisa

    2015-05-01

    The large number of rural older adults suffering from untreated psychiatric illnesses suggests that stigma may be a significant barrier to the utilization of mental health services in this population. The current study examines self-stigma, public stigma, and attitudes toward specialty mental health care in a community sample of older adults living in a geographically isolated rural area, a rural area adjacent to a metropolitan area, and an urban area. One hundred and 29 older adults age 60 and above from the 3 geographic areas completed self-report measures of these constructs, and differences on the measures were assessed among the groups. Results indicated that older adults living in isolated rural counties demonstrated higher levels of public and self-stigma and lower levels of psychological openness than older adults in urban areas even after accounting for education, employment, and income. However, no differences emerged in reported willingness to use specialized mental health care in the event of significant distress. Results are discussed in the context of rural values, beliefs, and community structural factors. We further suggest that conventional binary rural/urban distinctions are not sufficient to understand the relationship between rurality and stigma. (c) 2015 APA, all rights reserved).

  20. 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.

  1. Metro U.S.A. Data Sheet: Population Estimates and Selected Demographic Indicators for the Metropolitan Areas of the United States. Special edition of the United States Population Data Sheet.

    Science.gov (United States)

    Population Reference Bureau, Inc., Washington, DC.

    This poster-size data sheet presents population estimates and selected demographic indicators for the nation's 281 metropolitan areas. These areas are divided into 261 Metropolitan Statistical Areas (MSAs) and 20 Consolidated Metropolitan Statistical Areas (CMSAs), reporting units which replace the Standard Metropolitan Statistical Areas (SMSAs)…

  2. Descriptive anthropometric reference data for older Americans.

    Science.gov (United States)

    Kuczmarski, M F; Kuczmarski, R J; Najjar, M

    2000-01-01

    To present selected anthropometric data derived from adults aged 60 years and older examined in the third National Health and Nutrition Examination Survey (NHANES III). NHANES III used a complex, stratified, multistage, probability cluster sample design to obtain a nationally representative sample of the US civilian, noninstitutionalized population. Persons aged 60 years and older, Mexican-Americans, and African-Americans were oversampled to produce more reliable estimates for these groups. Trained technicians measured height, weight, skinfold thickness, and circumferences using standardized procedures. A total of 5,700 persons aged 60 years and older, and 1,861 persons aged 50 to 59 years. Mean and selected percentiles for body weight, body mass index, triceps skinfold thickness, mid upper arm circumference, and arm muscle circumference were calculated by gender, race/ethnicity, and 3 age categories. Weight (lb) per height (in) tables were generated for men and women by age group. Mean body weight was lowest for persons aged 80 years and older. A decline in body mass index occurred that paralleled the direction and magnitude of the progressive decrease observed in weight. Muscle loss with increasing age, as indicated by arm muscle circumference, appeared to be greater among men than women. In addition to being relatively simple, quick, and inexpensive, anthropometry is the most reliable and specific indicator of malnutrition in the older adult population. The cross-sectional reference data provided can be used by dietitians to interpret anthropometric measurements of persons aged 60 years and older.

  3. Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?

    Science.gov (United States)

    Batsis, John A; Pletcher, Sarah N; Stahl, James E

    2017-01-05

    The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity. We describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, but also workforce shortages and lack of specialized services are emphasized. The use of Telemedicine has successfully been implemented in other specialties and could be a useful modality in delivering much needed intensive behavioral therapy, particularly in distant, under-resourced environments. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models. Recommendations to extend the benefit's coverage to be more inclusive of non-physician team members is needed but also for improvement in reimbursement for telemedicine services for older adults with obesity.

  4. Medication adherence among older adults with schizophrenia.

    Science.gov (United States)

    Leutwyler, Heather C; Fox, Patrick J; Wallhagen, Margaret

    2013-02-01

    Older adults with schizophrenia are a growing segment of the population, yet their physical and mental health status is extremely poor. This article presents findings from a qualitative study that explored the understanding older adults with schizophrenia have of their physical health status. The study was conducted among 28 older adults with schizophrenia from a variety of settings using semi-structured interviews and participant observation. Self-management of psychiatric and non-psychiatric medications and its effect on participants' health status was one of the central themes that emerged from the study. Different styles of medication adherence were identified and factors associated with each style are presented. The findings provide insights into the design of clinical interventions aimed at promoting medication adherence among older adults with schizophrenia.

  5. Attitudes and stereotypes regarding older women and HIV risk.

    Science.gov (United States)

    Beaulaurier, Richard; Fortuna, Karen; Lind, Danielle; Emlet, Charles A

    2014-01-01

    Persons aged 50 years and over will soon disproportionately represent the future of the HIV/AIDS epidemic. It is estimated that by 2015 older adults will represent 50% of persons living with HIV in the United States. Despite the HIV/AIDS growing population among older adults, attitudes, beliefs, and stereotypes toward older adults that exist in general society have affected HIV prevention, education, and care. Specifically, ageist attitudes about the sexuality of older adults in general and older women in particular, low clinical HIV suspicion among healthcare providers, lack of knowledge about risk among older women, and differentials in power related to negotiating sexual practices all lead to heightened concerns for the prevention, identification, and treatment of HIV disease in mature women. This article examines common attitudes, beliefs, and stereotypes that exist within general society as well as health and social service providers that place older women at a disadvantage when it comes to HIV prevention, education, and treatment.

  6. Objective measurements of daily physical activity patterns and sedentary behaviour in older adults

    DEFF Research Database (Denmark)

    Arnardottir, Nanna Yr; Koster, Annemarie; Van Domelen, Dane R

    2013-01-01

    objectively measured population physical activity (PA) data from older persons is lacking. The aim of this study was to describe free-living PA patterns and sedentary behaviours in Icelandic older men and women using accelerometer.......objectively measured population physical activity (PA) data from older persons is lacking. The aim of this study was to describe free-living PA patterns and sedentary behaviours in Icelandic older men and women using accelerometer....

  7. Missing Data: A Special Challenge in Aging Research

    OpenAIRE

    Hardy, Susan E.; Allore, Heather; Studenski, Stephanie A.

    2009-01-01

    Evidence about care of older adults informs practice but is influenced by special methodological challenges. Missing data, ranging from lack of individual items in questionnaires to complete loss to follow up, affect the quality of the evidence and are more likely to occur in studies of older adults because older adults have more health and functional problems that interfere with all aspects of data collection. The purpose of this article is to promote knowledge about the risks and consequenc...

  8. Population information on major technological risks and specially on nuclear risk; L'information de la population de l'isere en matiere de risques technologiques majeurs et plus particulierement de risque nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    De Choudens, H. [Centre d' Etudes Nucleaires de Grenoble, Commissariat a l' Energie Atomique (France)

    1992-07-01

    Following Chernobyl accident which has revealed in France a strong need for information on technological risks among population and a lack in its organization, the Mayor of Grenoble City who was also at this time, Environment Minister in French Government had initiated in lsere Region an important operation of consideration of action, which has to been undertaken to correct theses lacks. Among ten actions retained one of them was the creation of an Association for Information of the public for Prevention of major risks. This Association has first initiated a consultation on the perception by the population of the different major risks (Industrial and Naturals) in view of the results of this consultation, Medical Professions were the first concerned and a publication 'Medicine and Nuclear risk' has been elaborated and distributed to all doctors of the Region. A Memento on Nuclear risk as then been written and largely distributed in the region, especially in the medias. A booklet on nuclear risk and behavior in case of nuclear accident has then been realized and distributed to all people around Electronuclear Reactors of the Region and to children in the schools. In complement, public meetings have been organized in these sectors to inform, and discuss with the population. (author)

  9. International Specialization

    DEFF Research Database (Denmark)

    Kleindienst, Ingo; Geisler Asmussen, Christian; Hutzschenreuter, Thomas;

    2012-01-01

    Whether and how international diversification and cross-border arbitrage affects firm performance remains one of the major unresolved research questions in the strategy and international business literatures. We propose that knowing how much a firm has internationally diversified tells us very...... little about performance implications, if we do not know, and do not ask, how the firm has diversified. Therefore, building on the two broad arguments of operating flexibility and location-specific commitment, we develop a theoretical framework that focuses on the extent to which a firm's international...... arbitrage strategy is characterized by specialization versus replication and argue that these different strategies may have differential impact on profitability and risk reduction. Developing a sophisticated measure of international specialization and using a unique panel data set of 92 German MNEs to test...

  10. International Specialization

    DEFF Research Database (Denmark)

    Kleindienst, Ingo; Geisler Asmussen, Christian; Hutzschenreuter, Thomas

    2012-01-01

    Whether and how international diversification and cross-border arbitrage affects firm performance remains one of the major unresolved research questions in the strategy and international business literatures. We propose that knowing how much a firm has internationally diversified tells us very...... little about performance implications, if we do not know, and do not ask, how the firm has diversified. Therefore, building on the two broad arguments of operating flexibility and location-specific commitment, we develop a theoretical framework that focuses on the extent to which a firm's international...... arbitrage strategy is characterized by specialization versus replication and argue that these different strategies may have differential impact on profitability and risk reduction. Developing a sophisticated measure of international specialization and using a unique panel data set of 92 German MNEs to test...

  11. Special offer

    CERN Multimedia

    Staff Association

    2010-01-01

    Special offer for members of the Staff Association and their families 10% reduction on all products in the SEPHORA shop (sells perfume, beauty products etc.) in Val Thoiry ALL YEAR ROUND. Plus 20% reduction during their “vente privée”* three or four times a year. Simply present your Staff Association membership card when you make your purchase. * next “vente privée” from 24th to 29th May 2010  

  12. Special offer

    CERN Multimedia

    Staff Association

    2011-01-01

    SPECIAL OFFER FOR OUR MEMBERS Tarif unique Adulte/Enfant Entrée Zone terrestre 19 euros instead of 23 euros Entrée “Zone terrestre + aquatique” 24 euros instead of 31 euros Free for children under 3, with limited access to the attractions. Walibi Rhône-Alpes is open daily from 22 June to 31 August, and every week end from 3 September until 31 October. Closing of the “zone aquatique” 11 September.

  13. Special offer

    CERN Multimedia

    Staff Association

    2011-01-01

    SPECIAL OFFER FOR OUR MEMBERS Tarif unique Adulte/Enfant Entrée Zone terrestre 19 euros instead of 23 euros Entrée “Zone terrestre + aquatique” 24 euros instead of 31 euros Free for children under 3, with limited access to the attractions. Walibi Rhône-Alpes is open daily from 22 June to 31 August, and every week end from 3 September until 31 October. Closing of the “zone aquatique” 11 September.

  14. Treatment of Muscle-Invasive Bladder Cancer in Older Patients.

    Science.gov (United States)

    Skinner, Eila C

    2016-01-01

    Treatment of muscle-invasive bladder cancer in older patients is challenging. Definitive therapy of localized disease requires either surgery or radiation therapy, ideally combined with systemic chemotherapy. However, current population data suggest that less than half of patients older than age 70 are offered such treatments. We will review tools available to assess the fitness of older patients for surgery, alternatives, and tips for perioperative patient treatment.

  15. Missing data: a special challenge in aging research.

    Science.gov (United States)

    Hardy, Susan E; Allore, Heather; Studenski, Stephanie A

    2009-04-01

    Scientific evidence should guide clinical care, but special methodological challenges influence interpretation of the medical literature pertaining to older adults. Missing data, ranging from lack of individual items in questionnaires to complete loss to follow-up, affect the quality of the evidence and are more likely to occur in studies of older adults because older adults have more health and functional problems that interfere with all aspects of data collection than do younger people. The purpose of this article is to promote knowledge about the risks and consequences of missing data in clinical aging research and to provide an organized approach to prevention and management. Although it is almost never possible to achieve complete data capture, efforts to prevent missing data are more effective than analytical "cure." Strategies to prevent missing data include selecting a primary outcome that is easy to determine and devising valid alternate definitions, adapting data collection to the special needs of the target population, pilot testing data collection plans, and monitoring missing data rates during the study and adapting data collection procedures as needed. Key steps in the analysis of missing data include assessing the extent and types of missing data before analysis, exploring potential mechanisms that contributed to the missing data, and using multiple analytical approaches to assess the effect of missing data on the results. Manuscripts should disclose rates of missing data and losses to follow-up, compare dropouts with participants who completed the study, describe how missing data were managed in the analysis phase, and discuss the potential effect of missing data on the conclusions of the study.

  16. Older women caring for older women: the rewards and challenges of the home care aide job.

    Science.gov (United States)

    Butler, Sandra S; Wardamasky, Sara; Brennan-Ing, Mark

    2012-01-01

    As our population ages, the need for personal assistance services increases. Paid personal care is predominantly provided by women, often older women, and has been considered low-status, low-wage work. This article reports on a mixed-method, longitudinal study of 261 home care aides; study participants were 46 years old, on average. Predictors of termination included younger age and lack of health insurance. Study participants reported more rewarding than challenging aspects to the job, though low and inconsistent compensation often forced them to leave the work they loved. Implications of the study with regard to older women caring for older women are explored.

  17. Older workers in the labour market

    Directory of Open Access Journals (Sweden)

    Sabina Jelenc Krašovec

    2009-12-01

    Full Text Available Forecasts show that demographic changes will greatly affect changes in the structure of work force. Due to the coming mass retiring of the “baby-boom” generation, a fall in the active population share is to be expected and, consequently, changes in the social and health insurance amenities of the population. The European politicians press on the member countries with the demand to raise the retirement age, which raises the questions of what changes will employment of older people entail, what employment needs exist for older workers, and what measures are required to actually implement the new employment patterns. This article also deals with the question of education and training, an important factor for employment of older workers.

  18. Social Security's special minimum benefit.

    Science.gov (United States)

    Olsen, K A; Hoffmeyer, D

    Social Security would modify and strengthen the current-law special minimum benefit. Interest in the special minimum benefit may also increase because of labor force participation and marital trends that suggest that enhancing workers' benefits may be a more effective means of reducing older women's poverty rates than enhancing spousal or widow's benefits. By understanding the Social Security program's experience with the special minimum benefit, policymakers will be able to better anticipate the effectiveness of other initiatives to enhance benefits for long-term low earners. This article presents the most recent and comprehensive information available about the special minimum benefit in order to help policymakers make informed decisions about the provision's future. Highlights of the current special minimum benefit include the following: Very few persons receive the special minimum benefit. As of December 2001, about 134,000 workers and their dependents and survivors were entitled to a benefit based on the special minimum. Of those, only about 79,000 received a higher total benefit because of the special minimum; the other 55,000 were dually entitled. (In effect, when persons are eligible for more than one type of benefit--that is, they are dually eligible--the highest benefit payable determines total benefits. If the special minimum benefit is not the highest benefit payable, it does not increase total benefits paid.) As of February 2000, retired workers who were special minimum beneficiaries with unreduced benefits and were not dually entitled were receiving, on average, a monthly benefit of $510 per month. That amount is approximately $2,000 less than the annual poverty threshold for an aged individual. Special minimum benefits provide small increases in total benefits. For special minimum beneficiaries who were not dually entitled as of December 2001, the average special minimum monthly PIA was just $39 higher than the regular PIA. Most special minimum

  19. Older Motorcyclists in Ireland

    LENUS (Irish Health Repository)

    Fitzpatrick, D

    2017-06-01

    Older motorcyclists are under-recognised as vulnerable road users. Using Irish data from the Central Statistics Office, the Road Safety Authority and the Healthcare Pricing Office, we explored the trend of ageing riders and factors in older motorcyclist collisions and injuries. In 2005, 17 motorcyclists ≥55 were injured compared to 31 in 2012. Motorcyclists aged between 30 and 49 years and ≥50 have longer lengths of stay compared to riders <30. The percentage of motorcycles with an engine capacity of ≥750cc increased from 39.6% in 2007 to 46.7% in 2015. Older motorcyclists are less likely to be fatally injured in single vehicle collisions. Older motorcyclists are generally safer than younger riders but the proportion of older motorcyclist injury is rising. Irish road safety strategies and trauma services need to incorporate these findings into planning and development of preventive and treatment approaches

  20. Renovating Older Schools: Reusing Older Schools Workshop.

    Science.gov (United States)

    Mississippi State Univ., Mississippi State. Educational Design Inst.

    A slide presentation examines the decisionmaking process behind whether a community should renovate their older school facilities or abandon them for new facilities. Three factors to be considered in this decision are addressed and involve the school's location, the history of the school, and the relationship of the school to the community and the…

  1. Why children with severe bacterial infection die: a population-based study of determinants and consequences of suboptimal care with a special emphasis on methodological issues.

    Directory of Open Access Journals (Sweden)

    Elise Launay

    Full Text Available INTRODUCTION: Suboptimal care is frequent in the management of severe bacterial infection. We aimed to evaluate the consequences of suboptimal care in the early management of severe bacterial infection in children and study the determinants. METHODS: A previously reported population-based confidential enquiry included all children (3 months- 16 years who died of severe bacterial infection in a French area during a 7-year period. Here, we compared the optimality of the management of these cases to that of pediatric patients who survived a severe bacterial infection during the same period for 6 types of care: seeking medical care by parents, evaluation of sepsis signs and detection of severe disease by a physician, timing and dosage of antibiotic therapy, and timing and dosage of saline bolus. Two independent experts blinded to outcome and final diagnosis evaluated the optimality of these care types. The effect of suboptimal care on survival was analyzed by a logistic regression adjusted on confounding factors identified by a causal diagram. Determinants of suboptimal care were analyzed by multivariate multilevel logistic regression. RESULTS: Suboptimal care was significantly more frequent during early management of the 21 children who died as compared with the 93 survivors: 24% vs 13% (p = 0.003. The most frequent suboptimal care types were delay to seek medical care (20%, under-evaluation of severity by the physician (20% and delayed antibiotic therapy (24%. Young age (under 1 year was independently associated with higher risk of suboptimal care, whereas being under the care of a paediatric emergency specialist or a mobile medical unit as compared with a general practitioner was associated with reduced risk. CONCLUSIONS: Suboptimal care in the early management of severe bacterial infection had a global independent negative effect on survival. Suboptimal care may be avoided by better training of primary care physicians in the specifics of

  2. How Active Are Older Americans?

    Directory of Open Access Journals (Sweden)

    Judy Kruger, PhD

    2007-07-01

    Full Text Available IntroductionRegular physical activity can reduce age-related functional decline, as well people’s risk for chronic diseases such as coronary heart disease, hypertension, colon cancer, and diabetes. The objective of this study was to estimate the level of participation in aerobic, muscle-strengthening, and flexibility activities among Americans aged 50 years or older.MethodsUsing population-based data from the 2001 National Health Interview Survey, we classified qualified respondents (N = 11,969 according to whether they met the activity criteria used in Healthy People 2010 goals for leisure-time participation in regular aerobic physical activity, vigorous-intensity aerobic activity, strength-training activity, and flexibility activity. We also classified respondents according to their level of aerobic activity (i.e., inactive, insufficiently active, and regularly active.ResultsWe estimated that 46.4% of older Americans engaged in no leisure-time aerobic activity; that 26.1% were regularly active (participated in light- to moderate-intensity aerobic activities at least 5 days per week for at least 30 minutes or vigorous-intensity activities at least 3 days per week for at least 20 minutes; that 16.2% participated in vigorous-intensity aerobic activities at least 3 days per week for at least 20 minutes; that 13.7% participated in strength-training activities at least 2 days per week; and that 24.5% participated in flexibility activities at least 1 day per week. Among the 26.1% of older Americans who were regularly active, 30.5% engaged in strengthen-training activities at least 2 days per week. Overall, only 8.2% of older Americans met the criteria for both aerobic and strength-training activity.ConclusionAs of 2001, the percentage of older Americans who met recommended activity levels of physical activity were well below the goals for U.S. adults in Healthy People 2010. Further efforts are needed to encourage older Americans to engage in

  3. Potentially inappropriate medications among older adults in Pelotas, Southern Brazil.

    Science.gov (United States)

    Lutz, Bárbara Heather; Miranda, Vanessa Irribarem Avena; Bertoldi, Andréa Dâmaso

    2017-06-22

    To assess the use of potentially inappropriate medications among older adults. This is a population-based cross-sectional study with 1,451 older individuals aged 60 years or more in the city of Pelotas, State of Rio Grande do Sul, Brazil, in 2014. We have investigated the use of medications in the last 15 days. Using the Beers criteria (2012), we have verified the use of potentially inappropriate medications and their relationship with socioeconomic and demographic variables, polypharmacy, self-medication, and burden of disease. Among the 5,700 medications used, 5,651 could be assessed as to being inappropriate. Of these, 937 were potentially inappropriate for the older adults according to the 2012 Beers criteria (16.6%). Approximately 42.4% of the older adults studied used at least one medication considered as potentially inappropriate. The group of medications for the nervous system accounted for 48.9% of the total of the potentially inappropriate medications. In the adjusted analysis, the variables female, advanced age, white race, low educational level, polypharmacy, self-medication, and burden of disease were associated with the use of potentially inappropriate medications. It is important to known the possible consequences of the use of medication among older adults. Special attention should be given to the older adults who use polypharmacy. Specific lists should be created with more appropriate medications for the older population in the National Essential Medicine List. Avaliar o uso de medicamentos potencialmente inadequados entre idosos. Estudo transversal de base populacional com 1.451 idosos com 60 anos ou mais em Pelotas, RS, em 2014. Investigou-se o uso de medicamentos nos últimos 15 dias. Utilizando os critérios de Beers (2012), verificou-se a potencial inadequação dos medicamentos e sua relação com variáveis socioeconômicas e demográficas, polifarmácia, automedicação e carga de doença. Dentre os 5.700 medicamentos utilizados, 5

  4. Older Adult Representation in the Counseling Psychology Literature

    Science.gov (United States)

    Werth, James L., Jr.; Kopera-Frye, Karen; Blevins, Dean; Bossick, Brian

    2003-01-01

    The increasing older adult population has implications for the training and practice of counseling psychologists because of the field's avowed dedication to lifespan development. The present study examined the degree to which older adults were represented in articles in the "Journal of Counseling Psychology" and "The Counseling Psychologist" from…

  5. The Utility of Existential Therapy with Older Adults.

    Science.gov (United States)

    Lewis, Mary Miller

    Older adults, defined as those aged 65 or older, are rapidly becoming the largest group of individuals in the United States. As this population steadily increases, so will the demand for adequate and appropriate mental health care. Counselors need to be prepared to meet this increasing demand by understanding efficacious ways to conceptualize and…

  6. Medication Adherence in Older Adults: A Qualitative Study

    Science.gov (United States)

    Holt, Elizabeth W.; Rung, Ariane L.; Leon, Kyla A.; Firestein, Catherine; Krousel-Wood, Marie

    2014-01-01

    To effectively address medication adherence and improve cardiovascular health among older adults, a deeper understanding is needed of the barriers that this age group faces and of approaches that would be most effective and feasible for improving adherence. We conducted a focus group study (n = 25) in a diverse population of older adults with…

  7. Health Literacy Programs for Older Adults: A Systematic Literature Review

    Science.gov (United States)

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Older adults make up the fastest growing age group in North America. This has demanded increased attention in supporting the health and well-being of this population and, in particular, the role of health information in promoting the health and well-being of older adults. Increased availability and accessibility of information as well as a greater…

  8. Special Photoconverter

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    A special device with photocurrent amplification function is reported. The device with long base region structure consists of dual-route photodetectors and their amplifier. Two photodetectors with a space of 50μm are precisely located in this device. The device with current sensitivity of S≥15A/lm,static state current transmission coefficient of hFE≥5000, single-route dark current of ID≥1μA, high frequency current transmission coefficient modulus of |hfe|≥1 at 400MHz is obtained. At present, the device has been tried out in some inertia systems.

  9. Special offers

    CERN Multimedia

    Staff Association

    2011-01-01

    Are you a member of the Staff Association? Did you know that as a member you can benefit from the following special offers: BCGE (Banque Cantonale de Genève): personalized banking solutions with preferential conditions. TPG: reduced rates on annual transport passes for active and retired staff. Aquaparc: reduced ticket prices for children and adults at this Swiss waterpark in Le Bouveret. FNAC: 5% reduction on FNAC vouchers. For more information about all these offers, please consult our web site: http://association.web.cern.ch/association/en/OtherActivities/Offers.html

  10. Special Offers

    CERN Multimedia

    Association du personnel

    2011-01-01

    Are you a member of the Staff Association? Did you know that as a member you can benefit from the following special offers: BCGE (Banque Cantonale de Genève): personalized banking solutions with preferential conditions. TPG: reduced rates on annual transport passes for active and retired staff. Aquaparc: reduced ticket prices for children and adults at this Swiss waterpark in Le Bouveret. Walibi: reduced prices for children and adults at this French attraction park in Les Avenières. FNAC: 5% reduction on FNAC vouchers. For more information about all these offers, please consult our web site: http://association.web.cern.ch/association/en/OtherActivities/Offers.html

  11. Special offer

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    OFFRE SPECIALE POUR NOS MEMBRES Les vendredis 29 juillet, 5 et 12 août, Aquaparc fermera ses portes exceptionnellement à 22h00. Pour ces évènements, des tarifs défiant toute concurrence vous sont proposés. Au programme : Clown spécialiste de la sculpture de ballons de 16h00 à 21h00 Ambiance Salsa avec danseurs professionnel : Démonstration et Cours de Salsa. Les tarifs : Pour une entrée à partir de 15h00 : Enfant : CHF 22.- Adulte : CHF 26.-  

  12. Blueberry supplementation improves memory in older adults

    Science.gov (United States)

    The prevalence of dementia, in particular Alzheimer’s disease, is increasing with the expansion of the older adult population. In the absence of effective therapy, preventive approaches are essential to mitigate this public health problem. Blueberries contain polyphenolic compounds, most prominent...

  13. 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…

  14. Dynamics of Volunteering in Older Europeans

    Science.gov (United States)

    Hank, Karsten; Erlinghagen, Marcel

    2010-01-01

    Purpose: To investigate the dynamics of volunteering in the population aged 50 years or older across 11 Continental European countries. Design and Methods: Using longitudinal data from the first 2 waves of the Survey of Health, Ageing and Retirement in Europe, we run multivariate regressions on a set of binary-dependent variables indicating…

  15. Older Women's Career Development and Social Inclusion

    Science.gov (United States)

    McMahon, Mary; Bimrose, Jenny; Watson, Mark

    2010-01-01

    This paper considers women's career development and the potential contribution of career development theory, research, practice and policy in advancing a social inclusion agenda. In particular, the paper focuses on older women in the contexts of an ageing population, labour market shortages and Australia's social inclusion agenda. Supporting young…

  16. Perioperative care of the older patient

    NARCIS (Netherlands)

    E. Blommers; M. Klimek (Markus); K.A. Hartholt (Klaas); T.J.M. van der Cammen (Tischa); J. Klein (Jan); P. Noordzij (Peter)

    2011-01-01

    textabstractNearly 60% of the Dutch population undergoing surgery is aged 65 years and over. Older patients are at increased risk of developing perioperative complications (e.g., myocardial infarction, pneumonia, or delirium), which may lead to a prolonged hospital stay or death. Preoperative risk s

  17. Skills Development for a Diverse Older Workforce

    Science.gov (United States)

    Ferrier, Fran; Burke, Gerald; Selby Smith, Chris

    2008-01-01

    In the context of aging populations, governments in Australia and in other Western nations fear that slower growth in the numbers of people of working age (15-64 years) will have a dampening effect on economic growth. They are thus considering how to encourage older workers to remain in the workforce beyond the point at which many currently…

  18. Restorative dentistry for the older patient cohort.

    Science.gov (United States)

    Jablonski, R Y; Barber, M W

    2015-03-01

    The ageing UK population presents a number of challenges to the restorative dentist as a result of complex treatment needs and a significant maintenance burden. This paper discusses how ageing may influence the provision of dental treatment and outlines a variety of conservative, periodontal, endodontic and prosthodontic considerations that are important in the management of the older patient cohort.

  19. Older Women's Career Development and Social Inclusion

    Science.gov (United States)

    McMahon, Mary; Bimrose, Jenny; Watson, Mark

    2010-01-01

    This paper considers women's career development and the potential contribution of career development theory, research, practice and policy in advancing a social inclusion agenda. In particular, the paper focuses on older women in the contexts of an ageing population, labour market shortages and Australia's social inclusion agenda. Supporting young…

  20. Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study.

    Science.gov (United States)

    Huizenga, Petra; Finnema, Evelyn; Roodbol, Petrie

    2016-07-01

    To gain insight into a new type of nurse specialized in gerontology and geriatrics, how they find meaning in the care of older persons and how this relates to the seven professional roles derived from the CanMEDS theoretical framework. To promote the quality of care for older persons in the Netherlands, one of the measures taken is the training and deployment of Registered Nurses specialized in Gerontology and Geriatrics. We focus on their professional roles in this study, to gain insight into the extent to which they fulfil their professional standards. A qualitative study, consisting of seven focus group interviews. The study population included 67 Registered Nurses. Data were collected between October 2011-May 2013. Nurses work in all seven CanMEDS roles, but not with all competences associated with these seven roles. The more distant the role is from patient activities, the less frequently competences such as social networks; design; research; innovation of care; legal, financial and organizational frameworks; professional ethics and professional innovation are mentioned. Nurses engage in activities consistent with nursing care for older people; however, despite their training, they are mainly focused on direct-patient care. Their limited awareness of the complete range of professional competences risks the stagnation of their development in professional roles such as health advocate, scholar and professional, which will not lead to an improvement in the care for older persons. © 2016 John Wiley & Sons Ltd.

  1. Older Adults (and Oral Health)

    Science.gov (United States)

    ... Health Information Sorted by ... > OlderAdults Older Adults and Oral Health Main Content ​ Is dry mouth a natural part ... from fiction by reading this web page about oral health and growing older. Having the right information can ...

  2. Organizational Change Around an Older Workforce.

    Science.gov (United States)

    Moen, Phyllis; Kojola, Erik; Schaefers, Kate

    2017-10-01

    Demographic, economic, political, and technological transformations-including an unprecedented older workforce-are challenging outdated human resource logics and practices. Rising numbers of retirement-eligible Boomers portend a loss of talent, skills, and local knowledge. We investigate organizational responses to this challenge-institutional work disrupting age-graded mindsets and policies. We focus on innovative U.S. organizations in the Minneapolis-St. Paul region in the state of Minnesota, a hub for businesses and nonprofits, conducting in-depth interviews with informants from a purposive sample of 23 for-profit, nonprofit, and government organizations. Drawing on an organizational change theoretical approach, we find organizations are leading change by developing universal policies and practices, not ones intentionally geared to older workers. Both their narratives and strategies-opportunities for greater employee flexibility, training, and scaling back time commitments-suggest deliberate disrupting of established age-graded logics, replacing them with new logics valuing older workers and age-neutral approaches. Organizations in the different sectors studied are fashioning uniform policies regardless of age, exhibiting a parallel reluctance to delineate special policies for older workers. Developing new organizational logics and practices valuing, investing in, and retaining older workers is key 21st century business challenges. The flexibility, training, and alternative pathways offered by the innovative organizations we studied point to fruitful possibilities for large-scale replacement of outdated age-biased templates of work, careers, and retirement.

  3. Cancer Screening in Older Patients.

    Science.gov (United States)

    Salzman, Brooke; Beldowski, Kathryn; de la Paz, Amanda

    2016-04-15

    Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these patients should not be based on age alone. Studies suggest that a life expectancy of at least 10 years is necessary to derive a survival benefit from screening for breast and colorectal cancers; therefore, screening for these cancers is not recommended in those with a life expectancy of less than 10 years. Prostate cancer screening, if performed at all, should not be performed after 69 years of age. Cervical cancer screening may be stopped after 65 years of age if the patient has an adequate history of negative screening results. An individualized approach to cancer screening decisions involves estimating life expectancy, determining the potential benefits and harms of screenings, and weighing those benefits and harms in relation to the patient's values and preferences.

  4. Older people in Canada: their victimization and fear of crime.

    Science.gov (United States)

    Hayman, Stephanie

    2011-09-01

    Older people are more affected by fear of crime and the possibility of victimization, despite their being at lower risk of harm, than any other population group in Canada. Crime, victimization, and fear are not experienced uniformly among older Canadian citizens and residents, partly because older people do not form a homogeneous group. Being part of an ethnic, religious, or sexual minority, or being mentally frail, can have an impact on an individual's perceptions and experience of risk. This analysis explores older people's victimization and fear of crime, while it highlights the lack of consistency in the available data.

  5. Correlates of, and barriers to, Internet use among older adults.

    Science.gov (United States)

    Chang, Janet; McAllister, Carolyn; McCaslin, Rosemary

    2015-01-01

    Older adults constitute the group with the greatest increase in Internet usage in the past decade; however, usage varies greatly within this population. Services to older adults require a current understanding of Internet-use trends. This study utilized a quantitative survey method to examine correlates of, and barriers to, current Internet use in a demographically diverse county in Southern California. Findings indicate that the presence of a computer at home, a job requiring computer use, age, education, and ethnicity are important factors in predicting Internet use in older adults. Implications for social work practice with older adults is discussed.

  6. Teaching about Older People with Mental Retardation: An Educational Model.

    Science.gov (United States)

    Kropf, Nancy P.; And Others

    1993-01-01

    The University of Georgia model curriculum to prepare students to work with mentally retarded older adults has six units: population overview, physiological issues, mental health issues, social support systems, service delivery networks, and legal/ethical issues. (SK)

  7. Special Offers

    CERN Multimedia

    Association du personnel

    2011-01-01

    Are you a member of the Staff Association? Did you know that as a member you can benefit from the following special offers: BCGE (Banque Cantonale de Genève): personalized banking solutions with preferential conditions.     TPG: reduced rates on annual transport passes for active and retired staff.     Aquaparc: reduced ticket prices for children and adults at this Swiss waterpark in Le Bouveret.     Walibi: reduced prices for children and adults at this French attraction park in Les Avenières.       FNAC: 5% reduction on FNAC vouchers.       For more information about all these offers, please consult our web site: http://association.web.cern.ch/association/en/OtherActivities/Offers.html

  8. Special Offers

    CERN Multimedia

    Staff Association

    2011-01-01

    Are you a member of the Staff Association? Did you know that as a member you can benefit from the following special offers: BCGE (Banque Cantonale de Genève): personalized banking solutions with preferential conditions.     TPG: reduced rates on annual transport passes for all active and retired staff.     Aquaparc: reduced ticket prices for children and adults at this Swiss waterpark in Le Bouveret.     Walibi: reduced prices for children and adults at this French attraction park in Les Avenières.       FNAC: 5% reduction on FNAC vouchers.       For more information about all these offers, please consult our web site: http://association.web.cern.ch/association/en/OtherActivities/Offers.html

  9. Special convoy

    CERN Multimedia

    TS-IC Group

    2007-01-01

    A special wide-load convoy will affect traffic between Hall 180 (Meyrin site) and Point 1 (ATLAS) on Tuesday 29 May. The following measures will be in place: Partial closure of Route Arago and Route Einstein between 9.00 a.m. and 12 midday, depending on the rate at which the convoy advances. Closure of Route Einstein between 12 and 2.00 p.m. between Building 104 and Route Veksler (see diagram). Closure of Entrance B in both directions between 12 and 2.30 p.m. Please use Entrance A. For safety reasons, cyclists and pedestrians will not be allowed to ride or walk alongside the convoy. Please comply with the instructions given by the convoy officers. TS-IC Group (tel : 160319 - 163012)

  10. Special relativity

    CERN Document Server

    Faraoni, Valerio

    2013-01-01

    This book offers an essential bridge between college-level introductions and advanced graduate-level books on special relativity. It begins at an elementary level, presenting and discussing the basic concepts normally covered in college-level works, including the Lorentz transformation. Subsequent chapters introduce the four-dimensional worldview implied by the Lorentz transformations, mixing time and space coordinates, before continuing on to the formalism of tensors, a topic usually avoided in lower-level courses. The book’s second half addresses a number of essential points, including the concept of causality; the equivalence between mass and energy, including applications; relativistic optics; and measurements and matter in Minkowski spacetime. The closing chapters focus on the energy-momentum tensor of a continuous distribution of mass-energy and its covariant conservation; angular momentum; a discussion of the scalar field of perfect fluids and the Maxwell field; and general coordinates. Every chapter...

  11. A Bill of Rights for Hospitalized Older Adults.

    Science.gov (United States)

    Mezey, Mathy D; Mitty, Ethel

    2011-03-01

    Acute-care hospitals have few structures, programs, or staff prepared to address the special needs of older adults. To address this issue, the Hartford Institute for Geriatric Nursing [including the Nurses Improving Care for Hospitalized Elders (NICHE) program] and the Coalition of Geriatric Nursing Organizations proposed language for a Bill of Rights for Hospitalized Older Adults. The Bill of Rights moves from general value statements to the specific knowledge, skills, and actions necessary to provide quality of care to older adults. The authors describe the development and testing of the Bill of Rights and suggest steps for its adoption and dissemination.

  12. Older Adults and Alcohol

    Science.gov (United States)

    ... Problems Certain health problems are common in older adults. Heavy drinking can make these problems worse, including: Diabetes High blood pressure Congestive heart failure Liver problems Osteoporosis Memory problems Mood disorders Bad Interactions with Medications ...

  13. Older Adults and Depression

    Science.gov (United States)

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