Urinary and fecal incontinence in a community-residing older population in Japan.

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Nakanishi, N; Tatara, K; Naramura, H; Fujiwara, H; Takashima, Y; Fukuda, H

1997-02-01

To estimate the prevalence and risk factors of urinary and fecal incontinence among a community-residing older population in Japan. Population-based cross-sectional study. A randomly selected sample of 1473 people aged 65 years and older living in the City of Settsu, Osaka, in 1992. Data collected via in-home visits were used to estimate the prevalence of urinary and fecal incontinence and to provide information regarding potential risk factors of urinary and fecal incontinence. Data were obtained from 1405 older adults, a response rate of 95.4%. The prevalence of any degree of urinary incontinence was 98/1000 in both sexes, and 87/ 1000 men and 66/1000 women admitted to some degree of fecal incontinence. Daily, 34/1000 and 20/1000 of the population were incontinent of urine and feces, respectively. There was an increasing prevalence of urinary and fecal incontinence with age in both sexes, but the expected greater prevalence in women was not found. By univariate analyses, age older than 75 years, poor general health as measured by Activities of Daily Living, stroke, dementia, no participation in social activities, and lack of life worth living (Ikigai) were associated significantly with both urinary and fecal incontinence. In the multivariate analyses using logistic regression, age older than 75 years, poor general health, and stroke were independent risk factors for any type of incontinence. Diabetes was an independent risk factor for isolated fecal incontinence, and dementia and no participation in social activities were independent risk factors for double incontinence. Incontinence of urine and feces is a prevalent condition among very old people living in the community in Japan and is associated highly with health and psychosocial conditions.

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

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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

Musculoskeletal health conditions among older populations in urban slums in sub-Saharan Africa.

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Aboderin, Isabella; Nanyonjo, Agnes

2017-04-01

Debate on the burden of musculoskeletal (MSK) conditions in lower and middle income countries is intensifying; yet, little knowledge so far exists on patterns and impacts of such conditions among general or older adult populations in sub-Saharan Africa (SSA). The objectives of this study are to examine the prevalence, potential predictors, and sequelae of MSK among older adults residing in two low resource informal urban settlements or "slums" in Nairobi Kenya. Data on older adults aged 60 years and over from two unrelated cross-sectional surveys on the older slum populations are used: a 2006/7 survey on the social, health, and overall well-being of older people (sample N = 831), and a 2016 survey on realities and impacts of long-term care and social protection for older adults (sample n = 1026). Uni and multivariate regressions on the 2006/7 data are employed to examine relationships of back pain and symptoms of arthritis with sex, age, wealth, unemployment, diagnoses of hypertension, and diabetes; and with indicators of subjective well-being and functional ability. Descriptive frequencies and chi-squared tests of association are used on 2016 data to identify the overall prevalence and locations of activity limiting MSK pain, and sex differences in these. Prevalence of past month back pain and past 2 week symptoms of arthritis was 44% and 42.6%, respectively. Respective prevalence of past month activity limiting back pain and joint pain was 13.9% and 22.7%. A total of 42.6% of slum residents with a current health problem report MSK as the most severe problem. In multivariate regressions, female sex, unemployment, and diagnosis of hypertension are predictive of back pain and symptoms of arthritis. Both conditions are associated with raised odds of having lower quality of life, poorer life satisfaction, and depressive symptoms, and with mobility impairments and self-care difficulties. MSK conditions are salient, and a likely key cause of impaired subjective well

2001 New York State NHTS: Travel Patterns of Special Populations

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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.

Prevalence and correlates of depressive symptoms in Chinese older adults: A population-based study

NARCIS (Netherlands)

Yu, J.; Li, J.; Cuijpers, P.; Wu, S.; Wu, Z.

2012-01-01

Objective In China, the rapid socioeconomic transition and the consequential traditional culture change had significant influences on Chinese older-adult depression. In the present study, the prevalence, the potential risk, and the protective factors of depression in the Chinese older population

Special populations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

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Dries, David; Reed, Mary Jane; Kissoon, Niranjan; Christian, Michael D; Dichter, Jeffrey R; Devereaux, Asha V; Upperman, Jeffrey S

2014-10-01

Past disasters have highlighted the need to prepare for subsets of critically ill, medically fragile patients. These special patient populations require focused disaster planning that will address their medical needs throughout the event to prevent clinical deterioration. The suggestions in this article are important for all who are involved in large-scale disasters or pandemics with multiple critically ill or injured patients, including frontline clinicians, hospital administrators, and public health or government officials. Key questions regarding the care of critically ill or injured special populations during disasters or pandemics were identified, and a systematic literature review (1985-2013) was performed. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. The panel did not include pediatrics as a separate special population because pediatrics issues are embedded in each consensus document. Fourteen suggestions were formulated regarding the care of critically ill and injured patients from special populations during pandemics and disasters. The suggestions cover the following areas: defining special populations for mass critical care, special population planning, planning for access to regionalized service for special populations, triage and resource allocation of special populations, therapeutic considerations, and crisis standards of care for special populations. Chronically ill, technologically dependent, and complex critically ill patients present a unique challenge to preparing and implementing mass critical care. There are, however, unique opportunities to engage patients, primary physicians, advocacy groups, and professional organizations to lessen the impact of disaster on these special populations.

Integrating the older/special needs adoptive child into the family.

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Clark, Pamela; Thigpen, Sally; Yates, Amy Moeller

2006-04-01

This qualitative, grounded theory study investigated 11 families who reported having successfully integrated into their family unit at least one older/special needs adoptee. The theory that emerged through the constant comparative methodology consisted of two categories (Decision to Adopt and Adjustment) and a core category (Developing a Sense of Family). The two categories and core category comprised a process that was informed by the Family Narrative Paradigm and culminated in the successful integration of the child or children into the existing family unit. Parental perceptions that appeared to facilitate this process included: (a) finding strengths in the children overlooked by previous caregivers, (b) viewing behavior in context, (c) reframing negative behavior, and (d) attributing improvement in behavior to parenting efforts.

Depression in an older adult rural population in India.

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Sinha, Sati P; Shrivastava, Saurabh R; Ramasamy, Jegadeesh

2013-10-01

With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. In India, increased life expectancy led to a rise in the older adult population between 2001 and 2011, expected to reach 324 million by 2050. To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community. A cross-sectional descriptive study was conducted in February and March 2012 in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of 5948, 3.1% of whom are aged ≥60 years. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent (a thumbprint was taken if the person was illiterate), participants were assessed face to face for depression using the Short Form Geriatric Depression Scale. The inclusion criterion was a score >24 on the mini-mental state examination. Final sample size was 103. Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version 17. Of 103 respondents interviewed, 73 (70.9%) were aged 60-69 years and 58 (56.3%) were male. Forty-four (42.7%) individuals (17 males, 27 females) were found to be depressed; 23 (22.3%) with mild depression, 14 (13.6%) moderate depression and 7 (6.8%) severe depression. Female sex and widowhood were significantly associated with depression. Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more

Toward social system theory: implications for older people with developmental disabilities and service delivery.

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Dossa, P A

1990-01-01

The literature refers to older people with developmental disabilities as the "new service population." How and why this population emerged as a special category is discussed conceptually with reference to social systems theory. A brief review of social systems theory and some basic systemic tenets are presented. Systemic tenets are employed in examining the historical development of social gerontology and present trends in the service-delivery system. I show that the systemic variable of the economic model of human development has significantly impacted on the making of older people with developmental disabilities a dependent population. In the conclusion the systems perspective is explored in relation to recognizing the liminal, in-between parts between components. It is argued that such a perception minimizes the dichotomy between older people with developmental disabilities and the non-disabled population, paving the way for a genuine encounter.

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. full text

Comparing the impact of socio-demographic factors associated with traffic injury among older road users and the general population in Japan

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Nagata Takashi

2012-10-01

Full Text Available Abstract Background The increasing number of older road users represents a public health issue because older individuals are more susceptible to traffic injury and mortality than the general population. This study investigated the association between socio-demographic factors and traffic injury and traffic mortality for the general population and among older road users in Japan. Methods An ecological study was conducted using national data in Japan. Multivariate regression methods were applied to investigate the association of traffic injury and traffic mortality for the general population and among older road users with significant demographic, economic, road traffic, and medical/cultural factors. Results Income per capita, total road length, and alcohol consumption per person were significantly associated with traffic injury and traffic mortality both for the general population and among older road users in Japan. Income per capita and alcohol consumption per person were negatively associated with traffic mortality for both groups. Meanwhile, for both groups, income per capita was positively associated with traffic injury, while total road length and alcohol consumption per person were negatively associated with traffic injury. Conclusions The effects of socio-demographic factors on traffic injury and traffic mortality in Japan were similar for both the general population and older road users. The study results suggest that injury preventive measures designed for the general population will be beneficial also for older road users in Japan.

Advances in Psychotherapy for Depressed Older Adults.

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

2017-09-01

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

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

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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. © Crown copyright 2014.

Factors Informing Outcomes for Older Cats and Dogs in Animal Shelters

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Sloane Hawes

2018-03-01

Full Text Available With advances in veterinary medicine that can increase the lifespan of cats and dogs and the effectiveness of spay/neuter programs in reducing the juvenile population of pets, animal shelters are experiencing an increasing population of older companion animals in their care. The purpose of this study was to assess the factors that inform the outcomes of these older cats and dogs. The sample consisted of 124 cats and 122 dogs that were over the age of 84 months (seven years who were taken into a shelter over a one-year period. To assess the impact of condition at intake on the outcome for the senior animals, a multinomial logistic regression was performed. These findings indicate that preventative programming that can address the reasons these older animals are surrendered, as well as advancements in specialized medical or behavioral programs for ageing companion animals, may support an increase in live outcomes for older cats and dogs in shelters. Further study is needed to evaluate how the quality of life of older animals is impacted by remaining in the care of shelters rather than being euthanized.

Do socio-economic factors, elderly population size and service development factors influence the development of specialist mental health programs for older people?

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Shah, Ajit

2008-12-01

Despite the increase in the proportion of older people in the population, little is known about factors that facilitate the development of specialist mental health services for older people. The relationship between the presence of specialist mental health programs for older people and elderly population size, proportion of older people in the population, gross national domestic product (GDP), and various parameters of health funding, mental health funding and mental health service provision was examined in an ecological study using data from the World Health Organization. The presence of specialist mental health programs for older people was significantly associated with higher GDP, higher expenditure on healthcare and mental healthcare, the presence of a national mental health policy and a national mental health program, the availability of mental health care in primary care and the community, and higher density of psychiatric beds, psychiatrists, psychiatric nurses, psychologists and social workers. The challenge will be to persuade policy-makers in low and medium income countries, where the increase in the elderly population is most rapid, to develop specialist mental health services for older people.

Supporting the long-term residential care needs of older homeless people with severe alcohol-related brain injury in Australia: the Wicking Project.

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Rota-Bartelink, Alice; Lipmann, Bryan

2007-01-01

For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model ofcare to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham's capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.

The Challenges of Treating Sciatica Pain in Older Adults.

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Ferreira, Manuela L; McLachlan, Andrew

2016-11-01

Sciatica is a debilitating condition affecting approximately 25 % of the population. Typically, the patient will complain of lower limb pain that is more severe than pain in the lower back, usually accompanied by numbness and motor weakness. Most international guidelines recommend pharmacological management for the pain relief of sciatica, including paracetamol, non-steroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants, and corticosteroids, among others. However, the evidence for most of these pharmacological options is scarce, and the majority of clinical trials exclude older patients. There is overall very limited information on the efficacy, safety, and tolerability of these medicines in older patients with sciatica. This review presents a critical appraisal of the existing evidence for the pharmacological treatment of sciatica, with a special focus on the older adult. The age-related changes in the health of older patients, as well as their impact on the response to pharmacological treatment, including polypharmacy, drug interactions, and drug-disease interactions, is also discussed.

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

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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.

Innovations in Play Therapy: Issues, Process, and Special Populations.

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Landreth, Garry L., Ed.

This book is a compilation of discussions on current issues in play therapy. It is designed to help therapists fill in the gaps about working with special populations, which is often not directly addressed in other play therapy resources. The object of the book is to bring together information related to issues and dynamics of the process of this…

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

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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 (Pdepression, students 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

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

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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.

The Relationship Between Pedometer-Determined Ambulatory Activity and Balance Variables Within an Older Adult Population

OpenAIRE

Campbell, Candice; Kress, Jeff; Schroeder, Jan; Donlin, Ayla; Rozenek, Ralph

2016-01-01

The purpose of this investigation was to determine the differences between gender, physical activity level, and balance in an older adult population. A secondary purpose was to examine the relationship between pedometer-determined ambulatory activity and balance. Forty-six older adults aged 73.7 ± 6.2 years participated in the study. Participants completed the Fullerton Advanced Balance (FAB) Scale and completed a 2-week daily step recording to determine average steps taken per day. Low-level...

Seasonality in mortality and its relationship to temperature among the older population in Hanoi, Vietnam

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Le Thi Thanh Xuan

2014-12-01

Full Text Available Background: Several studies have established a relationship between temperature and mortality. In particular, older populations have been shown to be vulnerable to temperature effects. However, little information exists on the temperature–mortality relationship in Vietnam. Objectives: This article aims to examine the monthly temperature–mortality relationship among older people in Hanoi, Vietnam, over the period between 2005 and 2010, and estimate seasonal patterns in mortality. Methods: We employed Generalized Additive Models, including smooth functions, to model the temperature–mortality relationships. A quasi-Poisson distribution was used to model overdispersion of death counts. Temporal trends, seasonality, and population size were adjusted for while estimating changes in monthly mortality over the study period. A cold month was defined as a month with a mean temperature below 19°C. Results: This study found that the high peak of mortality coincided with low temperatures in the month of February 2008, during which the mean temperature was the lowest in the whole study period. There was a significant relationship between mean monthly temperature and mortality among the older people (p<0.01. Overall, there was a significant decrease in the number of deaths in the year 2009 during the study period. There was a 21% increase in the number of deaths during the cold season compared to the warm season. The increase in mortality during the cold period was higher among females compared to males (female: IRR [incidence relative risk] =1.23; male: IRR=1.18. Conclusions: Cold temperatures substantially increased mortality among the older population in Hanoi, Vietnam, and there were gender differences. Necessary preventive measures are required to mitigate temperature effects with greater attention to vulnerable groups.

Societal consequences of falls in the older population: Injuries, healthcare costs, and long-term reduced quality of life

NARCIS (Netherlands)

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

2011-01-01

textabstractBACKGROUND:: Fall incidents are a major cause of morbidity and mortality in older adults. The aim of this cohort study was to determine the incidence, costs, and quality of life for fall-related injuries in the older Dutch population presenting at the emergency department. METHODS:: Data

Acquired Inhibitors: A Special Case of Bleeding in Older Adults

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Richard G. Stefanacci

2012-01-01

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

Characterizing executive functioning in older special populations: from cognitively elite to cognitively impaired.

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de Frias, Cindy M; Dixon, Roger A; Strauss, Esther

2009-11-01

The authors examined the structure and invariance of executive functions (EF) across (a) a continuum of cognitive status in 3 groups of older adults (cognitively elite [CE], cognitively normal [CN], and cognitively impaired [CI]) and (b) a 3-year longitudinal interval. Using latent variable analyses (LISREL 8.80), the authors tested 3-factor models ("Inhibition": Hayling [Burgess & Shallice, 1997], Stroop [Regard, 1981]; "Shifting": Brixton [Burgess & Shallice, 1997], Color Trails [D'Elia et al., 1996]; and "Updating": Reading and Computational Span [Salthouse & Babcock, 1991]) and 1-factor models within each group. Participants (initial N = 570; 53-90 years) were from the Victoria Longitudinal Study (Sample 3, Waves 1 and 2). Cross-sectionally, the authors observed a 3-factor EF structure especially for the CE group and 1-factor solutions for all 3 groups. Longitudinally, temporal invariance was supported for the 3-factor model (CE and CN groups) and the 1-factor model (CI and CN groups). Subgroups with higher cognitive status and greater 3-year stability performed better on EF factors than corresponding groups with lower cognitive status and less stability. Studies of EF structure, performance, dedifferentiation, and dysfunction will benefit from considering initial cognitive status and longitudinal stability.

Special Agents Can Promote Cooperation in the Population

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Wang, Xin; Han, Jing; Han, Huawei

2011-01-01

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. PMID:22216202

Depression in older people : meeting the challenges of an ageing population

OpenAIRE

Raeburn, Alison Somers

2014-01-01

This thesis has been conducted in part fulfilment of the Doctorate in Clinical Psychology. It comprises two parts: a systematic review and an empirical research study. These are two distinct articles both aiming to provide insight into the challenges of late life depression. Firstly, the ageing population will mean that mental health services are likely to see an increase in older people with depression, many of whom will have neurological conditions common in late life, inc...

Word class and context affect alpha-band oscillatory dynamics in an older population

Directory of Open Access Journals (Sweden)

Monika eMellem

2012-04-01

Full Text Available Differences in the oscillatory EEG dynamics of reading open class and closed class words have previously been found (Bastiaansen et al., 2005 and are thought to reflect differences in lexical-semantic content between these word classes. In particular, the theta band (4–7 Hz seems to play a prominent role in lexical-semantic retrieval. We tested whether this theta effect is robust in an older population of subjects. Additionally, we examined how the context of a word can modulate the oscillatory dynamics underlying retrieval for the two different classes of words. Older participants (mean age 55 read words presented in either syntactically-correct sentences or in a scrambled order (scrambled sentence while their EEG was recorded. We performed time-frequency analysis to examine how power varied based on the context or class of the word. We observed larger power decreases in the alpha (8–12Hz band between 200–700 ms for the open class compared to closed class words, but this was true only for the scrambled sentence context. We did not observe differences in theta power between these conditions. Context exerted an effect on the alpha and low beta (13–18 Hz bands between 0–700 ms. These results suggest that the previously observed word class effects on theta power changes in a younger participant sample do not seem to be a robust effect in this older population. Though this is an indirect comparison between studies, it may suggest the existence of aging effects on word retrieval dynamics for different populations. Additionally, the interaction between word class and context suggests that word retrieval mechanisms interact with sentence-level comprehension mechanisms in the alpha band.

Communication Skills Training for Surgical Residents: Learning to Relate to the Needs of Older Adults.

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Roberts, Linda; Cornell, Charles; Bostrom, Mathias; Goldsmith, Sandra; Ologhobo, Titilayo; Roberts, Timothy; Robbins, Laura

2018-03-30

It is vital for physicians and surgeons to communicate successfully with older adults, who will constitute one-fifth of the US population by 2030. Older adults often perceive themselves as stigmatized and powerless in healthcare settings. Effective communication leads to better patient compliance and satisfaction, which is now a component of Medicare hospital reimbursement and physician and surgeon compensation from hospitals and networks. To increase orthopaedic surgery resident understanding of the unique needs of older adults in order to maintain effective and sensitive communication with this vulnerable population. A two-part training program (ongoing for 8 years) comprised of: 1) small-group interactive didactic sessions on aging issues; and 2) workshop demonstrations given by the residents to a group of older adults, followed by a Question & Answer session. Residents were assessed using a 22-item pre-post questionnaire covering medical knowledge of aging, attitudes toward older adults, and personal anxiety about aging. Older adult participants were surveyed for perceptions of residents' sensitivity toward them. Hospital for Special Surgery in New York City, a specialized urban academic center, with a 5-year Orthopedic Surgery Residency program. 70 PGY3 residents, for whom the program is a requirement, and 711 older adult participants recruited from a community convenience sample. Older adult participants: Of 711 participants, 672 (95%) responded; 96% strongly agreed/agreed that the residents had demonstrated sensitivity toward them. Residents: Of 70 residents, 35 (50%) were assessed. Mean knowledge scores increased significantly (p ≤ 0.001); five of nine attitude items (p ≤ 0.05) and one of four anxiety items improved significantly (p ≤ 0.001). Significant change was seen in residents' attitudes and anxiety levels toward older adults, attributes that are usually deep seated and hard to change. Residents moved along the Accreditation Council for Graduate

Obesity Rates in Special Populations of Children and Potential Interventions

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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…

Social care networks and older LGBT adults: challenges for the future.

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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.

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

Directory of Open Access Journals (Sweden)

Milly A van der Ploeg

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

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

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.

Measurement of overgeneral autobiographical memory: Psychometric properties of the autobiographical memory test in young and older populations.

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Ros, Laura; Romero, Dulce; Ricarte, Jorge J; Serrano, Juan P; Nieto, Marta; Latorre, Jose M

2018-01-01

The Autobiographical Memory Test (AMT) is the most widely used measure of overgeneral autobiographical memory (OGM). The AMT appears to have good psychometric properties, but more research is needed on the influence and applicability of individual cue words in different languages and populations. To date, no studies have evaluated its usefulness as a measure of OMG in Spanish or older populations. This work aims to analyze the applicability of the AMT in young and older Spanish samples. We administered a Spanish version of the AMT to samples of young (N = 520) and older adults (N = 155). We conducted confirmatory factor analysis (CFA), item response theory-based analysis (IRT) and differential item functioning (DIF). Results confirm the one-factor structure for the AMT. IRT analysis suggests that both groups find the AMT easy given that they generally perform well, and that it is more precise in individuals who score low on memory specificity. DIF analysis finds three items differ in their functioning depending on age group. This differential functioning of these items affects the overall AMT scores and, thus, they should be excluded from the AMT in studies comparing young and older samples. We discuss the possible implications of the samples and cue words used.

National stereotypes of older people's competence are related to older adults' participation in paid and volunteer work.

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Bowen, Catherine E; Skirbekk, Vegard

2013-11-01

Why are older people perceived as more competent in some countries relative to others? In the current study, we investigate the extent to which national variation in perceptions of older people's competence is systematically related to national variation in the extent to which older people participate in paid and volunteer work. We used multilevel regression to analyze data from the European Social Survey and test the relationship between perceptions of older people's competence and older people's participation in paid and volunteer work across 28 countries. We controlled for a number of potentially confounding variables, including life expectancy as well as the gender ratio and average education of the older population in each country. We controlled for the average objective cognitive abilities of the older population in a subsample of 11 countries. Older people were perceived as more competent in countries in which more older people participated in paid or volunteer work, independent of life expectancy and the average education, gender makeup, and average cognitive abilities of the older population. The results suggest that older people's participation in paid and volunteer work is related to perceptions of older people's competence independent of older people's actual competence.

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

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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. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults.

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Zhong, Selena; Pinto, Jayant M; Wroblewski, Kristen E; McClintock, Martha K

2018-04-01

first nationally representative study of sexuality and multisensory dysfunction in community-dwelling older adults. 4 of the 5 classic senses were measured with objective tests, and hearing was rated by interviewers in the context of their conversation. Medical and health care interventions that can reduce the burden of sensory dysfunction may improve older adults' sexual experience. Sensory dysfunction is associated with sexual inactivity, but not with sexual motivation. Among those who are sexually active, sensory dysfunction did not interfere with sexual expression. Improving the sexual experience of older adults requires a focus on sensory dysfunction as an impediment to sexual activity given that older adults remain sexually motivated. Zhong S, Pinto JM, Wroblewski KE, et al. Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults. J Sex Med 2018;15:502-509. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

40 Is the New 65? Older Adults and Niche Targeting Strategies in the Online Dating Industry

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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.

Comparison of Well-being of Older Adult Choir Singers and the General Population in Finland: A Case-Control Study.

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Johnson, Julene K; Louhivuori, Jukka; Siljander, Eero

2017-06-01

Previous research suggests that singing in a choir as an older adult is associated with better quality of life (QOL). However, the degree to which sociodemographic variables and level of engagement in hobbies contribute to this relationship is largely unknown. The aim of the study was to compare quality of life (QOL) of older adult choir singers with a matched sample of older adults from the general population in Finland, taking into consideration sociodemographic, satisfaction with health, and level of engagement in hobbies (active, inactive). Case-control methods were used to match a sample of 109 older adult singers with a sample of 307 older adults from the general population. Tobit regression analysis with sociodemographic covariates was used to explore observed group differences in QOL as measured by two WHOQOL-Bref domains (psychological and physical). Probit regression analysis was used to examine the effect of sociodemographic variables and engagement in hobbies and on overall QOL and satisfaction with health. As expected, sociodemographic variables were strongly associated with physical and psychological QOL. After controlling for sociodemographic variables, the older choir singers reported significantly higher ratings on physical QOL, but not psychological QOL, compared to matched controls. Additional adjustment for satisfaction for health attenuated the results. When considering level of engagement in hobbies, older adult choir singers reported significantly higher overall QOL and satisfaction with health when compared to either controls who were either actively engaged in hobbies or not active in hobbies. These results suggest that singing in a choir as an older adult may promote well-being, even after accounting for sociodemographic and level of engagement in hobbies.

Routes to effective evacuation planning primer series : evacuating populations with special needs.

Science.gov (United States)

2009-04-01

Evacuation operations are conducted under the authority of, and based on decisions by, local and state authorities. The purpose of this primer, Evacuating Populations with Special Needs, is to provide local and state emergency managers, government of...

[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.

Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership.

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Hanlin, Erin R; Delgado-Rendón, Angélica; Lerner, E Brooke; Hargarten, Stephen; Farías, René

2013-01-01

The impact of falls in older adults presents a significant public health burden. Fall risk is not well-described in Latino populations nor have fall prevention programs considered the needs of this population. The objectives of this study were to develop a needs assessment of falls in older adult Latinos at a community center (CC), determine fall prevention barriers and strengths in this population, determine the level of interest in various fall prevention methods, and provide medical students an opportunity for participation in a culturally diverse community project. A cross-sectional survey was conducted with a convenience sample of older adult program participants. The survey was developed in collaboration with both partners. CC participants were approached by the interviewer and asked to participate. They were read the survey in their preferred language and their answers were recorded. Data were analyzed using descriptive statistics. We conducted 103 interviews. We found that 54% of participants had fallen in the last year, and of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. Of all respondents, 52% had 5 or more of the 10 surveyed risk factors for falling; 4% had no risk factors. Of all respondents, 75% were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (78% and 65%, respectively). Older adult Latinos in this selected population frequently fall and are worried about falling. Risk factors are prevalent. A fall prevention program is warranted and should include exercise classes and a connection with local primary care providers. A partnership between an academic organization and a CC is an ideal collaboration for the future development of prevention program.

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

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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.

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.

Older drivers : a review.

NARCIS (Netherlands)

Hakamies-Blomqvist, L. Sirén, A. & Davidse, R.J.

2004-01-01

The proportion of senior citizens (aged 65+) will grow from about 15 per cent in the year 2000 to about 30 per cent in the year 2050. The share of older drivers in the driver population will grow even faster because of increasing licensing rates among the ageing population. Older drivers do not have

Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care.

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Helmes, Edward; Ward, Bradley G

2017-03-01

Anxiety in older people is under-diagnosed and poorly treated despite significant impairments that arise from anxiety. Mindfulness-based cognitive therapy (MBCT) has been shown to be a promising treatment for anxiety. The aim of this study was to determine the effect of an MBCT program on anxiety symptoms in older people living in residential care. Fifty-two participants (34 females) were randomly allocated into therapy and control groups using a 2 × 3 mixed design. The average age of participants was 83 years. The group effect showed significant improvements on all measures at the end of the seven-week program in the therapy group, while the control group did not show significant changes. This study represents one of the first studies of the effectiveness of an MBCT program on anxiety symptoms for older people using a randomized controlled trial. The study has implications for future research that include the effectiveness of MBCT for the treatment of anxiety symptoms in older people, the utility of group therapy programs in residential care and the benefits of using specialized instruments for older populations.

"Seniors only want respect": designing an oral health program for older adults.

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Estrada, Ivette; Kunzel, Carol; Schrimshaw, Eric W; Greenblatt, Ariel P; Metcalf, Sara S; Northridge, Mary E

2018-01-01

Persistent socioeconomic disparities in the oral disease burden contribute to pain and suffering among vulnerable and underserved populations who face systemic barriers to access oral health care, including older adults living in disadvantaged urban neighborhoods. The aim of this study is to gain the views of racial/ethnic minority older adults regarding what they believe would support them and their peers in visiting the dentist regularly. Focus groups were conducted and digitally audio-recorded from 2013 to 2015 with 194 racial/ethnic minority women and men aged 50 years and older living in northern Manhattan who participated in one of 24 focus group sessions about improving oral health for older adults. Analysis of the transcripts was conducted using thematic content analysis. The majority of recommendations from racial/ethnic minority older adults to help older adults go to the dentist regularly were centered at the organization and provider level. The preeminence of respectful treatment to racial/ethnic minority older adults may be useful to underscore in oral health programs and settings. There is a need for greater engagement of and attention to patients and other stakeholders in developing, testing, and disseminating interventions to close the gaps in oral health care disparities. © 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.

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...

A support network typology for application in older populations with a preponderance of multigenerational households.

Science.gov (United States)

Burholt, Vanessa; Dobbs, Christine

2014-08-01

This paper considers the support networks of older people in populations with a preponderance of multigenerational households and examines the most vulnerable network types in terms of loneliness and isolation. Current common typologies of support networks may not be sensitive to differences within and between different cultures. This paper uses cross-sectional data drawn from 590 elders (Gujaratis, Punjabis and Sylhetis) living in the United Kingdom and South Asia. Six variables were used in K-means cluster analysis to establish a new network typology. Two logistic regression models using loneliness and isolation as dependent variables assessed the contribution of the new network type to wellbeing. Four support networks were identified: 'Multigenerational Households: Older Integrated Networks', 'Multigenerational Households: Younger Family Networks', 'Family and Friends Integrated Networks' and 'Non-kin Restricted Networks'. Older South Asians with 'Non-kin Restricted Networks' were more likely to be lonely and isolated compared to others. Using network typologies developed with individualistically oriented cultures, distributions are skewed towards more robust network types and could underestimate the support needs of older people from familistic cultures, who may be isolated and lonely and with limited informal sources of help. The new typology identifies different network types within multigenerational households, identifies a greater proportion of older people with vulnerable networks and could positively contribute to service planning.

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

International Nuclear Information System (INIS)

Corseuil, M.W.; Schneider, I.J.C.; Orsi, E.; Hallal, P.C.; Corseuil, H.X.

2012-01-01

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 Walk ability 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

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

Science.gov (United States)

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

2017-06-01

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

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

Science.gov (United States)

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

2016-02-01

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

Acute Myocardial Infarction Population Incidence and Mortality Rates, and 28-day Case-fatality in Older Adults. The REGICOR Study.

Science.gov (United States)

Vázquez-Oliva, Gabriel; Zamora, Alberto; Ramos, Rafel; Marti, Ruth; Subirana, Isaac; Grau, María; Dégano, Irene R; Marrugat, Jaume; Elosua, Roberto

2017-11-22

Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008. A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years. The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years. Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Commentary: the forgotten older adult with serious mental illness: the final challenge in achieving the promise of Olmstead?

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Bartels, Stephen J

2011-01-01

Older adults with serious mental illness disproportionately reside in nursing homes despite the U.S. Supreme Court Olmstead decision supporting the rights of persons with disabilities to benefit from integrated services in the community. This commentary addresses the neglected policy debate on implementing Olmstead for this rapidly growing, older population with special needs. First, the author describes research findings on older adults with serious mental illness living in nursing homes who might more appropriately reside and receive services in the community. Second, the author summarizes the evidence base for effective psychosocial rehabilitation interventions and services facilitating independent living in community settings for this subgroup. Finally, he concludes with seven policy recommendations aimed at advancing the promise of the Olmstead decision with respect to older adults with serious mental illness.

Motivation and readiness for drug treatment: differences by modality and special populations.

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Melnick, Gerald; Hawke, Josephine; De Leon, George

2014-01-01

The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of more than 6,000 admissions to 38 programs. Results from multilevel analyses show (a) an ordered increase in motivation by settings from referral to outpatient, to methadone maintenance, and to the highest levels in residential programs and (b) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment.

Consequences of habitat change and resource selection specialization for population limitation in cavity-nesting birds

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Martin, Thomas E.

2015-01-01

Resource selection specialization may increase vulnerability of populations to environmental change. One environmental change that may negatively impact some populations is the broad decline of quaking aspen Populus tremuloides, a preferred nest tree of cavity-nesting organisms who are commonly limited by nest-site availability. However, the long-term consequences of this habitat change for cavity-nesting bird populations are poorly studied.

Short- and Long-Term Outcomes of Student Field Research Experiences in Special Populations.

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Soliman, Amr S; Chamberlain, Robert M

2016-06-01

Global health education and training of biomedical students in international and minority health research is expending through U.S. academic institutions. This study addresses the short- and long-term outcomes of an NCI-funded R25 short-term summer field research training program. This program is designed for MPH and Ph.D. students in cancer epidemiology and related disciplines, in international and minority settings (special populations) in a recent 7-year period. Positive short-term outcome of 73 students was measured as publishing a manuscript from the field research data and having a job in special populations. Positive long-term outcome was measured as having a post-doc position, being in a doctoral program, and/or employment in special populations at least 3 years from finishing the program. Significant factors associated with both short- and long-term success included resourcefulness of the student and compatibility of personalities and interests between the student and the on-campus and off-campus mentors. Short-term-success of students who conducted international filed research was associated with visits of the on-campus mentor to the field site. Short-term success was also associated with extent of mentorship in the field site and with long-term success. Future studies should investigate how field research sites could enhance careers of students, appropriateness of the sites for specific training competencies, and how to maximize the learning experience of students in international and minority research sites.

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.

What Older Adults Need to Know about Retail Clinics

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

Health Care Needs of Prison Inmates: Treating a population that has special needs

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Wachsmuth, Anne

1991-01-01

Prisoners in correctional facilities constitute a unique population requiring specialized medical care. Drug withdrawal, self-destructive behavior, infectious diseases (including AIDS), and serious mental disorders are some of the challenges to the physician who provides medical services to these inmates.

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

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

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McDonald, Cameron Keith; Ankarfeldt, Mikkel Z; Capra, Sandra; Bauer, Judy; Raymond, Kyle; Heitmann, Berit Lilienthal

2016-05-01

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 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 measured by bioelectrical impedance using equations developed for this Danish population. The association between leucine and LBM changes was examined using multivariate linear regression and ANCOVA analyses adjusted for potential confounders. After adjustment for baseline LBM, sex, age, energy intake and physical activity, leucine intake was associated with LBM change in those older than 65 years (n 79), with no effect seen in those younger than 65 years. Older participants in the highest quartile of leucine intake (7·1 g/d) experienced LBM maintenance, whereas lower intakes were associated with LBM loss 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 corroborates findings from laboratory investigations in relation to protein and leucine intakes and LBM change. A more diverse and larger sample is needed for confirmation of these results.

Effect of a self-care program on oxidative stress and cognitive function in an older Mexican urban-dwelling population.

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Sánchez-Rodríguez, M A; Arronte-Rosales, A; Mendoza-Núñez, V M

2009-11-01

To determine the effect of a self-care program on oxidative stress (OxS) and cognitive function in an older, Mexican, urban-dwelling population. A longitudinal and pre-experimental study was carried out in a sample of 79 older healthy, urban-dwelling individuals residing in Mexico City, (62 females and 17 males), of which 71 of them (59 women and 12 males) complied with the entire self-care program. We measured OxS, cognitive function, the Nagi Disability Scale of physical task functioning, and Instrumental Activities of Daily Living (IADL) prior to and after 2 years of intervention with an active aging program. All older persons adopted healthy, self-care-based lifestyles according to the active aging program to which they were trained, which was associated with a statistically significant improvement of OxS and cognitive function markers on comparing pre- and post-community intervention data. Our findings suggest that self-care-based healthy lifestyles programs can improve the oxidative stress and cognitive function in urban-dwelling elderly population.

Self-Reported Loss of Consciousness After Head Trauma Does Not Predispose to Hypopituitarism in an Older Population

NARCIS (Netherlands)

Rabelink, N.M.; Peeters, G.M.E.E.; van Schoor, N.M.; Drent, M.L.; Lips, P.T.A.M.

2011-01-01

Objective: This population study examines the prevalence of hypopituitarism and low bone mineral density (BMD) in older persons reporting loss of consciousness after head trauma (HT). Methods: Data from the Longitudinal Aging Study Amsterdam were used pertaining to 630 women (53 HT) and 533 men (63

The contribution of family history to hearing loss in an older population.

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McMahon, Catherine M; Kifley, Annette; Rochtchina, Elena; Newall, Philip; Mitchell, Paul

2008-08-01

Although it has been well established that the prevalence of and severity of hearing loss increase with age, the contribution of familial factors to age-related hearing loss cannot be quantified. This is largely because hearing loss in older people has both genetic and environmental contributions. As environmental factors play an increasing role with age, it is difficult to delineate the separate contribution of genetic factors to age-related hearing loss. In a population-based survey of hearing loss in a representative older Australian community, we attempted to overcome this using logistic regression analysis, accounting for known factors associated with hearing loss including age, sex, noise exposure at work, diabetes, and current smoking. We tested hearing thresholds using pure tone audiometry and used a forced choice questionnaire to determine the nature of family history in a population of individuals aged 50 yrs or older in a defined region, west of Sydney, Australia (N = 2669). We compared the characteristics of participants with and without family history of hearing loss. Of those reporting a positive family history, we compared subgroups for age, gender and severity of hearing loss, and trends by the severity of hearing loss. Logistic regression was used to obtain odds ratios (ORs) with 95% confidence intervals (CIs) that compared the chances of having hearing loss in participants with and without family history, after adjusting for other factors known associated with hearing loss. Our findings indicate that family history was most strongly associated with moderate to severe age-related hearing loss. We found a strong association between maternal family history of hearing loss and moderate to severe hearing loss in women (adjusted OR 3.0; 95% CI 1.6-5.6 in women with without a maternal history). Paternal family history of hearing loss was also significantly, though less strongly, associated with moderate-severe hearing loss in men (adjusted OR 2.0; CI 1

OLDER ADULTS: AN ENVIRONMENTALLY SUSCEPTIBLE POPULATION

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The baby boom generation is quickly becoming the geriatric generation. The over-65 age bracket hit 13% of Americans in 1997, and is expected to reach 20% by 2030 accounting for 73 million Americans. World-wide the total number of older people (>60years) is expected to double from...

A reliable measure of frailty for a community dwelling older population

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Fletcher Astrid

2010-10-01

Full Text Available Abstract Background Frailty remains an elusive concept despite many efforts to define and measure it. The difficulty in translating the clinical profile of frail elderly people into a quantifiable assessment tool is due to the complex and heterogeneous nature of their health problems. Viewing frailty as a 'latent vulnerability' in older people this study aims to derive a model based measurement of frailty and examines its internal reliability in community dwelling elderly. Method The British Women's Heart and Health Study (BWHHS cohort of 4286 women aged 60-79 years from 23 towns in Britain provided 35 frailty indicators expressed as binary categorical variables. These indicators were corrected for measurement error and assigned relative weights in its association with frailty. Exploratory factor analysis (EFA reduced the data to a smaller number of factors and was subjected to confirmatory factor analysis (CFAwhich restricted the model by fitting the EFA-driven structure to observed data. Cox regression analysis compared the hazard ratios for adverse outcomes of the newly developed British frailty index (FI with a widely known FI. This process was replicated in the MRC Assessment study of older people, a larger cohort drawn from 106 general practices in Britain. Results Seven factors explained the association between frailty indicators: physical ability, cardiac symptoms/disease, respiratory symptoms/disease, physiological measures, psychological problems, co-morbidities and visual impairment. Based on existing concepts and statistical indices of fit, frailty was best described using a General Specific Model. The British FI would serve as a better population metric than the FI as it enables people with varying degrees of frailty to be better distinguished over a wider range of scores. The British FI was a better independent predictor of all-cause mortality, hospitalization and institutionalization than the FI in both cohorts. Conclusions

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

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

2018-01-01

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. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

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

Lifelong Learning and Older Workers

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Karmel, Tom; Woods, Davinia

2004-01-01

Discussion about Australia's ageing population has focused on the importance of increasing labour force participation rates of older people. This paper examines the influence of education and training on the participation of older people in the labour market, and the pay-off of undertaking education and training as an older-person compared to…

Neuropathic pain is not adequately treated in the older general population: Results from the KORA F4 survey.

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Meisinger, Christa; Bongaerts, Brenda W C; Heier, Margit; Amann, Ute; Kowall, Bernd; Herder, Christian; Rückert-Eheberg, Ina-Maria; Rathmann, Wolfgang; Ziegler, Dan

2018-05-24

We evaluated the pharmacological treatment of distal sensorimotor polyneuropathy (DSPN) among older subjects from the general population. The study included subjects aged 61 to 82 years from the KORA F4 survey (2006-2008). DSPN was defined as the presence of bilaterally impaired foot-vibration perception and/or bilaterally impaired foot-pressure sensation. Pain intensity was assessed with the painDETECT questionnaire. From the included 1076 older persons, 172 (16%) persons reported pain in the lower extremities and DSPN was present in 150 (14%) subjects. Forty-eight people with pain in the lower extremities reported DSPN. Only 38% of the subjects with DSPN reporting an average pain level of ≥4 during the past 4 weeks received medical treatment, predominantly nonsteroidal anti-inflammatory drugs (NSAIDs 20% and opioids 12%). The medication of choice for neuropathic pain, antidepressants, anticonvulsants, and opioids was relatively being underused. However, opioids and neuropathy preparations were prescribed preferably for subjects with painful DSPN. In the older general population, only a small proportion of subjects with painful DSPN receive analgesic pharmacotherapy. Although not recommended by guidelines for the treatment of neuropathic pain, NSAIDs were the most frequently used class of analgesic drugs. Copyright © 2018 John Wiley & Sons, Ltd.

Assessment and management of nutrition in older people and its importance to health.

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Ahmed, Tanvir; Haboubi, Nadim

2010-08-09

Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.

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

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

2017-09-01

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

The Relationship Between Pedometer-Determined Ambulatory Activity and Balance Variables Within an Older Adult Population.

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Campbell, Candice; Kress, Jeff; Schroeder, Jan; Donlin, Ayla; Rozenek, Ralph

2016-01-01

The purpose of this investigation was to determine the differences between gender, physical activity level, and balance in an older adult population. A secondary purpose was to examine the relationship between pedometer-determined ambulatory activity and balance. Forty-six older adults aged 73.7 ± 6.2 years participated in the study. Participants completed the Fullerton Advanced Balance (FAB) Scale and completed a 2-week daily step recording to determine average steps taken per day. Low-level activity participants (7,500 steps/day) in weight, age, and the number of medications reported. Males performed better than females on the two-footed jump test and reactive postural test FAB assessments. High-level activity participants performed significantly better than low-level activity participants on all FAB assessments except stand with feet together and eyes closed, reach forward to object, and walk with head turns.

Assessment and management of nutrition in older people and its importance to health

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Tanvir Ahmed

2010-07-01

Full Text Available Tanvir Ahmed, Nadim HaboubiAdult and Elderly Medicine, Nevill Hall Hospital, Abergavenny, Wales, UKAbstract: Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.Keywords: malnutrition, older people, anorexia of aging, sarcopinia, nutritional assessment

Estimating Glomerular Filtration Rate in Older People

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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.

Sexual Homicide by Older Male Offenders.

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Myers, Wade C; Chan, Heng Choon Oliver; Mariano, Timothy Y; Safarik, Mark E; Geberth, Vernon J

2017-07-01

Recent research has expanded our understanding of sexual homicide offenders (SHOs). However, little exists beyond case reports for older SHOs. We characterized male SHOs ≥ 55 years, comparing them to typical adult male SHOs who are in their 20s. Analysis of 37 years (1976-2012) of US Supplementary Homicide Reports data provided a large SHO sample (N = 3453). Three case reports provide clinical context for the diverse nature and patterns of older SHOs. Only 32 older male SHOs and no older female SHOs were identified. Murders by older SHOs accounted for only 0.5% of US sexual homicides. Unlike typical SHOs that generally target young adult females, over two-thirds of older SHO victims were ≥40 years, and one-third were ≥55 years. Sexual homicides by older SHOs, like sexual homicide in general, decreased over the study period. These crimes, while exceedingly rare, do occur, warranting special consideration. © 2017 American Academy of Forensic Sciences.

A Systematic Literature Review of Studies Analyzing Inequalities in Health Expectancy among the Older Population.

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Benedetta Pongiglione

Full Text Available To collect, organize and appraise evidence of socioeconomic and demographic inequalities in health and mortality among the older population using a summary measure of population health: Health Expectancy.A systematic literature review was conducted. Literature published in English before November 2014 was searched via two possible sources: three electronic databases (Web of Science, Medline and Embase, and references in selected articles. The search was developed combining terms referring to outcome, exposure and participants, consisting in health expectancy, socioeconomic and demographic groups, and older population, respectively.Of 256 references identified, 90 met the inclusion criteria. Six references were added after searching reference lists of included articles. Thirty-three studies were focused only on gender-based inequalities; the remaining sixty-three considered gender along with other exposures. Findings were organized according to two leading perspectives: the type of inequalities considered and the health indicators chosen to measure health expectancy. Evidence of gender-based differentials and a socioeconomic gradient were found in all studies. A remarkable heterogeneity in the choice of health indicators used to compute health expectancy emerged as well as a non-uniform way of defining same health conditions.Health expectancy is a useful and convenient measure to monitor and assess the quality of ageing and compare different groups and populations. This review showed a general agreement of results obtained in different studies with regard to the existence of inequalities associated with several factors, such as gender, education, behaviors, and race. However, the lack of a standardized definition of health expectancy limits its comparability across studies. The need of conceiving health expectancy as a comparable and repeatable measure was highlighted as fundamental to make it an informative instrument for policy makers.

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

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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.

Coping and health in older adults.

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Yancura, Loriena A; Aldwin, Carolyn M

2008-02-01

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

The safety of meperidine prescribing in older adults: A longitudinal population-based study.

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Friesen, Kevin J; Falk, Jamie; Bugden, Shawn

2016-05-11

Meperidine (pethidine) is an opioid analgesic that offers little advantage relative to other opioids and several disadvantages including limited potency, short duration of action, and the production of a neurotoxic metabolite (normeperidine) with a long half-life. Older adults are more sensitive to meperidine's side effects and may have diminished renal function which leads to the accumulation of normeperidine. The Institute for Safe Medication Practices has suggested avoiding meperidine in older adults, limiting its dose (≤600 mg/day) and duration of use (≤48 h). The objective of this study was to determine the level of meperidine use in older adults and assess the dosage and duration of meperidine with reference to these safety recommendations. A longitudinal study using administrative healthcare data was conducted to examine meperidine utilization and levels of high dose and extended duration prescribing among persons ≥65 years of age between April 1, 2001, and March 31, 2014 in Manitoba, Canada. The number of meperidine prescriptions, users, duration of treatment, defined daily doses (DDD) dispensed and number of prescribers were determined over the study period. In the Manitoba older adult population there was a marked decline in meperidine users and prescriptions from 2001 to 2014. There was an average use of 26.4 (95 % CI 24.0-28.8) DDDs of meperidine per user per year. While only 3.7 % of the prescriptions exceeded the 600 mg maximum daily dose, 96.7 % of prescriptions exceeded the recommended 2 days of therapy. For the remaining users of meperidine, the amount of meperidine used per person rose from 18.98 to 56.14 DDDs/user/year over the study period. The number of prescribers of meperidine declined throughout the study, but low DDD prescribers declined more quickly than high DDD prescribers. While meperidine use has declined, the remaining use appears to be decreasing in safety, with more meperidine prescribed per user. This seems to be driven by

Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults.

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Sjöberg, Linnea; Karlsson, Björn; Atti, Anna-Rita; Skoog, Ingmar; Fratiglioni, Laura; Wang, Hui-Xin

2017-10-15

Depression prevalence in older adults varies largely across studies, which probably reflects methodological rather than true differences. This study aims to explore whether and to what extent the prevalence of depression varies when using different diagnostic criteria and rating scales, and various samples of older adults. A population-based sample of 3353 individuals aged 60-104 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were examined in 2001-2004. Point prevalence of depression was estimated by: 1) diagnostic criteria, ICD-10 and DSM-IV-TR/DSM-5; 2) rating scales, MADRS and GDS-15; and 3) self-report. Depression prevalence in sub-samples by dementia status, living place, and socio-demographics were compared. The prevalence of any depression (including all severity grades) was 4.2% (moderate/severe: 1.6%) for ICD-10 and 9.3% (major: 2.1%) for DSM-IV-TR; 10.6% for MADRS and 9.2% for GDS-15; and 9.1% for self-report. Depression prevalence was lower in the dementia-free sample as compared to the total population. Furthermore, having poor physical function, or not having a partner were independently associated with higher depression prevalence, across most of the depression definitions. The response rate was 73.3% and this may have resulted in an underestimation of depression. Depression prevalence was similar across all depression definitions except for ICD-10, showing much lower figures. However, independent of the definition used, depression prevalence varies greatly by dementia status, physical functioning, and marital status. These findings may be useful for clinicians when assessing depression in older adults and for researchers when exploring and comparing depression prevalence across studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Frailty transitions and types of death in Chinese older adults: a population-based cohort study

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Jiang, Xiao-yan; Wang, Xiao-feng; Shi, Yan; Hai, Hua

2018-01-01

Background Little is known about the adverse effects of frailty transitions. In this study, we aimed to characterize the transitions between frailty states and examine their associations with the type of death among older adults in China, a developing country with a rapidly growing aging population. Methods We used data of 11,165 older adults (aged 65–99 years) from the 2002 and 2005 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Overall, 44 health deficits were used to construct frailty index (FI; range: 0–1), which was then categorized into a three-level variable: nonfrail (FI ≤0.10), prefrail (0.100.21). Outcome was four types of death based on bedridden days and suffering state (assessed in the 2008 wave of CLHLS). Results During the 3-year period, 3,394 (30.4%) participants had transitioned between different frailty states (nonfrail, prefrail, and frail), one-third transitioned to death, and one-third remained in previous frailty states. Transitions to greater frailty (ie, “worsening”) were more common than transitions to lesser frailty (ie, “improvement”). Among four categories of frailty transitions, “worsening” and “remaining frail” had increased risks of painful death, eg, with odds ratios of 1.92 (95% confidence interval [CI] =1.41, 2.62) and 4.75 (95% CI =3.32, 6.80), respectively, for type 4 death (ie, ≥30 bedridden days with suffering before death). Conclusion This large sample of older adults in China supports that frailty is a dynamic process, characterized by frequent types of transitions. Furthermore, those who remained frail had the highest likelihood of experiencing painful death, which raises concerns about the quality of life in frail populations. PMID:29805253

Multimorbidity, dementia and health care in older people:a population-based cohort study.

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Tonelli, Marcello; Wiebe, Natasha; Straus, Sharon; Fortin, Martin; Guthrie, Bruce; James, Matthew T; Klarenbach, Scott W; Tam-Tham, Helen; Lewanczuk, Richard; Manns, Braden J; Quan, Hude; Ronksley, Paul E; Sargious, Peter; Hemmelgarn, Brenda

2017-08-14

Little is known about how multimorbidity, dementia and increasing age combine to influence health outcomes or utilization. Our objective was to examine the joint associations between age, dementia and burden of morbidity with mortality and other clinical outcomes. We did a retrospective population-based cohort study of all adults aged 65 years and older residing in Alberta, Canada, between 2002 and 2013. We used validated algorithms applied to administrative and laboratory data from the provincial health ministry to assess the presence/absence of dementia and 29 other morbidities, and their associations with mortality (our primary outcome), other clinical outcomes (emergency department visits, all-cause hospital admissions) and a proxy for loss of independent living (discharge to long-term care). Cox and Poisson models were adjusted for year-varying covariates. A 3-way interaction was modelled for dementia, the number of comorbidities, and age. There were 610 457 adults aged 65 years and older living in Alberta over the study period. Over median follow-up of 6.8 years, 153 125 (25.1%) participants died and 5569 (0.9%) were discharged to long-term care. The prevalence of people with at least 3 morbidities was 33.7% in 2003 and 50.2% in 2012. The prevalence of dementia rose from 6.2% in fiscal year 2003 to 8.3% in fiscal year 2012, representing a net increase of approximately 13 700 people. The likelihood of all 4 outcomes increased with age and with greater burden of morbidity; the presence of dementia further increased these risks. For example, the risk of mortality increased by 1.54 to 6.38 in the presence of dementia, depending on age and morbidity burden. The risk associated with dementia was attenuated by increasing comorbidity. Older age, multimorbidity and dementia are all strongly correlated with adverse health outcomes as well as a proxy for loss of independent living. The increasing prevalences of dementia and multimorbidity over time suggest the

Communicating the risks of bioterrorism and other emergencies in a diverse society: a case study of special populations in North Dakota.

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McGough, Marty; Frank, Loreeta Leer; Tipton, Stacia; Tinker, Tim L; Vaughan, Elaine

2005-01-01

In the event that terrorists use air, water, or food to deliver destructive agents to civilian populations, some groups and populations may be disproportionately at risk and have unique communications needs. Bioterrorism represents an even greater national public health threat if the nation's preparedness and readiness plans do not address the needs and perspectives of, for example, low-income residents, racially and ethnically diverse communities, and other "special populations". The objective of this study was to develop communications strategies to reach special populations in North Dakota before, during, and after a bioterrorism attack or other crisis. To achieve the study objectives, the investigators used telephone interviews and telephone focus groups with organizations that represented special populations. Areas of inquiry included attitudes and concerns about crises, sources of information used and those identified as most credible, methods to reach people during a crisis event, and awareness of and attitudes about the agencies and organizations that affect risk communications.

The Relationship Between Pedometer-Determined Ambulatory Activity and Balance Variables Within an Older Adult Population

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Candice Campbell MS

2016-12-01

Full Text Available The purpose of this investigation was to determine the differences between gender, physical activity level, and balance in an older adult population. A secondary purpose was to examine the relationship between pedometer-determined ambulatory activity and balance. Forty-six older adults aged 73.7 ± 6.2 years participated in the study. Participants completed the Fullerton Advanced Balance (FAB Scale and completed a 2-week daily step recording to determine average steps taken per day. Low-level activity participants (7,500 steps/day in weight, age, and the number of medications reported. Males performed better than females on the two-footed jump test and reactive postural test FAB assessments. High-level activity participants performed significantly better than low-level activity participants on all FAB assessments except stand with feet together and eyes closed, reach forward to object, and walk with head turns.

Singapore Healthy Older People Everyday (HOPE) Study: Prevalence of Frailty and Associated Factors in Older Adults.

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Merchant, Reshma A; Chen, Matthew Zhixuan; Tan, Linda Wei Lin; Lim, Moses YiDong; Ho, Han Kwee; van Dam, Rob M

2017-08-01

In the context of a rapidly ageing population, Singapore is anticipating a rise in multimorbidity, disability, and dependency, which are driven by physical frailty. Healthy Older People Everyday (HOPE) is an epidemiologic population-based study on community-dwelling older adults aged 65 years and older in Singapore. To investigate the prevalence of frail and prefrail states and their association with polypharmacy, multimorbidity, cognitive and functional status, and perceived health status among community-dwelling older adults in Singapore. Participants for HOPE were older adults aged 65 years and older recruited from a cohort study on the northwest region of Singapore. Analysis was performed on data collected from a combination of interviewer-administered questionnaires (including FRAIL scale, EQ-5D, Mini Mental State Examination, Barthel index, and Lawton IADL scale), clinical assessments, and physical measurements (including hand grip strength and Timed-Up-and-Go [TUG] test). A total of 1051 older adults (mean age 71.2 years) completed the study. More than half (57.2%) were female. The prevalence of frailty and prefrailty was 6.2% and 37%, respectively. Frailty was associated with older age, female gender, Indian (instead of Chinese) ethnicity, multimorbidity, polypharmacy, cognitive and functional impairment, weaker hand grip strength, longer TUG times, and poor perceived health status. Those with underlying cognitive impairment and frailty were at greater risk of adverse health outcome. Frailty is a complex health state with multiple domains and dimensions. In our study in a multiethnic Asian population, we identified nonmodifiable factors and modifiable risk factors (multimorbidity, polypharmacy, cognitive and functional impairment) that were associated with frailty. Interventions will have to be multipronged and will require a collaborated effort in order to effect change and improve the health span in rapidly ageing populations. Copyright © 2017 AMDA �

Treating rhinitis in the older population: special considerations

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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.

Comparison of anxiety as reported by older people with intellectual disabilities and by older people with normal intelligence

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Hermans, H.; Beekman, A.T.F.; Evenhuis, H.M.

2014-01-01

Objectives Older people with intellectual disabilities (ID) may experience more and different symptoms of anxiety than older people with normal intelligence. Study questions: (1) Is the reported severity of anxiety in this group similar to that in the general older population; (2) Are specific

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

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Emlet, Charles A

2016-01-01

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

Predictors of senior center use among older adults in New York City public housing.

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Schneider, Amanda E; Ralph, Nancy; Olson, Carolyn; Flatley, Anne-Marie; Thorpe, Lorna

2014-12-01

Despite agreement among stakeholders that senior centers can promote physical and mental health, research on senior center use in urban populations is limited. Our objective was to describe demographic and health factors associated with senior center use among urban, low-income older adults in order to inform programming and outreach efforts. We used data from a 2009 telephone survey of 1036 adults randomly selected from rosters of New York City public housing residents aged 65 and older. We analyzed senior center use by race/ethnicity, age, gender, health, housing type, and income, and used a forward selection approach to build best-fit models predicting senior center use. Older adults of all ages and of both genders reported substantial use of senior centers, with nearly one third (31.3%) reporting use. Older adults living alone, at risk of depression, or living in specialized senior housing had the greatest use of centers. Senior center use varied by race/ethnicity, and English-speaking Hispanics had a higher prevalence of use than Spanish-speaking Hispanics (adjusted prevalence ratio [PR]=1.69, 95% CI: 1.11-2.59). Spanish-speaking communities and older adults living in non-senior congregate housing are appropriate targets for increased senior center outreach efforts.

Tender point count, pain, and mobility in the older population: the mobilize Boston study.

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Eggermont, Laura H P; Shmerling, Robert H; Leveille, Suzanne G

2010-01-01

Prevalence of tender points (TP), and widespread pain and fibromyalgia, as well as the relationship between TP and widespread pain and mobility, was examined in 585 community-dwelling older adults (mean age 78.2 years, 63.4% female). Pain was based on location (none, single site, multisite, widespread). Mobility was measured by the Short Physical Performance Battery (SPPB), gait speed, and self-reported (S-R) mobility difficulty. Tender-point count and health characteristics (ie, BMI, chronic conditions, analgesic use, number of medications, depression, and blocks walked per week) were assessed. Several participants had 3 or more TP (22.1%) although prevalence of criteria-based fibromyalgia was low (.3%). Mobility was more limited in persons with higher tender-point counts. After adjustment for pain and other risk factors, higher tender-point count was associated with poorer SPPB performance (score < 10, aOR = 1.09 per TP, 95%CI, 1.01-1.17), and slow gait speed (< .784m/sec, aOR = 1.14 per TP, 95%CI, 1.05-1.24), but not with S-R mobility difficulty. S-R mobility difficulty was associated with more disseminated pain (multisite pain, aOR = 2.01, 95%CI, 1.21-3.34; widespread pain, aOR = 2.47, 95%CI, 1.09-5.62). These findings portray a significant mobility burden related to tender-point count and multisite and widespread pain in the older population. Future studies using longitudinal methods are warranted. Higher tender-point count, multisite pain, and widespread pain are common in community-dwelling older adults and associated with mobility problems. Both the manual tender-point exam and the McGill Pain Map may provide important yet different information about risks for mobility disability in older individuals. Copyright 2010 American Pain Society. All rights reserved.

Ensuring oral health for older individuals with intellectual and developmental disabilities.

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Waldman, H Barry; Perlman, Steven P

2012-04-01

To emphasise the oral health needs of older individuals with intellectual and developmental disabilities, the impact on the individual's general health and the role that can be played by nurses. All too often an examination and consideration of the oral health condition of this patient population by nurses/physicians is cursory at best. The increasing retention of the dentition into later years of life provides both the favourable abilities for eating, speech and self esteem, but also the potential for local and general health concerns. Discursive paper. Based on the findings from dental examination of thousands of international athletes in the Special Olympic Games and clinical experiences in academic and private practice settings for care of individuals with intellectual and developmental disabilities, a discursive listing was developed for use in a preliminary examination of the oral cavity. A nurse can play a critical role in the examination, preventive services and referrals for dental care for older individuals with intellectual and developmental disabilities. The specific oral health needs of older individuals with intellectual and developmental disabilities should be an integral component of the preventive and general health care provided by nurses. © 2012 Blackwell Publishing Ltd.

Researching older lesbians: problems and partial solutions.

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Westwood, Sue

2013-01-01

There is a lack of research about older lesbians, who can be considered not only a "hidden population" but also a population in hiding. Yet older lesbians hold vital historical and cultural narratives that are, in turn, the heritage of younger lesbians. They also have much to contribute to understandings about gender, sexuality and aging, and to their currently unmet needs in terms of age-related housing, health, and social care provision. This article reflects on some of the issues that make it difficult to access older lesbians for research purposes. It identifies four problematic areas in researching older lesbians: definitions, access, representative sampling, and ethical issues. It suggests that participative action research might offer a means of widening access and engaging with older lesbians in a more collaborative way.

Older people living with HIV in Uganda: understanding their ...

African Journals Online (AJOL)

HIV-prevention, treatment and care programmes should seek to meet the special needs of older people through focused and innovative approaches. Further research with larger samples is needed to explore the impact of these healthcare needs on the quality of life of older people living with HIV. Keywords: ageing ...

Spinal cord injury in older population in Turkey.

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Güzelküçük, Ü; Demir, Y; Kesikburun, S; Yaşar, E; Yılmaz, B

2014-11-01

Retrospective, comparative 4-year study. To identify the clinical characteristics unique to older patients with spinal cord injury (SCI). Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. The study included 870 consecutive patients with SCI that were divided into two groups according to age. Patients aged ⩾60 years at the time of injury constituted the study group, and randomly selected patients aged 0.05). More patients in the study group had neuropathic pain (50.7 vs 34.7%, P=0.049) and abnormal urinary ultrasound findings (23.3 vs 9.3%, P=0.021). RESULTS revealed that older patients with SCI may have different demographic and clinical features compared with younger patients.

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.

Geriatric dermatology: optimising care in frail older adults

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Lubeek, S.F.K.

2017-01-01

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

Decrease in incidence of colorectal cancer among individuals 50 years or older following recommendations for population-based screening

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Murphy, Caitlin C.; Sandler, Robert S.; Sanoff, Hanna K.; Yang, Y. Claire; Lund, Jennifer L.; Baron, John A.

2016-01-01

Background & Aims The incidence of colorectal cancer (CRC) in the U.S. is increasing among adults younger than age 50 years, but incidence has decreased among older populations after population-based screening was recommended in the late 1980s. Blacks have higher incidence than whites. These patterns have prompted suggestions to lower the screening age for average-risk populations or in blacks. At the same time, there has been controversy over whether reductions in CRC incidence can be attributed to screening. We examined age- and race-related differences in CRC incidence over a 40-year time period. Methods We determined the age-standardized incidence of CRC, from 1975 through 2013, using the population-based Surveillance, Epidemiology, and End Results (SEER) program of cancer registries. We calculated incidence for 5-year age categories (20—24 years through 80—84 years and 85 years or older) for different time periods (1975—1979, 1980—1984, 1985—1989, 1990—1994, 1995—1999, 2000—2004, 2005—2009, and 2010—2013), tumor subsite (proximal colon, descending colon, and rectum), and stages at diagnosis (localized, regional, and distant). Analyses were stratified by race (white vs. black). Results There were 450,682 incident cases of CRC reported to the SEER registries over the entire period (1975—2013). Overall incidence was 75.5/100,000 white persons and 83.6/100,000 black persons. CRC incidence peaked during 1980 through 1989 and began to decrease in 1990. In whites and blacks, the decreases in incidence between the time periods of 1980—1984 and 2010—2013 were limited to the screening-age population (ages 50 years or older). Between these time periods, there was a 40% decrease in incidence among whites compared with a 26% decrease in incidence among blacks. Decreases in incidence were greater for cancers of the distal colon and rectum, and reductions in these cancers were greater among whites than blacks. CRC incidence among persons younger

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.

CT examinations in older patients

International Nuclear Information System (INIS)

Sciuk, J.; Peters, P.E.

1989-01-01

A total of 2,878 unselected subsequent CT examinations carried out in 1984 were analyzed retrospectively. All studies were performed in a university hospital with a centralized department of diagnostic radiology. Most of the patients investigated were hospitalized; there were only 12% outpatients. Of the patients studied 12.6% were older than 65 years and 20.5% older than 60; 17.7% were emergency cases and patients between 16 and 25 years of age represented the largest fraction. In all other age groups the relative distribution between emergency cases and regular studies revealed no significant differences. There was no statistically significant difference between the older age group (patients older than 65 years) and the total population of this study in almost all items investigated, i.e., no differences in CT examination time and no differences in preparation time (time between two CT studies). The rate of abdominal CT examinations was 7% higher in the older age group, while the relative distribution of all other CT examinations was again comparable to the total population under study. Thus, the expected increase in patients in the older age group does not measurably prolong the CT examination time. This statement applies to a major referral center with a high percentage of inpatients. (orig.) [de

Power Relations and Health Care Communication in Older Adulthood: Educating Recipients and Providers.

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Eliassen, A Henry

2016-12-01

Unequal power relations lie just below the surface in much of today's discourse on health care communication with older adults. Focusing on pathologies or deficits tends to reinforce stereotypes of frailty and dependency, thus framing elders as a vulnerable group requiring special assistance. Implicit stereotyping frequently colors interactions of health care personnel with older clients and their families-interactions likely to affect elders' perceptions and health outcomes. Health care providers need to be attuned to the vast and growing diversity in today's older population, wherein many older adults are exemplars of what it takes to marshal resources and cope with multifaceted challenges. Thus, elders have the potential to teach medical personnel through narratives of resilience as well as tribulation. This potential can be fully realized, however, only in contexts where communication patterns characterized by paternalism, consumerism, and collaboration are mutually recognized and selectively challenged or implemented. Promising interventions to facilitate health care communication in older adulthood might well be directed toward (a) educating both recipients and providers to become more mindful of cues that evoke stereotypical thinking, (b) promoting an institutional culture that normalizes situationally appropriate assertive responses to stereotyping, and (c) formally ratifying older adults' life experience in the training of health care personnel. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cross-sectional relationship between haemoglobin concentration and measures of physical and cognitive function in an older rural South African population.

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Payne, Collin F; Davies, Justine I; Gomez-Olive, F Xavier; Hands, Katherine J; Kahn, Kathleen; Kobayashi, Lindsay C; Tipping, Brent; Tollman, Stephen M; Wade, Alisha; Witham, Miles D

2018-04-21

Age cohort differences in haemoglobin concentrations and associations with physical and cognitive performance among populations of lower income and middle-income countries have not previously been described. We examined the association between these factors among older men and women in rural South Africa. We analysed cross-sectional data from a population-based study of rural South African men and women aged 40 and over (n=4499), with data drawn from questionnaire responses, a cognitive battery, objective physical function tests and blood tests. Anaemia was defined as a haemoglobin concentration age, grip strength, walk speed and a latent cognitive function z-score for men and women separately. We used unadjusted correlations and linear models to adjust for comorbidities and inflammation. In total, 1042 (43.0%) women and 833 (40.1%) men were anaemic. Haemoglobin concentrations were inversely correlated with age for men but not for women; in adjusted analyses, haemoglobin was 0.3 g/dL lower per decade older for men (95% CI 0.2 to 0.4 g/dL). In adjusted analyses, haemoglobin concentration was independently associated with grip strength in women (B=0.391, 95% CI 0.177 to 0.605), but this did not reach significance in men (B=0.266, 95% CI -0.019 to 0.552); no associations were observed between haemoglobin levels and walk speed or cognitive score. Anaemia was prevalent in this study population of middle-aged and older, rural South African adults, but in contrast to high-income countries, it was not associated with poor physical or cognitive function. Our findings need to be replicated in other populations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Self-perceived coping resources of middle-aged and older adults - results of a large population-based study.

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Boehlen, Friederike H; Herzog, Wolfgang; Schellberg, Dieter; Maatouk, Imad; Saum, Kai-Uwe; Brenner, Hermann; Wild, Beate

2017-12-01

Psychosocial resources (personal resources, social resources, and other) are important for coping with aging and impairment. The aim of this study was to describe the resources of older adults and to compare subgroups with frailty, complex health care needs, and/or mental disorders. At the third follow-up of the large population-based German ESTHER study, 3124 elderly persons (aged 55-85) were included. Psychosocial resources were assessed during a home visit by trained study doctors by using a list of 26 different items. Resources were described for the total group, separated by sex, and for the three subgroups of persons with frailty, complex health care needs, and mental disorders. Family, self-efficacy, and financial security were the most frequently reported resources of older adults. Women and men showed significant differences in their self-perceived resources. Personal resources (self-efficacy, optimism, mastery), social resources, and financial security were reported significantly less frequently by frail persons, persons with complex health care needs, and mentally ill older adults compared to non-impaired participants. Apart from external support, patients who experienced complex health care needs reported resources less frequently compared to frail and mentally ill patients. Coping resources in older adults are associated with sex and impairment. Evaluation and support of personal resources of frail or mentally ill persons or individuals with complex health care needs should be integrated in the therapeutic process.

Characteristics Associated with Hallux Valgus in a Population-Based Study of Older Adults: The Framingham Foot Study

Science.gov (United States)

Dufour, Alyssa B.; Casey, Virginia A.; Golightly, Yvonne M.; Hannan, Marian T.

2015-01-01

Objective Hallux valgus (HV) is common in older adults, but limited studies of risk factors have reported conflicting results. This cross-sectional analysis examined the association of HV with foot pain and other characteristics in older adults. Methods HV, foot pain, foot structure (planus, rectus, cavus), current and past high heel use, age, and body mass index were assessed in the population-based Framingham Foot Study. Sex-specific logistic and multinomial logistic regression examined the association of HV and HV with pain with study variables. Results Of 1352 men and 1725 women (mean age 66 ± 10.5 years), 22% of men and 44% of women had HV and 3% of men and 11% of women had HV with pain. Foot pain increased odds of HV in both sexes (p 30 kg/m2 decreased odds of HV by 33% in men and 45% in women (p<0.05). In women only, odds of Pain & HV vs. No Pain & No HV were greater with older age and planus foot structure. Conclusions Our work showed different associations in participants who had HV with pain compared to those without foot pain. In both men and women, strong relations were observed between HV and foot pain and inversely with BMI. Older age was associated with HV in women only, as were protective associations with cavus foot structure. PMID:24965070

Prevalence of high, medium and low-risk medical conditions for pneumococcal vaccination in Catalonian middle-aged and older adults: a population-based study

Directory of Open Access Journals (Sweden)

O. Ochoa-Gondar

2017-06-01

Full Text Available Abstract Background Updated population-based data on the frequency and distribution of risk factors for pneumococcal disease is scarce. This study investigated the prevalence of distinct comorbidities and underlying risk conditions related to an increasing risk of pneumococcal disease among Catalonian middle-aged and older adults. Methods Cross-sectional population-based study including 2,033,465 individuals aged 50 years or older registered at 01/01/2015 in the Catalonian Health Institute (Catalonia, Spain. The clinical research database of the Information System for the Development of Research in Primary Care (SIDIAP database was used to identify high-risk (asplenia and/or immunocompromising conditions and other increased-risk conditions (chronic pulmonary, cardiac or liver disease, diabetes mellitus, alcoholism and/or smoking among study subjects. Results Globally, 980,310 (48.2% of the 2,033,465 study population had at least one risk condition of suffering pneumococcal disease (55.4% in men vs 42.0% in women, p < 0.001; 41.7% in people 50–64 years vs 54.7% in persons 65 years or older, p < 0.001. An amount of 176,600 individuals (8.7% had high-risk conditions (basically immunocompromising conditions. On the other hand, 803,710 persons (39.5% had one or more other risk conditions. In fact, 212,255 (10.4% had chronic pulmonary diseases, 248,377 (12.2% cardiac disease, 41,734 (2.1% liver disease, 341,535 (16.8% diabetes mellitus, 58,781 (2.9% alcoholism and 317,558 (15.6% were smokers. Conclusion In our setting, approximately 50 % of overall persons 50 years or older may be considered at-risk population for pneumococcal disease (almost 10 % have high-risk conditions and 40 % have other risk conditions.

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

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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

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

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Rosenberg, Molly S; 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

To identify the unmet needs for HIV prevention among older adults in rural South Africa. 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. 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. 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.

Osteoporosis in older persons: current pharmacotherapy and future directions.

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Duque, Gustavo

2013-10-01

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

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

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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

The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

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Wang, Jye; Lin, Wender; Chang, Ling-Hui

2018-01-01

The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

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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

Marketing to Older American Consumers.

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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…

Clinical Interviewing with Older Adults

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

2012-01-01

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

Transitional Care for Older Adults with Chronic Illnesses as a Vulnerable Population: Theoretical Framework and Future Directions in Nursing.

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Son, Youn Jung; You, Mi Ae

2015-12-01

Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

Districts Adjust to Growth in Older Population

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Sparks, Sarah D.

2012-01-01

The 1,000-student Allegheny Valley district in Pennsylvania boasts generations of alumni and a community so involved with the schools that high school graduation becomes an open celebration in downtown Springdale Borough. Yet the district hasn't asked for a tax increase in three years, and it is pushing out a message to older residents about…

Epidemiological aspects of acquired immunodeficiency syndrome in older Brazilians: a comparative approach

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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.

Older adult education in Lithuanian ageing society

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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.

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

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

Directory of Open Access Journals (Sweden)

Lisa F Carver

Full Text Available 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.

No excess risk of adverse birth outcomes in populations living near special waste landfill sites in Scotland.

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Morris, S E; Thomson, A O; Jarup, L; de Hoogh, C; Briggs, D J; Elliott, P

2003-11-01

A recent study showed small excess risks of low birth weight, very low birth weight and certain congenital anomalies in populations living near landfill sites in Great Britain. The objective of the current study was to investigate the risk of adverse birth outcomes associated with residence near special waste landfill sites in Scotland. We studied risks of adverse birth outcomes in populations living within 2 km of 61 Scottish special waste landfill sites operational at some time between 1982 and 1997 compared with those living further away. 324,167 live births, 1,849 stillbirths, and 11,138 congenital anomalies (including terminations) were included in the study. Relative risks were computed for all congenital anomalies combined, some specific anomalies and prevalence of stillbirth and low and very low birth weight (special waste landfill sites was 0.96 (99% confidence interval 0.89 to 1.02) adjusted for confounders. Adjusted risks were 0.71 (0.36 to 1.42) for neural tube defects, 1.03 (0.85 to 1.26) for cardiovascular defects, 0.84 (0.58 to 1.22) for hypospadias and epispadias (with no excess of surgical corrections), 0.78 (0.27 to 2.23) for abdominal wall defects (1.32 (0.42-4.17) for hospital admissions), 1.22 (0.28 to 5.38) for surgical correction of gastroschisis and exomphalos and 1.01 (0.96 to 1.07) and 1.01 (0.90 to 1.15) for low and very low birth weight respectively. There was no excess risk of stillbirth. In conclusion, we found no statistically significant excess risks of congenital anomalies or low birth weight in populations living near special waste landfill sites in Scotland.

Prevalence of Falls in an Urban Community-Dwelling Older Population of Cape Town, South Africa.

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Zimba Kalula, S; Ferreira, M; Swingler, G; Badri, M; Aihie Sayer, A

2015-12-01

Falls are a major cause of disability and mortality in older adults. Studies on falls in this population have mainly been conducted in high income countries, and scant attention has been given to the problem in low and middle income countries, including South Africa. The aim of the study was to establish a rate for falls in older adults in South Africa. A cross-sectional survey with a 12-month follow-up survey. Three purposively selected suburbs of Cape Town: Plumstead, Wynberg Central and Gugulethu. Eight hundred and thirty seven randomly sampled ambulant community-dwelling subjects aged ≥ 65 years grouped according to ethnicity in three sub-samples: black Africans, coloureds (people of mixed ancestry) and whites. Data were collected on socio-demographic and health characteristics, and history of falls using a structured questionnaire and a protocol for physical assessments and measurements. Of the total baseline (n=837) and follow-up (n=632) survey participants, 76.5% and 77.2 % were females with a mean (S.D) age of 74 years (6.4) and 75 years (6.2), respectively. Rates of 26.4% and 21.9% for falls and of 11% and 6.3% for recurrent falls, respectively, were calculated at baseline and follow-up. Fall rates differed by ethnic sub-sample at baseline: whites 42 %, coloureds 34.4% and black Africans 6.4 % (p=0.0005). Rates of 236, 406 and 354 falls per 1000 person years were calculated for men, women and both genders, respectively. Recurrent falls were more common in women than in men. Falls are a significant problem in older adults in South Africa. Effective management of falls and falls prevention strategies for older people in South Africa, need to be developed and implemented.

Older adults: are they ready to adopt health-related ICT?

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Heart, Tsipi; Kalderon, Efrat

2013-11-01

The proportion of older adults in the population is steadily increasing, causing healthcare costs to rise dramatically. This situation calls for the implementation of health-related information and communication technologies (ICT) to assist in providing more cost-effective healthcare to the elderly. In order for such a measure to succeed, older adults must be prepared to adopt these technologies. Prior research shows, however, that this population lags behind in ICT adoption, although some believe that this is a temporary phenomenon that will soon change. To assess use by older adults of technology in general and ICT in particular, in order to evaluate their readiness to adopt health-related ICT. We employed the questionnaire used by Selwyn et al. in 2000 in the UK, as well as a survey instrument used by Morris and Venkatesh, to examine the validity of the theory of planned behavior (TPB) in the context of computer use by older employees. 123 respondents answered the questions via face-to-face interviews, 63 from the US and 60 from Israel. SPSS 17.0 was used for the data analysis. The results show that although there has been some increase in adoption of modern technologies, including ICT, most of the barriers found by Selwyn et al. are still valid. ICT use was determined by accessibility of computers and support and by age, marital status, education, and health. Health, however, was found to moderate the effect of age, healthier older people being far more likely to use computers than their unhealthy coevals. The TPB was only partially supported, since only perceived behavioral control (PBC) emerged as significantly affecting intention to use a computer, while age, contrary to the findings of Morris and Venkatesh, interacted differently for Americans and Israelis. The main reason for non-use was 'no interest' or 'no need', similar to findings from data collected in 2000. Adoption of technology by older adults is still limited, though it has increased as compared

Mobility impairment, social engagement, and life satisfaction among the older population in China: a structural equation modeling analysis.

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Li, Linna; Loo, Becky P Y

2017-05-01

Revealing the relationship between mobility impairment and life satisfaction can help to propose effective interventions to secure mobility and life satisfaction. However, the relationship remains unclear and lacks quantitative evidence in China. This study therefore assesses the association of mobility impairment, social engagement, and life satisfaction among the older population in China. Based on the sample of China Health and Retirement Longitudinal Survey database in 2013, a structural equation modeling is established. The sample size is 4245 with 55.9% with mobility impairment. The model shows that the length of suffering from disability is significantly related to mobility impairment (β = 0.058, p life satisfaction (β = -0.311, p life satisfaction (β = 0.211, p life satisfaction partly because they usually participate less in social activities. Different strategies are suggested to be adopted to improve the life satisfaction of the older population from the aspects of promoting mobility and social engagement, including improving the design of transport facilitates, providing assistive facilities for the seniors with severe mobility impairment, promoting the accessibility of community leisure and healthcare services, and constructing more community senior activity centers.

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...

Enhancing resiliency for elderly populations : Shelter-in-place planning and training at facilities serving elderly populations through the Rhode Island Senior Resiliency Project.

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Smith, Richard; Mozzer, Michael; Albanese, Joseph; Paturas, James; Gold, Julia

2017-06-01

Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters. Based on this, the Rhode Island Department of Health established the Senior Resiliency Project to bolster the level of resiliency for the types of living facilities housing older adults. The project involves performing onsite assessments of energy resources, developing site-specific sheltering-inplace and energy resiliency plans, and educating and training facility employees and residents on these plans and steps they can take to be better prepared. Based on the feasibility of conducting these activities within a variety of facilities housing older adults, the project is segmented into three phases. This paper describes survey findings, outcomes of interventions, challenges and recommendations for bridging gaps observed in phases 1 and 2 of the project.

Breast cancer screening in older women.

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Caplan, L S; Haynes, S G

1996-01-01

There is currently an epidemic of breast cancer in women 65 years of age and older. The purposes of this paper are to explore the breast cancer screening behaviors of older women and to identify some of the determinants of screening in these women. Data were analyzed from the 1987 National Health Interview Survey, a continuous nationwide household interview survey of the U.S. civilian, noninstitutionalized population. As in other studies, the utilization of breast cancer screening by older women was less in older women than in younger women. This was true for both mammography and clinical breast examination. A number of determinants of screening in older women were identified here. Women with a usual source of care and/or no activity limitation, as well as high school graduates, were the ones most likely to have received a screening mammogram and/or a screening clinical breast exam during the past year. The failure of older women to receive adequate breast cancer screening is an important concern which should be reevaluated, given the breast cancer epidemic in this population. This study identified a number of determinants of breast cancer screening in older women. For the most part, these determinants point to the primary care physician as the key to breast cancer screening in these women. Therefore, the primary care physician must be informed of, and encouraged to follow, the recommendations for periodic breast cancer screening in older women.

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

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Florio, Carol

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

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

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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.

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

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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. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Exploring Life Satisfaction Among Older Adults in Dakar.

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

2015-12-01

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

Emergency Department and Older Adult Motor Vehicle Collisions

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Lotfipour, Shahram

2013-11-01

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

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,

Diagnosis and management of osteoporosis in the older senior

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Sheryl F Vondracek

2009-03-01

Full Text Available Sheryl F Vondracek, Sunny A LinneburDepartment of Clinical Pharmacy, School of Pharmacy C238-L15, University of Colorado Denver, Aurora, CO, USAAbstract: The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weightbearing exercise and smoking cessation if necessary. It is important to remember that falls play a very important role in the risk for osteoporotic fractures, especially in the older senior. All older seniors should be evaluated annually for falls and strategies should be implemented to reduce fall risk in this population. The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. Adequate intakes of calcium and vitamin D are important and deficiencies need to be treated. Data on osteoporosis drug therapy in the older senior are lacking. Based on data from subgroup analyses of large osteoporosis trials in postmenopausal women, current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies. Further studies are needed in older seniors, especially men, to better understand the risks and benefits of pharmacologic therapy for the management of osteoporosis.Keywords: osteoporosis, aged, elderly, eighty and over, senior, diphosphonates

Pulmonary hypertension in older adults.

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

2007-12-01

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

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

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Catherine Garcia

2018-05-01

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

Job search requirements for older unemployed workers

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Bloemen, Hans

2016-01-01

Many OECD countries have, or have had, a policy that exempts older unemployed people from the requirement to search for a job. An aging population and low participation by older workers in the labor market increasingly place public finances under strain, and spur calls for policy measures that activate labor force participation by older workers. Introducing job search requirements for the older unemployed aims to increase their re-employment rates. Abolishing the exemption from job search req...

Problem drinking and associated factors in older adults in South Africa

African Journals Online (AJOL)

Objective: Alcohol abuse poses special risks for increased morbidity and mortality among older adults. Little attention has focused on assessing alcohol use and associated factors among older adults in transitional societies such as South Africa. This study aimed to determine the prevalence of alcohol use and associated ...

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

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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.

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

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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.

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

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Axmon, Anna; Ahlström, Gerd; Höglund, Peter

2017-11-23

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

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

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Anna Axmon

2017-11-01

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

Climate change and the possible health effects on older Australians.

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Saniotis, Arthur; Irvine, Rod

2010-01-01

Climate change is an important issue for Australia. Climate change research forecasts that Australia will experience accelerated warming due to anthrogenic activities. Australia's aging society will face special challenges that demand current attention. This paper discusses two issues in relation to climate change and older Australians: first, pharmacology and autoregulation; and second, mental health among older Australians.

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

Analysis of blood parameters in relation to the risk of cardiovascular disease for older population in Kelantan

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Nabela, Z.; Ramzun, M. R.; Hana, M. M.; Zahirah, N. Z. N.; Ashikin, N. A. R. N. N.; Nursakinah, S.; Azhar, A. R.; Iskandar, S. M.

2018-04-01

Cardiovascular disease (CVD) is known to be the leading cause of morbidity and mortality worldwide and its complication is increasing among older people. Blood parameters including blood pressure (BP), glucose (BG), cholesterol (CHL) and uric acid (UA) are important aspects in maintaining a good condition of the cardiovascular system. The aim of this study is to determine the reference values of blood parameters among older population as well as to assess the association of CVD risk factors with the factors of age, gender and body mass index (BMI). Blood samples were collected from 400 older respondents (≥50 years) in Kota Bharu, Kelantan. The findings showed that respondents aged ≥60 years had significantly higher levels of BP and UA, but lower CHL than 50-59 years respondents (p<0.05). The males had significantly higher BP and lower CHL than the females (p<0.05). The respondents with BMI of ≥25 kgm-2 had significantly higher BP and BG than the respondents with BMI of <25 kgm-2 (p<0.05). There were significant associations between BP-BG, BG-UA and CHL-UA. It can be concluded that the levels of blood parameters are affected by the factors of age, gender and BMI.

Cohabitation among older adults: a national portrait.

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

2006-03-01

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

Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: a systematic review and meta-analysis.

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Chan, Wai Chi; Yeung, Jerry Wing Fai; Wong, Corine Sau Man; Lam, Linda Chiu Wa; Chung, Ka Fai; Luk, James Ka Hay; Lee, Jenny Shun Wah; Law, Andrew Chi Kin

2015-02-01

Numerous studies have reported the prevention of falls through exercise among cognitively healthy older people. This study aimed to determine whether the current evidence supports that physical exercise is also efficacious in preventing falls in older adults with cognitive impairment. Two independent reviewers searched MEDLINE; EMBASE; PsycINFO; the Cumulative Index to Nursing & Allied Health Literature; the Cochrane Central Register of Controlled Trials; the Cochrane Bone, Joint, and Muscle Trauma Group Specialized Register; ClinicalTrials.gov; and the UK Clinical Research Network Study Portfolio up to July 2013 without language restriction. We included randomized controlled trials that examined the efficacy of physical exercise in older adults with cognitive impairment. The methodological qualities of the included trials were appraised according to the criteria developed for the Cochrane review of fall prevention trials. The primary outcome measure was the rate ratio of falls. A meta-analysis was performed to estimate the pooled rate ratio and summarize the results of the trials on fall prevention through physical exercise. Seven randomized controlled trials involving 781 participants were included, 4 of which examined solely older people with cognitive impairment. Subgroup data on persons with cognitive impairment were obtained from the other 3 trials that targeted older populations in general. The meta-analysis showed that physical exercise had a significant effect in preventing falls in older adults with cognitive impairment, with a pooled estimate of rate ratio of 0.68 (95% confidence interval 0.51-0.91). The present analysis suggests that physical exercise has a positive effect on preventing falls in older adults with cognitive impairment. Further studies will be required to determine the modality and frequency of exercise that are optimal for the prevention of falls in this population. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care

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

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

2007-01-01

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

Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

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Classen, Sherrilene; Lopez, Ellen DS; Winter, Sandra; Awadzi, Kezia D; Ferree, Nita; Garvan, Cynthia W

2007-01-01

The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research), and views (qualitative research) of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long-term outcomes. After completing the detailed plan we will test the effectiveness of this intervention on multiple levels. PMID:18225470

Factors influencing the life satisfaction in the older Korean women living alone.

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Kim, Sook-Young; Sok, Sohyune R

2013-04-01

The population of Korea is aging rapidly. The older population varies in characteristics in accordance with a wide-range of circumstances; therefore, categorizing the overall older population as a homogeneous group, could misrepresent their issues. For that reason, the study of older people should be focused on the diversity of characteristics among the older population. The aims of this study were to examine and identify the factors related to life satisfaction in older Korean women living alone. This study was a cross-sectional survey design. The participants comprised of 243 older women over the age of 65, who met eligibility criteria. Measures were a demographic characteristics form, the Health Self-Rating Scale, the Self-Esteem Scale (RSES), the Korean Geriatric Depression Scale Short Form, and the Life Satisfaction Instrument. Degrees of the perceived health status, self-esteem, and depression were higher than the median. Life satisfaction was lower than the median. Predictors that determine life satisfaction in older Korean women living alone were depression, perceived health status, self-esteem, and monthly allowance. All these predictors, or factors, had an explanatory power of 48.2% for life satisfaction among older Korean women living alone. Of all these predictor factors, depression had the largest impact. The major factor influencing the life satisfaction in older Korean women living alone was depression. These findings suggest that there is a need to develop nursing strategies aimed at decreasing depression in order to increase life satisfaction in older women living alone.

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

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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. © The Author(s) 2014.

Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study.

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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.

Incidence of loss of ability to walk 400 meters in a functionally limited older population.

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Chang, Milan; Cohen-Mansfield, Jiska; Ferrucci, Luigi; Leveille, Suzanne; Volpato, Stefano; de Rekeneire, Nathalie; Guralnik, Jack M

2004-12-01

To assess the incidence of and factors related to nondisabled but functionally limited older adults aged 75 to 85 years losing the ability to walk 400 m. Observational study with average follow-up of 21 months. Community. At baseline, 101 persons with objective signs of functional limitations and intact cognitive function agreed to participate in the study. Of these, 81 were able to walk 400 m at baseline, and 62 participated in the follow-up examination. Mobility disability was defined as an inability to complete a 400-m walk test. At baseline, eligible participants (n=81) had the ability to walk 400 m, scored between 4 and 9 on the Short Physical Performance Battery (SPPB; range 0-12), and scored 18 or more on the Mini-Mental State Examination. Demographics, difficulty in daily activities, disease status, behavioral risk factors, and muscle strength were assessed at baseline and follow-up. Of 62 persons at follow-up, 21 (33.9%) developed incident mobility disability. The strongest predictors of loss of mobility were the time to complete the 400-m walk at baseline (odds ratio (OR)=1.6 per 1-minute difference, 95% confidence interval (CI)=1.04-2.45), and decline in SPPB score over the follow-up (OR=1.4 per 1-point difference, 95% CI=1.01-1.92). Older persons with functional limitations have a high rate of loss of ability to walk 400 m. The 400-m walk test is a highly relevant, discrete outcome that is an ideal target for testing preventive interventions in vulnerable older populations.

White-matter microstructure and hearing acuity in older adults: a population-based cross-sectional DTI study.

Science.gov (United States)

Rigters, Stephanie C; Cremers, Lotte G M; Ikram, M Arfan; van der Schroeff, Marc P; de Groot, Marius; Roshchupkin, Gennady V; Niessen, Wiro J N; Baatenburg de Jong, Robert J; Goedegebure, André; Vernooij, Meike W

2018-01-01

To study the relation between the microstructure of white matter in the brain and hearing function in older adults we carried out a population-based, cross-sectional study. In 2562 participants of the Rotterdam Study, we conducted diffusion tensor imaging to determine the microstructure of the white-matter tracts. We performed pure-tone audiogram and digit-in-noise tests to quantify hearing acuity. Poorer white-matter microstructure, especially in the association tracts, was related to poorer hearing acuity. After differentiating the separate white-matter tracts in the left and right hemisphere, poorer white-matter microstructure in the right superior longitudinal fasciculus and the right uncinate fasciculus remained significantly associated with worse hearing. These associations did not significantly differ between middle-aged (51-69 years old) and older (70-100 years old) participants. Progressing age was thus not found to be an effect modifier. In a voxel-based analysis no voxels in the white matter were significantly associated with hearing impairment. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk Factors for Hip Fracture in Japanese Older Adults

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Takashi Yamashita

2012-09-01

Full Text Available Risk factors for hip fracture in Japanese older populations are understudied compared with Western countries arguably due to the relatively lower prevalence rates in Japan. Nationally representative data from the Nihon University Japanese Longitudinal Study of Aging were analyzed using logistic regression to examine possible risk factors of hip fractures, separately for older women (n = 2,859 and older men (n = 2,108. Results showed that older Japanese women with difficulty bending their knees (OR = 1.9, with diabetes (OR = 1.7 times, and/or with more activity of daily living limitations (OR = 1.1 had higher risks of hip fracture. Older Japanese men with difficulty bending their knees (OR = 2.6, who use more external prescription drugs (OR = 1.9, and with cancer (OR = 2.0 times had higher risks of hip fracture. Further considerations of gender- and culture-specific factors along with the identified risk factors may provide insights into future intervention programs for hip fracture in Japanese older populations.

Competences for Working with Older People: The Development and Verification of The European Core Competence Framework for Health and Social Care Professionals Working with Older People

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Dijkman, Bea; Reehuis, Lidwien; Roodbol, Petrie

2017-01-01

Universities of applied sciences in Europe face the challenge of preparing students in health and social care for working with older people and contributing to the innovations needed in light of the ageing of society, along with changes in the health and social care systems in many countries. Dealing with the special needs of older people and the…

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.

Implications of advanced vehicle technologies for older drivers.

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Molnar, Lisa J; Eby, David W

2017-09-01

Advances are being made in vehicle technologies that may help older adults compensate for some of the declines in abilities associated with aging. These advances hold promise for increasing vehicle safety, reducing injuries, and making the driving task more comfortable. However, important research gaps remain with regard to how various advanced technologies impact the safety of older drivers, as well as older drivers' perceptions about these technologies. This special issue contains seven original contributions that address these issues. Specific topics include the: congruence of design guidelines with the needs and abilities of older drivers, transfer of control between automated and manual driving, use of in-vehicle monitoring technology, motivations for technology use and assigned meanings, technology valuation, and effects on driving behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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....

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.

Frailty transitions and types of death in Chinese older adults: a population-based cohort study

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Liu ZY

2018-05-01

Full Text Available Zu-yun Liu,1,* Yin-zhi Wei,2,* Li-qing Wei,3,* Xiao-yan Jiang,4 Xiao-feng Wang,5 Yan Shi,6 Hua Hai7 1Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; 2Department of Geriatrics, Huangshi Central Hospital, Edong Healthcare Group, Huangshi, China; 3Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; 4Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, China; 5Unit of Epidemiology, Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China; 6Department of Emergency, Huai’an Second People’s Hospital and the Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, China; 7Department of Intensive Care Unit, Xuyi People’s Hospital, Xuyi, China *These authors contributed equally to this work Background: Little is known about the adverse effects of frailty transitions. In this study, we aimed to characterize the transitions between frailty states and examine their associations with the type of death among older adults in China, a developing country with a rapidly growing aging population. Methods: We used data of 11,165 older adults (aged 65–99 years from the 2002 and 2005 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS. Overall, 44 health deficits were used to construct frailty index (FI; range: 0–1, which was then categorized into a three-level variable: nonfrail (FI ≤0.10, prefrail (0.10< FI ≤0.21, and frail (FI >0.21. Outcome was four types of death based on bedridden days and suffering state (assessed in the 2008 wave of CLHLS. Results: During the 3-year period, 3,394 (30.4% participants had transitioned between different frailty states (nonfrail, prefrail, and frail, one-third transitioned to death, and one-third remained in previous frailty states

Time-location patterns of a diverse population of older adults: the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air).

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Spalt, Elizabeth W; Curl, Cynthia L; Allen, Ryan W; Cohen, Martin; Adar, Sara D; Stukovsky, Karen H; Avol, Ed; Castro-Diehl, Cecilia; Nunn, Cathy; Mancera-Cuevas, Karen; Kaufman, Joel D

2016-06-01

The primary aim of this analysis was to present and describe questionnaire data characterizing time-location patterns of an older, multiethnic population from six American cities. We evaluated the consistency of results from repeated administration of this questionnaire and between this questionnaire and other questionnaires collected from participants of the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Participants reported spending most of their time inside their homes (average: 121 h/week or 72%). More than 50% of the participants reported spending no time in several of the location options, including at home outdoors, at work/volunteer/school locations indoors or outdoors, or in "other" locations outdoors. We observed consistency between self-reported time-location patterns from repeated administration of the time-location questionnaire and compared with other survey instruments. Comparisons with national cohorts demonstrated the differences in time-location patterns in the MESA Air cohort due to differences in demographics, but the data showed similar trends in patterns by age, gender, season, and employment status. This study was the first to explicitly examine the time-location patterns in an older, multiethnic population and the first to add data on Chinese participants. These data can be used to inform future epidemiological research of MESA Air and other studies that include diverse populations.

Future trends in the prevalence of severe activity limitations among older adults in Europe: a cross-national population study using EU-SILC

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Scherbov, Sergei; Weber, Daniela

2017-01-01

Objective To project the proportion of population 65+ years with severe long-term activity limitations from 2017 to 2047. Design Large population study. Setting Population living in private households of the European Union (EU) and neighbouring countries. Participants Participants from the EU Statistics on Income and Living Conditions aged 55 years and older and living in one of 26 EU and neighbouring countries, who answered the health section of the questionnaire. Outcome measures Prevalence of severe long-term activity limitations of particular subpopulations (ie, 55+, 65+, 75+ and 85+ years) by sex and country. Results We find a huge variation in the prevalence of self-reported severe long-term limitations across Europe for both sexes. However, in 2017, about 20% of the female population aged 65 years and above and about 16% of their male counterparts are expected to report severe long-term activity limitations after accounting for differences in reporting. Accounting for cultural differences in reporting, we expect that European countries will have about 21% (decile 1: 19.5%; decile 9: 22.9%) of female and about 16.8% (decile 1: 15.4%; decile 9: 18.1%) of male 65+ years population with severe long-term activity limitations by 2047. Conclusions Overall, despite the expected increase of life expectancy in European countries, our results suggest almost constant shares of older adults with severe long-term activity limitations within the next 30 years. PMID:29061570

Dehydration in the Older Adult.

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Miller, Hayley J

2015-09-01

Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause. Traditional markers for dehydration do not take into consideration many of the physiological differences present in older adults. Clinical assessment of dehydration in older adults poses different findings, yet is not always diagnostic. Treatment of dehydration should focus on prevention and early diagnosis before it negatively effects health and gives rise to comorbidities. The current article discusses what has most thoroughly been studied; the best strategies and assessment tools for evaluation, diagnosis, and treatment of dehydration in older adults; and what needs to be researched further. [Journal of Gerontological Nursing, 41(9), 8-13.]. Copyright 2015, SLACK Incorporated.

Tourette's syndrome in a special education population: a pilot study involving a single school district.

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Kurlan, R; Whitmore, D; Irvine, C; McDermott, M P; Como, P G

1994-04-01

To determine whether children requiring special education represent a high-risk group for identifying Tourette's syndrome (TS), we performed direct examinations for the presence of tics in 35 special education and 35 regular classroom students from a single school district. Of the special education students, nine (26%) had definite or probable tics as compared with only two (6%) of the regular classroom students. About one-third of the students with tics currently meet diagnostic criteria for TS and probably more will do so in the future. About one-half of the subjects with tics have evidence of obsessive-compulsive behavior (OCB) or an attention-deficit hyperactivity disorder (ADHD). For three randomly selected students with definite tics, direct examinations of first-degree relatives revealed the presence of tics in all families. Subjects to the limitations of this pilot study, we conclude that TS and related tic disorders are commonly associated with the need for special education in this single school district. TS might also be an important contributor to school problems in the childhood population at large and may be a highly prevalent condition. In addition, we conclude that childhood tics are associated with OCB and ADHD, are genetically determined, and are part of the TS clinical spectrum.

Fractures as an independent predictor of functional decline in older people: a population-based study with an 8-year follow-up.

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Piirtola, Maarit; Löppönen, Minna; Vahlberg, Tero; Isoaho, Raimo; Kivelä, Sirkka-Liisa; Räihä, Ismo

2012-01-01

Fractures among older people are common, but there is scant evidence about the impact of fractures on functional decline in an unselected older population. The objective of this study was to analyze the impact of lower and upper body fractures on functional performance among older adults during an 8-year follow-up. A population-based cohort of 616 Finnish persons aged 65 and over was followed for up to 8 years, and the association between fractures and the risk of short-term (0-2 years) and long-term (up to 8 years) functional decline was analyzed. Fractures were categorized according their functional influence on mobility and activities of daily living (ADL) into lower and upper body fractures. Multivariate cumulative logistic regression model was used in the analyses. During the 8-year follow-up, 112 (18%) persons sustained at least one fracture. In the multivariate analyses, lower body fractures predicted both short-term and long-term decline in mobility [cumulative odds ratio (COR) 4.7, 95% confidence interval (95% CI) 1.9-11.7 and COR 2.6, 95% CI 1.1-6.2, respectively] and in ADL performance (COR 3.1, 95% CI 1.3-7.6 and COR 4.7, 95% CI 2.0-11.4, respectively). Upper body fractures predicted decline in ADL performance during the long-term follow-up (COR 2.5, 95% CI 1.3-4.8). Pre-fracture functional decline and inactivity in leisure time physical exercise were independently associated with the risk of decline in extensive activities. Fractures have an independent influence on the development of functional decline in older persons regardless of the pre-fracture health. Prevention of falls and fractures and improvement of treatment, rehabilitation and follow-up process after fractures are needed. Copyright © 2011 S. Karger AG, Basel.

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

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Rina K. Kusumaratna

2011-12-01

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

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

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Rina K. Kusumaratna

2016-02-01

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

What's different about older people.

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Crome, Peter

2003-10-01

Older people can be regarded as a marginalised group within society from a number of perspectives including that of health. When it comes to the use of medication older people have suffered from a double whammy. Not only are they more at risk from the adverse effects of drugs but also their involvement in clinical trials has been limited so that rational prescribing both to maximise benefit and to reduce risk has been problematic. Their special problems have been recognised formerly by the Department of Health in its NSF for Older People [National Service Framework for Older People. Department of Health, London (2001a)], [Medicines and Older People. Implementing medicines-related aspects of the NSF for Older People. Department of Health (2001b)]. Early studies focussed on compliance, the avoidance of poly-pharmacy and the high prevalence of adverse effects of drugs and the reasons for this. Studies in long-stay patients showed dramatic differences in pharmacokinetics between such older people and young healthy volunteers. Initially such differences were ascribed to age alone and the overall message became "start low and go slow". Studies in healthy older people then revealed that age differences in drug metabolism were, as a rule, not so marked although clearance of renally excreted drugs was reduced in line with the age associated decline in renal function. Including older people in clinical trials poses challenges. Many traditional trialists do not have ready access to older people, co-morbidity and poly-pharmacy are common and most people feel reluctant to ask older people to take part in complex and potentially hazardous trials. Concern about compliance is unwarranted. Adverse events may be more serious. Thus in a younger patient postural hypotension may make a subject unsteady but in an older subject the unsteadiness may lead to a fall, the fall to a fracture, and the fracture to poor recovery. The choice of end-points is crucial. Although reduction of

Statistical Profile of Older Hispanics

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... all older Americans (10.2 percent). *Income and poverty estimates are based on redesigned income questions from the Current Population Survey, Annual Social and Economic Supplement. SELF-RATED ...

Data Sources Available for Modeling Environmental Exposures in Older Adults

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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...

Give consideration to financial abuse among the older population.

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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.

Older People as a Developing Market for Cultural Heritage Sites

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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…

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

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

2015-10-01

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

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.

Social support and mental health status of older people: a population-based study in Iran-Tehran.

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Tajvar, Maryam; Grundy, Emily; Fletcher, Astrid

2018-03-01

To investigate direct and stress-buffering associations between social support from family and the mental health of older people in Iran, a country which has recently undergone an exceptionally fast fertility transition and is consequently experiencing rapid population ageing. A cross-sectional stratified random survey of 800 people aged 60+ years resident in Tehran was conducted. In total, 644 people responded. The Social Provisions Scale and the General Health Questionnaire were used to measure perceived social support and mental health, respectively. Multilevel mixed-effects models were used to examine the hypotheses. The findings supported the hypothesis of a direct association between perceived and received social support and mental health. However, we did not find strong evidence to suggest that social support buffered the effects of stress arising from limitations of physical functioning. Lack of help doing paperwork was associated with worse mental health for women but not men. Source of support did not seem to be important. Our results indicated that in Tehran, as in Western settings, social support is important for the mental well-being of older people. Recommendations for policy and further research priorities based on the study findings were provided.

Sexting Leads to "Risky" Sex? An Analysis of Sexting Behaviors in a Nonuniversity-Based, Older Adult Population.

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Currin, Joseph M; Hubach, Randolph D; Sanders, Carissa; Hammer, Tonya R

2017-10-03

Since few researchers have analyzed sexting behaviors in nonuniversity-based adult samples, we sought to determine if sexting is associated with negative psychological correlates and risky sexual behaviors in this population. Analysis of individuals who indicated having vaginal or anal sex in the past 12 months and who identified as single (n = 377) showed that condomless sex is independent of sexting behaviors. Results for those in committed relationships (n = 374) and having had vaginal or anal sex in the past 12 months also demonstrated condomless sex and sexting behaviors were not related. Furthermore, alcohol consumption and relational health were predictive of sexting behaviors in adults in committed relationships. These findings demonstrate that while risky sexual behavior and negative psychological correlates are associated with sexting and younger populations, the same might not be true for a nonuniversity-based, older adult sample.

Gotta survey somebody : Methodological challenges in population studies of older people

OpenAIRE

Kelfve, Susanne

2015-01-01

Conducting representative surveys of older people is challenging. This thesis aims to analyze a) the characteristics of individuals at risk of being underrepresented in surveys of older people, b) the systematic errors likely to occur as a result of these selections, and c) whether these systematic errors can be minimized by weighting adjustments.   In Study I, we investigated a) who would be missing from a survey that excluded those living in institutions and that did not use indirect interv...

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

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

2017-08-01

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

THE ROLE OF PHARMACISTS IN PREVENTING FALLS AMONG AMERICA’S OLDER ADULTS

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Mamta V Karani

2016-11-01

Full Text Available Falls are the leading cause of both fatal and nonfatal injuries in people aged 65 and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient centered team-based approach, pharmacists can collaborate with primary care providers to reduce fall risk. They can screen for fall risk, review and optimize medication therapy, recommend vitamin D, and educate patients and caregivers about ways to prevent falls. To help health care providers implement fall prevention, the Centers for Disease Control and Prevention (CDC developed the STEADI (Stopping Elderly Accidents, Death and Injuries initiative. Based on established clinical guidelines, STEADI provides members of the health care team, including pharmacists, with the tools and resources they need to manage their older patients’ fall risk. These tools are being adapted to specifically advance the roles of pharmacists in: reviewing medications, identifying those that increase fall risk, and communicating those risks with patients’ primary care providers. Through a multidisciplinary approach, pharmacists along with other members of the health care team can better meet the needs of America’s growing older adult population and reduce falls.

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

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

2016-01-01

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

Suicidal behavior in the older patient with schizophrenia

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Kasckow, John; Montross, Lori; Prunty, Laurie; Fox, Lauren; Zisook, Sidney

2011-01-01

Little is known about treating elderly suicidal patients with schizophrenia. The purpose of this article is to review the literature dealing with this population and to discuss what is required to advance this field. Most available studies from middle-aged and older individuals suggest that risk factors include hopelessness, lower quality of life, past traumatic events, depressive symptoms, lifetime suicidal ideation and past attempts; it is not clear whether these findings are generalizable to geriatric populations. Although little treatment research has been performed in older suicidal patients with schizophrenia, an integrated psychosocial and pharmacologic approach is recommended. In addition, one recent study augmented antipsychotic treatment with an SSRI (i.e., citalopram) in a sample of middle-aged and older individuals with schizophrenia with subsyndromal depression; in that study, serotonin selective reuptake inhibitor augmentation reduced depressive symptoms and suicidal ideation. More research is required to better understand suicidal behavior in older patients with schizophrenia. PMID:22028735

Older People of Tomorrow: A Psychosocial Profile.

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Silverstone, Barbara

1996-01-01

Attempts to narrow the scope of present uncertainties about the older population by sketching a psychosocial profile of the older people of tomorrow based on what is known today. Focuses on the baby boom generation and the interplay between personal attributes they could bring to late life and the social and physical environment in which they…

Differences in health-related quality of life between older nursing home residents without cognitive impairment and the general population of Norway.

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Drageset, Jorunn; Natvig, Gerd Karin; Eide, Geir Egil; Clipp, Elizabeth C; Bondevik, Margareth; Nortvedt, Monica W; Nygaard, Harald A

2008-05-01

To advance the understanding of health-related quality of life among older nursing home residents by assessing their health-related quality of life and comparing this with norms from the general population. The study used a two-group cross-sectional comparative design. The samples comprised 227 nursing home residents aged 65-102 years with at least six months' residence and a representative population sample of 1137 Norwegian citizens aged 65-102 years. All nursing home residents had a Clinical Dementia Rating Scale score > or =0.5 and were capable of conversing. The respondents provided demographic information and were surveyed using the SF-36 Health Survey. We used univariate and multivariate linear models to identify possible differences in health-related quality of life between the nursing home residents and the general population, controlled for age, sex, marital status and education. After adjustment for age, group, sex, marital status and education, the nursing home residents scored significantly higher on bodily pain and on physical and emotional role limitation and significantly lower on the other SF-36 subscales, except social functioning, with the largest differences for physical functioning (mean nursing home 23.2 and mean general population 62.9). The general population scores on all subscales generally increased with increasing education but not among the nursing home residents. The mean SF-36 scale scores differed markedly between the nursing home residents and the general population, with the nursing home residents generally scoring lower. The association with background variables known to be related to health-related quality of life differed between the groups. Healthcare professionals should increase attention to health-related quality of life among nursing home residents, periodically assess health-related quality of life and consider interventions that may improve health-related quality of life in older institutionalised populations. This study

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.

Suicide among Older People: Projections for the Future.

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Haas, Ann Pollinger; Hendin, Herbert

1983-01-01

Demonstrates the relationship between cohort size and longitudinal suicide rates, with reference to four particular cohorts. Combines this perspective with projected population increases among older age groups to estimate the scope of the problem of suicide among older people during the early decades of the next century. (Author/JAC)

Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

Science.gov (United States)

Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

2016-12-01

To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

Staphylococcus aureus carriage in older populations in community residential care homes: Prevalence and molecular characterization of MRSA isolates.

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Galán-Sánchez, Fátima; Pérez-Eslava, Maria; Machuca, Jesús; Trujillo-Soto, Teresa; Arca-Suarez, Jorge; Rodríguez-Iglesias, Manuel

2018-06-20

The epidemiology of S. aureus depends on conditions in specific populations. Few studies of S. aureus colonization in the older population have been performed in Spain. The aim of this study was to determine the prevalence of methicillin-resistant S. aureus (MRSA) colonization and its molecular epidemiological characteristics in an institutionalized population in community residential care homes in Cadiz, Spain. A cross-sectional epidemiological study was conducted in three residential care homes for older people. Axilla and nostril samples were tested. Identification of S. aureus and antimicrobial susceptibility testing were by MALDI-TOF and MicroScan panels. MRSA strains were subjected to SCCmec typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The presence of Panton-Valentine leukocidin (PVL) genes was determined by PCR in all S. aureus strains. A total of 293 residents were included. Fifty-one residents (17.4%) were colonized with methicillin-sensitive S. aureus (MSSA) and 11 (3.8%) with MRSA. Resistance to at least two aminoglycosides was observed in 25.4% of MSSA and 90.9% and of MRSA isolates, and resistance to levofloxacin in 80.3% of MSSA and 100% of MRSA isolates. SCCmecIV was detected in all isolates and all except one (ST-125) were ST-8. None of the S. aureus isolates were positive for PVL. A low rate of S. aureus carriage was detected and the prevalence of MRSA was very low. ST8-MRSA-IVc was the dominant clone, and only one strain belonged to ST125-MRSA-IVc. We found MRSA transmission within the residential care homes and a very high rate of quinolone resistance in MSSA and MRSA. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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

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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.

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

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Gardner, Raquel C; Langa, Kenneth M; Yaffe, Kristine

2017-03-01

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. 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 14.0, p = 0.21; calculation impairment

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

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Raquel C Gardner

2017-03-01

Full Text Available 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.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 14.0, p = 0.21; calculation

The effects of emotional television advertising on older and younger adults

NARCIS (Netherlands)

van der Goot, M.J.; van Reijmersdal, E.A.; Kleemans, M.; Verlegh, P.; Voorveld, H.; Eisend, M.

2016-01-01

Understanding older adults’ responses to advertising is vital for the industry because older adults constitute a large and lucrative market: The world population is aging (United Nations, 2012) and consumers of 50 years and older have more disposable income than younger consumers (e.g., Ahmad, 2003;

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

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

2018-02-17

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

A population-based study examining injury among older adults with and without dementia

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Lynn Meuleners

2017-04-01

Older adults with dementia were at increased risk of an admission for an injury compared to those without dementia. Multifactorial injury prevention programs should target older people with dementia, those over 85 years, living alone and with a history of previous falls.

Death Anxiety and Religiosity among an Older Adult Population.

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Holland, Wendy; And Others

One of the most significant factors in accounting for death attitudes is religious beliefs, yet this factor has been little studied or understood. This study examined the relationship between death anxiety, religiosity, and life satisfaction among a sample of retired older individuals. Sixty retired subjects between the ages of 60 and 84 years…

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

Social vulnerability from a social ecology perspective: a cohort study of older adults from the National Population Health Survey of Canada

Science.gov (United States)

2014-01-01

Background Numerous social factors, generally studied in isolation, have been associated with older adults’ health. Even so, older people’s social circumstances are complex and an approach which embraces this complexity is desirable. Here we investigate many social factors in relation to one another and to survival among older adults using a social ecology perspective to measure social vulnerability among older adults. Methods 2740 adults aged 65 and older were followed for ten years in the Canadian National Population Health Survey (NPHS). Twenty-three individual-level social variables were drawn from the 1994 NPHS and five Enumeration Area (EA)-level variables were abstracted from the 1996 Canadian Census using postal code linkage. Principal Component Analysis (PCA) was used to identify dimensions of social vulnerability. All social variables were summed to create a social vulnerability index which was studied in relation to ten-year mortality. Results The PCA was limited by low variance (47%) explained by emergent factors. Seven dimensions of social vulnerability emerged in the most robust, yet limited, model: social support, engagement, living situation, self-esteem, sense of control, relations with others and contextual socio-economic status. These dimensions showed complex inter-relationships and were situated within a social ecology framework, considering spheres of influence from the individual through to group, neighbourhood and broader societal levels. Adjusting for age, sex, and frailty, increasing social vulnerability measured using the cumulative social vulnerability index was associated with increased risk of mortality over ten years in a Cox regression model (HR 1.04, 95% CI:1.01-1.07, p = 0.01). Conclusions Social vulnerability has important independent influence on older adults’ health though relationships between contributing variables are complex and do not lend themselves well to fragmentation into a small number of discrete factors. A

Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study†

Science.gov (United States)

d'Arcy, Joanna L.; Coffey, Sean; Loudon, Margaret A.; Kennedy, Andrew; Pearson-Stuttard, Jonathan; Birks, Jacqueline; Frangou, Eleni; Farmer, Andrew J.; Mant, David; Wilson, Jo; Myerson, Saul G.; Prendergast, Bernard D.

2016-01-01

Background Valvular heart disease (VHD) is expected to become more common as the population ages. However, current estimates of its natural history and prevalence are based on historical studies with potential sources of bias. We conducted a cross-sectional analysis of the clinical and epidemiological characteristics of VHD identified at recruitment of a large cohort of older people. Methods and results We enrolled 2500 individuals aged ≥65 years from a primary care population and screened for undiagnosed VHD using transthoracic echocardiography. Newly identified (predominantly mild) VHD was detected in 51% of participants. The most common abnormalities were aortic sclerosis (34%), mitral regurgitation (22%), and aortic regurgitation (15%). Aortic stenosis was present in 1.3%. The likelihood of undiagnosed VHD was two-fold higher in the two most deprived socioeconomic quintiles than in the most affluent quintile, and three-fold higher in individuals with atrial fibrillation. Clinically significant (moderate or severe) undiagnosed VHD was identified in 6.4%. In addition, 4.9% of the cohort had pre-existing VHD (a total prevalence of 11.3%). Projecting these findings using population data, we estimate that the prevalence of clinically significant VHD will double before 2050. Conclusions Previously undetected VHD affects 1 in 2 of the elderly population and is more common in lower socioeconomic classes. These unique data demonstrate the contemporary clinical and epidemiological characteristics of VHD in a large population-based cohort of older people and confirm the scale of the emerging epidemic of VHD, with widespread implications for clinicians and healthcare resources. PMID:27354049

The role of chiropractic care in older adults

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Dougherty Paul E

2012-02-01

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

World Population Day special symposium.

Science.gov (United States)

1998-08-01

This article describes Japan's celebration of World Population Day, and provides excerpts from speeches at the symposium held on July 8, 1998. The symposium, in Tokyo, was attended by about 300 people. The Chairman of JOICFP gave the opening address. The executive director of UNFPA congratulated Japan for its efforts in the field of population awareness and noted Japan's self-sufficiency despite its importation of 40% of its food and most of its raw materials. A keynote address was delivered by the president of CPE and the former UN Secretary General, who stressed income inequities in the 66% of developing countries within the 185 UN member states. The UN has been promoting sustainable development, but is facing the issue of limited arable land and population growth. The Tutsi and Hutus are fighting due to population based issues. The emphasis should be on women's reproductive rights and protection of women's human rights. 1998 is the 50th year of human rights; progress has been made. The UNFPA Goodwill Ambassador spoke about the disparity between the rich and poor in the Philippines. A small donation reaps incredible progress. Manila has high levels of adolescent childbearing. Men appear to be unaware of the disadvantages of childbearing too early. Rural areas are dominated by strict Roman Catholic beliefs. Manila has commercial sex workers who provide services to Japanese men. The 1998 Kato Award was given to women who raised awareness about coercion in the sex trade and female genital mutilation. The economic situation in Japan creates even greater need to promote family planning and reproductive health.

Smart Homes for Older People: Positive Aging in a Digital World

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Tony Barnett

2012-06-01

Full Text Available Smart homes are homes with technologically advanced systems to enable domestic task automation, easier communication, and higher security. As an enabler of health and well-being enhancement, smart homes have been geared to accommodate people with special needs, especially older people. This paper examines the concept of “smart home” in a technologically driven society and its multi-functional contribution to the enhancement of older people’s lives. Discussion then focuses on the challenges in the use of smart homes among older people such as accessibility and ethical issues. Finally, some implications and recommendations are provided.

Struggles of Older Workers at the Labour Market

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Emília Krajňáková

2017-06-01

Full Text Available This study focuses on the issue of ageing population and the position of older employees at the labour market. We look into theoretical approaches towards the so called “positive ageing of population” and employability of older generations. In addition, we have conducted an empirical research, which allowed us map the employability of workers aged 50 and older in Slovakia. Consequently, we tried to determine the reasons why employers lack interest in employing older employees and how older employees themselves evaluate their position at the labour market today. Our findings suggest there is a discrimination against older workers, as well as inadequacy of state employment policy in the face of demographic changes and missing out on the work potential offered by older generations.The government could contribute to the solution of this problem through affirmative action, for example, by reducing the levy burden, which would deter employers from laying off older workers, who could thus continue sharing their knowledge stemming from profound work experience.

Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial

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Lin Lou

2017-01-01

Full Text Available The purpose of this present study was to examine the effect of Taichi softball (TCSB on physical function in Chinese older adults. Eighty Chinese older adults were randomly assigned into either an experimental group experiencing four 90-minute TCSB sessions weekly for seven consecutive weeks or a control group. At baseline and 7 weeks later, all participants were asked to perform physical functional tests for both lower and upper limbs. Multiple separate Analyses of Variance (ANOVA with repeated measures were applied to evaluate the effects of TCSB on function-related outcomes between baseline and postintervention in the two groups. The findings indicate that a short-term and intensive TCSB training program does not only improve low limb-related physical function such as dynamic balance and leg strength, but also strengthen upper limb-related physical function (e.g., arm and forearm strength, shoulder mobility, fine motor control, handgrip strength, and fine motor function. Health professionals could take into account TCSB exercise as an alternative method to help maintain or alleviate the inevitable age-related physical function degeneration in healthy older adults. In addition, researchers could investigate the effect of TCSB exercise on physical function in special populations such as patients with different chronic diseases or neurological disorder (e.g., Parkinson’s disease.

Managing Status Epilepticus in the Older Adult

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Legriel, Stephane; Brophy, Gretchen M.

2016-01-01

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

Systematic review of the use of online questionnaires of older adults.

Science.gov (United States)

Remillard, Meegan L; Mazor, Kathleen M; Cutrona, Sarah L; Gurwitz, Jerry H; Tjia, Jennifer

2014-04-01

To describe methodological approaches to population targeting and sampling and to summarize limitations of Internet-based questionnaires in older adults. Systematic literature review. Studies using online questionnaires in older adult populations. English-language articles using search terms for geriatric, age 65 and over, Internet survey, online survey, Internet questionnaire, and online questionnaire in PubMed and EBSCO host between 1984 and July 2012. Inclusion criteria were study population mean age 65 and older and use of an online questionnaire for research. Review of 336 abstracts yielded 14 articles for full review by two investigators; 11 articles met inclusion criteria. Articles were extracted for study design and setting, participant characteristics, recruitment strategy, country, and study limitations. Eleven articles were published after 2001. Studies had populations with a mean age of 65 to 78, included descriptive and analytical designs, and were conducted in the United States, Australia, and Japan. Recruiting methods varied widely from paper fliers and personal e-mails to use of consumer marketing panels. Investigator-reported study limitations included the use of small convenience samples and limited generalizability. Online questionnaires are a feasible method of surveying older adults in some geographic regions and for some subsets of older adults, but limited Internet access constrains recruiting methods and often limits study generalizability. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

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

NARCIS (Netherlands)

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

2016-01-01

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

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...

Insights on older adults' perception of at-home sensory-hedonic methods

NARCIS (Netherlands)

Ruark, Angelica; Vingerhoeds, Monique H.; Kremer, Stefanie; Nijenhuis, Mariska; Piqueras-Fiszman, Betina

2016-01-01

The increasing average life expectancy and overall percentage of the older population is leading to a growing interest in healthy aging. Thus, there is a demand for flavourful, and pleasant foods, rich in certain nutrients, targeted at older consumers. In order to be able to tailor foods to older

Nurses' attitudes towards older people care: An integrative review.

Science.gov (United States)

Rush, Kathy L; Hickey, Stormee; Epp, Sheila; Janke, Robert

2017-12-01

To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes. © 2017 John Wiley & Sons Ltd.

Health screening for older people—what are the current recommendations?

OpenAIRE

Sazlina, SG

2015-01-01

The world population of older people is on the rise with improved health services. With longevity, older people are at increased risk of chronic non-communicable diseases (NCDs), which are also leading causes of death among older people. Screening through case finding in primary care would allow early identification of NCDs and its risk factors, which could lead to the reduction of related complications as well as mortality. However, direct evidence for screening older people is lacking and t...

Tontura em idosos da comunidade: estudo de base populacional Dizziness in community-dewelling older adults: a population-based study

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Suzana Albuquerque de Moraes

2011-12-01

Full Text Available A queixa de tontura é comum em idosos. OBJETIVO: Identificar a prevalência de tontura e os fatores associados em uma amostra de idosos que vivem na comunidade. MATERIAL E MÉTODO: Estudo de coorte histórica prospectivo, com idosos de 65 anos ou mais. Foi utilizado um inquérito multidimensional e uma bateria de testes físico-funcionais. RESULTADOS: A prevalência de tontura foi de 45%. A tontura giratória foi relatada por 70,4% dos idosos e 43,8% disseram já ter tido crises vertiginosas em algum momento da vida. Houve associação significativa entre queixa de tontura e gênero feminino (p=0,004, relato de dificuldade de memória (p=0,015, má percepção de saúde (p=0,001, depressão (pDizziness is a common complaint among older adults. AIM: To identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults. METHODS: A prospective population-based study with a representative sample of older adults aged 65 years and over. A multidimensional questionnaire and a battery of measures were used for assessing physical function. RESULTS: The prevalence of dizziness was 45%. Vertigo was found in 70.4% of older adults with dizziness and 43.8% of them referred vertigo crises along life. A significant association was found between dizziness and female gender (p=0.004, memory difficulties complaints (p=0.015, bad health perception (p=0.001, depression (p<0.0001, five or more comorbidities (p=0.021, self-reported fatigue (p<0.0001, recurrent falls (p=0.001, excessive sleepiness (p=0.003, fear of falling (p<0.0001, left leg unipedal stance (p=0.002 and Short Performance Physical Battery score (p=0.009. CONCLUSION: Dizziness is a common complaint among older adults and it is associated with limiting clinical conditions, such as depression, fatigue, excessive sleepiness and impaired memory. It is highlighted the association between dizziness and recurrent falls, fear of falling and lower performance in physical

A Special Case of International Migration: Ethnic Hungarians Migrating from Transylvania to Hungary

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Irén Gödri

2004-01-01

Full Text Available The study examines a special case of international migration, when the ethnicity, mother tongue, historical and cultural traditions of the immigrants are identical with those of the receiving population. This is also a fundamental feature of immigration to Hungary in the last decade and a half and could be observed primarily in the migratory wave from neighboring countries (most of all from Transylvania in Romania. After presenting the historical background we will review the development of the present-day migratory processes as well as their social and economical conditions, relying on statistics based on various sources. The socio-demographic composition of the immigrants and their selection from the population of origin indicate that migration is more frequent among younger, better-educated people living in an ethnically heterogeneous urban environment. At the same time, the rising proportion of older people and pensioners among the immigrants suggests the commencement of the so-called secondary migration. This is con? rmed by a questionnaire-based survey conducted among immigrants, which showed that family reuni? cation is a migratory motivation for a signi? cant group of people, primarily for the older generation. Among younger people economic considerations are decisive in the migrants decision-making. Our analysis underscores the roles of ethnicity and network of connections in the processes under examination.

Ohio Special Education Profile, 2011

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Ohio Coalition for the Education of Children with Disabilities, 2011

2011-01-01

This report provides a brief, but substantive, profile of the special needs student population in Ohio, including academic performance and graduation trends and an overview of special education funding and related policy issues. The report's central message is that investments in students with special educational needs produce substantial results…

ShopComm: Community-Supported Online Shopping for Older Adults.

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

2017-01-01

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

Physicians' Non-Uniform Approach to Prescribing Drugs to Older Patients – A Qualitative Study

DEFF Research Database (Denmark)

Christensen, Line Due; Petersen, Janne; Andersen, Ove

2017-01-01

with 50 medical specialists in 23 different specialities throughout Denmark who had contact with older patients. Content analysis was performed to identify the relevant themes. Regardless of their medical or surgical background and how often they prescribed drugs for older patients in daily work, all...... that a cautious approach was needed when prescribing drugs for older people, there was no consensus about how to best accomplish this in practice. This article is protected by copyright. All rights reserved....

Prevalence of waterpipe tobacco smoking among population aged 15 years or older, Vietnam, 2010.

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Xuan, Le Thi Thanh; Van Minh, Hoang; Giang, Kim Bao; Nga, Pham Thi Quynh; Hai, Phan Thi; Minh, Nguyen Thac; Hsia, Jason

2013-04-18

The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45-54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking.

Motivators, barriers, and beliefs regarding physical activity in an older adult population.

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Costello, Ellen; Kafchinski, Marcia; Vrazel, JoEllen; Sullivan, Patricia

2011-01-01

Regular physical activity (PA) plays an important role in improving and maintaining one's health, especially as one ages. Although many older Americans are aware of the benefits of regular PA, the majority do not participate in regular PA that meets recommended guidelines. The purpose of this study was to gain insight into the motivators, barriers, and beliefs regarding PA of independent-living older adults with easy access to fitness facilities. In this qualitative design, focus group interviews were used to explore the individual perceptions of physically active and inactive older adults regarding PA and exercise. Thirty-one older adults, over age 60 participated in focus group discussions regarding PA beliefs and behaviors. Groups were homogenous based on current PA behaviors. Demographic information was collected. Discussions were audiotaped and transcribed verbatim and deidentified. Two researchers independently coded for emergent themes. Interrater reliability was established (κ = 0.89). Peer review was used to further ensure trustworthiness and credibility. No significant differences were noted in age, body mass index, or educational levels between the physically active and inactive groups. Differences in perceptions were noted between the groups regarding the construct of PA, barriers to participation in regular PA, and the components of an ideal PA program. Physically inactive persons had much lower fitness expectations of a physically active older adult, more perceived barriers to regular PA, and required individual tailoring of a PA program if they were going to participate. In addition, inactive persons were intimidated by the fitness facilities and concerned about slowing others down in a group exercise setting. Both groups shared similar motivators to participate in PA, such as maintaining health and socialization; however, inactive persons also described PA as needing to be purposeful and fun. Physically inactive persons perceived themselves to be

Factors That Drive Youth Specialization.

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Padaki, Ajay S; Popkin, Charles A; Hodgins, Justin L; Kovacevic, David; Lynch, Thomas Sean; Ahmad, Christopher S

Specialization in young athletes has been linked to overuse injuries, burnout, and decreased satisfaction. Despite continued opposition from the medical community, epidemiological studies suggest the frequency is increasing. Extrinsic pressures in addition to individual aspirations drive this national trend in sports specialization. Descriptive epidemiology study. Level 3. A novel instrument assessing the driving factors behind youth specialization was generated by an interdisciplinary team of medical professionals. Surveys were administered to patients and athletes in the department's sports medicine clinic. The survey was completed by 235 athletes between 7 and 18 years of age, with a mean age of 13.8 ± 3.0 years. Athletes specialized at a mean age of 8.1 years, and 31% of athletes played a single sport while 58% played multiple sports but had a preferred sport. More than 70% of athletes had collegiate or professional ambitions, and 60% played their primary sport for 9 or more months per year, with players who had an injury history more likely to play year-round ( P specialized athletes reporting this significantly more often ( P = 0.04). Half of the athletes reported that sports interfered with their academic performance, with older players stating this more frequently ( P specializing in a single sport before starting high school. While intrinsic drive may identify healthy aspirations, extrinsic influences are prevalent in specialized athletes. Extrinsic factors contributing to youth specialization were identified and compounded the deleterious sequelae of youth athlete specialization.

Exploring the construction of quality of life in older people / Lizanlé van Biljon.

OpenAIRE

Van Biljon, Lizanlé

2013-01-01

Ageing populations and the unique challenges they pose are characteristic of the accelerating demographic transition evident in both developed and developing countries. In South Africa the elderly population is also increasing dramatically. There is a disproportionate distribution of older persons per ethnic group, with white older people representing the largest group of older South Africans (21%, proportional to ethnic group). The influx of the baby boomer generation will inevitably lead to...

Age- and Gender-Based Populations

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... population increases the risks of cognitive decline and suicide. About 25% of older adults have some type of mental health problem, such as a mood disorder not associated with normal aging. Older adults with ...

Self-mastery among Chinese Older Adults in the Greater Chicago Area

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Xinqi Dong

2014-09-01

Full Text Available Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.

Attitudes of older mobile phone users towards mobile phones

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Vicente, P.; Lopes, I.

2016-01-01

Research on mobile technology adoption has focused predominantly on young adults, and little attention has been paid to older people. But with rapidly aging populations in most developed countries, and evidence from many studies that older adults are as capable of adopting and using mobile technology as everybody else, the academic, business and technology industry worlds are devoting more attention to this group. Research has already demonstrated that older people differ from young people in...

Atypical Antipsychotic Medications and Hyponatremia in Older Adults: A Population-Based Cohort Study

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Sonja Gandhi

2016-04-01

Full Text Available Background: A number of case reports have suggested a possible association between atypical antipsychotic medications and hyponatremia. Currently, there are no reliable estimates of hyponatremia risk from atypical antipsychotic drugs. Objective: The objective of this study was to examine the 30-day risk of hospitalization with hyponatremia in older adults dispensed an atypical antipsychotic drug relative to no antipsychotic use. Design: The design of this study was a retrospective, population-based cohort study. Setting: The setting of this study was in Ontario, Canada, from 2003 to 2012. Patients: Adults 65 years or older with an identified psychiatric condition who were newly dispensed risperidone, olanzapine, or quetiapine in the community setting compared to adults with similar indicators of baseline health who were not dispensed such a prescription. Measurements: The primary outcome was the 30-day risk of hospitalization with hyponatremia. The tracer outcome (an outcome that is not expected to be influenced by the study drugs was the 30-day risk of hospitalization with bowel obstruction. These outcomes were assessed using hospital diagnosis codes. Methods: Using health administrative data, we applied a propensity score technique to match antipsychotic users 1:1 to non-users of antipsychotic drugs (58,008 patients in each group. We used conditional logistic regression to compare outcomes among the matched users and non-users. Results: A total of 104 baseline characteristics were well-balanced between the two matched groups. Atypical antipsychotic use compared to non-use was associated with an increased risk of hospitalization with hyponatremia within 30 days (86/58,008 (0.15 % versus 53/58,008 (0.09 %; relative risk 1.62 (95 % confidence interval (CI 1.15 to 2.29; absolute risk increase 0.06 % (95 % CI 0.02 to 0.10. The limited number of events precluded some additional analyses to confirm if the association was robust. Atypical

Aging and the Socioeconomic Life of Older Adults in India

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Sanjeev Bakshi

2016-01-01

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

How older people with learning disabilities perceive ageing.

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Jenkins, Robert

2010-07-01

This article discusses the author's use of reflexivity in trying to gain a better understanding of ageing in older people with learning disabilities. In the general population ageing is viewed in rather negative terms and as a significant life transition. However, for some older people with learning disabilities this transition may go unnoticed because of their past negative life experiences and lack of opportunities. Reflexivity has the potential to provide nurses with greater understanding of the personal perspectives of older people with learning disabilities.

Heritability of the Number of Teeth in Middle-Aged and Older Danish Twins

DEFF Research Database (Denmark)

Kurushima, Y; Silventoinen, K; Dokkedal, U

2017-01-01

Tooth loss is a common health concern in older adults. We aimed to estimate the relative contributions of genetic and environmental factors to the variation in the number of teeth in middle-aged and older populations using a population-based cohort of Danish twins. The study included 5,269 Danish...

Interdisciplinary Collaboration in Medication-Related Falls Prevention in Older Adults.

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Huang, Lisa; Turner, Jazmin; Brandt, Nicole J

2018-04-01

The older adult population continues to steadily increase. Largely attributed to longer life spans and aging of the Baby Boomer generation, continued growth of this population is expected to affect a multitude of challenging public health concerns. Specifically, falls in older adults are prevalent but overlooked concerns. Health care providers are well-positioned to provide valuable interventions in this aspect. An interdisciplinary, team-based approach of health care providers is required to maximize falls prevention through patient-centered and collaborative care. The current article highlights the implications of inappropriate medication use and the need to improve care coordination to tackle this public health issue affecting older adults. [Journal of Gerontological Nursing, 44(4), 11-15.]. Copyright 2018, SLACK Incorporated.

Fall predictors in older cancer patients: a multicenter prospective study

OpenAIRE

Vande Walle, Nathalie; Kenis, Cindy; Heeren, Pieter; Van Puyvelde, Katrien; Decoster, Lore; Beyer, Ingo; Conings, Godelieve; Flamaing, Johan; Lobelle, Jean-Pierre; Wildiers, Hans; Milisen, Koen

2014-01-01

Background In the older population falls are a common problem and a major cause of morbidity, mortality and functional decline. The etiology is often multifactorial making the identification of fall predictors essential for preventive measures. Despite this knowledge, data on falls within the older cancer population are limited. The objective of this study was to evaluate the occurrence of falls within 2 to 3?months after cancer treatment decision and to identify predictors of falls (?1 fall)...

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

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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

Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study.

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d'Arcy, Joanna L; Coffey, Sean; Loudon, Margaret A; Kennedy, Andrew; Pearson-Stuttard, Jonathan; Birks, Jacqueline; Frangou, Eleni; Farmer, Andrew J; Mant, David; Wilson, Jo; Myerson, Saul G; Prendergast, Bernard D

2016-12-14

Valvular heart disease (VHD) is expected to become more common as the population ages. However, current estimates of its natural history and prevalence are based on historical studies with potential sources of bias. We conducted a cross-sectional analysis of the clinical and epidemiological characteristics of VHD identified at recruitment of a large cohort of older people. We enrolled 2500 individuals aged ≥65 years from a primary care population and screened for undiagnosed VHD using transthoracic echocardiography. Newly identified (predominantly mild) VHD was detected in 51% of participants. The most common abnormalities were aortic sclerosis (34%), mitral regurgitation (22%), and aortic regurgitation (15%). Aortic stenosis was present in 1.3%. The likelihood of undiagnosed VHD was two-fold higher in the two most deprived socioeconomic quintiles than in the most affluent quintile, and three-fold higher in individuals with atrial fibrillation. Clinically significant (moderate or severe) undiagnosed VHD was identified in 6.4%. In addition, 4.9% of the cohort had pre-existing VHD (a total prevalence of 11.3%). Projecting these findings using population data, we estimate that the prevalence of clinically significant VHD will double before 2050. Previously undetected VHD affects 1 in 2 of the elderly population and is more common in lower socioeconomic classes. These unique data demonstrate the contemporary clinical and epidemiological characteristics of VHD in a large population-based cohort of older people and confirm the scale of the emerging epidemic of VHD, with widespread implications for clinicians and healthcare resources. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Differences in mortality between groups of older migrants and older non-migrants in Belgium, 2001-09.

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Reus-Pons, Matias; Vandenheede, Hadewijch; Janssen, Fanny; Kibele, Eva U B

2016-12-01

European societies are rapidly ageing and becoming multicultural. We studied differences in overall and cause-specific mortality between migrants and non-migrants in Belgium specifically focusing on the older population. We performed a mortality follow-up until 2009 of the population aged 50 and over living in Flanders and the Brussels-Capital Region by linking the 2001 census data with the population and mortality registers. Overall mortality differences were analysed via directly age-standardized mortality rates. Cause-specific mortality differences between non-migrants and various western and non-western migrant groups were analysed using Poisson regression models, controlling for age (model 1) and additionally controlling for socio-economic status and urban typology (model 2). At older ages, most migrants had an overall mortality advantage relative to non-migrants, regardless of a lower socio-economic status. Specific migrant groups (e.g. Turkish migrants, French and eastern European male migrants and German female migrants) had an overall mortality disadvantage, which was, at least partially, attributable to a lower socio-economic status. Despite the general overall mortality advantage, migrants experienced higher mortality from infectious diseases, diabetes-related causes, respiratory diseases (western migrants), cardiovascular diseases (non-western female migrants) and lung cancer (western female migrants). Mortality differences between older migrants and non-migrants depend on cause of death, age, sex, migrant origin and socio-economic status. These differences can be related to lifestyle, social networks and health care use. Policies aimed at reducing mortality inequalities between older migrants and non-migrants should address the specific health needs of the various migrant groups, as well as socio-economic disparities. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Older people in the information society

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Aleksandra Marcinkiewicz-Wilk

2016-06-01

Full Text Available This paper focuses on the situation of older people in the information society. In the theoretical part of article phenomena of aging population and information society were described. This paper includes results of research conducted in qualitative strategy. The method of collecting data was biographical method. The method for data processing was qualitative content analysis. In the research 2 older, educationally active people took part. Results of research shows how older people understand the information society and what risk and opportunities they notice in this new reality. Narratives of the respondents indicated that education is of crucial importance for participation in the information society. Older people who take part in lifelong learning cope better with the new reality than people who do not learn. Based on the research results we can point out areas of education which should be development. Moreover, it is visible that educational activity of older people is very important in adaptation to the information society. Narratives of seniors indicate reasons for the lack of educational activity of other seniors. According to this, it can be specified what action should be undertaken to prevent the exclusion of older people in this new reality

Religiousness/Spirituality and Mental Health among Older Male Inmates

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Allen, Rebecca S.; Phillips, Laura Lee; Roff, Lucinda Lee; Cavanaugh, Ronald; Day, Laura

2008-01-01

Purpose: With the rapid growth in the older inmate population, emerging issues regarding physical and mental health require greater research and clinical attention. We examined the relation of religiousness/spirituality; demographic characteristics such as age, race, and type of crime; and physical and mental health among 73 older male inmates in…

Behavior-Analytic Research on Dementia in Older Adults

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Trahan, Maranda A.; Kahng, SungWoo; Fisher, Alyssa B.; Hausman, Nicole L.

2011-01-01

It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the "Journal of Applied Behavior Analysis" ("JABA") on behavioral gerontology (Iwata, 1986), there continues to be a paucity of…

How older people with incurable cancer experience daily living: A qualitative study from Norway.

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Haug, Sigrid Helene Kjørven; Danbolt, Lars J; Kvigne, Kari; Demarinis, Valerie

2015-08-01

An increasing number of older people are living with incurable cancer as a chronic disease, requiring palliative care from specialized healthcare for shorter or longer periods of time. The aim of our study was to describe how they experience daily living while receiving palliative care in specialized healthcare contexts. We conducted a qualitative research study with a phenomenological approach called "systematic text condensation." A total of 21 participants, 12 men and 9 women, aged 70-88, took part in semistructured interviews. They were recruited from two somatic hospitals in southeastern Norway. The participants experienced a strong link to life in terms of four subthemes: to acknowledge the need for close relationships; to maintain activities of normal daily life; to provide space for existential meaning-making and to name and handle decline and loss. In addition, they reported that specialized healthcare contexts strengthened the link to life by prioritizing and providing person-centered palliative care. Older people with incurable cancer are still strongly connected to life in their daily living. The knowledge that the potential for resilience remains despite aging and serious decline in health is considered a source of comfort for older people living with this disease. Insights into the processes of existential meaning-making and resilience are seen as useful in order to increase our understanding of how older people adapt to adversity, and how their responses may help to protect them from some of the difficulties inherent to aging. Healthcare professionals can make use of this information in treatment planning and for identification of psychosocial and sociocultural resources to support older people and to strengthen patients' life resources.

Self-transcendence in older men attending a prostate cancer support group.

Science.gov (United States)

Chin-A-Loy, S S; Fernsler, J I

1998-10-01

Self-transcendence has been shown to be related to well-being in older adults, women with breast cancer, women with AIDS, gay men with AIDS, and a healthy population. The purpose of this descriptive pilot study was to examine self-transcendence in another high-priority population: older men with prostate cancer. A convenience sample of 23 men, age 60 and older (M = 69), from three prostate cancer support groups completed Reed's Self-Transcendence Scale (STS) and a demographic data form. The men were predominantly white (82.6%), of the Catholic faith (56.5%), married (78.3%), and not working (87.0%). Over half (65.2%) had a college degree or higher; most viewed their health as good (69.6%) or excellent (21.7%); and the majority (56.5%) viewed their prostate cancer as affecting some of their daily activities. These men scored high on the STS (M = 50.07), which was consistent with previous findings in other populations. Findings of this study contribute to Reed's middle-range theory of self-transcendence. The discovery that self-transcendence is relevant to this group of older men with prostate cancer provides a basis for nurses to investigate the phenomenon in this population and help their clients explore the benefits of the self-transcendence resource.

Long-Term Acupuncture Therapy for Low-Income Older Adults with Multimorbidity: A Qualitative Study of Patient Perceptions.

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Pagones, Rachel; Lee, Janet L; Hurst, Samantha

2018-02-01

Multimorbidity is common, but often poorly managed, among the rapidly growing population of older adults. The existing guidelines followed by physicians frequently lead to polypharmacy and a complex treatment burden. The objective of this study was to explore what benefits are perceived by older adults with multimorbidity as a result of long-term, regular acupuncture treatment. A qualitative design with inductive thematic analysis of semistructured interviews. Participants were recruited from a no-cost, college-affiliated acupuncture clinic for low-income older adults in an urban, racially/ethnically diverse neighborhood in southern California. Fifteen patients aged 60 years and older suffering from at least two chronic conditions. Five themes were identified: (1) mind-body effects, (2) the enhanced therapeutic alliance, (3) what they liked best, (4) the conventional healthcare system, and (5) importance of regular schedule. A notable mind-body effect, reported by a substantial number of participants, was medication reduction. Participants also cited changes in mood, energy, and well-being as important benefits. In addition, they voiced widespread dissatisfaction with conventional healthcare. Keeping up regular treatments as a way to deal with new complaints and encourage a healthier lifestyle was seen an important aspect of care at the clinic. This cohort of older adults with multimorbidity valued acupuncture as a way to reduce medication as well as a means to maintain physical and mental health. In addition, they developed a strong trust in the clinic's ability to support the totality of their health as individuals, which they contrasted to the specialized and impersonal approach of the conventional medical clinic.

The effect of gender on foot anthropometrics in older people.

Science.gov (United States)

Paiva de Castro, Alessandra; Rebelatto, Jose Rubens; Aurichio, Thais Rabiatti

2011-08-01

Some questions remain regarding the anthropometric differences between the feet of young men and women, but the gap is much greater when dealing with older adults. No studies were found concerning these differences in an exclusively older adult population, which makes it difficult to manufacture shoes based on the specific anthropometric measurements of the older adult population and according to gender differences. To identify differences between the anthropometric foot variables of older men and women. Cross-sectional. 154 older women (69.0 ± 6.8 y) and 131 older men (69.0 ± 6.5 y). The foot evaluations comprised the variables of width, perimeter, height, length, 1st and 5th metatarsophalangeal angles, the Arch Index (AI), and the Foot Posture Index (FPI). A data analysis was performed using t test and a post hoc power analysis. Women showed significantly higher values for the width and perimeter of the toes, width of the metatarsal heads, and width of the heel and presented significantly lower values for the height of the dorsal foot after normalization of the data to foot length. The 1st and 5th metatarsophalangeal angles were smaller in the men. There were no differences between men and women with respect to AI and FPI. Overall, the current study shows evidence of differences between some of the anthropometric foot variables of older men and women that must be taken into account for the manufacture of shoes for older adults.

Optimal breast cancer screening strategies for older women: current perspectives

Directory of Open Access Journals (Sweden)

Braithwaite D

2016-02-01

Full Text Available Dejana Braithwaite,1 Joshua Demb,1 Louise M Henderson2 1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 2Department of Radiology, University of North Carolina, Chapel Hill, NC, USA Abstract: Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models. Keywords: aging, breast cancer, precision cancer screening

Referral patterns and general anesthesia in a specialized paediatric dental service.

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Alkilzy, Mohammad; Qadri, Ghalib; Horn, Janina; Takriti, Moutaz; Splieth, Christian

2015-05-01

The caries patterns of child populations in Germany have changed during the last 20 years. This affects the referrals and provision of specialist dental care for children. This study has two aims: first, to investigate referrals received by a specialized pediatric dental institution in 1995 and 2008, and second, to assess the treatments performed during full oral rehabilitations under general anesthesia in this institution from 2007 to 2008. All data of referred patients were evaluated for 1995 and 2008 separately. Comparisons were carried out for different socio-demographic, medical, and dental parameters. All patients treated under general anesthesia (GA) between March/2007 and December/2008 were examined retrospectively and their data were analyzed. In 1995 (n = 191), significantly older children were referred to specialized pediatric dental care compared to 2008 (n = 179). In addition, a shift of surgical referrals to very young children with high caries levels was clearly noticed, resulting in considerably more oral rehabilitation performed under GA in 2008 (n = 73). Thus, the mean values of 6.4 fillings and 2.7 extractions per child were quite high. Preventive treatment approaches for primary dentition in Germany need further improvement by focusing on high caries-risk groups, as specialized pediatric dentistry bears the great burden of providing oral rehabilitations under GA in young children. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Relationship between perceived sleep and polysomnography in older adult patients

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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.

Incorporating Social Support in the Treatment of Anorexia Nervosa: Special Considerations for Older Adolescents and Young Adults

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Pisetsky, Emily M.; Utzinger, Linsey M.; Peterson, Carol B.

2016-01-01

Currently, research support is strongest for family-based treatment (FBT) for the treatment of anorexia nervosa (AN) in adolescents. However, a strong evidence base for treatments for older adolescents and young adults with AN is lacking. Emphasizing social support in the treatment of AN may be beneficial for older adolescents and young adults with AN. This paper provides a brief review of the literature on FBT for adolescent AN and provides a case example of adolescent AN treated with FBT. We then discuss novel treatments that have incorporated social support for older adolescents and young adults with AN, such as modified FBT and couples-based interventions. We provide case studies of each of these novel treatment approaches as well. Additionally, this paper highlights and discusses developmental considerations and challenges in working with older adolescents and young adults with AN. PMID:27429544

“Conviv\\^{e}ncia” Groups: Building Active and Healthy Communities of Older Adults in Brazil

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Tânia R. Bertoldo Benedetti

2012-01-01

Full Text Available In old age, social groups can be a crucial component for health and well-being. In 2009-2010, a follow-up survey was carried out in Florianópolis, Brazil to understand the impact of a variety of programs established since 2002 that were designed to enhance social activities among the older adult population. This study employed two surveys within the population of older adults in Florianópolis. The first survey interviewed a total of 875 older adults in 2002, and the second survey involved 1,705 older adults between 2009 and 2010. By 2010, many new programs were offered in the community and the enrollment of older adults in social programs followed similar trends. “Convivência” groups stood out as extremely popular social groups among this population. This paper discusses some of the potential outcomes associated with participation in “convivência” groups.

Narratives of Self in Older Bilingual Adults Diagnosed with Alzheimer's Disease

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López de Victoria Rodríguez, Patria C.

2016-01-01

As the boom in the older adult population continues to grow, so too grows the number of persons suffering from cognitive diseases, such as dementia of the Alzheimer's type (DAT). Older Latinos diagnosed with the disease make up 4 percent (200,000) of the current population; however, little research on bilinguals with DAT has been carried out…

Carotid stenosis and cognitive impairment amongst older Chinese adults living in a rural area: a population-based study.

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Yan, Z; Liang, Y; Shi, J; Cai, C; Jiang, H; Song, A; Qiu, C

2016-01-01

The possible association between carotid stenosis and cognitive impairment in the Chinese population has been rarely investigated. The association between the severity of carotid stenosis and cognitive impairment amongst older Chinese people living in a rural area was assessed. This cross-sectional study included 1375 participants (age ≥60 years) from the Confucius Hometown Aging Project in Shandong. In 2010-2011, data were collected through interviews and clinical examinations. Carotid stenosis was assessed using ultrasonography. Cognitive impairment was defined according to the education-specific cutoff scores of the Mini-Mental State Examination. Data were analyzed using multinomial logistic models. The overall prevalence was 7.0% for moderate carotid stenosis, 2.0% for severe stenosis and 6.0% for cognitive impairment. The multi-adjusted odds ratio of cognitive impairment was 1.43 (95% confidence interval 0.63-3.22) for moderate carotid stenosis and 3.75 (1.24-11.40) for severe carotid stenosis (P(trend) = 0.023). Similar results were obtained in people without a history of cerebrovascular disease. Severe carotid stenosis, even asymptomatic, is associated with cognitive impairment independent of atherosclerotic risk factors and disorders amongst older Chinese people. © 2015 EAN.

The neglected health needs of older Syrian refugees in Jordan

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Sigrid Lupieri

2018-02-01

Full Text Available Older refugees are often a neglected population, particularly when it comes to health. In Jordan, the specific health needs of older Syrian refugees tend to be overlooked, due in part to a lack of data, institutional biases and the nature of the humanitarian response.

Incidence and Short-term Mortality From Perforated Peptic Ulcer in Korea: A Population-Based Study

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Bae, SeungJin; Shim, Ki-Nam; Kim, Nayoung; Kang, Jung Mook; Kim, Dong-Sook; Kim, Kyoung-Min; Cho, Yu Kyung; Jung, Sung Woo

2012-01-01

Background Perforated peptic ulcer (PPU) is associated with serious health and economic outcomes. However, few studies have estimated the incidence and health outcomes of PPU using a nationally representative sample in Asia. We estimated age- and sex-specific incidence and short-term mortality from PPU among Koreans and investigated the risk factors for mortality associated with PPU development. Methods A retrospective population-based study was conducted from 2006 through 2007 using the Korean National Health Insurance claims database. A diagnostic algorithm was derived and validated to identify PPU patients, and PPU incidence rates and 30-day mortality rates were determined. Results From 2006 through 2007, the PPU incidence rate per 100 000 population was 4.4; incidence among men (7.53) was approximately 6 times that among women (1.24). Incidence significantly increased with advanced age, especially among women older than 50 years. Among 4258 PPU patients, 135 (3.15%) died within 30 days of the PPU event. The 30-day mortality rate increased with advanced age and reached almost 20% for patients older than 80 years. The 30-day mortality rate was 10% for women and 2% for men. Older age, being female, and higher comorbidity were independently associated with 30-day mortality rate among PPU patients in Korea. Conclusions Special attention should be paid to elderly women with high comorbidity who develop PPU. PMID:22955110

Antithrombotics in trauma: management strategies in the older patients

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Wong H

2017-10-01

Full Text Available Henna Wong,1,2 Nicola Lovett,3 Nicola Curry,1 Ku Shah,2 Simon J Stanworth1,2,4 1Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, 2Radcliffe Department of Medicine, University of Oxford, Oxford BRC Haematology Theme, 3Department of Geratology, Oxford University Hospitals NHS Foundation Trust, 4Department of Haematology, NHS Blood and Transplant, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Abstract: The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury. Following major trauma, definitive control of hemorrhage remains essential for improving outcomes. In the initial assessment of an injured patient, it is important to consider whether the patient is taking anticoagulants or antiplatelets and if measures to promote hemostasis such as reversal are indicated. After hemostasis is achieved and bleeding has stopped, longer-term decisions to recommence antithrombotic agents can be challenging, especially in older people. In this review, we discuss one aspect of management for the older trauma patients in greater detail, that is, acute and longer-term management of antithrombotic therapy. As we consider the health needs of an ageing population, rise in elderly trauma and increasing use of antithrombotic therapy, the need for research in this area becomes more pressing to establish best

Sexual activity in Brazilian women aged 50 years or older within the framework of a population-based study.

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Valadares, Ana Lúcia Ribeiro; Santos Machado, Vanessa S; da Costa-Paiva, Lúcia S; de Souza, Maria Helena; Osis, Maria José; Pinto-Neto, Aarão M

2014-03-01

This study aims to evaluate the prevalence of sexual activity, factors associated with being sexually active, and sexual self-perception in women 50 years or older living in a Brazilian city. This population-based study applied a questionnaire to a random sample of 622 Brazilian women 50 years or older, representative of a population of 131,800 women, to obtain data on sexual activity and women's perception of their sexual life as part of a broader study that dealt with women's health. Associations between sexual activity, women's perception of their sexual life, and demographic, behavioral, and medical characteristics were determined. Overall, 36.7% of the participants reported being sexually active. Of these, 53.5% classified their sexual life as very good or good. Multiple regression analysis showed that the main factors associated with the absence of sexual activity were not having a partner (prevalence ratio [PR], 0.16; 95% CI, 0.12-0.23; P aging (PR, 0.95; 95% CI, 0.94-0.96; P sexually active was associated with the practice of physical activity (PR, 1.20; 95% CI, 1.02-1.41; P = 0.032). A woman's classification of her sexual life as very poor, poor, or fair was associated with current or past use of natural remedies to treat menopausal symptoms (PR, 1.38; 95% CI, 1.06-1.81; P = 0.020). The main factors associated with the absence of sexual activity are not having a sexual partner, aging, and smoking, whereas weekly physical activity is associated with being sexually active. A poorer classification of a woman's sexual life is associated with her having used natural remedies to treat menopausal symptoms.

Experience of elder abuse among older Korean immigrants.

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Chang, Miya

2016-01-01

Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims' health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.

Learning from a Special Care Dentistry Needs Assessment.

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Johnson, Ilona

2015-05-01

The General Dental Council recognised special care dentistry (SCD) as a speciality in 2008 and local service reviews have been carried out in order to develop SCD services. A needs assessment was completed to inform the implementation of recommendations from a 2010 review of SCD in Wales. The aim of this paper is to outline the process, findings and learning from the needs assessment and the implications for SCD. A focused needs assessment approach was used. Stakeholder consultations were used to develop a working definition for the needs assessment. Data were collected from existing health and social care sources and analysed using descriptives and geographic information system (GIS) mapping. Data sources for needs assessment were limited. Analysis showed that health conditions were common in the population and increased with age. The majority of people who reported seeing a dentist were seen in general dental practice. Older people with health conditions were less likely to report seeing a dentist. Patients often needed to travel for specialist care services. General dental practice teams have a significant role in caring for SCD patients. Careful planning of specialist care, joint working and enhancing skills across the general practice team will reduce the burden of care and enhance patient safety. Improvements in data for assessment of SCD needs are required to help this process.

Research Ethics in Behavioral Interventions Among Special Populations: Lessons From the Peer Approaches to Lupus Self-Management Study.

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Faith, Trevor D; Egede, Leonard; Williams, Edith M

2018-02-01

Research involving a homogenous cohort of participants belonging to a special population must make considerations to recruit and protect the subjects. This study analyses the ethical considerations made in the peer approaches to lupus self-management project which pilot tested a peer mentoring intervention for African American women with systemic lupus erythematosus. Considerations made at the outset of the project are described and their justifications and reasoning are given. Through analysis of feedback from a postintervention focus group and mentors' logs, implications on program outcomes and participant satisfaction are discussed. Feedback indicated the importance of recruiting and training capable mentors, consistent contact from study staff to avert adverse events and avert fear or mistrust and careful consideration that must go into the pairing of mentors and mentees. Participant feedback also indicated that sensitive topics must be addressed carefully to prevent distress and dissatisfaction. Applying the lessons learned from this work as well as the considerations that proved successful may improve the contextualization and ethical conduct of behavioral interventions in special populations resulting in improved tailoring and acceptability toward historically underserved individuals. Published by Elsevier Inc.

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

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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

Optimizing Sleep in Older Adults: Treating Insomnia

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

2013-01-01

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

Attitudes and stereotypes regarding older women and HIV risk.

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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.

Walking and the Preservation of Cognitive Function in Older Populations

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Prohaska, Thomas R.; Eisenstein, Amy R.; Satariano, William A.; Hunter, Rebecca; Bayles, Constance M.; Kurtovich, Elaine; Kealey, Melissa; Ivey, Susan L.

2009-01-01

Purpose: This cross-sectional study takes a unique look at the association between patterns of walking and cognitive functioning by examining whether older adults with mild cognitive impairment differ in terms of the community settings where they walk and the frequency, intensity, or duration of walking. Design and Methods: The sample was based on…

Depression among family caregivers of community-dwelling older people who used services under the Long Term Care Insurance program: a large-scale population-based study in Japan.

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Arai, Yumiko; Kumamoto, Keigo; Mizuno, Yoko; Washio, Masakazu

2014-01-01

To identify predictors for depression among family caregivers of community-dwelling older people under the Long Term Care Insurance (LTCI) program in Japan through a large-scale population-based survey. All 5938 older people with disabilities, using domiciliary services under the LTCI in the city of Toyama, and their family caregivers participated in this study. Caregiver depression was defined as scores of ≥16 on the Center for Epidemiological Studies Depression Scale (CES-D). Other caregiver measures included age, sex, hours spent caregiving, relationship to the care recipient, income adequacy, living arrangement, self-rated health, and work status. Care recipient measures included age, sex, level of functional disability, and severity of dementia. The data from 4128 pairs of the care recipients and their family caregivers were eligible for further analyses. A multiple logistic regression analysis was used to examine the predictors associated with being at risk of clinical depression (CES-D of ≥16). Overall, 34.2% of caregivers scored ≥16 on the CES-D. The independent predictors for depression by logistic regression analysis were six caregiver characteristics (female, income inadequacy, longer hours spent caregiving, worse subjective health, and co-residence with the care recipient) and one care-recipient characteristic (moderate dementia). This is one of the first population-based examinations of caregivers of older people who are enrolled in a national service system that provides affordable access to services. The results highlighted the importance of monitoring caregivers who manifest the identified predictors to attenuate caregiver depression at the population level under the LTCI.

Housing and respiratory health at older ages.

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Webb, E; Blane, D; de Vries, Robert

2013-03-01

A large proportion of the population of England live in substandard housing. Previous research has suggested that poor-quality housing, particularly in terms of cold temperatures, mould, and damp, poses a health risk, particularly for older people. The present study aimed to examine the association between housing conditions and objectively measured respiratory health in a large general population sample of older people in England. Data on housing conditions, respiratory health and relevant covariates were obtained from the second wave of the English Longitudinal Study of Ageing. Multivariate regression methods were used to test the association between contemporary housing conditions and respiratory health while accounting for the potential effect of other factors; including social class, previous life-course housing conditions and childhood respiratory health. Older people who were in fuel poverty or who did not live in a home they owned had significantly worse respiratory health as measured by peak expiratory flow rates. After accounting for covariates, these factors had no effect on any other measures of respiratory health. Self-reported housing problems were not consistently associated with respiratory health. The housing conditions of older people in England, particularly those associated with fuel poverty and living in rented accommodation, may be harmful to some aspects of respiratory health. This has implications for upcoming UK government housing and energy policy decisions.

Organizational Change Around an Older Workforce.

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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. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Substance use disorder among older adults in the United States in 2020.

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Han, Beth; Gfroerer, Joseph C; Colliver, James D; Penne, Michael A

2009-01-01

This study aimed to project the number of people aged 50 years or older with substance use disorder (alcohol/illicit drug dependence or abuse) in the United States in 2020. Logistic regression models were applied to estimate parameters predicting past-year substance use disorder using the 2002-06 National Survey on Drug Use and Health data. We applied these parameters to the projected US 2020 population to estimate the number of adults aged 50 or older with substance use disorder in 2020. Non-institutionalized US residences. Representative sample of the US civilian, non-institutionalized population. Substance use disorder is classified based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Due to the large population size and high substance use rate of the baby-boom cohort, the number of adults aged 50 or older with substance use disorder is projected to double from 2.8 million (annual average) in 2002-06 to 5.7 million in 2020. Increases are projected for all examined gender, race/ethnicity and age groups. Our estimates provide critical information for policymakers to allocate resources and develop prevention and treatment approaches to address future needs of the US older adult population with substance use disorder.

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

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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. Copyright 2003 John Wiley & Sons, Ltd.

Periodontal disease and systemic diseases in an older population.

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Özçaka, Özgün; Becerik, Sema; Bıçakcı, Nurgün; Kiyak, Asuman H

2014-01-01

To evaluate the relationship between older adults' medical and oral conditions and their self-reports of periodontal conditions with clinically obtained data. Concerns about oral health of elders and its association with systemic diseases have been gaining more attention. A total of 201 older subjects were interviewed about their previous medical and dental histories and were asked to complete a health questionnaire. Each subject received full mouth exam, including counting number of natural teeth remaining, gingival (GI) and plaque index (PI), CPITN and denture status. Elders who completed health questionnaires had mean age of 62.5. Mean CPITN score was 1.62(± 1.12), PI was 1.57(± 1.48), and GI was 1.55(± 1.31). Women had higher prevalence of CVD and osteoporosis than men (p=0.008, p=0.0001, respectively). Subjects who reported bleeding upon brushing had higher PI and GI scores (p=0.03, p=0.05, respectively). Smokers were more likely to describe their periodontal tissues as unhealthy (72.3% vs. 27.7%, p=0.01), whereas self-reports of healthy vs. unhealthy gums did not differ between non-smokers. These findings suggest that a number of systemic conditions are associated with indicators of periodontal disease, and self-reports of oral conditions are independent of systemic diseases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Trends in disability of instrumental activities of daily living among older Chinese adults, 1997-2006: population based study.

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Liang, Yajun; Welmer, Anna-Karin; Möller, Jette; Qiu, Chengxuan

2017-08-28

Data on trends for disability in instrumental activity of daily living (IADL) are sparse in older Chinese adults. To assess trends in prevalence and incidence of IADL disability among older Chinese adults and to explore contributing factors. Population based study. 15 provinces and municipalities in China. Participants (age ≥60) were from four waves of the China Health and Nutrition Survey, conducted in 1997 (n=1533), 2000 (n=1581), 2004 (n=2028) and 2006 (n=2256), and from two cohorts constructed within the national survey: cohort 1997-2004 (n=712) and cohort 2000-2006 (n=823). IADL disability was defined as inability to perform one or more of the following: shopping, cooking, using transportation, financing and telephoning. Data were analysed with logistic regression and generalised estimating equation models. The prevalence of IADL disability significantly decreased from 1997 to 2006 in the total sample and in all of the subgroups by age, sex, living region and IADL items (all p trend 0.10). The recovery rate from IADL disability significantly increased over time in those aged 60-69 years (p=0.03). Living in a rural area or access to local clinics for healthcare was less disabling over time (p trend <0.02). The prevalence of IADL disability decreased among older Chinese adults during 1997-2006, whereas the incidence remained stable. The declining prevalence of IADL disability might be partly due to the decreased duration of IADL disability, and to improvements in living conditions and healthcare facilities over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

HIV Infection and Older Americans: The Public Health Perspective

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Buchacz, Kate; Gebo, Kelly A.; Mermin, Jonathan

2012-01-01

HIV disease is often perceived as a condition affecting young adults. However, approximately 11% of new infections occur in adults aged 50 years or older. Among persons living with HIV disease, it is estimated that more than half will be aged 50 years or older in the near future. In this review, we highlight issues related to HIV prevention and treatment for HIV-uninfected and HIV-infected older Americans, and outline unique considerations and emerging challenges for public health and patient management in these 2 populations. PMID:22698038

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

“Convivência” Groups: Building Active and Healthy Communities of Older Adults in Brazil

OpenAIRE

Benedetti, Tânia R. Bertoldo; d'Orsi, Eleonora; Schwingel, Andiara; Chodzko-Zajko, Wojtek J.

2012-01-01

In old age, social groups can be a crucial component for health and well-being. In 2009-2010, a follow-up survey was carried out in Florianópolis, Brazil to understand the impact of a variety of programs established since 2002 that were designed to enhance social activities among the older adult population. This study employed two surveys within the population of older adults in Florianópolis. The first survey interviewed a total of 875 older adults in 2002, and the second survey involved 1,7...

Older medical students' performances at McGill University.

Science.gov (United States)

Feil, D; Kristian, M; Mitchell, N

1998-01-01

To compare admission data and academic performances of medical students younger and older than 25, and to qualify older students' experiences and perceptions in medical school. The authors reviewed 1988-1991 data for applications to the McGill University Faculty of Medicine. Data included GPAs and MCAT scores, as well as ratings for reference letters, autobiographical statements, and interviews. For those same years, the authors measured students' academic performances in the preclinical and clinical years. The authors compared the data by students' age: "younger" students, aged 17 to 24; and "older" students, aged 25 and above. All enrolled students took the Derogatis Stress Profile, and the older students participated in focus groups. The older applicants had lower GPAs and MCAT scores, but higher interview and reference letter ratings. For older accepted students, basic science course scores were lower than those of younger students, but clinical scores did not differ significantly between the groups. The two groups had similar stress levels, although older students tested lower in driven behavior, relaxation potential, attitude posture, and hostility. In focus groups, the older students spoke of learning style differences, loss of social support, and loss of professional identity. Different scores in admission criteria suggest that McGill uses different standards to select older medical students. Older students admitted under different criteria, however, do just as well as do younger students by their clinical years. A broad-based study of admission criteria and outcomes for the older student population is warranted.

The older orthopaedic patient: general considerations.

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Potter, Jane F

2004-08-01

People older than 65 years are more likely to need elective and emergent orthopaedic surgery compared with younger persons. They also experience significant benefits. Although age-related changes increase the risk of perioperative complications, understanding those changes allows prevention or at least early recognition and treatment when problems arise. Because of comorbidities, older persons take more medications that need to be managed in the perioperative period. Care could be simplified if patients were to bring their medications to the preoperative evaluation. Central nervous system sensitivity to certain pain medications (meperidine and propoxyphene) means that these drugs are best avoided as good alternatives exist (morphine and oxycodone). Adverse reactions to drugs are an important cause of acute confusion (delirium) that often complicates orthopaedic care. Early mobilization after surgery, avoiding certain drugs, avoiding restraints (including Foley catheters), attending to hydration, promoting normal sleep, compensating for sensory disorders, and stimulating daytime activities can prevent delirium. Patients with dementia are more likely to have delirium develop and, like many older people, will present special challenges in communication and decision making. Including family members in discussions may be helpful in ensuring truly informed consent.

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

OpenAIRE

Ellis, Demetrius; Miyashita, Yosuke

2011-01-01

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 cultu...

Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia.

Science.gov (United States)

Mohd Mokhtar, Mohd Amin; Pin, Tan Maw; Zakaria, Mohd Idzwan; Hairi, Noran Naqiah; Kamaruzzaman, Shahrul Bahiyah; Vyrn, Chin Ai; Hua, Philip Poi Jun

2015-08-01

To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting. The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week. A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P older adults remained an independent predictor of hospital admission (OR 2.75, 95% CI 2.11-3.57). The ratio of older adult patients attending our ED over the proportion of older people in the general population was 26:6, which is far higher than reported in previous published studies carried out in other countries. Older ED attenders are also more likely to require investigations, procedures and hospital admissions. With the rapidly aging population in Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met. © 2014 Japan Geriatrics Society.

Sexual health and function in later life: a population-based study of 606 older adults with a partner.

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Wang, Vicki; Depp, Colin A; Ceglowski, Jennifer; Thompson, Wesley K; Rock, David; Jeste, Dilip V

2015-03-01

Sexual health and function is an important yet understudied aspect of overall health and well-being in older adults. There are limited data on the relative strength of associations between various aspects of sexual health with the physical, emotional, and cognitive function in older adults. Additionally, there is little information on how these associations differ by age and sex. In this Successful Aging Evaluation (SAGE) study, 606 community-dwelling adults in San Diego County, aged 50-99 years and who had a partner, were included in the analysis. Evaluations included a phone-based cognitive screening followed by a comprehensive mail-in survey including rating scales of sexual health, depression, anxiety, and physical function. The mean age of the sample was 75.2 years. Over 80% of respondents had engaged in sexual activity in the past year, over 70% engaged in sexual activity weekly or more than once a week, and over 60% were somewhat or very satisfied with their sex lives. No sex differences were evident on dimensions of sexual health except for a higher rate of rejection of sexual overtures by women. Depressive symptoms were negatively associated with all assessed aspects of sexual health, even after adjusting for age, physical functioning, anxiety, cognitive ability, or perceived stress in both men and women. In this population-based study older men and women who had a partner reported frequent engagement in and satisfaction with sexual activity. Depressive symptoms were broadly associated with worse sexual health, more so than physical function, anxiety or stress, or age itself. Copyright © 2015. Published by Elsevier Inc.

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

Depression and substance use in a middle aged and older Puerto Rican population.

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Weingartner, Katherine; Robison, Julie; Fogel, Denise; Gruman, Cynthia

2002-01-01

This study focuses on depression and substance use in Puerto Rican primary care patients, age 50 and older, recruited from five clinics in Hartford, CT (n = 303). One-third of the participants screened positive for depression using the Center for Epidemiologic Studies-Depression scale, and 16 percent either reported excessive alcohol use, prescription drug abuse, and/or illegal drug use in the past year. Correlates of depression include younger age, female gender, being separated or divorced, low perceived adequacy of income, poor health status, functional limitations, few emotional supports, and a history of an "ataque de nervios." Younger age, male gender, low perceived adequacy of income, few emotional supports, suicidal ideation, and a history of an "ataque de nervios" were associated with substance use. While the relationship between excessive alcohol use and a higher rate of depression did not reach statistical significance, drug use was a strong predictor of depression, particularly prescription drug abuse. However substance use did not significantly affect the likelihood of seeking treatment for depression. These findings underscore the need for appropriate interventions for those at risk for depression among the Puerto Rican population.

Diabetes Self-Care and the Older Adult

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

2014-01-01

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

Neuropsychological Mechanisms for Falls in Older Adults

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Yu eLiu

2014-04-01

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

Transition from the labor market: older workers and retirement.

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Peterson, Chris L; Murphy, Greg

2010-01-01

The new millennium has seen the projected growth of older populations as a source of many problems, not the least of which is how to sustain this increasingly aging population. Some decades ago, early retirement from work posed few problems for governments, but most nations are now trying to ensure that workers remain in the workforce longer. In this context, the role played by older employees can be affected by at least two factors: their productivity (or perceived productivity) and their acceptance by younger workers and management. If the goal of maintaining employees into older age is to be achieved and sustained, opportunities must be provided, for example, for more flexible work arrangements and more possibilities to pursue bridge employment (work after formal retirement). The retirement experience varies, depending on people's circumstances. Some people, for example, have retirement forced upon them by illness or injury at work, by ill-health (such as chronic illnesses), or by downsizing and associated redundancies. This article focuses on the problems and opportunities associated with working to an older age or leaving the workforce early, particularly due to factors beyond one's control.

Guidance on the management of pain in older people.

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Abdulla, Aza; Adams, Nicola; Bone, Margaret; Elliott, Alison M; Gaffin, Jean; Jones, Derek; Knaggs, Roger; Martin, Denis; Sampson, Liz; Schofield, Pat

2013-03-01

This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research. The assessment of pain in older people has not been covered within this guidance and can be found in a separate document (http://www.britishpainsociety.org/pub_professional.htm#assessmentpop). Substantial differences in the population, methods and definitions used in published research makes it difficult to compare across studies and impossible to determine the definitive prevalence of pain in older people. There are inconsistencies within the literature as to whether or not pain increases or decreases in this age group, and whether this is influenced by gender. There is, however, some evidence that the prevalence of pain is higher within residential care settings. The three most common sites of pain in older people are the back; leg/knee or hip and 'other' joints. In common with the working-age population, the attitudes and beliefs of older people influence all aspects of their pain experience. Stoicism is particularly evident within this cohort of people. Evidence from the literature search suggests that paracetamol should be considered as first-line treatment for the management of both acute and persistent pain, particularly that which is of musculoskeletal origin, due to its demonstrated efficacy and good safety profile. There are few absolute contraindications and relative cautions to prescribing paracetamol. It is, however, important that the maximum daily dose (4 g/24 h) is not exceeded. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in older people after other safer treatments have not provided sufficient pain relief. The lowest dose should be provided

Active Ageing Level of Older Persons: Regional Comparison in Thailand

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Md. Nuruzzaman Haque

2016-01-01

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

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

Lifelong learning, intergenerational relationships and ICT: perceptions of children and older adults

OpenAIRE

Patrício, Maria Raquel; Osório, António

2011-01-01

Ageing population is one of the topics that have attracted the attention of several countries in the interest of social cohesion, economic growth and financial sustainability. Promoting active ageing population is one of the strategies adopted by different countries to avoid early retirement and to encourage older workers to remain longer in the labour market, to remain healthy, active and independent, as long as possible. Active ageing requires the involvement of older adults in a increas...

The Social Outcomes of Older Adult Learning in Taiwan: Evaluation Framework and Indicators

Science.gov (United States)

Lin, Li-Hui

2015-01-01

The purpose of this study is to explore the social outcomes of older adult learning in Taiwan. In light of our society's aging population structure, the task of establishing evaluation framework and indicators for the social outcomes of learning (SOL) as applied to older adults is urgent. In order to construct evaluation indicators for older adult…

How Older Adults Make Decisions regarding Smart Technology: An Ethnographic Approach

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Davenport, Rick D.; Mann, William; Lutz, Barbara

2012-01-01

Comparatively little research has been conducted regarding the smart technology needs of the older adult population despite the proliferation of smart technology prototypes. The purpose of this study was to explore the perceived smart technology needs of older adults with mobility impairments while using an ethnographic research approach to…

The ageing of Croatian population.

Science.gov (United States)

Murgić, Jure; Jukić, Tomislav; Tomek-Roksandić, Spomenka; Ljubicić, Mate; Kusić, Zvonko

2009-06-01

With a share of people older than 65 years of 16.64 per cent in total population, Croatia is considered a very old country regarding it's population. This percentage is one of the highest in already old Europe. Demographic projections reveal a further increase of share of people older than 65 years in future. There are many causes of this condition. This fact carries negative economic and health care implications which burden Croatia. Many administrative reforms are necessary to resolve this issue and to avoid economy problems and intergenerational conflicts.

National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

Science.gov (United States)

Schatz, Bruce R

2015-12-01

At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

Vaccines for Older Adults.

Science.gov (United States)

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

2017-09-01

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

Barriers to treatment for older adults seeking psychological therapy.

Science.gov (United States)

Wuthrich, Viviana M; Frei, Jacqueline

2015-07-01

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

A comparison of dance interventions in people with Parkinson disease and older adults.

Science.gov (United States)

McNeely, M E; Duncan, R P; Earhart, G M

2015-05-01

It is important for our aging population to remain active, particularly those with chronic diseases, like Parkinson disease (PD), which limit mobility. Recent studies in older adults and people with PD suggest dance interventions provide various motor benefits. The literature for dance in PD is growing, but many knowledge gaps remain, relative to what is known in older adults. The purpose of this review is to: (1) detail results of dance intervention studies in older adults and in PD, (2) describe limitations of dance research in these populations, and (3) identify directions for future study. Generally, a wide variety of dance styles have been investigated in older adults, while a more limited subset has been evaluated in PD. Measures vary widely across studies and a lack of standardized outcomes measures hinders cross-studies comparisons. Compared to the dance literature in older adults, there is a notable absence of evidence in the PD literature in outcome domains related to cardiovascular health, muscle strength, body composition, flexibility, and proprioception. As a whole, the dance literature supports substantial and wide-ranging benefits in both populations, but additional effort should be dedicated to well-designed comparative studies using standardized outcome measures to identify optimal treatment programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Comparison of Dance Interventions in People with Parkinson Disease and Older Adults

Science.gov (United States)

McNeely, ME; Duncan, RP; Earhart, GE

2015-01-01

It is important for our aging population to remain active, particularly those with chronic diseases, like Parkinson disease (PD), which limit mobility. Recent studies in older adults and people with PD suggest dance interventions provide various motor benefits. The literature for dance in PD is growing, but many knowledge gaps remain, relative to what is known in older adults. The purpose of this review is to: 1) detail results of dance intervention studies in older adults and in PD, 2) describe limitations of dance research in these populations, and 3) identify directions for future study. Generally, a wide variety of dance styles have been investigated in older adults, while a more limited subset has been evaluated in PD. Measures vary widely across studies and a lack of standardized outcomes measures hinders cross-studies comparisons. Compared to the dance literature in older adults, there is a notable absence of evidence in the PD literature in outcome domains related to cardiovascular health, muscle strength, body composition, flexibility, and proprioception. As a whole, the dance literature supports substantial and wide-ranging benefits in both populations, but additional effort should be dedicated to well-designed comparative studies using standardized outcome measures to identify optimal treatment programs. PMID:25771040

Occupational therapists lead a national injury prevention strategy to help older drivers.

Science.gov (United States)

Craik, Janet M

2011-04-01

As older adults are the fastest growing segment of the driving population, the Canadian Association of Occupational Therapists (CAOT) has taken older driver safety as a key priority. The purpose of this paper is to present the National Blueprint for Injury Prevention in Older Drivers (Blueprint) and its related activities. Since 2006, CAOT has been working on initiatives relating to the National Blueprint for Injury Prevention in Older Drivers. The most recent activities include the launch of informational brochures and a website. The Blueprint and its related activities were developed with the intent to prolong safe driving among older adults in Canada, and to propose future actions to be addressed by all stakeholders interested in older driver safety.

Macroeconomic implications of population ageing and selected policy responses.

Science.gov (United States)

Bloom, David E; Chatterji, Somnath; Kowal, Paul; Lloyd-Sherlock, Peter; McKee, Martin; Rechel, Bernd; Rosenberg, Larry; Smith, James P

2015-02-14

Between now and 2030, every country will experience population ageing-a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population-a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries' economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties. Copyright © 2015 World Health Organization. Published by Elsevier Ltd

The Impact of Disordered Gambling Among Older Adults.

Science.gov (United States)

Kerber, Cindy; Adelman-Mullally, Theresa; Kim, MyoungJin; Astroth, Kim Schafer

2015-10-01

The current study is a secondary analysis that describes the mental, social, and economic health impacts of disordered gambling in older adults recovering from pathological gambling. The study sought to answer the following research questions: (a) What are the problem behaviors in the mental, social, and economic health dimensions?; and (b) What is the association between mental, social, and economic health impact dimensions and the South Oaks Gambling Screen score? The study population comprised a convenience sample of 40 older adults recovering from pathological gambling in the Midwestern United States. Participants were originally recruited from Gamblers Anonymous(®) meetings and gambling treatment centers. Significant findings for the current study population were: gambling causing depression, being fired from a job due to gambling, and still paying off gambling debt. Nurses should evaluate effects of disordered gambling, assess for disordered gambling, and include a financial assessment in routine care of this patient population. Copyright 2015, SLACK Incorporated.

DIAGNOSTICS OF MOTOR ABILITY AS A BASE OF CORRECTION PLANNING OF TRANSFORMATION PROCESSES IN SPECIAL POPULATIONS

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Kosta Goranović

2011-08-01

Full Text Available In the research, at sample of 80 tested, employees in the special police force, as representatives of police population age from 20 to 25, diagnostics of motor potential in transitive period of annual macrostructure was done. The aim of the research was doing potential correction in planning and programming of transformation process in the next cycles of sports preparation on the base of diagnosed quantitative value of motor abilities. Besides analyses of achieved values, the difference was established between two leading teams in the space of measuring potential. The research results indicated to statistically important differences between two groups of tested people, as well as to unacceptable level of development in some abilities. The achieved results are, from aspect of training process’ control, the indicator to instructors’ team on the need of correction of transformation process’ content, with aim of improving bad segments. Diagnostics of motor abilities with measuring instruments in terrain conditions is one of methods, which can be in function of valorising transformation process of the special police force, taking into account specifics of their professional manifestation.

Bereavement-related depression in the older adult population: a distinct disorder?

Science.gov (United States)

Jozwiak, Natalia; Preville, Michel; Vasiliadis, Helen-Maria

2013-12-01

Bereavement is a phenomenon that shares many symptoms with depression, and that a great number of older adults experience following the loss of a close relative. The objectives of the present study were to (1) determine whether the symptoms of depression reported by bereaved individuals differ from those with non-bereavement minor/major depression (NBRD), (2) assess whether BRD is as persistent during a one year follow-up as compared to NBRD, and (3) identify factors and consequences associated with BRD. The data used for this study came from the Longitudinal Study ESA (Study Health of Elders), conducted between 2005 and 2008, using a representative sample (n=2811) of community-dwelling older adults, aged 65 and over. To test our hypothesis, an exploratory latent class analysis and multivariate logistic regression were used. BRD prevalence among older adults suffering from depression was 39%. BRD individuals report all symptoms of depression, but in lower probabilities, and BRD is as persistent as MDD over 12 months, suggesting that it does not differ from NBRD. The principal factors associated with BRD were widowhood and lower level of education. Individuals with BRD are less likely to consult medical services and be dispensed an antidepressant, compared to NBRD. We have to be cautious when generalizing our findings to individuals with major depression alone, since our results included both minor and major depressions in the same group. No evidence was found that BRD differed from non BRD in terms of depressive symptoms and persistence. The bereavement exclusion criterion in the DSM-IV should be reconsidered. Crown Copyright © 2013 Published by Elsevier B.V. All rights reserved.

The availability and affordability of long-term care for disabled older people in China: The issues related to inequalities in social security benefits.

Science.gov (United States)

Lei, Peng; Feng, Zhixin; Wu, Zhuochun

2016-01-01

China is experiencing increasing pressure from issues relating to an ageing population. The rationality of different eligibility criteria of the benefits within the social security system has been widely challenged; however, to date, no previous study has explored its association with the availability and affordability of long-term care (LTC). This study evaluates the availability and affordability of Long-Term Care (LTC) services for disabled older people (aged 65 and above) in China, with special attention to the differences among groups in receipt of specific social security benefits. The data of availability and affordability of LTC services for disabled older people is from a nationally representative sample Chinese Longitudinal Healthy Longevity Survey (CLHLS). Three different social security benefits were identified and their effects on the long-term care services for disabled older people were explored. The overall proportions of disabled older people who have only limited or no available or affordable LTC services were remarkably high, especially for those who have moderate or no social security benefits. Compared to those who are entitled to generous social security benefits, older people who have no social security benefits are 18.45 times more likely to be unable to afford health care expenses. The findings imply that policy makers in China could focus on the LTC needs for the social security and socioeconomically disadvantaged (who have limited or no social security benefits and in low household income) disabled older people which could reduce the gap between them and those who are entitled to generous social security benefits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Risks, consequences, and prevention of falls of older people in oral healthcare centers.

Science.gov (United States)

de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

2017-03-01

One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Undernutrition management and the role of protein-enriched meals for older adults

NARCIS (Netherlands)

Ziylan, Canan

2016-01-01

Undernutrition is a major health problem in the growing elderly population. It is estimated that one in ten Dutch community-dwelling older adults is suffering from undernutrition, and one in three Dutch older adults who receive home care. Undernutrition may lead to many negative consequences,

Normative functional fitness standards and trends of Portuguese older adults: cross-cultural comparisons.

Science.gov (United States)

Marques, Elisa A; Baptista, Fátima; Santos, Rute; Vale, Susana; Santos, Diana A; Silva, Analiza M; Mota, Jorge; Sardinha, Luís B

2014-01-01

This cross-sectional study was designed to develop normative functional fitness standards for the Portuguese older adults, to analyze age and gender patterns of decline, to compare the fitness level of Portuguese older adults with that of older adults in other countries, and to evaluate the fitness level of Portuguese older adults relative to recently published criterion fitness standards associated with maintaining physical independence. A sample of 4,712 independent-living older adults, age 65-103 yr, was evaluated using the Senior Fitness Test battery. Age-group normative fitness scores are reported for the 10th, 25th, 50th, 75th, and 90th percentiles. Results indicate that both women and men experience age-related losses in all components of functional fitness, with their rate of decline being greater than that observed in other populations, a trend which may cause Portuguese older adults to be at greater risk for loss of independence in later years. These newly established normative standards make it possible to assess individual fitness level and provide a basis for implementing population-wide health strategies to counteract early loss of independence.

The Digital Divide and urban older adults.

Science.gov (United States)

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

2010-01-01

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

Older Persons at Risk of Hospital Readmission

DEFF Research Database (Denmark)

Pedersen, Mona Kyndi

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

Special Education Teacher Resilience: A Phenomenological Study of Factors Associated with Retention and Resilience of Highly Resilient Special Educators

Science.gov (United States)

Downing, Brienne

2017-01-01

Special education teachers are in high demand and greatly needed to meet the needs of the growing population of students qualified for special education services under the Individual with Disabilities Education Act (IDEA) of 2004. The increasing attrition rates of special education teachers are a social justice issue that needs attention. The…

Time to call it quits? The safety and health of older workers.

Science.gov (United States)

Bohle, Philip; Pitts, Claudia; Quinlan, Michael

2010-01-01

The workforces of many countries are aging, creating pressure for older workers to retire later despite greater vulnerability to various occupational safety and health (OSH) risks. Some specific risks to older workers arise from age-related physical or psychological changes, while others reflect exposures to poor work organization or employment conditions. This article reviews evidence on the nature of the OSH risks faced by older workers, focusing on work ability, contingent work, and working hours. Work ability, the capacity to meet the physical, mental, and social demands of a job, has been linked to positive health outcomes for older workers. However, work characteristics seem to be more critical than workers' individual capacities. Contingent work is generally associated with poorer OSH outcomes, and older workers are more likely to be contingent, with special implications for their safety and health. There has been limited research on age and working hours, but risks for many physical and mental health problems are known to increase with shift work experience, and physiological and psychosocial changes associated with age may also increase injury risks. The authors discuss organizational practices and regulatory policies to protect and enhance the OSH of older workers.

The Housing and Support Needs of People with an Intellectual Disability into Older Age

Science.gov (United States)

Shaw, K.; Cartwright, C.; Craig, J.

2011-01-01

Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the…

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

Science.gov (United States)

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

2011-11-01

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

The built environment and older adults: A literature review and an applied approach to engaging older adults in built environment improvements for health.

Science.gov (United States)

Tuckett, Anthony G; Banchoff, Ann W; Winter, Sandra J; King, Abby C

2018-03-01

This paper presents a review of the literature about the built environment as it impacts the health of older people. It then introduces the gerontological nurse and researcher to the Our Voice framework for engaging older people as citizen scientists in order to empower them as agents of change in improving their local built environment and ultimately advancing community health. Community-level strategies to promote successful ageing in place are critical both to optimising health outcomes and containing healthcare costs. Such strategies must take into account the influence of the built environment both on individual health behaviours and on overall community health. At the same time, the perspectives and experiences of older people themselves ought to inform policies and practices in a systematic way. Integrative literature review. A wide scan of English language articles published in the EMBASE, PubMed and CINAHL bibliographic databases was conducted. Additional articles were sourced by mining relevant reference lists (i.e., snowball sampling). Papers included were published between 2005 and 2016. Three distinct components emerged from the review: the impact of the built environment on health-in particular the health of older persons; citizen science and its applicability for older people research; and the promise of the Our Voice citizen science framework to activate changes in the built environment that improve older peoples' health. The ageing of the world's population brings with it an increased population-level risk of chronic disease and disability. We present the Our Voice framework, developed by researchers at Stanford University, as a promising strategy for engaging and empowering older people as citizen scientists, as a framework to apply to gerontological nursing and improving community health. Gerontology nurses are encouraged to: (i) Recognise the impact of the built environment and other community-level factors on the health of their patients. (ii

Office of Special Services Annual Report, FY 1999.

Science.gov (United States)

Front Range Community Coll., Westminster, CO.

This report lists support services provided by the Westminster Campus Special Services Department to the Westminster, Brighton, Longmont, and North Boulder Campuses. The Special Services Department provides disability services, including interpreting for the deaf, tutoring, gender equity support, and special populations transition support.…

Exploring the Housing Needs of Older People in Standard and Sheltered Social Housing.

Science.gov (United States)

Fox, Siobhan; Kenny, Lorna; Day, Mary Rose; O'Connell, Cathal; Finnerty, Joe; Timmons, Suzanne

2017-01-01

Objective: Our home can have a major impact on our physical and mental health; this is particularly true for older people who may spend more time at home. Older people in social (i.e., public) housing are particularly vulnerable. Housing options for older people in social housing include standard design dwellings or specially designed "sheltered housing." The most suitable housing model should be identified, with older people consulted in this process. Method: Survey of older people (aged ≥60) living in standard or sheltered social housing. Data were analyzed using descriptive and inferential statistics in SPSS Version 22. Results: Overall, 380 surveys were returned (response rate = 47.2%). All older people had similar housing needs. Those in sheltered housing were more satisfied with the physical home design and reported more positive outcomes. Older people in standard housing were less likely to have necessary adaptations to facilitate aging-in-place. Discussion: Older people in standard housing reported more disability/illnesses, are worried about the future, and felt less safe at home. However, few wanted to move, and very few viewed sheltered housing as an alternative, suggesting limited knowledge about their housing options. Future social housing designs should be flexible, that is, adaptable to the needs of the tenants over time.

How can online communication enhance older adults’ social connectivity? : Implementation and adoption issues

NARCIS (Netherlands)

Hage, Maria Louisa

2015-01-01

It is often assumed online communication can enhance older adults’ social connectivity. However, previous studies have indicated two obstacles. First, older adults tend to be late adopters, or laggards. This raises the question how online communication tools can be implemented among a population

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

Science.gov (United States)

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

2017-01-01

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

Social capital and self-rated health among older Korean immigrants.

Science.gov (United States)

Kim, Bum Jung; Harris, Lesley Maradik

2013-12-01

The objective of this article is to investigate determinants of self-rated health and describe their association with social capital and socioeconomic characteristics among older Korean immigrants. A cross-sectional study of 205 older Korean immigrants (aged 60 years and older) was conducted in Los Angeles county. Independent variables included age, gender, marital status, income of the older Koreans, and social capital included social norms, trust, partnership with the community, information sharing, and political participation. Self-rated health was the dependent variable. Descriptive analyses were done to show group differences in self-rated health and logistic regression analyses to identify determinants of self-rated health. Gender (male), high income, and high levels of information sharing were significant determinants of high self-rated health status among older Korean immigrants. This population-based study provides empirical evidence that gender, income, and information sharing are directly associated with the self-rated health status of older Korean immigrants.

Home as a health promotion setting for older adults

DEFF Research Database (Denmark)

Mahler, Marianne; Sarvimäki, Anneli; Clancy, Anne

2014-01-01

promotion care. As official guidelines in the Nordic countries state that home is the best place to grow old, it is essential that older persons keep their health and functional capacity in order to be able to live at home for as long as possible. As current policy emphasises living at home, home care......The number and the proportion of older persons is growing in the Nordic Countries. The growth in the older population has a clear impact on the care system for older persons. One trend is to prioritise home care instead of care in institutions. Another trend is to emphasise preventive and health......, preventive work and health promotion it becomes essential to study the home as a health promotion setting. Objective: The aim of this study was to reach a new understanding of home as a health promotion setting for older persons. Study design: The method used was a literature reflection and analysis...

Buffers or Boosters? The Role of HRM Practices in Older Workers' Experience of Stereotype Threat.

Science.gov (United States)

Oliveira, Eduardo André da Silva; Cabral-Cardoso, Carlos José

2018-01-02

Building on the social identity approach and the HRM literature, this two-wave cross-sectional study examined the effects of negative age-based metastereotypes on the age-based stereotype threat experience of older workers and on organizational disidentification. The moderator role of HRM practices in the relationship between negative age-based metastereotypes and age-based stereotype threat was also investigated. Older workers survey results (n = 469) from 14 manufacturing companies indicated that negative age-based metastereotypes correlate positively with stereotype threat. Moderation results showed that age-awareness HRM practices (training for older workers) reinforced age-based stereotype threat, whereas general HRM practices (recognition and respect) impaired it. The article suggests that the combination of age-based metastereotypes with a stereotype threat framework contributes to further understand older workers' beliefs and attitudes. It also indicates that to be effective, HRM practices should emphasize positive social identities older workers share with their colleagues, rather than giving older workers special treatment that may, after all, reinforce stigmatization.

Who, How, and Where: Special Education's Issues in Perpetuity.

Science.gov (United States)

Bateman, Barbara D.

1994-01-01

Issues that are central to special education and appear destined to remain so are discussed, including professional divisions among special educators and between special and regular educators, the population to be served, individualization, and placement. (JDD)

Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

Directory of Open Access Journals (Sweden)

Sherrilene Classen

2008-01-01

Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research, and views (qualitative research of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long

Population characteristics and absorbed dose to the population from nuclear medicine: United States--1982

International Nuclear Information System (INIS)

Mettler, F.A. Jr.; Christie, J.H.; Williams, A.G. Jr.; Moseley, R.D. Jr.; Kelsey, C.A.

1986-01-01

Those in the U.S. population who receive nuclear medicine examinations have been characterized by age and sex. Males received 42% of examinations while females received 58%. More than one-third of the examinations were done on persons older than 64 y of age and more than two-thirds on patients older than 45 y of age. The per caput effective dose equivalent from nuclear medicine procedures in 1982 was 140 muSv (14 mrem); whereas, the per caput age-specific effective dose equivalent to the U.S. population was 50 muSv (5.9 mrem). These can be compared with 2 mSv (200 mrem) from natural background

Dental Implants in the Elderly Population: A Long-Term Follow-up.

Science.gov (United States)

Compton, Sharon M; Clark, Danielle; Chan, Stephanie; Kuc, Iris; Wubie, Berhanu A; Levin, Liran

The objectives of this study were to evaluate implant survival and success in the elderly population and to assess indicators and risk factors for success or failure of dental implants in older adults (aged 60 years and older). This historical prospective study was developed from a cohort of patients born prior to 1950 who received dental implants in a single private dental office. Implant survival and marginal bone levels were recorded and analyzed with regard to different patient- and implant-related factors. The study examined 245 patient charts and 1,256 implants from one dental clinic. The mean age at the time of implant placement was 62.18 ± 8.6 years. Smoking was reported by 9.4% of the cohort studied. The overall survival rate of the implants was 92.9%; 7.1% of the implants had failed. Marginal bone loss depicted by exposed threads was evident in 23.3% of the implants. Presenting with generalized periodontal disease and/or severe periodontal disease negatively influenced the survival probability of the implant. Implants placed in areas where bone augmentation was performed prior to or during implant surgery did not have the same longevity compared with those that did not have augmentation prior to implantation. The overall findings concluded that implants can be successfully placed in older adults. A variety of factors are involved in the long-term success of the implant, and special consideration should be taken prior to placing implants in older adults to limit the influence of those risk factors.

Depression among older people in Sri Lanka: With special reference to ethnicity.

Science.gov (United States)

Khaltar, Amartuvshin; Priyadarshani, Neelawala Gw; Delpitiya, Nisansala Y; Jayasinghe, Chandrika; Jayasinghe, Ananda; Arai, Asuna; Tamashiro, Hiko

2017-12-01

To ascertain if the factors associated with depression differ among ethnic groups in community-dwelling older people in Kandy District, Sri Lanka. A cross-sectional survey was carried out of people aged ≥60 years living in a single divisional secretariat of Kandy District. The participants were asked about ethnicity (Sinhalese, Tamil and Muslim), sociodemographic characteristics and depression status by face-to-face interviews with a structured questionnaire. Depression was measured by the 15-item Geriatric Depression Scale, and the total score of ≥6 was considered as depression. The χ 2 -test and multivariate logistic regression with two-way interaction terms between sociodemographic characteristics and ethnicity were carried out. Participants (n = 778) consisted of 56.6% Sinhalese, 22.1% Tamils and 21.3% Muslims. Of the participants, the prevalence of depression was 31.8% (27.3% in Sinhalese, 42.1% in Tamils and 32.9% in Muslims). Multivariate analyses showed that there were no significant interactions between sociodemographic characteristics and ethnicity. However, low economic status, low perceived social support and more than two self-reported diseases were significantly associated with depression in all ethnic groups. Some factors were found to be significantly associated with depression, but did not differ among ethnic groups. The findings would help practitioners to identify older people with a high risk of depression, and to intervene in its development or exacerbation. Geriatr Gerontol Int 2017; 17: 2414-2420. © 2017 Japan Geriatrics Society.

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…

Hippocampal Sclerosis in Older Patients

Science.gov (United States)

Cykowski, Matthew D.; Powell, Suzanne Z.; Schulz, Paul E.; Takei, Hidehiro; Rivera, Andreana L.; Jackson, Robert E.; Roman, Gustavo; Jicha, Gregory A.; Nelson, Peter T.

2018-01-01

Context Autopsy studies of the older population (≥65 years of age), and particularly of the “oldest-old” (≥85 years of age), have identified a significant proportion (~20%) of cognitively impaired patients in which hippocampal sclerosis is the major substrate of an amnestic syndrome. Hippocampal sclerosis may also be comorbid with frontotemporal lobar degeneration, Alzheimer disease, and Lewy body disease. Until recently, the terms hippocampal sclerosis of aging or hippocampal sclerosis dementia were applied in this context. Recent discoveries have prompted a conceptual expansion of hippocampal sclerosis of aging because (1) cellular inclusions of TAR DNA-binding protein 43 kDa (TDP-43) are frequent; (2) TDP-43 pathology may be found outside hippocampus; and (3) brain arteriolosclerosis is a common, possibly pathogenic, component. Objective To aid pathologists with recent recommendations for diagnoses of common neuropathologies in older persons, particularly hippocampal sclerosis, and highlight the recent shift in diagnostic terminology from HS-aging to cerebral age-related TDP-43 with sclerosis (CARTS). Data Sources Peer-reviewed literature and 5 autopsy examples that illustrate common age-related neuropathologies, including CARTS, and emphasize the importance of distinguishing CARTS from late-onset frontotemporal lobar degeneration with TDP-43 pathology and from advanced Alzheimer disease with TDP-43 pathology. Conclusions In advanced old age, the substrates of cognitive impairment are often multifactorial. This article demonstrates common and frequently comorbid neuropathologic substrates of cognitive impairment in the older population, including CARTS, to aid those practicing in this area of pathology. PMID:28467211

Older-Adult Playfulness: An Innovative Construct and Measurement for Healthy Aging Research

Science.gov (United States)

Yarnal, Careen; Qian, Xinyi

2011-01-01

Few studies of adult playfulness exist, but limited research on older adults and playfulness suggests that playfulness in later life improves cognitive, emotional, social, and psychological functioning and healthy aging overall. Older adults represent a rapidly growing segment of the U.S. population, underscoring the need to understand the aging…

Low Energy Trauma in Older Persons: Where to Next?

Science.gov (United States)

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

2015-01-01

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

The Relationship between Outdoor Activity and Health in Older Adults Using GPS

OpenAIRE

Kerr, Jacqueline; Marshall, Simon; Godbole, Suneeta; Neukam, Suvi; Crist, Katie; Wasilenko, Kari; Golshan, Shahrokh; Buchner, David

2012-01-01

Physical activity (PA) provides health benefits in older adults. Research suggests that exposure to nature and time spent outdoors may also have effects on health. Older adults are the least active segment of our population, and are likely to spend less time outdoors than other age groups. The relationship between time spent in PA, outdoor time, and various health outcomes was assessed for 117 older adults living in retirement communities. Participants wore an accelerometer and GPS device for...

An overview of children as a special population-Relevance to predictive biomarkers

International Nuclear Information System (INIS)

Kimmel, Gary L.

2005-01-01

There has been an increasing focus on children as a special population in the fields of toxicology and epidemiology. At the same time, there has been considerable improvement in the technology for defining normal development and pathways of pathogenesis. Increased support of these areas has culminated in stronger research programs and greater professional involvement in addressing the specific challenges of applying new techniques and data to the improvement of children's health. Part of these challenges relates to the ever changing environment of the child. Not only does a child's anatomy, physiology, and metabolism change with time, but their lifestyle and awareness change as well. All of these can have a significant impact on a child's exposure and the potential of that exposure to have an effect on health and development. This paper will provide a brief overview of the susceptibility of the child relative to sensitive developmental life stages, the changing nature of exposure parameters during development, and how these factors can impact the relevance of predictive biomarkers of chemical toxicity in children

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…

School Enrollment in the United States: 2006. Population Characteristics. Current Population Reports

Science.gov (United States)

Davis, Jessica W.; Bauman, Kurt J.

2008-01-01

This report discusses school enrollment levels and trends in the population aged 3 and older based on data collected in 2006 by the U.S. Census Bureau in the American Community Survey (ACS) and the Current Population Survey (CPS). Historically, the CPS has been the only data source used to produce school enrollment reports. This is the first…

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

Directory of Open Access Journals (Sweden)

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.

UNDERSTANDING OLDER ADULT LEARNERS IN DISTANCE EDUCATION: The Case of Universiti Sains Malaysia

Directory of Open Access Journals (Sweden)

Nailul Morad MOHD NOR

2011-07-01

Full Text Available World population ageing is unprecedented and pervasive which will affect all countries in the world. According to a United Nation report (2010: “By 2045, the number of older persons in the world will exceed the number of young for the first time in history.” The number of the older adult learners in distance education programs is also expected to increase in tandem with the growth of ageing population throughout the world. As such distance education institutions and instructors should be vigilant to this new emerging group of learners. The objectives of this study were to identify factors related to older adult learners’ participation in the distance education degree programs and their characteristics. Data were collected by using interviews and questionnaires. Respondents for the study were older adult learners age 50 and over who enrolled in degree programs at the School of Distance Education (SDE, Universiti Sains Malaysia in Malaysia. Five older adult learners were interviewed and 72 out of 123 respondents completed the questionnaires. The findings indicated that older adult learners’ participation in the distance education degree programs is mainly due to career advancement and to seek knowledge. The older adult learners’ distinct characteristics are high motivation, eager to learn, health conscious, effective time management, good social skills, no financial difficulties and have strong family support.

[Medication use among community-dwelling older Icelanders. Population-based study in urban and rural areas].

Science.gov (United States)

Sigurdardottir, Arun K; Arnadottir, Solveig Asa; Gunnarsdottir, Elín Díanna

2011-12-01

To describe medication use among older community-dwelling Icelanders by collecting information on number of medicine, polypharmacy (>5 medications), and medications by ATC categories. Moreover, to explore the relationship between medication use and various influential factors emphasizing residency in urban and rural areas. Population-based, cross-sectional study. Participants were randomly selected from the National registry in one urban (n=118) and two rural (n=68) areas. 1) ≥ 65 years old, 2) community-dwelling, 3) able to communicate verbally. Information on medication use was obtained from each person's medication list and interviews. A questionnaire and five standardized instruments were used to assess the potential influencing factors. On average, participants used 3.9 medications and prevalence of polypharmacy was 41%. Men used 3.5 medications on average and women 4.4 (p=0.018). Compared to rural residents, urban residents had fewer medical diagnoses, better mobility, less pain, and fewer depressive symptoms. By controlling for the effects of these variables, more medications were associated with urban living (pbetter scores on health assessments.

A healthy aging program for older adults: effects on self-efficacy and morale.

Science.gov (United States)

Scult, Matthew; Haime, Vivian; Jacquart, Jolene; Takahashi, Jonathan; Moscowitz, Barbara; Webster, Ann; Denninger, John W; Mehta, Darshan H

2015-01-01

As of 2012, 810 million people worldwide were older than 60 y, accounting for 11% of the population. That number is expected to rise to 2 billion by 2050 or to 22% of the overall population. As a result, a growing need exists to understand the factors that promote mental and physical health in older populations. The purpose of this study was to develop a healthy aging program for older adults and to measure the changes from baseline to the end of the program in participants' relevant psychosocial outcomes (ie, self-efficacy and morale). The study's healthy aging mind-body intervention (MBI) was adapted from the Relaxation Response Resiliency Program (3RP) at the Benson-Henry Institute for Mind Body Medicine, which incorporates elements from the fields of stress management, cognitive behavioral therapy, and positive psychology. That program was modified with examples and exercises targeted to an older population and evaluated in the current single-arm pilot study. The program took place at the Massachusetts General Hospital (MGH). The 9-wk healthy aging MBI was developed for participants aged 65 y and older. Fifty-one older adults from the surrounding community participated in the study's groups. A new intervention group began the program every 3 mo, with a maximum of 12 individuals per group. For each group, the MBI consisted of weekly 90-min sessions for 9 consecutive wk, directed by a psychologist. The program included sessions that taught participants (1) a variety of methods to elicit the relaxation response (RR), (2) the practice of adaptive coping and cognitions, (3) behaviors necessary to create a healthy lifestyle, and (4) methods of building social support. The research team chose to focus on 2 psychological variables of interest for aging populations: morale and self-efficacy. The study used 2 questionnaires to measure those outcomes, the Philadelphia Geriatric Center Morale Scale (PGCMS), a multidimensional measure of the psychological state of older

Nurses' understandings of suitable footwear for older people.

Science.gov (United States)

Borland, Andrea; Martin, Caroline Hollins; Locke, John

2013-01-01

The purpose of this paper is to gain insight into nurses' understandings of what constitutes suitable footwear for older people in care homes. An exploratory descriptive qualitative survey was carried out of 20 registered nurses employed in six Scottish care homes for older people. Data were collected using a semi-structured questionnaire that included five open-ended questions. Content analysis was used to theme footwear perceptions. Participants had several views about what encompasses safe footwear; some were erroneous. The link between inappropriate footwear and falls was recognised by 80 per cent of respondents, but some were unclear about the features that effect or inhibit safety. No UK or international standardised guidelines were identified that advise nurses about appropriate footwear for older people. It is unknown whether respondents represent the nurse population because findings are restricted by a small sample size. Nonetheless, the group showed variable understanding of what constitutes safe footwear for older people and links with fall prevention. Improved nurse-education about what comprises safe footwear and the links with falls prevention in older people is required. Structured guidelines to direct nurse educators about what to teach student nurses about appropriate footwear for older people may work towards reducing falls. No guidelines to direct nurses about appropriate footwear for older people in care homes have been written. Key points have been developed.

Appetizing muffins designed for nutritional needs of older adults

OpenAIRE

Höglund, Evelina; Albinsson, Berit; Rothenberg, Elisabet; Wendin, Karin

2016-01-01

Introduction: Due to good living conditions, the population of older adults is growing. Increased age increases prevalence of diseases and thereby also the risk of disease related malnutrition (DRM) increases. Appetizing and nutritious food products are needed to counteract DRM. One possible way to enable increased nutritional intake for older people with poor appetite is to offer energy/protein rich snacks between meals. In Sweden, afternoon coffee is an appreciated part of the day. It has a...

Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress?

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Ganda Mall, John-Peter; Östlund-Lagerström, Lina; Lindqvist, Carl Mårten; Algilani, Samal; Rasoal, Dara; Repsilber, Dirk; Brummer, Robert J; V Keita, Åsa; Schoultz, Ida

2018-03-20

Despite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults. Three study populations were included: 1) older adults with GI symptoms (n = 24), 2) a group of older adults representing the general elderly population in Sweden (n = 22) and 3) senior orienteering athletes as a potential model of healthy ageing (n = 27). Questionnaire data on gut-health, psychological distress and level of physical activity were collected. Intestinal permeability was measured by quantifying zonulin in plasma. The level of systemic and local inflammation was monitored by measuring C-reactive protein (CRP), hydrogen peroxide in plasma and calprotectin in stool samples. The relationship between biomarkers and questionnaire data in the different study populations was illustrated using a Principal Component Analysis (PCA). Older adults with GI symptoms displayed significantly higher levels of both zonulin and psychological distress than both general older adults and senior orienteering athletes. The PCA analysis revealed a separation between senior orienteering athletes and older adults with GI symptoms and showed an association between GI symptoms, psychological distress and zonulin. Older adults with GI symptoms express increased plasma levels of zonulin, which might reflect an augmented intestinal permeability. In addition, this group suffer from higher psychological distress compared to general older adults and senior orienteering athletes. This relationship was further confirmed by a PCA plot, which illustrated an association between GI symptoms, psychological distress and intestinal permeability.

Assessing the Prayer Lives of Older Whites, Older Blacks and Older Mexican Americans: A Descriptive Analysis

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Krause, Neal

2011-01-01

The purpose of this study was to see whether differences emerge between older whites, older blacks, and older Mexican Americans in 12 measures of prayer. These measures assess four dimensions of prayer: The social context of prayer, interpersonal aspects of prayer, beliefs about how prayer operates, and the content or focus of prayers. Data from two nationwide surveys of older adults suggest that with respect to all four dimensions, the prayer lives of older whites appear be less developed than the prayer lives of older blacks and older Mexican Americans. In contrast, relatively few differences were found in the prayer lives of older African Americans and older Mexican Americans. The theoretical implications of these findings are discussed. PMID:22523464

Effect of an AIDS education program for older adults.

Science.gov (United States)

Rose, M A

1996-01-01

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

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.

Dating Relationships in Older Adulthood: A National Portrait

Science.gov (United States)

Brown, Susan L.; Shinohara, Sayaka K.

2013-01-01

Dating in later life is likely common, especially as the proportion of older adults who are single continues to rise. Yet there are no recent national estimates of either the prevalence or factors associated with dating during older adulthood. Using data from the 2005-2006 National Social Life, Health, and Aging Project, a nationally representative sample of 3,005 individuals ages 57-85, the authors constructed a national portrait of older adult daters. Roughly 14% of singles were in a dating relationship. Dating was more common among men than women and declined with age. Compared to non-daters, daters were more socially advantaged. Daters were more likely to be college educated and had more assets, were in better health, and reported more social connectedness. This study underscores the importance of new research on partnering in later life, particularly with the aging of the U.S. population and the swelling ranks of older singles. PMID:24319296

Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study

NARCIS (Netherlands)

Huizenga, Petra; Finnema, Evelyn; Roodbol, Petrie

Aim. 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. Background. To promote the quality of care for older

Oropharyngeal dysphagia in older persons – from pathophysiology to adequate intervention

DEFF Research Database (Denmark)

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

2016-01-01

Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why...... interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies...

ICT, Education and Older People in Australia: A Socio-Technical Analysis

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Tatnall, Arthur

2014-01-01

People over 65 (or older people) are a growing proportion of the population in many developed countries including Australia. In the last 10 to 12 years interest from this group in the use of Information and Communication Technologies (ICT) and the Internet has also grown considerably. ICT has much to offer older people as a means of keeping in…

Managing effective partnerships in older people's services

NARCIS (Netherlands)

Nies, Henk

The integration of older people's services is a challenge to all countries with an ageing population. Although it is widely acknowledged that acute care, long-term care, social care, housing, leisure, education and other services should all operate in a more 'joined-up manner', achieving this in

Osteoporotic fractures in older adults

OpenAIRE

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

2006-01-01

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

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

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Hinterlong, James; Ryan, Scott

2008-08-01

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

Age-related response to redeemed antidepressants measured by completed suicide in older adults

DEFF Research Database (Denmark)

Erlangsen, Annette; Conwell, Yeates

2014-01-01

OBJECTIVE: To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. METHODS: A population-based cohort study using a nationwide linkage of individua...... between estimated prevalence of depression and antidepressant prescription rate in persons dying by suicide underscores the need for assessment of depression in the oldest old.......OBJECTIVE: To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. METHODS: A population-based cohort study using a nationwide linkage of individual......-level records was conducted on all persons aged 50+ living in Denmark during 1996-2006 (1,215,524 men and 1,343,568 women). Suicide rates by treatment status were calculated using data on all antidepressant prescriptions redeemed at pharmacies. RESULTS: Individual-level data covered 9,354,620 and 10...

An examination of electronic health information privacy in older adults.

Science.gov (United States)

Le, Thai; Thompson, Hilaire; Demiris, George

2013-01-01

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

Volunteering and older women: psychosocial and health predictors of participation.

Science.gov (United States)

Parkinson, Lynne; Warburton, Jeni; Sibbritt, David; Byles, Julie

2010-11-01

As populations age, there will be a need for more volunteers in social welfare, and consequently a need to better understand potential effects of volunteering for older people. Whilst there is a body of international literature exploring health benefits of volunteering in later life, there are currently no longitudinal studies of Australian populations. Internationally, there is a lack of studies focusing on older women, who comprise the majority of the ageing population. The aim of this article was to explore the relationship between volunteering and psychosocial and health factors for a cohort of older Australian women over time. Data for this study were from the oldest cohort of Australian Longitudinal Study on Women's Health, a 20-year longitudinal survey of Australian women aged 70-75 years in 1996. Volunteering status was the factor of interest and study factors included a broad range of demographic, health and social factors. A longitudinal model was developed for mediators of volunteering over time. Of 7088 women in 2005, 24.5% reported actively volunteering, 15.5% were continuing, 7.5% were new, 15.3% were intermittent and 34.7% had never been volunteers. Volunteering was associated with increased quality of life and social support. Women were more likely to continue volunteering over time if they lived in a rural area, had higher socioeconomic indicators, and better levels of physical and mental health. This study contributes to the literature on the relationship between volunteering and health for older women. Understanding the potential health implications of volunteering is a critical issue in current policy debates.

Social support, stressors, and frailty among older Mexican American adults.

Science.gov (United States)

Peek, M Kristen; Howrey, Bret T; Ternent, Rafael Samper; Ray, Laura A; Ottenbacher, Kenneth J

2012-11-01

There is little research on the effects of stressors and social support on frailty. Older Mexican Americans, in particular, are at higher risk of medical conditions, such as diabetes, that could contribute to frailty. Given that the Mexican American population is rapidly growing in the United States, it is important to determine whether there are modifiable social factors related to frailty in this older group. To address the influence of social support and stressors on frailty among older Mexican Americans, we utilized five waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (Hispanic EPESE) to examine the impact of stressors and social support on frailty over a 12-year period. Using a modified version of the Fried and Walston Frailty Index, we estimated the effects of social support and stressors on frailty over time using trajectory modeling (SAS 9.2, PROC TRAJ). We first grouped respondents according to one of three trajectories: low, progressive moderate, and progressive high frailty. Second, we found that the effects of stressors and social support on frailty varied by trajectory and by type of stressor. Health-related stressors and financial strain were related to increases in frailty over time, whereas social support was related to less-steep increases in frailty. Frailty has been hypothesized to reflect age-related physiological vulnerability to stressors, and the analyses presented indicate partial support for this hypothesis in an older sample of Mexican Americans. Future research needs to incorporate measures of stressors and social support in examining those who become frail, especially in minority populations.

Factors associated with sexual health and well being in older adulthood.

Science.gov (United States)

Kleinstäuber, Maria

2017-09-01

To provide an update of recent studies on factors associated with sexual well being in older people with a special focus on sexual activity, satisfaction and function. Most recent studies confirmed the relationship between mental health status, especially negative affect and depressive symptoms, and sexual health in older adulthood. However, when this relationship is investigated more deeply, it seems that in fact positive psychological well being (positive affect and quality of life) accounts for sexual activity rather than the lack of depressive symptoms. Moreover, recent studies provided more insight into the relationship between marital characteristics, religion, cognitive functioning and sleeping difficulties and different dimensions of sexual health in older adulthood. In summary, there is substantial previous research revealing associations between various psychosocial, health-related and demographic variables and sexual health in older adulthood. Most considered variables are, for example, age, sex, general physical and mental health. For future research, it is important to consider that relationships between specific variables and sexual health in higher age are usually more complex than they are expected to be and factors differ between different dimensions of sexual health. Communication about sexuality between health-care providers and older patients still implies a lot of barriers and lack of knowledge. Therefore, the provision of communication training for health-care providers to older people in which knowledge is gained about correlates of sexual health in older adulthood should be implemented.

Translating Research for Professional Development and Effective Clinical Practice with Older Adults

Science.gov (United States)

Steffen, Ann M.

2012-01-01

This paper offers a commentary on the articles in the special series on cognitive behavior therapy with older adults (Carmin, 2012-this issue), noting the commonalities found across discussions of diagnostic interviewing and cognitive-behavioral assessment and treatment for late-life insomnia, depression and suicide risk, PTSD, and OCD. These case…

Paradoxes in the care of older people in the community : Walking a tightrope

NARCIS (Netherlands)

Janssen, B.; Van Regenmortel, T.; Abma, T.A.

2014-01-01

The expansion of the older population suggests that there will be significant numbers in need of care and support in their own home environment. Yet, little is known about the kind of situations professionals are faced with and how they intervene in the living environment of older people.

Narratives of family members on the suicide of older adults in an Amazonian metropolis.

Science.gov (United States)

Costa, André Luis Sales da; Souza, Maximiliano Loiola Ponte de

2017-12-11

To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in Manaus, State of Amazonas, Brazil, where there is a low availability

Narratives of family members on the suicide of older adults in an Amazonian metropolis

Directory of Open Access Journals (Sweden)

André Luis Sales da Costa

2017-12-01

Full Text Available ABSTRACT OBJECTIVE To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. METHODS This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. RESULTS The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. CONCLUSIONS Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in

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

2017-12-01

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 community belonging, and 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; Pcommunity belonging and social participation varied as a function of resilience, especially in men. Greater community belonging further enhanced social participation, especially among women (P=.03) and men (Pcommunity 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.

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

Directory of Open Access Journals (Sweden)

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.

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…

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.

Physical and leisure activity in older community-dwelling canadians who use wheelchairs: a population study.

Science.gov (United States)

Best, Krista L; Miller, William C

2011-04-13

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.

Concepts and causation of depression:a cross-cultural study of the beliefs of older adults

OpenAIRE

Lawrence, Vanessa; Murray, Joanna; Banerjee, Sube; Turner, Sara; Sangha, Kuljeet; Byng, Richard; Bhugra, Dinesh; Huxley, Peter; Tylee, Andre; Macdonald, Alastair

2006-01-01

PURPOSE: This U.K. study explored how older adults with depression (treated and untreated) and the general older population conceptualize depression. A multicultural approach was used that incorporated the perspectives of Black Caribbean, South Asian, and White British older adults. The study sought to explore and compare beliefs about the nature and causes of depression, and to suggest ways in which these beliefs act to facilitate or deter older people from accessing treatment.DESIGN AND MET...

Cohort analysis of older adults' travel patterns in Denmark

DEFF Research Database (Denmark)

Siren, Anu Kristiina; Haustein, Sonja

2012-01-01

a variety of social implications, for example on care and health systems, labour market, and pensions, which has made the issue to enter the socio-political agendas. One, although often overlooked, aspect of this is the everyday mobility in the transport system of the ageing population. Nevertheless, ageing...... and transport has several im-portant societal implications. First, society will face a challenge of providing policies and plans that support the mobility needs of the senior population. Mobility is closely connected to well-being and health of older persons. Mobility and the ability to leave the home are among...... the way transportation is planned, organized and managed (Coughlin, 2009). The older road users have somewhat different needs and preferences than younger adults, which will have an impact on traffic flows, safety, and infrastructural needs....

Food for the ageing population

NARCIS (Netherlands)

Raats, M.M.; Groot, de C.P.G.M.; Staveren, van W.A.

2008-01-01

The world’s ageing population is increasing and food professionals will have to address the needs of older generations more closely in the future. This unique volume reviews the characteristics of the ageing population as food consumers, the role of nutrition in healthy ageing and the design of food

Correlates of preferences for autonomy in long-term care: results of a population-based survey among older individuals in Germany

Directory of Open Access Journals (Sweden)

Hajek A

2018-01-01

Full Text Available André Hajek,1 Thomas Lehnert,1 Annemarie Wegener,1 Steffi G Riedel-Heller,2 Hans-Helmut König1 1Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 2Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany Purpose: Thus far, there is little evidence concerning the factors associated with preferences for autonomy in long-term care. Therefore, the aim of the present study was to investigate the correlates of preferences for autonomy in long-term care among older individuals in Germany. Methods: Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006. Results: Multiple logistic regressions revealed that preferences for freedom of choice for foods were positively associated with living with partner or spouse (OR: 1.5 [1.0–2.2], being born in Germany (OR: 1.9 [1.1–3.3], and lower self-rated health (OR: 1.3 [1.1–1.6]. Preferences for freedom in choosing bedtime and sleep duration were positively associated with lower age (OR: 1.1 [1.0–1.1] and having children (OR: 2.2 [1.0–4.9]. Preferences for customized living space were positively associated with being female (OR: 2.5 [1.4–4.5] and being born in Germany (OR: 3.7 [1.9–7.1]. Neither preferences for decent and sanitary housing nor preferences for shared decision-making were associated with any of the independent variables. Conclusion: Various independent variables were associated with preferences for autonomy in long-term care. This suggests that preferences for care-related autonomy are complex. Knowing these might help refine long-term care health services. Keywords: caregivers, older adult, long-term care, Germany

Promoting Food Safety Awareness for Older Adults by Using Online Education Modules

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Roy, Amber; Francis, Sarah L.; Shaw, Angela; Rajagopal, Lakshman

2016-01-01

Older adults are susceptible to and at greater risk for food-borne illness in comparison to those in other adult age groups. Online education is an underused method for the delivery of food safety information to this population. Three online mini-modules, based on social marketing theory (SMT), were created for and pilot-tested with older adults.…

Effects of Companies’ Initiatives to Reduce Early Retirement Among Older Workers

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Tove Midtsundstad

2012-08-01

Full Text Available Although active ageing policy and practice vary between countries, we believe that knowledge about the effects of Norwegian companies’ initiatives to delay early retirement is of interest for all countries striving to increase the employment rates of older workers. Since the agreement on a more inclusive working life (IW agreement was signed in 2001, the Norwegian government and social partners have encouraged companies to develop a more senior-friendly policy and implement special measures to retain older workers. In this article, we evaluate the effects of such measures. Our research question is, have preventive measures offered by companies to employees aged 62 years and older contributed to reduced rates of early retirement? We use a ‘difference-in-differences’ approach and examine whether measures at the company level to counteract early retirement actually affect older employees’ retirement decisions, controlling for different individual and enterprise factors. This is done by comparing changes and differences in the individual likelihood of early retirement on the contractual pension (AFP scheme and disability pension in the period 2002–2007 among employees 62 years of age in businesses with and without the corresponding preventive measures/instruments. The analyses show that the likelihood that a 62-year-old worker will retire on the AFP scheme has increased from 2002 to 2007. This applies equally to 62-year-old employees in enterprises that have enacted special measures to retain older workers as well as 62-year-olds in enterprises that have not enacted any such measures. On the other hand, the likelihood that a 62-year-old worker will retire because of disability decreased from 2002 to 2007, among employees in both the intervention enterprises and the control enterprises. However, when controlling for other relevant characteristics of individuals and enterprises, the analysis indicates that the measures as such have had no

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

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

2015-07-01

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

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

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Munk, Niki; Zanjani, Faika

2011-04-01

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

Family Support and Loneliness among Older Persons in Multiethnic Malaysia

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

2014-01-01

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

Are HIV-Infected Older Adults Aging Differently?

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Karpiak, Stephen E; Havlik, Richard

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

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

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

2016-11-01

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

Familism and Health Care Provision to Hispanic Older Adults.

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

2016-01-01

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

The association between social participation and cognitive function in community-dwelling older populations: Japan Gerontological Evaluation Study at Taisetsu community Hokkaido.

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Sakamoto, Ai; Ukawa, Shigekazu; Okada, Emiko; Sasaki, Sachiko; Zhao, Wenjing; Kishi, Tomoko; Kondo, Katsunori; Tamakoshi, Akiko

2017-10-01

To study the association between the number of area-level and individual-level social participation items and cognitive function in the community-dwelling older populations of three towns in Hokkaido, Japan. A survey on the frequency of social participation was mailed to those in the Japan Gerontological Evaluation Study 2013 who were aged ≥65 years, were not certified as needing long-term care, and lived in Higashikawa, Higashikagura, or Biei. A subset of participants aged 70-74 years completed the Japanese version of the Montreal Cognitive Assessment in a home visit survey. Both the area-level and individual-level social participation and demographic information were obtained on the self-administered questionnaire. A multilevel analysis using a generalized linear mixed-effects model was used to examine the association between variables in the area-level and individual-level social participation items and cognitive function. Out of 4042 respondents, data from 2576 were used in the area-level analysis. Of those, 180 were aged 70-74 years and completed the home visit survey for the individual-level analysis. A greater number of higher social participation items at the individual level was associated with higher cognitive function scores after adjusting for area-level social participation variables and confounders (regression coefficient: 0.19; 95% confidence interval: 0.03, 0.35). There were no significant associations between area-level social participation item averages and individual-level cognitive function scores. Older populations participating in many kinds of social activities exhibited preserved cognitive function even after adjusting for area-level social participation variables. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Ethnic Differences in Nonverbal Pain Behaviors Observed in Older Adults with Dementia.

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Ford, Brianne; Snow, A Lynn; Herr, Keela; Tripp-Reimer, Toni

2015-10-01

Research supports using nonverbal pain behaviors to identify pain in persons with dementia. It is unknown whether variations exist among ethnic groups in the expression of nonverbal pain behaviors in this special population. The purpose of this descriptive study was to examine ethnic differences in the presentation and intensity of nonverbal pain behaviors among African American, Caucasian, and Hispanic older adults with dementia when screened for pain by certified nursing assistants. Six certified nursing assistants were trained to review and score 28 video recordings of subjects with dementia for nonverbal pain behaviors using the Non-Communicative Patient's Pain Assessment Instrument. Chi-square was used to examine differences among ethnic groups with regard to the display of nonverbal pain behaviors, and ANOVA was used to evaluate differences in the intensity of overall pain across ethnic groups. Of the 168 assessments, pain words (28%), pain noises (29.8%), and pain faces (28%) were observed most often as indicators of pain. Rubbing, bracing, and restlessness were rarely noted. Chi-square analysis revealed ethnic differences in the expression of pain words (χ(2) = 19.167, p ethnic groups with regards to overall pain intensity. These findings are the first to examine ethnic differences in nonverbal pain behaviors for older adults with dementia. However, future work should examine assessment tendencies of providers in a larger, more diverse sample. Copyright © 2015 American Society for Pain Management Nursing. All rights reserved.

Sexual behaviors among older adults in Spain: results from a population-based national sexual health survey.

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Palacios-Ceña, Domingo; Carrasco-Garrido, Pilar; Hernández-Barrera, Valentín; Alonso-Blanco, Cristina; Jiménez-García, Rodrigo; Fernández-de-las-Peñas, César

2012-01-01

The Spanish National Sexual Health Survey (SNSHS) is designed to examine sexual activity, sexual behaviors, and sexual health among the Spanish population. To describe sexual activity and behaviors of Spaniards aged ≥ 65 years old focusing on gender differences. A population-based descriptive study was conducted using individual data from the SNSHS. The number of subjects aged ≥ 65 years included was 1,939 (1,118 women, 821 men). Sexual activity, frequency, sexual behaviors, sexual practices, and reasons for lack of sexual activity were assessed from questions included in the survey. Subjects who reported having any sexual practice including giving or receiving kissing and hugging, vaginal intercourse, oral sex, or masturbation, with at least one partner in the previous 12 months were considered as sexually active. We analyzed sociodemographic characteristics, self-rated physical and sexual health, comorbid conditions, and medications using multivariate logistic regression models. Overall, 62.3% of men and 37.4% of elderly women were sexually active (P practices were kissing, hugging, and vaginal intercourse. The most common reasons for sexual inactivity were: partner was physically ill (23%), lack of interest (21%), and the man was a widower (23%). This study provided data on sexual activity in older Spanish adults and has identified potential factors that appear to influence sexuality in the elderly with some gender differences. Current results can have implications for healthcare providers for addressing these concerns in an effective manner. © 2011 International Society for Sexual Medicine.

Teacher Efficacy and Disproportional Special Education Recommendations

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Branscombe, Peter

2017-01-01

According to literature, African American male students are disproportionately placed in special education programs throughout our national public school systems. Therefore, this study was intended to examine factors that may influence a teacher's decision to recommend students for special education services. The target population for this study…

Demographic Trends of Adults in New York City Opioid Treatment Programs--An Aging Population.

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Han, Benjamin; Polydorou, Soteri; Ferris, Rosie; Blaum, Caroline S; Ross, Stephen; McNeely, Jennifer

2015-01-01

The population of adults accessing opioid treatment is growing older, but exact estimates vary widely, and little is known about the characteristics of the aging treatment population. Further, there has been little research regarding the epidemiology, healt h status, and functional impairments in this population. To determine the utilization of opioid treatment services by older adults in New York City. This study used administrative data from New York State licensed drug treatment programs to examine overall age trends and characteristics of older adults in opioid treatment programs in New York City from 1996 to 2012. We found significant increases in utilization of opioid treatment programs by older adults in New York City. By 2012, those aged 50-59 made up the largest age group in opioid treatment programs. Among older adults there were notable shifts in demographic background including gender and ethnicity, and an increase in self-reported impairments. More research is needed to fully understand the specific characteristics and needs of older adults with opioid dependence.

50 CFR 17.86 - Special rules-plants. [Reserved

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 2 2010-10-01 2010-10-01 false Special rules-plants. [Reserved] 17.86... WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS Experimental Populations § 17.86 Special rules—plants. [Reserved] ...

Reducing the Digital Divide: Connecting Older Adults to iPad Technology.

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Delello, Julie A; McWhorter, Rochell R

2017-01-01

America's older adult population is increasing at a dramatic rate due to better health care, technology, and improved living conditions. However, as individuals 65 years and older begin to live longer and experience multiple life changes, there is a larger incidence of social isolation leading to loneliness, depression, and a general decline in health. This mixed-method study aimed to explore whether information and communication technologies, specifically iPads, improved the lives of older adults. Our findings suggest that the use of technology increased knowledge, elicited closer family ties, and led to a greater overall connection to society. © The Author(s) 2015.

Prolonged employment of older workers : determinants of managers' decisions regarding hiring, retention and training

NARCIS (Netherlands)

Karpinska, K.

2013-01-01

Prolonged and productive employment of older workers is a necessary condition to maintain welfare and social security systems threatened by ageing populations. Despite this importance, the labour market position of older workers is much worse than that of workers in primal age. Yet not much is known

Prolonged employment of older workers: determinants of managers' decisions regarding hiring, retention and training

NARCIS (Netherlands)

Karpinska, K.

2013-01-01

Prolonged and productive employment of older workers is a necessary condition to maintain welfare and social security systems threatened by ageing populations. Despite this importance, the labour market position of older workers is much worse than that of workers in primal age. Yet not much is known

Perceptions, Expectations, and Informal Supports Influence Exercise Activity in Frail Older Adults

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Louise Broderick

2015-04-01

Full Text Available This study aims to explore frail older adults’ perceptions of what influences their exercise behaviors. A qualitative descriptive design was used. Semi-structured, open-ended interviews were conducted with 29 frail older adults. Thematic content analysis established the findings. Frail older adults perceive exercise as a by-product of other purposeful activities such as manual work or social activities. Progression into frailty appears to be associated with a decline in non-family support, changing traditional roles within family support networks, and lower baseline activity levels. Frail older adults perceive exercise as incidental to more purposeful activities rather than an endpoint in itself. Therefore, exercise programs concentrating on functional outcomes may be more relevant for this population. Strategies that educate and promote social support networks may also benefit frail older adults.

Older Workers and the Motivation for Foreign Language Learning

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Mateja Letnar

2014-08-01

Full Text Available As an inevitable process facing modern societies, an aging population brings with it new and different challenges for social actors. The extension of working life requires increased investments in an older workforce, in order for these people to retain their employability and productivity. Globalisation and the ubiquity of information communication technology place increasing importance on foreign language knowledge – an area of deficiency among older workers.  Knowledge of what motivates learners to learn foreign languages is thus also gaining importance. In conducting a survey of language school learners, we found that the motivation for learning foreign languages differs significantly between younger and older generations. As a result, employers, as well as language schools, will need to reconsider their current practices.

Validating an electronic health literacy scale in an older hispanic population.

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Aponte, Judith; Nokes, Kathleen M

2017-09-01

To examine the validity of the Spanish version of an instrument used to measure electronic health literacy (eHEALS) with an older Hispanic population from a number of Spanish-language countries living in New York City in the United States (US). Although the Internet is available globally, complex skills are needed to use this source of valuable health-related information effectively. Electronic health literacy is a multifactorial concept that includes health literacy but also requires technology skills. Cross-sectional. Recruitment occurred at a Senior Organization located in a largely Hispanic neighbourhood in New York City (N = 100). Participants completed eHEALS and selected items from the Health Information National Trends Survey (HINTS) which assesses how adults use different communication channels, including the Internet, to obtain vital health information. Data from the US HINTS sample (N = 162) were matched to the Senior Organization sample on age range and Hispanic ethnicity. The average Senior Organization participant was 68 years old, female, born in one of six different Spanish-language countries, and completed high school while the average HINTS participant was 67 years old, female and had high school or less education. Although there was no relationship with the two HINTS subscales and electronic health literacy, there were significant relationships between electronic health literacy and health status and confidence in self-care. Inadequate electronic health literacy is a barrier to positive health outcomes. The Spanish version of eHEALS could be used as a screening instrument to identify gaps and tailored interventions could be developed to increase consumer confidence in using the Internet for reliable health-related information. Knowledge in self-management is related to positive health outcomes; all persons irrespective of their electronic health literacy should be able to use all sources of health information to enhance their self-care. �

Validity and usability of a safe driving behaviors measure for older adults : strategy for congestion mitigation.

Science.gov (United States)

2012-01-01

Statistics project that crash/injury/fatality rates of older drivers will increase with the future growth of : this population. Accurate and precise measurement of older driver behaviors becomes imperative to : curtail these crash trends and resultin...

Oral Health Conditions of Older People: Focus on the Balkan Countries

OpenAIRE

Chatzopoulos Georgios S.

2015-01-01

Oral health plays a pivotal role in general health, especially in older people. Oral diseases may affect the development of systemic conditions, such as diabetes mellitus, cardiovascular disease, stroke and hypertension. The most important oral health conditions that have been recorded in dental literature for older population include tooth loss, dental caries, periodontal diseases, xerostomia (dry mouth) and oral cancer. Edentulism influences social life, either causing aesthetic problems or...

An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care.

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Ratcliffe, Julie; Flint, Thomas; Easton, Tiffany; Killington, Maggie; Cameron, Ian; Davies, Owen; Whitehead, Craig; Kurrle, Susan; Miller, Michelle; Liu, Enwu; Crotty, Maria

2017-06-01

To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures. There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks' follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period. This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.

Evacuating People and Their Pets: Older Floridians' Need for and Proximity to Pet-Friendly Shelters.

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Douglas, Rachel; Kocatepe, Ayberk; Barrett, Anne E; Ozguven, Eren Erman; Gumber, Clayton

2017-10-04

Pets influence evacuation decisions, but little is known about pet-friendly emergency shelters' availability or older adults' need for them. Our study addresses this issue, focusing on the most densely populated area of Florida (Miami-Dade)-the state with the oldest population and greatest hurricane susceptibility. We use Geographic Information Systems (GIS)-based methodology to identify the shortest paths to pet-friendly shelters, based on distance and congested and uncongested travel times-taking into account the older population's spatial distribution. Logistic regression models using the 2013 American Housing Survey's Disaster Planning Module examine anticipated shelter use as a function of pet ownership and requiring pet evacuation assistance. Thirty-four percent of older adults in the Miami-Dade area have pets-35% of whom report needing pet evacuation assistance. However, GIS accessibility measures show that travel time factors are likely to impede older adults' use of the area's few pet-friendly shelters. Logistic regression results reveal that pet owners are less likely to report anticipating shelter use; however, the opposite holds for pet owners reporting they would need help evacuating their pets-they anticipate using shelters. High pet shelter need coupled with low availability exacerbates older adults' heightened vulnerability during Florida's hurricane season. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The new caring: financial asset management and older people.

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Tilse, Cheryl; Wilson, Jill; Setterlund, Deborah; Rosenman, Linda

2007-10-01

Increasing longevity and the growing proportion of the aged in the population in most countries have served to focus on the question of how governments and older people can finance living, health, and care options in retirement. Prudent management of income and assets is an increasingly complex and important aspect of aging as assets and expectations of self-financing increase. Although many informal caregivers act as asset managers and/or substitute decision-makers for older people, little attention has been paid to this increasingly important aspect of care. This paper summaries key findings of a broad research program exploring family involvement in the management of older people's assets and the practices that constitute good practice as well as financial mismanagement and abuse. It identifies multi-level and multi-strategy responses needed to address the issues raised by the research and outlines an innovative community demonstration project aimed at improving financial management practices in relation to older people's assets.

Non-Digital Game Playing by Older Adults.

Science.gov (United States)

Mortenson, W Ben; Sixsmith, Andrew; Kaufman, David

2017-09-01

Research on video games' effect on cognition and behaviour has been extensive, yet little research has explored non-digital forms of game playing, especially among older adults. As part of a larger survey on game playing, 886 respondents (≥ age 55) filled out questionnaires about non-digital game play. The study aims were to determine perceived benefits of non-digital game play and to determine socio-demographic factors that might predict perceived benefits. Survey results indicate that non-digital game playing is social in nature and common (73% of respondents) among older adults. Older adults play for fun, but also to help maintain their cognition. Regression analyses indicated various socio-demographic factors - age, education, gender, and race - were independently associated with perceived benefits from game playing. The results thus emphasize the importance of non-digital game playing in this population and suggest that efforts to facilitate game playing may improve social interactions and quality of life.

Xerostomia Among Older Adults With Low Income: Nuisance or Warning?

Science.gov (United States)

Lee, Young-Shin; Kim, Hee-Gerl; Moreno, Kim

2016-01-01

The purpose of this study was to identify the prevalence of xerostomia and related factors among low-income older adults in South Korea. A cross-sectional, population-based study. Using data from the Home Healthcare Service Project, a population-based interview survey with home healthcare service, a total of 9,840 adults 65 years of age and older were assessed for the presence of xerostomia in association with aspects of health lifestyles, chronic disease, oral conditions, and oral function. Overall, 40% of participants reported experiencing xerostomia. Multivariate regression analysis indicated xerostomia was more likely to be reported by women having symptoms of gingival bleeding/pain, having difficulty swallowing liquid or chewing solid food, and having multiple chronic diseases. Interestingly, older adults who live alone and drink alcohol (two or more times per week) reported fewer problems with xerostomia. Increased focus on the detrimental health consequences of xerostomia would make treatment a higher priority. Improved assessment of at-risk populations, particularly among the elderly, could lead to earlier preventative interventions, lessening the negative impact on quality of life. Health professionals along with the general public need increased knowledge about the detrimental effects of xerostomia on overall health. There is a need for earlier assessment and treatment to facilitate optimal health promotion and disease prevention. © 2015 Sigma Theta Tau International.

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

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

2017-01-01

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

Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design.

Science.gov (United States)

Kelly, Sarah; Olanrewaju, Olawale; Cowan, Andy; Brayne, Carol; Lafortune, Louise

2018-01-01

Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed. Systematic review of qualitative studies in older populations (55+ years) to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature) were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA. Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful. To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.

Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design.

Directory of Open Access Journals (Sweden)

Sarah Kelly

Full Text Available Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed.Systematic review of qualitative studies in older populations (55+ years to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA.Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful.To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.

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

Science.gov (United States)

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

2017-05-01

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

Strengthening Social Capital Through Residential Environment Development for Older Chinese in a Canadian Context.

Science.gov (United States)

Luo, Hai

2016-01-01

Among Canada's visible-minority population 65 years of age or older, nearly four out of ten are Chinese. However, little research has been devoted to the examination of the role of the housing environment in building social capital for older Chinese despite the increase in this population and related social issues. The purpose of this paper is to examine Chinese elders' experience of social capital and how it is affected by their residential environment in a Canadian context. In this qualitative study, forty-three Chinese elders in a Canadian context were interviewed with a focus group approach. Findings indicate that the environments in which these older adults lived either hindered or assisted them in building or increasing their social capital. A culturally and linguistically homogeneous residential environment does not necessarily provide positive support to older Chinese for their acquisition of social capital. Adversities in the environment, such as maltreatment or lack of support from their immediate micro environment (family), tended to motivate older adults to improve their social capital for problem-solving. The study offers implications from research findings to social work practice and concludes with an analysis of limitations.

Motivations for sexual risk behaviors among older men in Shanghai, China: a qualitative study.

Science.gov (United States)

Zhou, Yanqiu; Ding, Yingying; Gu, Kaikan; Lu, Xiaonian; Gao, Meiyang; He, Na

2014-08-07

China's population is quickly aging and this trend is expected to continue. Thus it is important to develop HIV interventions to help protect older Chinese from infection. Limited information exists regarding sexual risk behaviors and associated personal motivations among persons aged 50 and over in China. In-depth interviews were conducted with 12 HIV-infected and 14 uninfected men aged 50 and over in Shanghai, China. More than 71% of heterosexual participants had engaged in commercial sex, 37.5% either had engaged in casual sex or had a steady extramarital partner. All gay/bisexual participants had engaged in casual sex with men, and 16.7% had engaged in commercial sex. Personal motivations associated with sexual risk behaviors included sexual desire and interest in sex remaining high at an older age, unfulfilled sexual desires within marriage, homosexual or bisexual orientation, need to socialize with others, peer influence, personal choice of "hobby", and financial freedom. This study sheds light on the sexual needs of older people. Our findings underscore the need for both greater education in order to reshape societal perceptions of sexuality among older adults and prevention strategies to help the older male population maintain a healthy sexual life.

Rural older people had lower mortality after accidental falls than non-rural older people

Directory of Open Access Journals (Sweden)

Huang JW

2017-01-01

Full Text Available Jen-Wu Huang,1,2 Yi-Ying Lin,2,3 Nai-Yuan Wu,4 Yu-Chun Chen5–7 1Department of Surgery, National Yang-Ming University Hospital, National Yang-Ming University, Yilan, Taiwan; 2Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 3Department of Pediatrics, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan; 4Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; 5Department of Medical Research and Education, National Yang-Ming University Hospital, Yilan, Taiwan; 6Faculty of Medicine and School of Medicine, National Yang-Ming University, Taipei, Taiwan; 7Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan Objective: This study aimed to investigate the mortality rate after falls of rural and non-rural older people and to explore the risk factors of mortality after falls among older people. Patients and methods: This population-based case–control study identified two groups from a nationwide claim database (National Health Insurance Research Database in Taiwan: a rural group and a non-rural group, which included 3,897 and 5,541 older people, respectively, who were hospitalized for accidental falls (The International Classification of Diseases, Ninth Revision, Clinical Modification: E880–E888 during 2006–2009. Both groups were followed up for 4 years after falls. Four-year cumulative all-cause mortality rate after falls was calculated, and the demographic factor, comorbidity, and medications were considered as the potential risk factors of mortality after falls. Results: The rural group had a significantly higher frequency of fall-related hospitalizations (7.4% vs 4.3%, P<0.001, but a lower 4-year cumulative all-cause mortality rate after falls than the non-rural group (8.8% vs 23.4%, P<0.001. After adjusting for age, gender, comorbidity, and medication use, the rural group had

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.

Catastrophic events and older adults.

Science.gov (United States)

Cloyd, Elizabeth; Dyer, Carmel B

2010-12-01

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

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…

Key Challenges in the Search for Innovative Drug Treatments for Special Populations. Converging Needs in Neonatology, Pediatrics, and Medical Genetics.

Science.gov (United States)

MacLeod, Stuart

2017-08-04

The explosion of knowledge concerning the interplay of genetic and environmental factors determining pathophysiology and guiding therapeutic choice has altered the landscape in pediatric clinical pharmacology and pharmacy. The need for innovative research methods and design expertise for small clinical trials to be undertaken in sparse populations has been accentuated. At the same time, shortfalls in critical human resources represent a key challenge, especially in low- and middle-income countries where the need for new research and education directions is greatest. Unless a specific action plan is urgently developed, there will be a continuing gap in availability of the essential expertise needed to address treatment challenges in special patient populations such as neonates, patients suffering from rare or neglected diseases, and children of all ages.

Family Assistance for Older Adults in Puerto Rico

Directory of Open Access Journals (Sweden)

Paul-Jesús Fericelli

2013-09-01

Full Text Available Global aging is a growing issue in most countries, including Puerto Rico. The well being of the older adult population depends mainly on a collaborative government initiative that uses both public assistance and the engagement of family members. Puerto Rican policymakers are searching for alternatives to care for the expanding elderly population as well as to protect the country’s economy, avoid the financial cliff, and reduce the high cost of public assistance. The purpose of this article is to analyze The Act for the Improvement of the Family Assistance and for the Support of the Elderly, Act No. 193 of 2002, under the criteria-based model (Gallagher & Haskins, 1984 with a value-critical appraisal (Chambers & Wedel, 2009. I suggest Act No. 193 of 2002 as a model for policymakers who are seeking ways to improve assistance for older adults, by promoting the following values: fairness, familism, fraternity, and accountability.

Planning for an ageing population: strategic considerations

LENUS (Irish Health Repository)

O'Shea, Dr Eamon

2005-01-01

This report presents both the proceedings of the Council’s conference, Planning for an Ageing Population: Strategic Considerations, and the Council’s discussion paper, ‘The Older Population: Information Issues and Deficits’, which was introduced at that conference.\\r\

Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People

NARCIS (Netherlands)

Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn; de Craen, Anton J. M.; Slaets, Joris P. J.; Westendorp, Rudi J.

2016-01-01

Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people's self-ratings. We examined self-rated,

Determinants of uptake of home modifications and exercise to prevent falls in community-dwelling older people.

Science.gov (United States)

Harvey, Lara A; Mitchell, Rebecca J; Lord, Stephen R; Close, Jacqueline C T

2014-12-01

To examine the age-specific population prevalence and predictors of uptake of home modifications and exercise to prevent falls in the NSW older population. A total of 5,681 respondents were asked questions on fall prevention activities as part of the 2009 NSW Falls Prevention Survey. RESULTS were weighted to represent the NSW population. Regression analysis was used to determine factors associated with uptake of interventions. Overall, 28.9% of the older population have modified their home, and 35.1% increased exercise to prevent falls. Main predictors of home modification were being aged 85+ (RR 2.04, 95% CI 1.76-2.35) and physiotherapy/occupational therapy intervention (RR 1.57, 95% CI 1.22-2.01). Main predictors of increasing exercise were physiotherapy/OT intervention (RR 2.12, 95% CI 1.86-2.42) and medical advice (RR 1.45, 95% CI1.32-1.60). Older respondents (RR 0.68, 95% CI 0.57-0.81) and those with fair/poor health (RR 0.86, 95% CI 0.77-0.96) were less likely to report increased exercise. More than one-quarter of the older population of NSW report having made modifications to their home and one-third increased exercise to prevent falls. There was a clear gradient of increased uptake of home modifications with increasing age, with the reverse trend for increased exercise. Although fall prevention initiatives are having an impact at the population level, targeted strategies for high-risk groups are still required. © 2014 Public Health Association of Australia.

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

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

2015-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Ageing well? : A cross-country analysis of the way older people are visually represented on websites of organizations for older people

NARCIS (Netherlands)

Loos, E.F.|info:eu-repo/dai/nl/078758475; Ivan, Loredana; Fernández-Ardèvol, Mireia; Sourbati, Maria; Ekström, Maria; Wilińska, Monika; Carlo, Simone; Schiau, Ioana

2017-01-01

The ‘aging well’ discourse advances the idea of making older people responsible for their capability to stay healthy and active. In the context of an increased ageing population, which poses several challenges to countries’ government, this discourse has become dominant in Europe. We explore the way

Ageing well? A cross-country analysis of the way older people are visually represented on websites of organizations for older people

NARCIS (Netherlands)

Loos, E.; Ivan, L.; Fernández-Ardèvol, M.; Sourbati, M.; Ekström, M.; Wilińska, M.; Carlo, S.; Schiau, I.

2017-01-01

The ‘aging well’ discourse advances the idea of making older people responsible for their capability to stay healthy and active. In the context of an increased ageing population, which poses several challenges to countries’ government, this discourse has become dominant in Europe. We explore the way

Naturalistic Assessment of Executive Function and Everyday Multitasking in Healthy Older Adults

Science.gov (United States)

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2013-01-01

Everyday multitasking and its cognitive correlates were investigated in an older adult population using a naturalistic task, the Day Out Task. Fifty older adults and 50 younger adults prioritized, organized, initiated and completed a number of subtasks in a campus apartment to prepare for a day out (e.g., gather ingredients for a recipe, collect change for a bus ride). Participants also completed tests assessing cognitive constructs important in multitasking. Compared to younger adults, the older adults took longer to complete the everyday tasks and more poorly sequenced the subtasks. Although they initiated, completed, and interweaved a similar number of subtasks, the older adults demonstrated poorer task quality and accuracy, completing more subtasks inefficiently. For the older adults, reduced prospective memory abilities were predictive of poorer task sequencing, while executive processes and prospective memory were predictive of inefficiently completed subtasks. The findings suggest that executive dysfunction and prospective memory difficulties may contribute to the age-related decline of everyday multitasking abilities in healthy older adults. PMID:23557096

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

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

2018-03-01

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

Managing the safe mobility of older road users: How to cope with their diversity?

DEFF Research Database (Denmark)

Haustein, Sonja; Marin-Lamellet, Claude

2014-01-01

Against the background of an ageing population, the management of older people's safe mobility is becoming an increasingly important issue. Mobility is vital for older people's quality of life and several examples of good practice that support older people's safe mobility already exist. However...... groups who are already users and improve their (safe) use of the preferred transport mode. However, they do not seem to succeed in increasing mobility options, e.g. by encouraging car-reliant users to cycle or use public transport or by helping older women to continue to drive. We advise that existing...... systems, a lack of programmes to increase perceived security, as well as a comprehensive scheme for older drivers who have to stop driving....

Robotics to Enable Older Adults to Remain Living at Home

OpenAIRE

Pearce, Alan J.; Adair, Brooke; Miller, Kimberly; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E.

2012-01-01

Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effec...

Evaluating Everyday Competence in Older Adult Couples: Epidemiological Considerations

OpenAIRE

Dixon, Roger A.

2010-01-01

Among older adults, everyday competence is often expressed in the context of other participating individuals. Although this active human context may be occasionally comprised of mere acquaintances, long-term partners (such as couples) often act as a unit in engaging in everyday actions or reporting on familiar domains. This special section reflects an important movement in aging research to examine couples as an alternative but normatively common unit of analysis. My discussion focuses on 2 m...

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

Science.gov (United States)

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

2015-01-01

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

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.

Directory of Open Access Journals (Sweden)

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.

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.

Science.gov (United States)

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.

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

Science.gov (United States)

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

Managing mixed dyslipidemia in special populations

OpenAIRE

Miller, Michael

2010-01-01

Controlling low-density lipoprotein cholesterol is one of the major focuses of cardiovascular care. However, the twin global pandemics of obesity and diabetes are promoting an increased prevalence of associated cardiometabolic risk factors. These factors include mixed dyslipidemia, which is prevalent among several important subgroups of the overall population. Cardiovascular risk increases as women reach and extend beyond menopause, partly reflective of dyslipidemia. In addition, women with p...

The Muscle Metabolome Differs between Healthy and Frail Older Adults.

Science.gov (United States)

Fazelzadeh, Parastoo; Hangelbroek, Roland W J; Tieland, Michael; de Groot, Lisette C P G M; Verdijk, Lex B; van Loon, Luc J C; Smilde, Age K; Alves, Rodrigo D A M; Vervoort, Jacques; Müller, Michael; van Duynhoven, John P M; Boekschoten, Mark V

2016-02-05

Populations around the world are aging rapidly. Age-related loss of physiological functions negatively affects quality of life. A major contributor to the frailty syndrome of aging is loss of skeletal muscle. In this study we assessed the skeletal muscle biopsy metabolome of healthy young, healthy older and frail older subjects to determine the effect of age and frailty on the metabolic signature of skeletal muscle tissue. In addition, the effects of prolonged whole-body resistance-type exercise training on the muscle metabolome of older subjects were examined. The baseline metabolome was measured in muscle biopsies collected from 30 young, 66 healthy older subjects, and 43 frail older subjects. Follow-up samples from frail older (24 samples) and healthy older subjects (38 samples) were collected after 6 months of prolonged resistance-type exercise training. Young subjects were included as a reference group. Primary differences in skeletal muscle metabolite levels between young and healthy older subjects were related to mitochondrial function, muscle fiber type, and tissue turnover. Similar differences were observed when comparing frail older subjects with healthy older subjects at baseline. Prolonged resistance-type exercise training resulted in an adaptive response of amino acid metabolism, especially reflected in branched chain amino acids and genes related to tissue remodeling. The effect of exercise training on branched-chain amino acid-derived acylcarnitines in older subjects points to a downward shift in branched-chain amino acid catabolism upon training. We observed only modest correlations between muscle and plasma metabolite levels, which pleads against the use of plasma metabolites as a direct read-out of muscle metabolism and stresses the need for direct assessment of metabolites in muscle tissue biopsies.

Epidemiology of Traumatic Spinal Cord Injury Among Persons Older Than 21 Years: A Population-Based Study in South Carolina, 1998-2012.

Science.gov (United States)

Selassie, Anbesaw; Cao, Yue; Saunders, Lee L

2015-01-01

A gap exists in the current knowledge regarding the epidemiology of traumatic spinal cord injury (TSCI) in a statewide population. To describe population-based epidemiology and trend of TSCI in persons 22 years and older in South Carolina over a 15-year period from 1998 through 2012. Data on patients with TSCI were obtained from ongoing statewide TSCI surveillance and follow-up registry. Deaths were ascertained by linking surveillance files and the multiple cause-of-death dataset. Descriptive analyses were completed, and incidence and mortality rates were calculated based on the civilian adult population of the state. Over the 15 years, 3,365 persons with incident TSCI were discharged alive from acute care hospitalization, of whom 555 died during the period of observation. Age-standardized cumulative mortality rate was 14 per million, and the average incidence rate was estimated at 70.8 per million population per year. Age-standardized incidence rate of TSCI increased significantly from 66.9 in 1998 to 111.7 per million in 2012. Standardized incidence rates were significantly higher among non-Whites and males. Motor vehicle crashes and falls were the leading causes, accounting for nearly 70% of TSCI. Standardized incidence and mortality rates of TSCI in South Carolina are higher than reported rates for the US population. Motor vehicle crashes and falls are the leading causes of TSCI. There was a significant increase in the overall trend of the incidence rates over the 15 years. A well-coordinated preventive strategy is needed to reduce incidence and improve survival of persons with TSCI.

The quality of life of older people aging in place: a literature review.

Science.gov (United States)

Vanleerberghe, Patricia; De Witte, Nico; Claes, Claudia; Schalock, Robert L; Verté, Dominique

2017-11-01

In order to cope with the challenges that are the result of an aging population, policies and services promote keeping elders in the community and letting them age in place rather than sending them to specialized institutions. Aging in place refers to the option where people can stay in their homes as they age. This policy option, however, poses various challenges and may also threaten the quality of life of the aging. A literature review was performed on the quality of life of older people aging in place to determine whether the actual assessment of quality of life can be used within aging in place. Web of Science, PubMed, CINAHL, Sociological Abstracts and Social Science Research Network were searched for publications on "Ag(e)ing in place" AND "Quality of life." Although assessment is crucial to a policy pursuing a good quality of life, literature reveals that it is seldom performed. Only a small part of the studies report on the assessment of quality of life, including the instruments used and the results. The findings also indicate that there is no consensus on the definition of quality of life or its domains structures. As no existing instrument assessing the quality of life of older people aging in place could be identified, such a tool should be developed, because any policy towards this growing group of people should be complemented by an evaluation.

Association between edentulism and angina pectoris in Mexican adults aged 35 years and older: a multivariate analysis of a population-based survey.

Science.gov (United States)

Medina-Solís, Carlo Eduardo; Pontigo-Loyola, América Patricia; Pérez-Campos, Eduardo; Hernández-Cruz, Pedro; Ávila-Burgos, Leticia; Kowolik, Michael J; Maupomé, Gerardo

2014-03-01

The possible association between oral infection and chronic inflammation and cardiovascular disease risk has been studied intensively. The present study is designed to determine the strength of association between edentulism and angina pectoris in Mexican adults aged 35 years and older. Using the tools and sampling strategies of the World Health Survey of the World Health Organization, cross-sectional data were collected in Mexico in the National Performance Assessment Survey (probabilistic, multistage, and cluster sampling). Dental information was available for 20 of the 32 states of Mexico. Angina and edentulism are self-reported in this study. Statistical analysis was performed using binary logistic regression adjusting for complex samples. A total of 13,966 participants, representing a population of 29,853,607 individuals, were included. Of the complete study population, 3,052,263 (10.2%) were completely toothless, and 673,810 (2.3%) were diagnosed with angina pectoris. After adjusting for smoking, alcohol consumption, diabetes, body mass index, and sex, the effect of edentulism on angina was modified by age (interaction), being more marked in the younger age group (odds ratio [OR] = exp(2.5597) =12.93) than in the older individuals surveyed (OR = exp(2.5597 + (-0.0334)) =12.51). Additionally, low physical activity (OR = 1.51; 95% confidence interval [CI] = 1.03 to 2.22) and higher socioeconomic status (OR = 1.37; 95% CI = 1.00 to 1.90) were more likely to be associated with angina pectoris. Overall, the results of this study, conducted in a representative sample of Mexican adults, suggest that an association exists between edentulism and angina pectoris. Additional studies are necessary to elucidate the underlying mechanism for this association.

Physician Training in Cancer Prevention and Control: A Population Health Imperative.

Science.gov (United States)

Moore, Miranda A; Goodman, Richard A

2018-03-01

Cancer is the second leading cause of morbidity and mortality in the U.S. Although reducing the number of new cancer cases is a national health goal, the continuing growth of the older adult population ensures that the burden of cancer will increase. Despite documentation of the shortage of oncologists to meet the growing need, relatively limited attention has been focused on increasing the physician workforce trained in the prevention and control of cancer. The existing physician workforce with such specialized training in cancer prevention and control is small, aging, increasing at a low rate, and likely to decrease because of an imbalance between retiring physicians and new entrants. This commentary addresses the imperative for increasing the number of physicians trained in preventive medicine with a specialization in cancer prevention and control by first providing a brief overview of U.S. cancer morbidity and mortality, then describing the status of, and trends in, physician training in cancer prevention and control, and concluding by suggesting opportunities for bolstering physician training in cancer prevention and control. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Older driver involvements in police reported crashes and fatal crashes: trends and projections

OpenAIRE

Lyman, S; Ferguson, S; Braver, E; Williams, A

2002-01-01

Objectives: Older drivers have become a larger part of the driving population and will continue to do so as the baby boomers reach retirement age. The purpose of this study was to identify the potential effects of this population increase on highway safety.

Validity of the International Fitness Scale "IFIS" in older adults.

Science.gov (United States)

Merellano-Navarro, Eugenio; Collado-Mateo, Daniel; García-Rubio, Javier; Gusi, Narcís; Olivares, Pedro R

2017-09-01

To validate the "International Fitness Scale" (IFIS) in older adults. Firstly, cognitive interviews were performed to ensure that the questionnaire was comprehensive for older Chilean adults. After that, a transversal study of 401 institutionalized and non-institutionalized older adults from Maule region in Chile was conducted. A battery of validated fitness tests for this population was used in order to compare the responses obtained in the IFIS with the objectively measured fitness performance (back scratch, chair sit-and-reach, handgrip, 30-s chair stand, timed up-and-go and 6-min walking). Indicated that IFIS presented a high compliance in the comprehension of the items which defined it, and it was able of categorizing older adults according to their measured physical fitness levels. The analysis of covariance ANCOVA adjusted by sex and age showed a concordance between IFIS and the score in physical fitness tests. Based on the results of this study, IFIS questionnaire is a good alternative to assess physical fitness in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.