WorldWideScience

Sample records for older population special

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

    Science.gov (United States)

    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.

  2. 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...

  3. AFib in special populations.

    Science.gov (United States)

    French, William J

    2014-04-01

    CHF has not been seen for patients with CHF and concomitant AFib, meaning that even with optimal therapy, the patient with AFib who develops CHF is at higher risk of mortality. The challenge for patients with ACS and AFib is that their ACS will probably require antiplatelet therapy, and addition of anticoagulation therapy as prophylaxis against stroke and systemic embolism because of the AFib creates the problem of so-called "triple therapy." This review includes a clinical decision algorithm for balancing the lowest risk of thromboembolic events against the highest risk of bleeding in patients who must receive triple therapy. Finally, this review concludes with a brief overview of the possible benefits of the NOACs in these populations, while also emphasizing that all clinicians-especially primary care physicians, who may become the principal caregivers for these patients with AFib in the era of NOACs-should be familiar with one of current bleeding scores, perhaps the best of which is the HAS-BLED score, which includes patients who have hypertension, abnormal renal or liver function, bleeding history, predisposition or labile INR, elderly patients who are frail or >65 years, or with a history of drugs/alcohol concomitantly. Copyright © 2014. Published by Elsevier Inc.

  4. Population Health Management for Older Adults

    Science.gov (United States)

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

    2016-01-01

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

  5. Wilderness Preparticipation Evaluation and Considerations for Special Populations.

    Science.gov (United States)

    Joy, Elizabeth; Van Baak, Karin; Dec, Katherine L; Semakula, Barbara; Cardin, Ashlea D; Lemery, Jay; Wortley, George C; Yaron, Michael; Madden, Christopher

    2015-12-01

    Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population- specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports. Copyright © 2015. Published by Elsevier Inc.

  6. 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.

  7. Financial Literacy and Financial Sophistication in the Older Population

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  9. Districts Adjust to Growth in Older Population

    Science.gov (United States)

    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…

  10. OLDER ADULTS: AN ENVIRONMENTALLY SUSCEPTIBLE POPULATION

    Science.gov (United States)

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

  11. Cookbooks and Good Eating: Cookbooks for Special Populations.

    Science.gov (United States)

    Ensign, Arselia S., Ed.

    1990-01-01

    The brochure briefly describes approximately 50 cookbooks and related materials appropriate for use with special populations. For most entries, title, author, source, price, and a brief description are provided. Entries include general cookbooks, large print and Braille cookbooks, cookbooks for special diets, cookbooks for special conditions,…

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

    Directory of Open Access Journals (Sweden)

    Richard G. Stefanacci

    2012-01-01

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

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

    Science.gov (United States)

    Luallen, Jeremy; Cutler, Christopher

    2017-09-01

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

  14. 2001 New York State NHTS: Travel Patterns of Special Populations

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-03-01

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

  15. 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...

  16. Managing mixed dyslipidemia in special populations.

    Science.gov (United States)

    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 polycystic ovary syndrome display a cluster of risk factors reminiscent of the metabolic syndrome. Certain ethnic groups are also at increased risk for type 2 diabetes or the metabolic syndrome. Dyslipidemia contributes significantly to overall cardiovascular risk in the elderly, and the frequency of children and adolescents presenting with type 2 diabetes or metabolic syndrome is increasing worldwide. Physicians should be aware of the possibility of mixed dyslipidemia in patients at elevated cardiometabolic risk. However, while combination therapy may successfully correct the associated dyslipidemia, it remains to be established whether the addition of a second agent improves coronary risk beyond statin monotherapy.

  17. Treating rhinitis in the older population: special considerations

    Directory of Open Access Journals (Sweden)

    Slavin Raymond G

    2009-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Ellis D

    2011-07-01

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

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

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

    2009-01-01

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

  1. Depression in an older adult rural population in India.

    Science.gov (United States)

    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

  2. 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

  3. Primary prevention of psychiatric illness in special populations.

    Science.gov (United States)

    Sajatovic, Martha; Sanders, Renata; Alexeenko, Lada; Madhusoodanan, Subramoniam

    2010-11-01

    Some populations appear to be particularly vulnerable to the development of psychiatric symptomatology related to life events and biologic or social/cultural factors. Such groups include individuals who have experienced traumatic events, military personnel, individuals with serious medical conditions, postpartum women, and immigrants. This study reviews the literature regarding primary prevention of psychiatric disorders in special populations and identifies a variety of universal, selective, and indicated prevention measures aimed at minimizing the psychiatric sequelae in these groups. The authors reviewed the literature regarding the prevention of psychiatric symptoms in trauma/abuse victims, individuals in the military, oncology patients, patients with diabetes, pregnant/postpartum women, and immigrants. The literature on primary prevention of psychiatric illness in the special populations identified is rather limited. Universal prevention may be beneficial in some instances through public awareness campaigns and disaster planning. In other instances, more specific and intensive interventions for individuals at high risk of psychiatric illness may improve outcomes, for example, crisis counseling for those who have experienced severe trauma. Primary prevention of psychiatric illness may be an attainable goal via implementation of specific universal, selected, and indicated primary prevention measures in special populations.

  4. Well-being of nursing staff on specialized units for older patients with combined care needs.

    Science.gov (United States)

    Collet, J; de Vugt, M E; Schols, J M G A; Engelen, G J J A; Winkens, B; Verhey, F R J

    2018-03-01

    Working in long-term care is seen as a stressful, physically and mentally demanding occupation, and thus, nursing staff are at risk for work and stress-related diseases. In older patients, psychiatric illnesses often occur in combination with physical illnesses, requiring nursing care that is specific to these combined care needs. The impact of caring for these patients on the mental well-being of nurses is unknown. Nursing staff working on specialized units for patients with combined care needs experience high levels of self-efficacy in combination with strong feelings of self-rated competence. Although levels of burnout are relatively low, mental healthcare nursing staff is more at risk for burnout when working in specialized settings for patients with combined care needs than nursing home staff working in specialized settings for these patients. Nursing staff characteristics, such as years of working experience and age, seem more important in relation to staff well-being than patient characteristics in specialized settings for combined care needs. Staff well-being might benefit from specializing care, so that patients with similar care needs are placed together and care is focused. The presence of specialized care units for older patients with combined care needs can allow for both targeted and focused allocation of nursing staff to these units and provision of specific training. Introduction In older patients, psychiatric illnesses frequently exist in tandem with physical illnesses, requiring nursing care that is specific to these combined care needs. The impact of caring for these patients on the mental well-being of nursing staff is unknown. To investigate whether care characteristics of patients with combined care needs are related to the mental well-being of nursing staff. Well-being of nursing staff was studied within a larger exploratory observational cross-sectional study that examined the differences and similarities of specialized combined care units

  5. Care satisfaction among older people receiving public care and service at home or in special accommodation.

    Science.gov (United States)

    Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

    2013-02-01

    To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

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

    Science.gov (United States)

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

    2013-01-01

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

  7. Socioeconomic determinants of health inequalities among the older population in India: a decomposition analysis.

    Science.gov (United States)

    Goli, Srinivas; Singh, Lucky; Jain, Kshipra; Pou, Ladumai Maikho Apollo

    2014-12-01

    This study quantified and decomposed health inequalities among the older population in India and analyzes how health status varies for populations between 60 to 69 years and 70 years and above. Data from the 60th round of the National Sample Survey (NSS) was used for the analyses. Socioeconomic inequalities in health status were measured by using Concentration Index (CI) and further decomposed to find critical determinants and their relative contributions to total health inequality. Overall, CI estimates were negative for the older population as a whole (CI = -0.1156), as well as for two disaggregated groups, 60 to 69 years (CI = -0.0943) and 70 years and above (CI = -0.08198). This suggests that poor health status is more concentrated among the socioeconomically disadvantaged older population. Decomposition analyses revealed that poor economic status (54 %) is the dominant contributor to total health inequalities in the older population, followed by illiteracy (24 %) and rural place of residence (20 %). Other indicators, such as religion, gender and marital status were positive, while Caste was negatively associated with health inequality in the older populations. Finally, a comparative assessment of decomposition results suggest that critical contributors for health inequality vary for the older population of 60 to 69 years and 70 years and above. These findings provide important insights on health inequalities among the older population in India. Implications are advanced.

  8. Special Agents Can Promote Cooperation in the Population

    Science.gov (United States)

    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

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

    Science.gov (United States)

    Swan, Amy

    2007-10-01

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

  10. 15 CFR 50.10 - Fee structure for special population censuses.

    Science.gov (United States)

    2010-01-01

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

  11. 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

  12. Walking and the Preservation of Cognitive Function in Older Populations

    Science.gov (United States)

    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…

  13. Death Anxiety and Religiosity among an Older Adult Population.

    Science.gov (United States)

    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…

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

    LENUS (Irish Health Repository)

    Cahir, Caitriona

    2010-05-01

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

  15. Burden of poor oral health in older age: findings from a population-based study of older British men.

    Science.gov (United States)

    Ramsay, S E; Whincup, P H; Watt, R G; Tsakos, G; Papacosta, A O; Lennon, L T; Wannamethee, S G

    2015-12-29

    Evidence of the extent of poor oral health in the older UK adult population is limited. We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population-based study of older men. Cross-sectional study. A representative sample of men aged 71-92 years in 2010-2012 from the British Regional Heart Study, initially recruited in 1978-1980 from general practices across Britain. Physical examination among 1660 men included the number of teeth, and periodontal disease in index teeth in each sextant (loss of attachment, periodontal pocket, gingival bleeding). Postal questionnaires (completed by 2147 men including all participants who were clinically examined) included self-rated oral health, oral impacts on daily life and current perception of dry mouth experience. Among 1660 men clinically examined, 338 (20%) were edentulous and a further 728 (43%) had 5.5 mm) affecting 1-20% of sites while 303 (24%) had >20% sites affected. The prevalence of gingival bleeding was 16%. Among 2147 men who returned postal questionnaires, 35% reported fair/poor oral health; 11% reported difficulty eating due to oral health problems. 31% reported 1-2 symptoms of dry mouth and 20% reported 3-5 symptoms of dry mouth. The prevalence of edentulism, loss of attachment, or fair/poor self-rated oral health was greater in those from manual social class. These findings highlight the high burden of poor oral health in older British men. This was reflected in both the objective clinical and subjective measures of oral health conditions. The determinants of these oral health problems in older populations merit further research to reduce the burden and consequences of poor oral health in older people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

    Science.gov (United States)

    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.

  17. Spinal cord injury in older population in Turkey.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  19. Periodontal disease and systemic diseases in an older population.

    Science.gov (United States)

    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.

  20. Effectiveness of transmucosal sedation for special needs populations in the ambulatory care setting.

    Science.gov (United States)

    Tetef, Sue

    2014-12-01

    Transmucosal is an alternative route for administering medications (ie, dexmedetomidine, midazolam, naloxone) that can be effective for procedural or moderate sedation in patients with special needs when other routes are not practical or are contraindicated. Special needs populations include children, older adults, pregnant and breast-feeding women, and people with disabilities or conditions that limit their ability to function and cope. Understanding the perioperative nurse's role in the care of patients receiving medications via the transmucosal route can lead to better clinical outcomes. Successful use of the transmucosal route requires knowledge of when to administer a medication, how often and how much of a medication should be administered, the onset and duration of action, the adverse effects or contraindications, and the key benefits. In addition, a case study approach suggests that transmucosal sedation can decrease patient stress and anxiety related to undergoing medical procedures or surgery in the ambulatory care setting. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

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

    LENUS (Irish Health Repository)

    O'Mahony, Denis

    2012-02-03

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

  2. Prevalence and correlates of special health care needs in a population cohort of Australian children at school entry.

    Science.gov (United States)

    Goldfeld, Sharon; O'Connor, Meredith; Sayers, Mary; Moore, Tim; Oberklaid, Frank

    2012-05-01

    Children with special health care needs are an important population for educational and health service providers. Accurate information about the prevalence and characteristics of these children and their families is needed to inform the planning and development of systems of care, yet data in Australia are currently lacking. This study utilizes population-level data from the Australian Early Development Index, a teacher-rated checklist, to provide estimates of the prevalence and developmental and demographic characteristics of Australian children with special health care needs on entrance to school. Four percent of children were reported with established special health care needs, and a further 18% were identified by teachers as "of concern." These children showed higher rates of vulnerability across all domains of development. Although children with established special health care needs were represented across demographic profiles, proportions were greater among boys, those from lower socioeconomic status communities, and Indigenous and older children. In contrast, those living in more remote settings were as likely to be identified as "of concern" as their peers but were less likely to have established special health care needs. These findings have important implications for service provision and policy development. There are substantial opportunities to reorient schooling and early childhood systems to better detect and accommodate the needs of these children.

  3. 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...

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

    Science.gov (United States)

    Chen, Xi; Clark, Jennifer J J

    2013-01-01

    This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  5. Biomarkers of Presbycusis and Tinnitus in a Portuguese Older Population

    Directory of Open Access Journals (Sweden)

    Haúla F. Haider

    2017-11-01

    Full Text Available Introduction: Presbycusis or age-related hearing loss (ARHL is a ubiquitous health problem. It is estimated that it will affect up to 1.5 billion people by 2025. In addition, tinnitus occurs in a large majority of cases with presbycusis. Glutamate metabotropic receptor 7 (GRM7 and N-acetyltransferase 2 (NAT2 are some of the genetic markers for presbycusis.Objectives: To explore patterns of hearing loss and the role of GRM7 and NAT2 as possible markers of presbycusis and tinnitus in a Portuguese population sample.Materials and Methods: Tonal and speech audiometry, tinnitus assessment, clinical interview, and DNA samples were obtained from patients aged from 55 to 75 with or without tinnitus. GRM7 analysis was performed by qPCR. Genotyping of single nucleotide polymorphisms (SNPs in NAT2 was performed by PCR amplification followed by Sanger sequencing or by qPCR.Results: We screened samples from 78 individuals (33 men and 45 women. T allele at GRM7 gene was the most observed (60.3% T/T and 33.3% A/T. Individuals with a T/T genotype have a higher risk for ARHL and 33% lower risk for tinnitus, compared to individuals with A/A and A/T genotype, respectively. Being a slow acetylator (53% was the most common NAT2 phenotype, more common in men (55.8%. Intermediate acetylator was the second most common phenotype (35.9% also more frequent in men (82.6%. Noise exposed individuals and individuals with ‘high frequency’ hearing loss seem to have a higher risk for tinnitus. Our data suggests that allele AT of GRM7 can have a statistically significant influence toward the severity of tinnitus.Conclusion: For each increasing year of age the chance of HL increases by 9%. The risk for ARHL was not significantly associated with GRM7 neither NAT2. However, we cannot conclude from our data whether the presence of T allele at GRM7 increases the odds for ARHL or whether the A allele has a protective effect. Genotype A/T at GRM7 could potentially be considered a

  6. Biomarkers of Presbycusis and Tinnitus in a Portuguese Older Population.

    Science.gov (United States)

    Haider, Haúla F; Flook, Marisa; Aparicio, Mariana; Ribeiro, Diogo; Antunes, Marilia; Szczepek, Agnieszka J; Hoare, Derek J; Fialho, Graça; Paço, João C; Caria, Helena

    2017-01-01

    Introduction: Presbycusis or age-related hearing loss (ARHL) is a ubiquitous health problem. It is estimated that it will affect up to 1.5 billion people by 2025. In addition, tinnitus occurs in a large majority of cases with presbycusis. Glutamate metabotropic receptor 7 ( GRM7 ) and N -acetyltransferase 2 ( NAT2 ) are some of the genetic markers for presbycusis. Objectives: To explore patterns of hearing loss and the role of GRM7 and NAT2 as possible markers of presbycusis and tinnitus in a Portuguese population sample. Materials and Methods: Tonal and speech audiometry, tinnitus assessment, clinical interview, and DNA samples were obtained from patients aged from 55 to 75 with or without tinnitus. GRM7 analysis was performed by qPCR. Genotyping of single nucleotide polymorphisms (SNPs) in NAT2 was performed by PCR amplification followed by Sanger sequencing or by qPCR. Results: We screened samples from 78 individuals (33 men and 45 women). T allele at GRM7 gene was the most observed (60.3% T/T and 33.3% A/T). Individuals with a T/T genotype have a higher risk for ARHL and 33% lower risk for tinnitus, compared to individuals with A/A and A/T genotype, respectively. Being a slow acetylator (53%) was the most common NAT2 phenotype, more common in men (55.8%). Intermediate acetylator was the second most common phenotype (35.9%) also more frequent in men (82.6%). Noise exposed individuals and individuals with 'high frequency' hearing loss seem to have a higher risk for tinnitus. Our data suggests that allele AT of GRM7 c an have a statistically significant influence toward the severity of tinnitus. Conclusion: For each increasing year of age the chance of HL increases by 9%. The risk for ARHL was not significantly associated with GRM7 neither NAT2 . However, we cannot conclude from our data whether the presence of T allele at GRM7 increases the odds for ARHL or whether the A allele has a protective effect. Genotype A/T at GRM7 could potentially be considered a

  7. [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.

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

    Science.gov (United States)

    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

  9. 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

  10. Atherosclerosis and Nutrition with Special Reference to Populations ...

    African Journals Online (AJOL)

    Severe atherosclerosis and its sequelae-coronary heart disease, cerebral vascular disease, and peripheral vascular disease-share major responsibility for half the mortality rate in affluent Western populations. In Africa, particularly South Africa, a study of the extent and severity of lesions is particularly interesting because of ...

  11. Atherosclerosis and Nutrition with Special Reference to Populations ...

    African Journals Online (AJOL)

    Severe atherosclerosis and its sequelae-coronary heart disease, cerebral ... the different population groups in various stages of tran- sition. ... 'These data show how emotional challenges may produce conspicuous .... and coronary arteries of White men. ... evidence of left ventricular hypertrophy, and glucose in- tolerance ...

  12. 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...

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

    Science.gov (United States)

    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.

  14. 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.

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

    Science.gov (United States)

    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.

  16. Barriers to disaster preparedness among medical special needs populations

    Directory of Open Access Journals (Sweden)

    Leslie eMeyer

    2015-09-01

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

  17. Sexual issues in special populations: lesbian and gay individuals.

    Science.gov (United States)

    Dibble, Suzanne; Eliason, Michele J; Dejoseph, Jeanne F; Chinn, Peggy

    2008-05-01

    To provide an overview of health care needs and related sexuality issues of lesbian and gay patients. Research articles, books, clinical experience. Attitudes of health professionals as well as patients impact care in relation to sexuality and sexual issues. Oncology nurses using a framework of awareness, sensitivity, and knowledge can obtain and apply the essential information needed to provide culturally appropriate nursing care to this population. Lesbian and gay patients need nurses as allies in their fight with cancer. This is particularly true in assessment and managing concerns about sexuality and sexual issues.

  18. 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...

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  3. 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

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

    Science.gov (United States)

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

    2014-10-01

    Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population, in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio. Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons. The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain. © Crown copyright 2014.

  5. 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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2015-03-01

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

  9. 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...

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

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2017-05-01

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

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

    Science.gov (United States)

    Peltzer, Karl

    2017-05-09

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

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

    Science.gov (United States)

    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.

  13. 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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  17. 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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    OpenAIRE

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2015-09-01

    Acculturation is a difficult process for minority older adults for a variety of reasons, including access and exposure to mainstream culture, competing ethnic identities, and linguistic ability and preference. There is a paucity of research regarding overall level of acculturation for Chinese older adults in the United States. This study aimed to provide an overall estimate of level of acculturation of Chinese older adults in the United States and to examine correlations between sociodemographic characteristics, self-reported health measures, and level of acculturation. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study. This community-based participatory research study surveyed 3,159 Chinese older adults aged 60 and older. The PINE Study Acculturation Scale was used to assess level of acculturation in three dimensions: language preference, media use, and ethnic social relations. Mean acculturation level for all items was 15.3 ± 5.1, indicating low levels of acculturation. Older age, more offspring, lower income, fewer years living in the United States, lower overall health status, and lower quality of life were associated with lower levels of acculturation. Level of acculturation was low in Chinese older adults, and certain subsets of the population were more likely to have a lower level of acculturation. Future research should investigate causality and effects of level of acculturation. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Samantha Caesar de Andrade, PhD

    2016-12-01

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

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

    Science.gov (United States)

    Hoffman, Geoffrey J; Rodriguez, Hector P

    2015-12-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2005-01-01

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

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

    Science.gov (United States)

    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

  11. A reliable measure of frailty for a community dwelling older population

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

  17. 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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Viscogliosi Chantal

    2007-08-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Favier, S; Izaute, M; Teissèdre, F

    2017-04-01

    Negative representations of ageing are conveyed in our society. We see that people frequently avoid working with older people, due to a lack of motivation. Depressive signs in older people are more frequently associated with normal ageing, rather than a pathology, giving health professionals the feeling that therapeutic efforts are likely to be unproductive. Yet, depression is a major public health problem, particularly among older people. It is a real pathology, affecting 20% of people aged 65 and older. In retirement homes the percentage can be as high as 45%. To study and evaluate how theoretical knowledge about older people and depression affects the motivation of 2nd year psychology students to work with this population. The study involves two groups. One of the groups (experimental group) followed an 8hour course on depression in older people, whereas the other (control group) followed an 8hour course on a different topic. The study was conducted in two parts. First, the two groups answered an initial questionnaire which measured how motivated they were to work with older people and what they knew about depression in older people. Then, after the experimental phase, all of the students answered the same questionnaire a second time. The comparison shows a significant decline in knowledge between T1 and T2 for the control group (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

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

    Science.gov (United States)

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

    2016-11-01

    Regular physical activity (PA) promotes musculoskeletal health in older adults. However, the majority of older individuals do not meet current PA guidelines and are also highly sedentary. Emerging evidence indicates that large amounts of sedentary time accelerate the loss of skeletal muscle mass (i.e., sarcopenia) and physical function with advancing age. However, current PA recommendations for sedentary time are non-specific (i.e., keep sedentary time to a minimum). Research indicates that physical inactivity and large amounts of sedentary time accelerate sarcopenic muscle loss by inducing skeletal muscle 'anabolic resistance'. These findings suggest a critical interaction between engaging in 'sufficient' levels of PA, minimising sedentary time, and consuming 'adequate' nutrition to promote optimal musculoskeletal health in older adults. However, current PA recommendations do not take into account the important role that nutrition plays in ensuring older adults can maximise the benefits from the PA in which they engage. The aim of this narrative review is: (1) to briefly summarise the evidence used to inform current public health recommendations for PA and sedentary time in older adults; and (2) to discuss the presence of 'anabolic resistance' in older adults, highlighting the importance of regular PA and minimising sedentary behaviour. It is imperative that the synergy between PA, minimising sedentary behaviour and adequate nutrition is integrated into future PA guidelines to promote optimal musculoskeletal health and metabolic responses in the growing ageing population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  7. 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

  8. 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,

  9. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  12. Cognitive lifestyle in older persons: the population-based Sydney Memory and Ageing Study.

    Science.gov (United States)

    Valenzuela, Michael J; Leon, Irene; Suo, Chao; Piamba, Diana Martinez; Kochan, Nicole; Brodaty, Henry; Sachdev, Perminder

    2013-01-01

    Cognitive lifestyle may be an important modifiable risk factor for dementia but has not yet been comprehensively studied in healthy elderly. To examine gender- and lifespan-related differences in cognitive lifestyle in a population-based cohort. 872 individuals from the second wave of the Sydney Memory and Ageing Study (MAS) cohort were invited to complete the Lifetime of Experiences Questionnaire (LEQ), a validated measure of cognitive lifestyle. Of 555 questionnaires returned (64%), 253 were excluded due to prior diagnosis of mild cognitive impairment, leaving n = 302 cognitively-intact elders (mean age 80.1 years, ±SD 4.7, 40.1% men). Total LEQ was significantly higher in men (97.9 ± 20.0) than women (90.0 ± 24.5), resulting mainly from midlife LEQ differences. Men were more likely to have worked in managerial or professional jobs (73.8% versus 39.5% women), and twice as likely to have supervised large groups of workers. In late life, women were significantly more likely to be living alone (68.1% versus 25.4% men), but otherwise significantly more engaged in specific cognitive activities, including reading novels (72.3% versus 52.0% men) and incorporating volunteer work (31.9% versus 19.7% men) and socializing (59.0% versus 37.0% men) into their typical day. Over the adult lifespan, it was more common for men and women to transition between LEQ tertiles than remain the same. Cognitive lifestyle changes over the adult lifespan and exhibits a range of gender-based differences. While older women are more likely to be living alone they generally lead a more active current cognitive lifestyle.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  15. 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...

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

    Science.gov (United States)

    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.

  17. 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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  1. 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

  2. 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.

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

    Science.gov (United States)

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

    2016-08-22

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

  4. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

    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.

  10. Oral health care behavior and frailty-related factors in a care-dependent older population.

    NARCIS (Netherlands)

    Niesten, D.J.M.; Witter, D.J.; Bronkhorst, E.M.; Creugers, N.H.J.

    2017-01-01

    OBJECTIVES: To assess, in older people with different levels of care-dependency 1) which frailty- and non-frailty related predisposing, enabling and need factors are associated with a) dental service use (DSU) frequency, b) changed DSU after the onset of care-dependency, c) brushing frequency, and

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

    Science.gov (United States)

    Jecker-Parvex, Maurice; Breitenbach, Nancy

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2015-01-01

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

  16. A GIS Approach to Identifying Socially and Medically Vulnerable Older Adult Populations in South Florida.

    Science.gov (United States)

    Hames, Elizabeth; Stoler, Justin; Emrich, Christopher T; Tewary, Sweta; Pandya, Naushira

    2017-11-10

    We define, map, and analyze geodemographic patterns of socially and medically vulnerable older adults within the tri-county region of South Florida. We apply principal components analysis (PCA) to a set of previously identified indicators of social and medical vulnerability at the census tract level. We create and map age-stratified vulnerability scores using a geographic information system (GIS), and use spatial analysis techniques to identify patterns and interactions between social and medical vulnerability. Key factors contributing to social vulnerability in areas with higher numbers of older adults include age, large household size, and Hispanic ethnicity. Medical vulnerability in these same areas is driven by disease burden, access to emergency cardiac services, availability of nursing home and hospice beds, access to home health care, and available mental health services. Age-dependent areas of social vulnerability emerge in Broward County, whereas age-dependent areas of medical vulnerability emerge in Palm Beach County. Older-adult social and medical vulnerability interact differently throughout the study area. Spatial analysis of older adult social and medical vulnerability using PCA and GIS can help identify age-dependent pockets of vulnerability that are not easily identifiable in a populationwide analysis; improve our understanding of the dynamic spatial organization of health care, health care needs, access to care, and outcomes; and ultimately serve as a tool for health care planning. © 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.

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

    Science.gov (United States)

    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.

  18. 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

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

    Science.gov (United States)

    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.

  20. 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.

  1. 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

  2. Exercise effects on bone mineral density in older men: a systematic review with special emphasis on study interventions.

    Science.gov (United States)

    Kemmler, W; Shojaa, M; Kohl, M; von Stengel, S

    2018-04-05

    This systematic review detected only limited positive effects of exercise on bone mineral density in older men. Further, based on the present literature, we were unable to suggest dedicated exercise prescriptions for this male cohort that might differ from recommendations based on studies with postmenopausal women. The primary aim of this systematic review was to determine the effect of exercise on bone mineral density (BMD) in healthy older men. A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement included only randomized or non-randomized controlled trials of exercise training ≥ 6 months with study groups of ≥ eight healthy men aged 50 years or older, not using bone-relevant pharmacological therapy, that determined BMD by dual-energy X-ray absorptiometry. We searched PubMed, Scopus, Web of Science, Cochrane, Science Direct, and Eric up to November 2016. Risk of bias was assessed using the PEDro scale. We identified eight trials with 789 participants (PEDro-score, mean value 6 of 10) which satisfied our eligibility criteria. Studies vary considerably with respect to type and composition of exercise. Study interventions of six trials were considered to be appropriate for successfully addressing BMD in this cohort. Between-group differences were not or not consistently reported by three studies. Three studies reported significant exercise effects on BMD for proximal femur; one of them determined significant differences between the exercise groups. None of the exercise trials determined significant BMD effects at the lumbar spine. Based on the present studies, there is only limited evidence for a favorable effect of exercise on BMD in men. More well-designed and sophisticated studies on BMD in healthy older men have to address this topic. Further, there is a need to define intervention quality standards and implement a universal scoring system that allows this pivotal determinant

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

    Science.gov (United States)

    Axmon, Anna; Ahlström, Gerd; Höglund, Peter

    2017-11-23

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

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

    Directory of Open Access Journals (Sweden)

    Anna Axmon

    2017-11-01

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

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

    Science.gov (United States)

    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.

  6. 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.

  7. 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.

  8. 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.

  9. Periodontal inflammation in relation to cognitive function in an older adult danish population

    DEFF Research Database (Denmark)

    Kamer, Angela R; Morse, Douglas E; Holm-Pedersen, Poul

    2012-01-01

    Inflammation plays a significant role in Alzheimer's disease (AD) pathogenesis. Studies have shown that systemic, peripheral infections affect AD patients. Cognitive dysfunction is a consistent finding in AD and periodontal disease is a chronic, peripheral infection often resulting in tooth loss....... We hypothesized that older adults with periodontal inflammation (PI) or many missing teeth would show impaired cognition compared to subjects without PI or with few missing teeth, and among subjects with PI, those with many missing teeth would show impaired cognition compared to those with few...

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

    Science.gov (United States)

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

    2015-05-01

    Curcumin possesses many properties which may prevent or ameliorate pathological processes underlying age-related cognitive decline, dementia or mood disorders. These benefits in preclinical studies have not been established in humans. This randomized, double-blind, placebo-controlled trial examined the acute (1 and 3 h after a single dose), chronic (4 weeks) and acute-on-chronic (1 and 3 h after single dose following chronic treatment) effects of solid lipid curcumin formulation (400 mg as Longvida®) on cognitive function, mood and blood biomarkers in 60 healthy adults aged 60-85. One hour after administration curcumin significantly improved performance on sustained attention and working memory tasks, compared with placebo. Working memory and mood (general fatigue and change in state calmness, contentedness and fatigue induced by psychological stress) were significantly better following chronic treatment. A significant acute-on-chronic treatment effect on alertness and contentedness was also observed. Curcumin was associated with significantly reduced total and LDL cholesterol and had no effect on hematological safety measures. To our knowledge this is the first study to examine the effects of curcumin on cognition and mood in a healthy older population or to examine any acute behavioral effects in humans. Results highlight the need for further investigation of the potential psychological and cognitive benefits of curcumin in an older population. © The Author(s) 2014.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. The Intersectionality of Stigmas among Key Populations of Older Adults Affected by HIV: a Thematic Analysis.

    Science.gov (United States)

    Johnson Shen, Megan; Freeman, Ryann; Karpiak, Stephen; Brennan-Ing, Mark; Seidel, Liz; Siegler, Eugenia L

    2018-03-26

    The present study examined the intersectionality of stigma across varying groups of older persons living with HIV (PWH). Four focus groups of older PWH (gay/bisexual men, heterosexual men, heterosexual and bisexualwomen, and Spanish-speaking) were audio-recorded and transcribed. Inductive thematic text analysis was used to identify qualitative themes. Five major themes emerged from the data: 1) disclosure of HIV status; 2) types of stigma experienced; 3) discrimination experienced; 4) other outcomes associated with experiencing stigma; and 5) influence of aging on social isolation experienced due to stigma. Findings indicate women did not suffer from the intersection of stigmas. Other groups suffered from the intersection of stigma due to HIV status and age (gay/bisexual males); HIV status and perceived stigma of sexual orientation or drug use (heterosexual males); and HIV status and culture/ethnicity (Spanish-speaking). Results indicate that many at-risk groups, including heterosexual men, homosexual men, and Spanish-speaking individuals, experience an intersection of stigma between aging and their sexuality, HIV status, or real or perceived drug use. Results highlight the need for HIV support, especially social support, to address intersection of stigmas for unique groups of individuals disproportionately affected by HIV.

  15. The economic impact of wasted prescription medication in an outpatient population of older adults.

    Science.gov (United States)

    Morgan, T M

    2001-09-01

    The causes and costs of outpatient medication waste are not known. We report the results of a cross-sectional pilot survey of medication waste in a convenience sample of 73 New Hampshire retirement community residents aged 65 years or older. We used questionnaires and in-home pill counts to determine the annual occurrence of medication waste, defined as no intention to take leftover medicines prescribed within the past year. Mean individual annual cost of wasted medication was $30.47 (range = $0-$131.56). Waste represented 2.3% of total medication costs. The main causes for waste included: resolution of the condition for which the medication was prescribed (37.4%), patient-perceived ineffectiveness (22.6%), prescription change by the physician (15.8%), and patient-perceived adverse effects (14.4%). Individual costs were modest, but if $30 per person represents a low estimate of average annual waste, the US national cost for adults older than 65 years would top $1 billion per year.

  16. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Lai Hsiu-Yun

    2010-09-01

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

  20. Quality of life and physical activity in an older working-age population

    Directory of Open Access Journals (Sweden)

    Puciato D

    2017-10-01

    Full Text Available Daniel Puciato,1 Zbigniew Borysiuk,1 Michał Rozpara2 1Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, 2Faculty of Physical Education, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland Objective: Physical activity can be an effective means of prevention and therapy of many psychosomatic disorders. It can also have a significant impact on the quality of life of older working-age people. The aim of the present study was to assess the relationships between quality of life and physical activity in older working-age people from Wroclaw, Poland.Materials and methods: The study group comprised 1,013 people, including 565 women and 448 men, aged 55–64 years (59.1±2.9 years. The study took form of a questionnaire survey. The participants assessed their physical activity and quality of life using the International Physical Activity Questionnaire Short Version (IPAQ-SF and the World Health Organization Quality of Life (WHOQOL-BREF, respectively.Results: The highest mean indices of general quality of life, perceived health status, and quality of life in the physical, psychological, social, and environmental domains were shown by respondents whose intensity of physical activity was the highest. Moreover, the odds of high assessment of overall quality of life increased with respondents’ higher levels of physical activity.Conclusion: Quality of life improvement programs should also involve increased physical activity components. Keywords: physical activity, IPAQ-SF, quality of life, WHOQOL-BREF, big city environment

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Afshin Vafaei

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

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

    Science.gov (United States)

    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.

  4. Wound Healing in Older Adults.

    Science.gov (United States)

    Gould, Lisa J; Fulton, Ana Tuya

    2016-02-01

    Impaired wound healing in the elderly represents a major clinical problem that is growing as our population ages. Wound healing is affected by age and by co-morbid conditions, particularly diabetes and obesity. This is particularly important in Rhode Island as the state has a very high percentage of vulnerable older adults. A multi- disciplinary approach that incorporates the skills of a comprehensive wound center with specialized nursing, geriatric medicine and palliative care will facilitate rapid wound healing, reduce costs and improve outcomes for our older adults that suffer from 'problem wounds'.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  8. National study on carless and special needs populations mobilizing your community for emergency evacuation.

    Science.gov (United States)

    2012-12-01

    The National Study on Carless and Special Needs Evacuation Planning was a multi-year study funded by the Federal Transit Administration : to research how state Departments of Transportation (DOTs), metropolitan planning organizations (MPOs), transit ...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  11. 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.

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

    Science.gov (United States)

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

    2014-05-09

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

  13. Cardiovascular risk profile and frailty in a population-based study of older British men.

    Science.gov (United States)

    Ramsay, S E; Arianayagam, D S; Whincup, P H; Lennon, L T; Cryer, J; Papacosta, A O; Iliffe, S; Wannamethee, S G

    2015-04-01

    Frailty in older age is known to be associated with cardiovascular disease (CVD) risk. However, the extent to which frailty is associated with the CVD risk profile has been little studied. Our aim was to examine the associations of a range of cardiovascular risk factors with frailty and to assess whether these are independent of established CVD. Cross-sectional study of a socially representative sample of 1622 surviving men aged 71-92 examined in 2010-2012 across 24 British towns, from a prospective study initiated in 1978-1980. Frailty was defined using the Fried phenotype, including weight loss, grip strength, exhaustion, slowness and low physical activity. Among 1622 men, 303 (19%) were frail and 876 (54%) were pre-frail. Compared with non-frail, those with frailty had a higher odds of obesity (OR 2.03, 95% CI 1.38 to 2.99), high waist circumference (OR 2.30, 95% CI 1.67 to 3.17), low high-density lipoprotein-cholesterol (HDL-C) (OR 2.28, 95% CI 1.47 to 3.54) and hypertension (OR 1.79, 95% CI 1.27 to 2.54). Prevalence of these factors was also higher in those with frailty (prevalence in frail vs non-frail groups was 46% vs 31% for high waist circumference, 20% vs 11% for low HDL and 78% vs 65% for hypertension). Frail individuals had a worse cardiovascular risk profile with an increased risk of high heart rate, poor lung function (forced expiratory volume in 1 s (FEV1)), raised white cell count (WCC), poor renal function (low estimated glomerular filtration rate), low alanine transaminase and low serum sodium. Some risk factors (HDL-C, hypertension, WCC, FEV1, renal function and albumin) were also associated with being pre-frail. These associations remained when men with prevalent CVD were excluded. Frailty was associated with increased risk of a range of cardiovascular factors (including obesity, HDL-C, hypertension, heart rate, lung function, renal function) in older people; these associations were independent of established CVD. Published by the BMJ

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-11-01

    Vitamin B12 and folic acid deficiency are common in the older and are associated with several conditions including anaemia, cardiovascular disease, cognitive impairment and cancer. Evidence from in vitro studies suggests that solar radiation can degrade both vitamins in the skin. Chile is the longest country in the world running perfectly North-South making it an ideal place to study potential associations of latitude and solar radiation on vitamin B12 and folic acid deficiency. The objective was to examine the association between vitamin B12 and folic acid deficiencies and latitude. Plasma samples were collected from Chileans aged 65+ years (n=1013) living across the whole country and assayed for vitamin B12 and folic acid concentrations as part of the Chilean Health Survey 2009-2010, which is a national representative sample study. Overall, the prevalence of vitamin B12 deficiency was 11.3%, with the prevalence in the North of the country being significantly greater than in the Central and South zones (19.1%,10.5%, and 5.7%, respectively; Psolar radiation (OR 1.203 [95% confidence intervals 1.119-1.294], Psolar radiation. Although degradation by solar radiation might explain this observation, further work is required to establish the potential mechanisms. In countries that routinely fortify food with folic acid, efforts to identify vitamin B12 deficiency might be more cost-efficiently targeted in areas closest to the Equator. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Junqing Wang

    2017-01-01

    Full Text Available Objective. This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients. Method. A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years. Results. 76 patients (99 eyes were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years. Vision loss was severe at presentation, with initial best corrected vision activity (BCVA < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD, 1.3% were diagnosed with multiple sclerosis (MS, 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years developed NMOSD or MS. Conclusion. Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  1. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults

    DEFF Research Database (Denmark)

    Straus, Sabine M J M; Kors, Jan A; De Bruin, Marie L

    2006-01-01

    OBJECTIVES: This study sought to investigate whether prolongation of the heart rate-corrected QT (QTc) interval is a risk factor for sudden cardiac death in the general population. BACKGROUND: In developed countries, sudden cardiac death is a major cause of cardiovascular mortality. Prolongation...... of the QTc interval has been associated with ventricular arrhythmias, but in most population-based studies no consistent association was found between QTc prolongation and total or cardiovascular mortality. Only very few of these studies specifically addressed sudden cardiac death. METHODS: This study......). The association between a prolonged QTc interval and sudden cardiac death was estimated using Cox proportional hazards analysis. RESULTS: During an average follow-up period of 6.7 years (standard deviation, 2.3 years) 125 patients died of sudden cardiac death. An abnormally prolonged QTc interval (>450 ms in men...

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

    Science.gov (United States)

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

    2017-05-01

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

  3. Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology.

    Science.gov (United States)

    Ratner, Elena S; Erekson, Elisabeth A; Minkin, Mary Jane; Foran-Tuller, Kelly A

    2011-11-01

    SEXUAL FUNCTION IN AGING WOMEN: Sexuality is an integral part of human expressions. Mental health plays a major role in sexuality. Several psychological interventions are proposed to increase the sexual quality of life in older women with diverse gynecologic pathology. A biopsychosocial approach utilizing brief strategies can be easily implemented in clinics to help women of all ages increase their sexual quality of life. THE IMPACT OF FEMALE PELVIC FLOOR DISORDERS ON SEXUAL FUNCTION IN OLDER WOMEN: Female pelvic floor disorders include urinary incontinence, pelvic organ prolapse, and fecal incontinence. These disorders increase dramatically with increasing age. Urinary incontinence has been demonstrated to have a negative impact on a woman's sexual function. Among sexually active older women with urinary incontinence, 22% report being moderately or extremely worried that sexual activity would cause urine loss. An increased prevalence of sexual distress [9% (6/76) vs. 1.3% (2/216), p=0.005] has been reported in sexually active women over 40 years old with urinary incontinence. Treatment of urinary incontinence can improve sexual function in older women. Among sexually active women (N=53) who underwent midurethral slings procedures for the correction of urinary incontinence, increased coital frequency, decrease fear of incontinence with coitus, decreased embarrassment due to incontinence was reported six months after surgery. Pelvic organ prolapse, a hernia of the vagina resulting in a visible vaginal bulge, has also been associated with a negative impact on sexual function. Women with advanced pelvic organ prolapse (POP-Q stage III or IV) have been demonstrated to have decreased body image reporting that they are more self-conscious about their appearance [adjusted odds ratio (AOR) 4.7; 95% confidence interval (CI) 2.9, 51], feel less feminine (AOR 4.0; 95% CI 1.2, 15) and less sexually attractive (AOR 4.6; 95% CI 1.4, 17) compared with women who have normal pelvic

  4. Body Part Concerns Questionnaire (BPCQ in an Iranian Population with Special Needs

    Directory of Open Access Journals (Sweden)

    Katayoun Khademi

    2012-10-01

    Full Text Available Objectives: During the past decades, cosmetic surgery has become increasingly popular. The purpose of this study is to make questionnaire for screening patients with negative body image in cosmetic clinics for special need people. Methods: In the present study, 150 special need people in cosmetic clinics were randomly assigned to fill questionnaires for assessing body area concerns. Results: Results of reliability analysis and validity have shown the effectiveness of this questionnaire for recognizing individuals with having negative body image. These preliminary results suggest that body dysmorphic disorder may be relatively common among patients seeking cosmetic surgery. Discussion: A high proportion of participants in cosmetic clinics have demonstrated significant body image concerns. These relatively common body image concerns deserve more study in adolescents and people with special needs.

  5. Health trends in a geriatric and special needs clinic patient population.

    Science.gov (United States)

    Lee, Katherine J; Ettinger, Ronald L; Cowen, Howard J; Caplan, Daniel J

    2015-01-01

    To quantify differences and recent changes in health status among patients attending the Geriatric and Special Needs Dentistry (GSND) and Family Dentistry (FAMD) clinics at the University of Iowa College of Dentistry. A total of 388 randomly selected records from patients attending the GSND or FAMD clinics from 1996-2000 or from 2006-2010 were reviewed. Univariate and bivariate analyses were conducted, followed by multivariable logistic regression analyses to compare characteristics of patients across clinics. Between the two GSND cohorts, the mean number of medications reported increased from 4.0 to 6.5 (p Special Care Dentistry Association and Wiley Periodicals, Inc.

  6. Comparative impacts of Tai Chi, balance training, and a specially-designed yoga program on balance in older fallers.

    Science.gov (United States)

    Ni, Meng; Mooney, Kiersten; Richards, Luca; Balachandran, Anoop; Sun, Mingwei; Harriell, Kysha; Potiaumpai, Melanie; Signorile, Joseph F

    2014-09-01

    To compare the effect of a custom-designed yoga program with 2 other balance training programs. Randomized controlled trial. Research laboratory. A group of older adults (N=39; mean age, 74.15 ± 6.99 y) with a history of falling. Three different exercise interventions (Tai Chi, standard balance training, yoga) were given for 12 weeks. Balance performance was examined during pre- and posttest using field tests, including the 8-foot up-and-go test, 1-leg stance, functional reach, and usual and maximal walking speed. The static and dynamic balances were also assessed by postural sway and dynamic posturography, respectively. Training produced significant improvements in all field tests (Ptime × group interaction were not detected. For postural sway, significant decreases in the area of the center of pressure with eyes open (P=.001) and eyes closed (P=.002) were detected after training. For eyes open, maximum medial-lateral velocity significantly decreased for the sample (P=.013). For eyes closed, medial-lateral displacement decreased for Tai Chi (Ptime on the test (P=.006), and 2 linear measures in lateral (P=.001) and anterior-posterior (P<.001) directions were seen for the sample. Yoga was as effective as Tai Chi and standard balance training for improving postural stability and may offer an alternative to more traditional programs. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Study of Duchenne muscular dystrophy long-term survivors aged 40 years and older living in specialized institutions in Japan.

    Science.gov (United States)

    Saito, Toshio; Kawai, Mitsuru; Kimura, En; Ogata, Katsuhisa; Takahashi, Toshiaki; Kobayashi, Michio; Takada, Hiroto; Kuru, Satoshi; Mikata, Takashi; Matsumura, Tsuyoshi; Yonemoto, Naohiro; Fujimura, Harutoshi; Sakoda, Saburo

    2017-02-01

    The national muscular dystrophy wards database of Japan lists 118 long-term Duchenne muscular dystrophy (DMD) patients who were at least 40 years old as of October 1, 2013. To elucidate the clinical features of DMD patients aged 40 years and older, we obtained gene analysis and muscle biopsy findings, as well as medical condition information. Ninety-four of the registered patients consented to participate, of whom 55 meeting genetic or biochemical criteria confirming DMD were analyzed. The mean age at the time of the study was 43.6 ± 3.0 years, while at the time of independent ambulation loss it was 10.6 ± 1.5 years and at mechanical ventilation introduction it was 24.1 ± 5.5 years. All were receiving continuous ventilation support, 27 with non-invasive positive pressure ventilation and 28 with tracheal intermittent positive pressure ventilation. Thirty-eight were receiving β-blockers or a renin-angiotensin system inhibitor, while 9 were free from those agents. Forty had maintained oral nutrition. The 55 analyzed patients had survived into their 40s by receiving multidisciplinary intervention. Our findings emphasize the need of future studies to investigate disease modifiers and the mechanism of long-term survival. In addition, establishment of a worldwide care standard with focus on quality of life for adult males with DMD is important. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Evaluation of water balance in a population of older adults. A case control study.

    Science.gov (United States)

    Malisova, Olga; Poulia, Kalliopi-Anna; Kolyzoi, Kleoniki; Lysandropoulos, Athanasios; Sfendouraki, Kalliopi; Kapsokefalou, Maria

    2018-04-01

    Older adults are at risk for dehydration and its' potentially life-threatening consequences. Unrecognized dehydration can complicate chronic medical problems and increase morbidity. The objective of the study was to estimate water balance, intake and loss in elderly people living in Greece using the Water Balance Questionnaire (WBQ). WBQ was administered in winter to 108 independents (65-81yrs) (Group A), 94 independents (82-92yrs) (Group B) and 51 hospitalized (65-92yrs) (Group C). A database from previous study of 335 adults (18-65yrs) (Control Group) used for comparison. Mean estimates of water balance, intake and loss were, respectively, for Group A -749 ± 1386 mL/day, 2571 ± 739 mL/day and 3320 ± 1216 mL/day, for Group B -38 ± 933 mL/day, 2571 ± 739 mL/day and 3320 ± 1216 mL/day, for Group C 64 ± 1399 mL/day, 2586 ± 1071 mL/day and 2522 ± 1048 mL/day and for Control Group -253 ± 1495 mL/day, 2912 ± 1025 mL/day and 3492 ± 2099 mL/day. Significant differences were detected in water balance, intake and loss (p < 0.01). Water balance and water intake in Group A was the lowest. For Groups A, B, C and Control, contribution of solid foods to water intake was 36%, 29%, 32%, 25%, of drinking water was 32%, 48%, 45%, 47%, of beverages was 32%, 23%, 23% and 28% respectively. Significant differences observed in the contribution of drinking water and beverages (p < 0.01). Group A had lower water balance and water intake. Groups B and C had lower water intake from beverages. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  9. 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.

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

    Science.gov (United States)

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

    1998-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Christopher Vinnard

    2013-01-01

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

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

    Science.gov (United States)

    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.

  14. Mathematical Learning Disabilities in Special Populations: Phenotypic Variation and Cross-Disorder Comparisons

    Science.gov (United States)

    Dennis, Maureen; Berch, Daniel B.; Mazzocco, Michele M. M.

    2009-01-01

    What is mathematical learning disability (MLD)? The reviews in this special issue adopt different approaches to defining the construct of MLD. Collectively, they demonstrate the current status of efforts to establish a consensus definition and the challenges faced in this endeavor. In this commentary, we reflect upon the proposed pathways to…

  15. 34 CFR 403.193 - What are the information requirements regarding special populations?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What are the information requirements regarding special... TECHNOLOGY EDUCATION PROGRAM What Conditions Must be Met by Local Recipients? § 403.193 What are the... their parents information concerning— (i) The opportunities available in vocational education; (ii) The...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  18. C-reactive protein, APOE genotype and longitudinal cognitive change in an older population

    Science.gov (United States)

    Lima, Thomas A. S.; Adler, Amanda L.; Minett, Thais; Matthews, Fiona E.; Brayne, Carol; Marioni, Riccardo E.

    2014-01-01

    Background: circulating measures of inflammatory markers, such as C-reactive protein (CRP) have been associated with an increased risk of future cognitive decline. However, the nature of the relationship among the very old (>75 years) is unclear. Cross-sectional evidence suggests that elevated CRP may even be protective in this age group. This study examines these associations longitudinally. Methods: logistic regression was used to investigate the association between CRP and drop in cognitive performance (≥3 point change on the Mini-Mental State Examination) over a 4-year period in a population of 266 people, mean age 77 years. Results: increased levels of CRP were associated with a decreased risk of a drop in cognitive performance; however, this association was only seen in those without an APOE e4 allele [odds ratio of decline per unit increase in ln(CRP) 0.57, P = 0.04]. The magnitude of the finding remained consistent after adjustment for cardiovascular confounders (smoking, drinking, MI, stroke, diabetes, education, medication and blood pressure). For those with an e4 allele, the relationship with longitudinal cognitive decline was neither statistically significant nor in a consistent direction after controlling for acute inflammation. Conclusions: this study strengthens previous cross-sectional findings and shows elevated levels of CRP to be linked to a decreased risk of longitudinal cognitive decline in the very old. However, as with prior analyses, this was only observed in those not carrying an APOE e4 allele. Future work on larger APOE e4 allele carrying samples is required to determine the nature of the association in this population. PMID:24305621

  19. Hypertension management in a population of older adults in rural South Africa.

    Science.gov (United States)

    Jardim, Thiago Veiga; Reiger, Sheridan; Abrahams-Gessel, Shafika; Gomez-Olive, F Xavier; Wagner, Ryan G; Wade, Alisha; Bärnighausen, Till W; Salomon, Joshua; Tollman, Stephen; Gaziano, Thomas A

    2017-06-01

    Assess awareness, treatment, and control of hypertension, as an indication of its management, in rural South Africa, especially regarding modifiers of these variables. A population-representative sample of adults aged at least 40 years residing in the rural Agincourt subdistrict (Mpumalanga Province) covered by a long-term health and sociodemographic surveillance system was recruited. In-person interviews, physical exams, and dried blood spots were collected. Hypertension awareness, treatment, and control rates were assessed. A regression model was built to identify predictors of those outcomes. The mean age of the 2884 hypertensive participants was 64.1 ± 12.7 years. Hypertension awareness rate was 64.4%, treatment among those aware was 89.3 and 45.8% of those treated were controlled. Considering aware and unaware hypertensives, treatment rate was 49.7% and control 22.8%. In the multivariable regression model, awareness was predicted by female sex, age at least 60 years, higher social economic status, prior cardiovascular disease (CVD), nonimmigrant status, literacy, and physical limitation. Improved control among those treated was predicted by age at least 60 years. Blood pressure control among all hypertensive study participants was predicted by female sex, being HIV-negative, age at least 60 years, nonimmigrant status, and prior CVD. High rates of awareness and treatment of hypertension as well as good levels of control were found in this population, probably explained by the long-term surveillance program conducted in the area. Considering the predictors of hypertension management, particular attention should be given to men, residents younger than 60 years, immigrants, and study participants without CVD as these characteristics were predictors of poor outcome.

  20. The relationship between social functioning and subjective memory complaints in older persons: a population-based longitudinal cohort study.

    Science.gov (United States)

    Kuiper, Jisca S; Oude Voshaar, Richard C; Zuidema, Sytse U; Stolk, Ronald P; Zuidersma, Marij; Smidt, Nynke

    2017-10-01

    Poor social functioning is associated with cognitive decline in older adults. It is unclear whether social functioning is also associated with subjective memory complaints (SMC). We investigated the association between social functioning and incident SMC and SMC recovery. A population-based sample of 8762 older adults (aged ≥65 years) with good objective cognitive functioning at baseline (MMSE ≥26) from the LifeLines Cohort Study were followed for 1.5 years. Self-reported SMC were measured at baseline and after 1.5 years follow-up. Aspects of social functioning included marital status, household composition, social network size, social activity, quality of social relationships, social support, affection, behavioral confirmation, and status. Thirteen percent (513/3963) developed SMC during follow-up (incident SMC). Multivariate logistic regression analyses (adjusted for age, gender, education level, physical activity, alcohol use, smoking status, depression, arrhythmia, myocardial infarction, heart failure, stroke) showed that participants with better feelings of affection, behavioral confirmation and stable good social support had a lower risk of incident SMC. Thirty-four percent (1632/4799) reported recovery. Participants with good social functioning at baseline on all determinants reported more SMC recovery. People who remained stable in a relationship, stable in good quality of social relationships or increased in quality of social relationships more often report SMC recovery. Good social functioning is associated with less incident SMC and more SMC recovery over a follow-up period of 1.5 years. Albeit future confirmative studies are needed, we argue for targeting also social functioning when designing multidomain interventions to prevent or slow down cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Population-Based Study of Cerebral Microbleeds in Stroke-Free Older Adults Living in Rural Ecuador: The Atahualpa Project.

    Science.gov (United States)

    Del Brutto, Victor J; Zambrano, Mauricio; Mera, Robertino M; Del Brutto, Oscar H

    2015-07-01

    Prevalence of cerebral microbleeds (CMB) in white and Asian populations range from 4% to 15%. However, there is no information from indigenous Latin American people. We aimed to assess prevalence and cerebrovascular correlates of CMB in stroke-free older adults living in rural Ecuador. Of 311 Atahualpa residents aged ≥60 years identified during a door-to-door survey, 258 (83%) underwent brain magnetic resonance imaging. Twenty-one were further excluded for a diagnosis of overt stroke. Using multivariate logistic regression models, adjusted for demographics and cardiovascular risk factors, we evaluated whether CMB were independently associated with silent strokes, white matter hyperintensities, and global cortical atrophy. Twenty-six (11%) of 237 participants had CMB, which were single in 54% of cases. CMB were deep in 11 patients, cortical in 9, and located both deep and cortical in 6. In univariate analyses, CMB were associated with age, systolic blood pressure, moderate-to-severe white matter hyperintensities, silent lacunar infarcts, and cortical atrophy. Mean (±SD) values for systolic blood pressure were 155±27 mm Hg in patients who had CMB versus 142±26 mm Hg in those who did not (P=0.017). In the adjusted models, moderate-to-severe white matter hyperintensities (P=0.009), silent lacunar infarcts (P=0.003), and global cortical atrophy (P=0.04) were independently associated with CMB. Prevalence of CMB in stroke-free older adults living in Atahualpa is comparable with those reported from other ethnic groups. There is a strong relationship between CMB and increased age, high systolic blood pressure, silent markers of cerebral small vessel disease, and cortical atrophy. © 2015 American Heart Association, Inc.

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

    Science.gov (United States)

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

    2017-02-14

    Use of information and communication technologies (ICT) among seniors is increasing; however, studies on the use of ICT by seniors at the highest risk of health impairment are lacking. Frail and prefrail seniors are a group that would likely benefit from preventive nutrition and exercise interventions, both of which can take advantage of ICT. The objective of the study was to quantify the differences in ICT use, attitudes, and reasons for nonuse among physically frail, prefrail, and nonfrail home-dwelling seniors. This was a population-based questionnaire study on people aged 65-98 years living in Northern Finland. A total of 794 eligible individuals responded out of a contacted random sample of 1500. In this study, 29.8% (237/794) of the respondents were classified as frail or prefrail. The ICT use of frail persons was lower than that of the nonfrail ones. In multivariable logistic regression analysis, age and education level were associated with both the use of Internet and advanced mobile ICT such as smartphones or tablets. Controlling for age and education, frailty or prefrailty was independently related to the nonuse of advanced mobile ICT (odds ratio, OR=0.61, P=.01), and frailty with use of the Internet (OR=0.45, P=.03). The frail or prefrail ICT nonusers also held the most negative opinions on the usefulness or usability of mobile ICT. When opinion variables were included in the model, frailty status remained a significant predictor of ICT use. Physical frailty status is associated with older peoples' ICT use independent of age, education, and opinions on ICT use. This should be taken into consideration when designing preventive and assistive technologies and interventions for older people at risk of health impairment. ©Niina Susanna Keränen, Maarit Kangas, Milla Immonen, Heidi Similä, Heidi Enwald, Raija Korpelainen, Timo Jämsä. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.02.2017.

  3. The validity of the 12-item Bem Sex Role Inventory in older Spanish population: an examination of the androgyny model.

    Science.gov (United States)

    Vafaei, Afshin; Alvarado, Beatriz; Tomás, Concepcion; Muro, Carmen; Martinez, Beatriz; Zunzunegui, Maria Victoria

    2014-01-01

    The Bem Sex Role Inventory (BSRI) is the most commonly used and validated gender role measurement tool across countries and age groups. However, it has been rarely validated in older adults and sporadically used in aging and health studies. Perceived gender role is a crucial part of a person's identity and an established determinant of health. Androgyny model suggests that those with high levels of both masculinity and femininity (androgynous) are more adaptive and hence have better health. Our objectives were to explore the validity of BSRI in an older Spanish population, to compare different standard methods of measuring gender roles, and to examine their impact on health indicators. The BSRI and health indicator questions were completed by 120 community-dwelling adults aged 65+ living in Aragon, Spain. Exploratory factor analysis was performed to examine psychometric properties of the BSRI. Androgyny was measured by three approaches: geometric mean, t-ratio, and traditional four-gender groups classification. Relationships between health indicators and gender roles were explored. Factor analysis resulted in two-factor solution consistent with the original masculine and feminine items with high loadings and good reliability. There were no associations between biological sex and gender roles. Different gender role measurement approaches classified participants differently into gender role groups. Overall, androgyny was associated with better mobility and physical and mental health. The traditional four groups approach showed higher compatibility with the androgyny model and was better able to disentangle the differential impact of gender roles on health. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Factors associated to serum 25-hydroxyvitamin D levels among older adult populations in urban and suburban communities in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Qun Cheng

    2017-10-01

    Full Text Available Abstract Background Vitamin D deficiency is widespread in China, particularly among older adults. Factors associated with suboptimal vitamin D levels are not well defined. The present study was a population-based study that included 10 urban and suburban communities in Shanghai, to evaluate vitamin D status and its correlates among older adults. Method This cross-sectional study was based on study data for 3924 healthy men and women aged 65−95 years. Anthropometric and socioeconomic data were collected in June−July 2014. Serum 25(OHD levels were detected using a chemiluminescence immunoassay. The following socioeconomic data were obtained through self-administered questionnaires: education level, lifestyle, residency, and dietary habits. A logistic regression model was used to assess associations between anthropometric factors, socioeconomic factors and serum 25(OHD levels. Results Median levels of serum 25(OHD in men and women were 22.73 and 19.99 ng/mL, respectively. Vitamin D deficiency was common in subjects, even though data collection was conducted during summer. The general prevalence of serum 25(OHD levels <20 ng/mL were 35.4% and 50.5% for men and women respectively. The general prevalence of serum 25(OHD levels <10 ng/mL were 2.73% and 5.9% for men and women respectively. A multivariable model indicated serum 25(OHD levels ≥20 ng/mL were significantly and positively correlated with male sex, calcium or vitamin D supplementation, and residency in suburban communities. The model also indicated that high level of physical activity was protective factors of vitamin D deficiency for men and milk consumption for women, respectively. By contrast, deficient serum 25(OHD levels were significantly correlated with education level (lower than primary school or obesity [body mass index (BMI ≥ 26.06 kg/m2] for men or women, respectively. Conclusion This cross-sectional study of older adults in communities in Shanghai demonstrates that

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

    Directory of Open Access Journals (Sweden)

    R Muppa

    2013-01-01

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

  6. Severity of cotton whitefly (bemisia tabaci genn.) population with special reference to abiotic factors

    International Nuclear Information System (INIS)

    Zia, K.; Bashir, M.H.; Khan, B.S.; Khan, R.R.; Hafeez, F.

    2013-01-01

    Bemisia tabaci is serious insect and constantly destabilizing the cotton production. The research was conducted to evaluate cotton cultivars (transgenic and non transgenic) for resistance against whitefly and further correlated with weather factors such as temperature, relative humidity and rainfall, during the cropping seasons 2010 and 2011. However, peak population (6.36 per leaf) was recorded from FH-113 followed FH-167 and FH-114, whereas minimum population was recorded from FH-4243 in transgenic group whereas peak population (5.24 per leaf) was recorded from FH- 941 followed by FH-100 and FH- 901 while minimum population was recorded from FH-207, in non transgenic group of cultivars in the year 2010. The incidence and abundance was much high and reaching towards two folds in the year 2011 but the trend of whitefly varied with peak population (11.03 per leaf) recorded from FH -167 followed by FH- 4243 and FH113 (from transgenic group of cultivars) whereas a peak of 10.77 per leaf population of whitefly, recorded followed by FH-901 and FH-941 (from non transgenic group of cultivars). FH-207 found more resistant from all ten cultivars studied in 2011. Correlation among weather factors and whitefly population showed that rainfall was negatively correlated while temperature and relative humidity were positively correlated with whitefly population. In addition to that situation is becoming worse because of shifting from conventional to more advanced transgenic cultivars that are susceptible and serve as host. Moreover, climatic conditions provide addition favor and helps in population buildup, abundance and incidence. (author)

  7. Attempted suicide in the elderly: characteristics of suicide attempters 70 years and older and a general population comparison group.

    Science.gov (United States)

    Wiktorsson, Stefan; Runeson, Bo; Skoog, Ingmar; Ostling, Svante; Waern, Margda

    2010-01-01

    To identify factors associated with attempted suicide in the elderly. Social, psychological, and psychiatric characteristics were compared in suicide attempters (70 years and older) and a representative population sample. Emergency departments at five hospitals in western Sweden and a representative sample of the elderly population. Persons with Mini Mental State Examination (MMSE) score age 80 years). Comparison subjects matched for gender and age group (N = 408) were randomly selected among participants in our general population studies. Symptoms were rated with identical instruments in cases and comparison subjects. The examination included the MMSE and tests of short- and long-term memory, abstract thinking, aphasia, apraxia, and agnosia. Depressive symptomatology was measured using the Montgomery-Asberg Depression Rating Scale, and major and minor depressions were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using symptom algorithms. Factors associated with attempted suicide included being unmarried, living alone, low education level, history of psychiatric treatment, and previous suicide attempt. There was no association with dementia. Odds ratios were increased for both major (odds ratio [OR]: 47.4, 95% confidence interval [CI]: 19.1-117.7) and minor (OR: 2.6, 95% CI: 1.5-4.7) depressions. An association was observed between perceived loneliness and attempted suicide; this relationship was independent of depression (OR: 2.8, 95% CI: 1.3-6.1). Observed associations mirrored those previously shown for completed suicide. Results may help to inform clinical decisions regarding suicide risk evaluation in this vulnerable and growing age group.

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

    Science.gov (United States)

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

    2017-10-01

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

  9. A population based eye survey of older adults in Tirunelveli district of south India: blindness, cataract surgery, and visual outcomes

    Science.gov (United States)

    Nirmalan, P K; Thulasiraj, R D; Maneksha, V; Rahmathullah, R; Ramakrishnan, R; Padmavathi, A; Munoz, S R; Ellwein, L B

    2002-01-01

    Aims: To assess the prevalence of vision impairment, blindness, and cataract surgery and to evaluate visual acuity outcomes after cataract surgery in a south Indian population. Methods: Cluster sampling was used to randomly select a cross sectional sample of people ≥50 years of age living in the Tirunelveli district of south India. Eligible subjects in 28 clusters were enumerated through a door to door household survey. Visual acuity measurements and ocular examinations were performed at a selected site within each of the clusters in early 2000. The principal cause of visual impairment was identified for eyes with presenting visual acuity India) was found in 11.0%, and in 4.6% with best correction. Presenting blindness was associated with older age, female sex, and illiteracy. Cataract was the principal cause of blindness in at least one eye in 70.6% of blind people. The prevalence of cataract surgery was 11.8%—with an estimated 56.5% of the cataract blind already operated on. Surgical coverage was inversely associated with illiteracy and with female sex in rural areas. Within the cataract operated sample, 31.7% had presenting visual acuity ≥6/18 in both eyes and 11.8% were <6/60; 40% were bilaterally operated on, with 63% pseudophakic. Presenting vision was <6/60 in 40.7% of aphakic eyes and in 5.1% of pseudophakic eyes; with best correction the percentages were 17.6% and 3.7%, respectively. Refractive error, including uncorrected aphakia, was the main cause of visual impairment in cataract operated eyes. Vision <6/18 was associated with cataract surgery in government, as opposed to that in non-governmental/private facilities. Age, sex, literacy, and area of residence were not predictors of visual outcomes. Conclusion: Treatable blindness, particularly that associated with cataract and refractive error, remains a significant problem among older adults in south Indian populations, especially in females, the illiterate, and those living in rural areas. Further

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

    Science.gov (United States)

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

    2004-01-01

    The U.S. Supreme Court recently re-examined the constitutionality of the death penalty in the context of two of three special offender populations of murderers (juveniles, mentally retarded, and mentally incompetent). The Court reaffirmed the imposition of the death penalty for juveniles 16 and 17, while reversing itself on the mentally retarded. In reaching its decision, the Court relied on society's "evolving standards of decency." Using Likert-type items, this study is the first to have prospective jurors assess support for the death penalty for these specific offender groups. The public's support for the execution of each of the groups is then compared with existing case law. Descriptive statistics and regression analyses indicate that, as expected, the levels of support for the applicability of capital punishment to the various special offender populations are much lower than that for the general adult offender. Moreover, these findings are congruent with the holdings of the Court with one notable exception: a slight majority of respondents supported executing the mentally incompetent. Reasons for the public's apparent departure from the Supreme Court holding prohibiting the execution of mentally incompetent convicted murderers are discussed. The Court's continued role in protecting marginalized populations from "cruel and unusual punishment" is explored in the context of strong public sentiment demanding justice and finality despite changes in offenders' mental capacity. Copyright 2003 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2016-03-01

    South-central Africa is characterized by an archipelago of wetlands, which has evolved in time and space since at least the Miocene, providing refugia for animal species during Pleistocene arid episodes. Their importance for biodiversity in the region is reflected in the evolution of a variety of specialist mammal and bird species, adapted to exploit these wetland habitats. Populations of lions (Panthera leo) across south-central and east Africa have contrasting signatures of mitochondrial DNA haplotypes and biparental nuclear DNA in wetland and savannah habitats, respectively, pointing to the evolution of distinct habitat preferences. This explains the absence of genetic admixture of populations from the Kalahari savannah of southwest Botswana and the Okavango wetland of northern Botswana, despite separation by only 500 km. We postulate that ancestral lions were wetland specialists and that the savannah lions evolved from populations that were isolated during arid Pleistocene episodes. Expansion of grasslands and the resultant increase in herbivore populations during mesic Pleistocene climatic episodes provided the stimulus for the rapid population expansion and diversification of the highly successful savannah lion specialists. Our model has important implications for lion conservation. © The American Genetic Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    KAUST Repository

    Fusi, Marco; Giomi, Folco; Babbini, Simone; Daffonchio, Daniele; Mcquaid, Christopher D.; Porri, Francesca; Cannicci, Stefano

    2014-01-01

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

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

    KAUST Repository

    Fusi, Marco

    2014-11-18

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

  14. The psychometric properties of the German version of the WHOQOL-OLD in the German population aged 60 and older.

    Science.gov (United States)

    Conrad, Ines; Matschinger, Herbert; Riedel-Heller, Steffi; von Gottberg, Carolin; Kilian, Reinhold

    2014-09-05

    The WHOQOL-OLD is an instrument for the assessment of subjective quality of life in elderly people. It is based on the WHO definition of quality of life and is available in more than 20 languages. However, in most countries, the psychometric properties of the WHOQOL-OLD have been assessed only on the basis of small local samples and not in representative studies. In this study, the psychometric properties of the WHOQOL-OLD are evaluated based on a representative sample of Germany's elderly population. Face-to-face interviews with 1133 respondents from the German population aged 60 years and older were conducted. Quality of life was assessed by means of the WHOQOL-BREF, the WHOQOL-OLD and the SF12. Moreover, the GDS, the DemTect and the IADL were applied for the assessment of depressive symptoms, cognitive capacities and capacity for carrying out daily activities. Psychometric properties of the WHOQOL-OLD were evaluated by means of classical and probabilistic test theory, confirmatory factor analysis and multivariate regression model. Cronbach's alpha was found to be above 0.85 for four and above .75 for two of the six facets of the WHOQOL-OLD. IRT analyses indicated that all items of the WHOQOL-OLD contribute considerably to the measurement of the associated facets. While the six-facet structure of the WHOQOL-OLD was well supported by the results of the confirmatory factor analysis, a common latent factor for the WHOQOL-OLD total scale could not be identified. Correlations with other quality of life measures and multivariate regression models with GDS, IADL and the DemTect indicate a good criterion validity of all six WHOQOL-OLD facets. Study results confirm that the good psychometric properties of the WHOQOL-OLD that have been found in international studies could be replicated in a representative study of the German population. These results suggest that the WHOQOL-OLD is an instrument that is well suited to identify the needs and the wishes of an aging population.

  15. Relationships of inflammatory and haemostatic markers with social class: results from a population-based study of older men.

    Science.gov (United States)

    Ramsay, Sheena; Lowe, Gordon D O; Whincup, Peter H; Rumley, Ann; Morris, Richard W; Wannamethee, S Goya

    2008-04-01

    Haemostatic and inflammatory markers have been hypothesised to mediate the relationship of social class and cardiovascular disease (CVD). We investigated whether a range of inflammatory/haemostatic markers are associated with social class independent of chronic diseases and behavioural risk factors in a population-based sample of 2682 British men aged 60-79 without a physician diagnosis of CVD, diabetes or musculoskeletal disease requiring anti-inflammatory medications. Men in lower social classes had higher mean levels of C-reactive protein, fibrinogen, interleukin-6, white blood cell count, von Willebrand factor (vWF), factor VIII, activated protein C (APC) resistance, plasma viscosity, fibrin D-dimer and platelet count, compared to higher social class groups; but not of tissue plasminogen activator antigen, haematocrit or activated partial prothrombin time. After adjustment for behavioural risk factors (smoking, alcohol, physical activity and body mass), the associations of social class with vWF, factor VIII, APC resistance, plasma viscosity, and platelet count though weakened, remained statistically significant, while those of other markers were considerably attenuated. In this study of older men without CVD, the social gradient in inflammatory and haemostatic markers was substantially explained by behavioural risk factors. The effect of socio-economic gradient on the factor VIII-vWF complex, APC resistance, plasma viscosity and platelet count merits further study.

  16. A population-based longitudinal study of Clostridium difficile infection-related hospitalization in mid-age and older Australians.

    Science.gov (United States)

    Chen, Y; Glass, K; Liu, B; Riley, T V; Korda, R; Kirk, M D

    2017-02-01

    Clostridium difficile is the principal cause of infectious diarrhoea in hospitalized patients. We investigated the incidence and risk factors for hospitalization due to C. difficile infection (CDI) in older Australians. We linked data from a population-based prospective cohort study (the 45 and Up Study) of 266 922 adults aged ⩾45 years recruited in New South Wales, Australia to hospitalization and death records for 2006-2012. We estimated the incidence of CDI hospitalization and calculated days in hospital and costs per hospitalization. We also estimated hazard ratios (HR) for CDI hospitalization using Cox regression with age as the underlying time variable. Over a total follow-up of 1 126 708 person-years, 187 adults had an incident CDI hospitalization. The crude incidence of CDI hospitalization was 16·6/100 000 person-years, with a median hospital stay of 6 days, and a median cost of AUD 6102 per admission. Incidence increased with age and year of follow-up, with a threefold increase for 2009-2012. After adjustment, CDI hospitalization rates were significantly lower in males than females (adjusted HR 0·6, 95% confidence interval 0·4-0·7). CDI hospitalization rates increased significantly over 2009-2012. There is a need to better understand the increasing risk of CDI hospitalization in women.

  17. [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.

  18. Disparity in dental attendance among older adult populations: a comparative analysis across selected European countries and the USA.

    Science.gov (United States)

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

    2016-02-01

    The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the USA and selected European countries. The analyses relied on 2006/2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents≥51 years of age. Logistic regression models were estimated to identify impacts of dental-care coverage, and of oral and general health status, on dental-care use. 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 according to social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified according to welfare state regime or according to the presence or absence of social health insurance. The findings of this study suggest that income and education have a stronger, and more persistent, correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that: (i) higher overall rates of coverage in most European countries, compared with relatively lower rates in the USA, contribute to this finding; and that (ii) 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. © 2015 FDI World Dental Federation.

  19. 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.

  20. Leisure Today: Leisure and Special Populations--Satisfaction, Enrichment, and Hope.

    Science.gov (United States)

    Raymond, Lisa Pesavento; And Others

    1992-01-01

    A series of nine articles discusses how to meet the leisure needs of diverse populations, focusing on pluralism and gang prevention, children and AIDS, socialization for the homeless, homosexual youth, the unemployed, recovering alcoholics, adult survivors of childhood sexual abuse, and Vietnam veterans with posttraumatic stress disorder. (SM)

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

    Science.gov (United States)

    Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy

    2016-03-01

    Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy. © 2015 John Wiley & Sons Ltd.

  2. Population growth and rural-urban migration, with special reference to Ghana.

    Science.gov (United States)

    De Graft-johnson, K T

    1974-01-01

    While the population of Ghana is expected to double in 25 years at the current rate of increase (approximately 2.5% per annum), the population of urban centers is increasing even faster. The 1970 census shows the urban population growing by 4.8% per annum. This is mainly the result of rural to urban migration and, to a smaller extent, the increase in the number of urban centers from 39 in 1948 to 98 in 1960 to 135 in 1970. In the 1970 census only 57.1% of the population were enumerated in their locality of birth and only 20.9% in a locality other than their place of birth but in the same region. 4.1% were born outside Ghana, mostly in another West African country. 1 striking difference between urban and rural areas is the differing sex ratio of the working population. In rural areas there are 91.0 males aged 15-64 years for every 100 females while in urban areas there are 107.1. Most migration in Africa is for employment and those most likely to migrate are working-age males. Because secondary schools are scarce in rural areas, urban dwellers generally have a higher education level. There are no significant differences between overall labor force participation rates for females. The nationwide participation rate was 38.9% for both males and females (males 43.8%, females 34.1%); in urban areas the total was 40.0% (males 46.3%, females 33.7%) and in rural areas 38.5% (males 42.7%, females 34.3%). Ghanaian women have traditionally occupied a prominent place in the labor force. The theory that urban migration is due to urban-rural income disparities is not confirmed by figures. Considering the high amount of unemployment in urban areas, a rural dweller can average as much as a city dweller. In fact, poorly educated migrants are the ones most affected by urban unemployment. A recent study by Kodwo Ewusi considered the impact of many variables on migration; he found depressed social conditions at the place of origin are more compelling motivations than economic factors

  3. Association between socioeconomic and health factors and edentulism in people aged 65 and older - a population-based survey.

    Science.gov (United States)

    Olofsson, Hanna; Ulander, Eva Lena; Gustafson, Yngve; Hörnsten, Carl

    2017-08-01

    To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland. In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study ( n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism. The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden ( p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas ( p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds ( p < 0.001), and was 23.8% in women, compared with 27% in men ( p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31-3.58), low income level (OR 1.7, CI 1.09-1.47), residence in a rural area (OR 1.43, CI 1.23-1.66), male sex (OR 1.30, CI 1.12-1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25-1.74), social isolation (OR 1.52, CI 1.17-1.98) and poor self-experienced health (OR 1.38, CI 1.17-1.62). One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.

  4. Childhood deprivation and later-life cognitive function in a population-based study of older rural South Africans.

    Science.gov (United States)

    Kobayashi, Lindsay C; Glymour, M Maria; Kahn, Kathleen; Payne, Collin F; Wagner, Ryan G; Montana, Livia; Mateen, Farrah J; Tollman, Stephen M; Berkman, Lisa F

    2017-10-01

    Little research has evaluated the life course drivers of cognitive aging in South Africa. We investigated the relationships of self-rated childhood health and father's occupation during childhood with later-life cognitive function score and whether educational attainment mediated these relationships among older South Africans living in a former region of Apartheid-era racial segregation. Data were from baseline assessments of "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community" (HAALSI), a population-based study of 5059 men and women aged ≥40 years in 2015 in rural Agincourt sub-district, South Africa. Childhood health, father's occupation during childhood, and years of education were self-reported in study interviews. Cognitive measures assessed time orientation, numeracy, and word recall, which were included in a z-standardized latent cognitive function score variable. Linear regression models adjusted for age, sex, and country of birth were used to estimate the total and direct effects of each childhood risk factor, and the indirect effects mediated by years of education. Poor childhood health predicted lower cognitive scores (total effect = -0.28; 95% CI = -0.35, -0.21, versus good); this effect was not mediated by educational attainment. Having a father in a professional job during childhood, while rare (3% of sample), predicted better cognitive scores (total effect = 0.25; 95% CI = 0.10, 0.40, versus unskilled manual labor, 29% of sample). Half of this effect was mediated by educational attainment. Education was linearly associated with later-life cognitive function score (0.09; 95% CI = 0.09, 0.10 per year achieved). In this post-Apartheid, rural South African context, older adults with poor self-reported childhood health or whose father worked in unskilled manual labor had relatively poor cognitive outcomes. Educational attainment strongly predicted cognitive outcomes, and appeared to be, in part, a mechanism of social

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

    Science.gov (United States)

    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.

  6. Population information on major technological risks and specially on nuclear risk

    International Nuclear Information System (INIS)

    De Choudens, H.

    1992-01-01

    Following Chernobyl accident which has revealed in France a strong need for information on technological risks among population and a lack in its organization, the Mayor of Grenoble City who was also at this time, Environment Minister in French Government had initiated in lsere Region an important operation of consideration of action, which has to been undertaken to correct theses lacks. Among ten actions retained one of them was the creation of an Association for Information of the public for Prevention of major risks. This Association has first initiated a consultation on the perception by the population of the different major risks (Industrial and Naturals) in view of the results of this consultation, Medical Professions were the first concerned and a publication 'Medicine and Nuclear risk' has been elaborated and distributed to all doctors of the Region. A Memento on Nuclear risk as then been written and largely distributed in the region, especially in the medias. A booklet on nuclear risk and behavior in case of nuclear accident has then been realized and distributed to all people around Electronuclear Reactors of the Region and to children in the schools. In complement, public meetings have been organized in these sectors to inform, and discuss with the population. (author)

  7. 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

  8. 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

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

    Science.gov (United States)

    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.

  10. Liver safety assessment in special populations (hepatitis B, C, and oncology trials).

    Science.gov (United States)

    Kullak-Ublick, Gerd A; Merz, Michael; Griffel, Louis; Kaplowitz, Neil; Watkins, Paul B

    2014-11-01

    The FDA guidance for industry in the premarketing clinical evaluation of drug-induced liver injury (DILI) is the most specific regulatory guidance currently available and has been useful in setting standards for the great majority of clinical indications involving subjects with a low risk of liver disorders. However, liver safety assessment faces challenges in populations with underlying liver disease, such as viral hepatitis or metastatic cancer. This is an important issue because there are currently many promising anti-viral and oncologic therapies in clinical development, with a trend toward oral therapies with reduced side effects. Without clearer guidelines, questions regarding liver safety may become a major factor in regulatory approval and ultimately physician uptake of the new treatments. The lack of consensus in defining stopping rules based on serum alanine aminotransferase (ALT) levels underscores the need for precompetitive data sharing to improve our understanding of DILI in these populations and to allow evidence-based rather than empirical definition of stopping rules. A workshop was convened to discuss best practices for the assessment of drug-induced liver injury (DILI) in clinical trials.

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

    Directory of Open Access Journals (Sweden)

    Andreia Machado Miranda

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

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

    Science.gov (United States)

    Cheng, Alice Y Y

    2014-04-01

    Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  13. Bioscience-bioethics and life factors affecting reproduction with special reference to the Indigenous Australian population.

    Science.gov (United States)

    Pollard, Irina

    2005-04-01

    The demand for equality of recognition or respect is the dominant passion of modernity. The 20th century experienced a giant leap in technological inventiveness and ruthless use of technological power. In the 21st century, human welfare and environmental wellbeing demand fundamental political appraisal. We have the means, if we choose, to eradicate poverty and to responsibly protect the global environment. However, economic, political and cultural systems act to differentially allocate the benefits and risks for growth between socioeconomic groups. For example, it is a matter of pride that the neonatal mortality rate in affluent societies has dropped substantially since the late 1970s. However, the level of infant mortality (three times the national average) and low birthweight (13%) among the Indigenous Australian population is the highest in the country. With hindsight we now know that is the inevitable legacy of Australia's colonial history. Chronic physical and psychological stress is recognized as an important etiological factor in many lifestyle diseases of the cardiovascular, immune and reproductive systems. Diseases of adaptation are further advanced by non-adaptive lifestyle choices, depression, alcoholism and other drug dependencies. This review describes the principles of bioscience ethics and targets equity issues as they affect human reproduction across generations with particular reference to the Indigenous population of Australia. The review also considers ways we may advance global and cultural maturity from the Indigenous Australian perspective and proposes an ecologically based model of preventative care. If we are to embrace fundamental social change and protect future children without threatening parents' basic freedoms, then new beliefs and priorities--based on a compassionate understanding of biological systems--must evolve from the general public. Belief in human rights arising from a sense of human dignity is a collective outcome originating

  14. Advances in Psychotherapy for Depressed Older Adults.

    Science.gov (United States)

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

    2017-09-01

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

  15. Pharmacokinetics and pharmacodynamics of insulin analogs in special populations with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Morello CM

    2011-12-01

    special patient groups.Keywords: insulin analogs, type 2 diabetes mellitus, pharmacodynamics, pharmacokinetics

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  17. The Effect of Being Aerobically Active vs. Inactive on Cutaneous Vascular Conductance during Local Heat Stress in an Older Population

    Directory of Open Access Journals (Sweden)

    Ulrike H. Mitchell

    2017-10-01

    Full Text Available Objective: To test the hypothesis that long- term aerobically trained elderly individuals have a greater amount of bioavailable nitric oxide (NO and have a larger cutaneous vasodilation during local heat stress compared to their inactive elderly counterparts.Methods: Eight aerobically trained and 8 inactive older men (>60 years old participated in this study. NO bioavailability in blood and intradermal dialysate were measured with an ozone based chemiluminescence NO analyzer. Cutaneous vasodilator response to local heating was obtained using laser Doppler velocimetry.Results: Whole blood NO were similar in older- trained and inactive subjects (0.75 ± 0.56 and 0.38 ± 0.32 μM, respectively; Mann–Whitney, p = 0.153, as was intradermal dialysate NO before (7.82 ± 6.32 and 4.18 ± 1.89 μM, respectively and after local heating (7.16 ± 6.27 and 5.88 ± 3.97 μM, respectively, p = 0.354. The cutaneous vasodilator response of the older- inactive group was smaller than the older- trained group [Group-Time interaction, F(24, 264 = 12.0, p < 0.0001]. When compared to a young group the peak vasodilator response of the older- trained subjects was similar. However, the time to initial dilation was 3.1 and 2.2 times longer (p < 0.05 in older- inactive and older- trained subjects, respectively, compared to young subjects.Conclusions: Our data support the hypothesis that the age-related reductions in cutaneous vasodilation can possibly be restored by maintaining an aerobic training regimen (at least 3 years. However, some residual effects of aging remain, specifically a delayed cutaneous vasodilator response to local heating is still present in active older adults. We found no evidence for an increase in systemic or local NO-bioavailability with an extended commitment to aerobic fitness.

  18. The Effect of Being Aerobically Active vs. Inactive on Cutaneous Vascular Conductance during Local Heat Stress in an Older Population.

    Science.gov (United States)

    Mitchell, Ulrike H; Burton, Samantha; Gordon, Christopher; Mack, Gary W

    2017-01-01

    Objective: To test the hypothesis that long- term aerobically trained elderly individuals have a greater amount of bioavailable nitric oxide (NO) and have a larger cutaneous vasodilation during local heat stress compared to their inactive elderly counterparts. Methods: Eight aerobically trained and 8 inactive older men (>60 years old) participated in this study. NO bioavailability in blood and intradermal dialysate were measured with an ozone based chemiluminescence NO analyzer. Cutaneous vasodilator response to local heating was obtained using laser Doppler velocimetry. Results: Whole blood NO were similar in older- trained and inactive subjects (0.75 ± 0.56 and 0.38 ± 0.32 μM, respectively; Mann-Whitney, p = 0.153), as was intradermal dialysate NO before (7.82 ± 6.32 and 4.18 ± 1.89 μM, respectively) and after local heating (7.16 ± 6.27 and 5.88 ± 3.97 μM, respectively, p = 0.354). The cutaneous vasodilator response of the older- inactive group was smaller than the older- trained group [Group-Time interaction, F (24, 264) = 12.0, p < 0.0001]. When compared to a young group the peak vasodilator response of the older- trained subjects was similar. However, the time to initial dilation was 3.1 and 2.2 times longer ( p < 0.05) in older- inactive and older- trained subjects, respectively, compared to young subjects. Conclusions: Our data support the hypothesis that the age-related reductions in cutaneous vasodilation can possibly be restored by maintaining an aerobic training regimen (at least 3 years). However, some residual effects of aging remain, specifically a delayed cutaneous vasodilator response to local heating is still present in active older adults. We found no evidence for an increase in systemic or local NO-bioavailability with an extended commitment to aerobic fitness.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Science.gov (United States)

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

    2013-06-01

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

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

    KAUST Repository

    Thompson, Luke R

    2013-05-11

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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2017-08-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  6. 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.

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

    Science.gov (United States)

    Quade, Mandy; Kirch, Wilhelm

    2014-01-01

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

  8. Mobile applications for diabetics: a systematic review and expert-based usability evaluation considering the special requirements of diabetes patients age 50 years or older.

    Science.gov (United States)

    Arnhold, Madlen; Quade, Mandy; Kirch, Wilhelm

    2014-04-09

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

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

    Science.gov (United States)

    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.

  10. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  13. The relationship between social functioning and subjective memory complaints in older persons : a population-based longitudinal cohort study

    NARCIS (Netherlands)

    Kuiper, Jisca S; Oude Voshaar, Richard C; Zuidema, Sytse U; Stolk, Ronald P; Zuidersma, Marij; Smidt, Nynke

    2017-01-01

    OBJECTIVE: Poor social functioning is associated with cognitive decline in older adults. It is unclear whether social functioning is also associated with subjective memory complaints (SMC). We investigated the association between social functioning and incident SMC and SMC recovery. METHODS: A

  14. Exploring the aggregation of four functional measures in a population of older adults with joint pain and comorbidity

    NARCIS (Netherlands)

    Hermsen, L.A.H.; Leone, S.S.; Smalbrugge, M.; Knol, D.L.; van der Horst, H.E.; Dekker, J.

    2013-01-01

    Background: In clinical settings, it is important for health care providers to measure different aspects of functioning in older adults with joint pain and comorbidity. Besides the use of distinct measures, it could also be attractive to have one general measure of functioning that incorporates

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

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2011-11-01

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

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

    Science.gov (United States)

    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.

  17. The role of natural radioresistance and ecological specialization of a specie in radio adaptation (as exemplified by natural rodent populations)

    Energy Technology Data Exchange (ETDEWEB)

    Grigorkina, E.; Olenev, G. [Institute of Plant and Animal Ecology, Ural Branch RAS, Ekaterinburg, (Russian Federation)

    2004-07-01

    The problem of mammal radio-adaptation is closely connected with problems of micro-evolution and prediction of the fate of irradiated populations. This report gives new materials on radio-adaptation of small mammals inhabiting the East Ural Radioactive Trace (EURT) which has been formed after the Kyshtym accident in 1957 year. The EURT zone is a unique area for studying long-term consequences of chronic low-dose irradiation of small mammal populations many generations being born after the accident. The role of natural radioresistance, ecological specialization and biological characteristics of a specie in the development of radio-adaptation are discussed. The objects of investigation were rodents: 1) Ellobius talpinus is a peculiar specialized specie with low ability to migrate, burrowing underground way of life and lifespan up to 6 years; 2) Sylvaemus uralensis, Apodemus agrarius, Clethrionomys rutilus widespread aboveground species, very active migrators with a 1.5 year lifespan. Significant differences were found among species in natural radioresistance to acute gamma-irradiation. LD{sub 50/30} is 5.0{+-}0.7 Gy for the Ellobius talpinus, 7.0{+-}0.4 Gy for the Sylvaemus uralensis, 10.0{+-}0.2 Gy for the Apodemus agrarius, 12.8{+-}0.2 Gy for the Clethrionomys rutilus. Despite the high radiosensitivity the Ellobius talpinus was more tolerant to chronic irradiation (over 45 years inhabiting the EURT, soil pollution by {sup 90}Sr was 950-1050 Ci/km{sup 2} - 35-39 MBq/m{sup 2}) in a complex of morpho-physiological, haematological and immunological parameters, than other species with active migration activity (the initial pollution of soil by {sup 90}Sr was 400-540 Ci/km{sup 2} - 15-20 MBq/m{sup 2}). This phenomenon is explained by radio-adaptation which developed in the Ellobius talpinus due to isolation of their settlement in the periphery of the area in conditions of radio-contamination. Various radioresistance to acute and chronic irradiation, disproportion of

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

    LENUS (Irish Health Repository)

    Hickey, Anne

    2009-01-01

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

  19. The longitudinal relationship between mental health disorders and chronic disease for older adults: a population-based study.

    Science.gov (United States)

    Chen, Chun-Min; Lee, I-Chen; Su, Yung-Yu; Mullan, Judy; Chiu, Herng-Chia

    2017-09-01

    Although mental health disorders in older adults are common, their relationship with chronic disease and the influence of chronic disease on the development of mental health disorders over time is not well understood. This longitudinal study investigated the change in status of mental health disorders and chronic disease, as well as their interrelationships, over time. Participants included community-dwelling older adults living in Taiwan, aged 65 years or older, who completed six waves of survey interviews. Mental health disorders were scored using the Short Psychiatric Evaluation Schedule, and chronic disease(s) status was recorded during consecutive biennial data collection waves. The autoregressive latent trajectory model and parallel latent growth curve model were used for data analysis. The study findings suggest that in older people pre-existing mental health disorders and/or chronic disease(s) will predispose them to developing significantly more mental health disorders and/or chronic diseases respectively. The study findings also suggest that pre-existing mental health disorders can significantly contribute to the development of chronic disease over time, and that pre-existing chronic disease(s) significantly can contribute to the development of mental health disorders over time, indicating a reciprocal interrelationship. Our study findings suggest that it in addition to monitoring and treating chronic disease(s) in older people, it is also important to monitor and treat their mental health disorders. Doing so will result in overall better health outcomes and will facilitate a better quality of life as they age. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study.

    Science.gov (United States)

    Stringhini, Silvia; Carmeli, Cristian; Jokela, Markus; Avendaño, Mauricio; McCrory, Cathal; d'Errico, Angelo; Bochud, Murielle; Barros, Henrique; Costa, Giuseppe; Chadeau-Hyam, Marc; Delpierre, Cyrille; Gandini, Martina; Fraga, Silvia; Goldberg, Marcel; Giles, Graham G; Lassale, Camille; Kenny, Rose Anne; Kelly-Irving, Michelle; Paccaud, Fred; Layte, Richard; Muennig, Peter; Marmot, Michael G; Ribeiro, Ana Isabel; Severi, Gianluca; Steptoe, Andrew; Shipley, Martin J; Zins, Marie; Mackenbach, Johan P; Vineis, Paolo; Kivimäki, Mika

    2018-03-23

    To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Multi-cohort population based study. 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. 109 107 men and women aged 45-90 years. Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning

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

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    Irwin eLevin

    2015-04-01

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

  2. Effects of a community health promotion program on social factors in a vulnerable older adult population residing in social housing.

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    Agarwal, Gina; Brydges, Madison

    2018-04-16

    Supporting older adults' health and wellbeing in the community is an important policy goal that can be supported by health promotion. Despite widespread acceptance of the biopsychosocial model of health and its relation to health, many health promotion programs fail to realize this model in program design. Further, there is limited evidence to support program design targeting social determinants of health such as social isolation or connectedness. To fill this gap, we aimed to understand older adult's experiences participating in cardiovascular health promotion program in a subsidized residential building to capture unintended 'spin-off' psychosocial effects. This study took a constructivist, ethnographic approach utilizing participant observation and semi-structured interviews with participants of the program to understand participant's lived experiences of a health promotion program. In total, we conducted eighty hours of field work and fifteen semi-structured interviews with participants of the program. Thematic analysis was used to analyze the data. Four themes emerged. First, the health promotion program filled a perceived gap caused by a constrained and impersonal health care system. Secondly, the program connected older adults with resources and provided regular and secure access to health information and support. Third, for some residents, the program facilitated social relationships between older adults, leaving participants feeling more socially connected to other residents. Lastly, a paradox of loneliness emerged where older adults talked openly about feelings of loneliness, however not in relation to themselves, but rather regarding their peers. Psychosocial aspects of health, such as loneliness, social connectedness, and social support may be of equal value as the physical health benefits to the older adults who participate in health promotion programs. Incorporating these elements into programming is a complex goal, and the complexity of targeting

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

    Science.gov (United States)

    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.

  4. 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.

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

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    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.

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

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    Ann M. Albertson

    2012-01-01

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

  7. 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

  8. 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

    2016-12-14

    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.

  9. Nutritional status and falls in community-dwelling older people: a longitudinal study of a population-based random sample.

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    Ming-Hung Chien

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

  10. 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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    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

  13. 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

  14. Adjustment to Aging, Subjective Age and Age Representation: Assessing a Nationally-Diverse Population of Older Adults

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    Sofia von Humboldt

    2012-11-01

    Full Text Available Aim: This research sought to analyse older adults’ conceptualization of adjustment to aging (AtA, subjective age (SA and age representation (AR, adding a cross-national comparative perspective to aging well. Method: Questionnaires were completed, assessing participants’ background information. Semi-structured interviews were performed, addressing three core areas: SA, AtA and AR. Complete information on 231 older adults aged between 74-102 years (M = 83.1; SD = 6.692 from four different nationalities, was available. Data was subjected to content analysis. Results: Seven categories were identified to contribute to AtA: ‘accomplishment, personal fulfilment and future projects’, ‘occupation, profession, autonomy and leisure’, ‘health status, physical and intellectual functioning’, ‘valorisation of time and age’, ‘family, social and interpersonal attachment’, ‘stability, quality and financial situation’, and ‘sense of limit and existential issues’. Five categories were identified for SA: ‘with congruence’, ‘without concern’, ‘with apprehension’, ‘young-at-heart’ and ‘good enough’. For AR, eight emergent categories were found: ‘future investment’, ‘reconciliation with life’, ‘present challenge’, ‘regret about the past’, ‘dynamic life’, ‘with contentment’, ‘as an opportunity’ and ‘with dissatisfaction’. Conclusion: This research contributes for a better understanding of what defines AtA, SA and AR in older adults. Moreover, interventions and communication approaches in clinical practice and program development in health care context should focus on shared perceptions of aging well.

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

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    Aquiles Salas

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

  16. 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.

  17. 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

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

    Science.gov (United States)

    Coetsee, Carla; Terblanche, Elmarie

    2017-01-01

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

  19. Social participation, willingness and quality of life: A population-based study among older adults in rural areas of China.

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    He, Qian; Cui, Yanjie; Liang, Ling; Zhong, Qi; Li, Jie; Li, Yuancheng; Lv, Xiaofeng; Huang, Fen

    2017-10-01

    The present study aimed to reflect the current situation of social participation in rural areas of China, willingness to participate in social activities, association between health-related quality of life and social participation, and factors related to social participation. A total of 2644 rural adults aged 60 years and older were randomly selected and surveyed with a self-rating questionnaire. We used the unified definition of social participation in our study. The Medical Outcomes Study Short-Form Health Survey was used to measure health-related quality of life. The overall engagement of social activities was 26%. Those who participated in social activities were more likely to have high scores of health-related quality of life. Older men with a high educational level (OR 1.59, 95% CI 1.01-2.29) living alone or with a spouse (OR 1.51, 95% CI 1.08-2.12), high objective social support (OR 1.08, 95% CI 1.00-1.17) and high support utilization (OR 1.13, 95% CI 1.07-1.21) were inclined to engage in social participation. Older women with high individual income (OR 1.74, 95% CI 1.25-2.43), single marital status (OR 1.53, 95% CI 1.11-2.10), normal weight (OR 1.92, 95% CI 1.10-3.34), overweight (OR 2.28, 95% CI 1.24-4.19), living alone or with a spouse (OR 1.55, 95% CI 1.20-2.00), objective social support (OR 1.11, 95% CI 1.04-1.18) and subjective social support (OR 1.15, 95% CI 1.10-1.20) were more willing to engage in social participation. Engagement in social activities is relatively low in rural areas, and associations of willingness and health-related quality of life with social participation were found. Policy-makers and government workers should make appropriate types of encouragement policies around social participation for older adults in rural areas. Geriatr Gerontol Int 2017; 17: 1593-1602. © 2016 Japan Geriatrics Society.

  20. Overview of persistent pain in older adults.

    Science.gov (United States)

    Molton, Ivan R; Terrill, Alexandra L

    2014-01-01

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

  1. Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population.

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    Lacherez, Philippe; Wood, Joanne M; Anstey, Kaarin J; Lord, Stephen R

    2014-02-01

    To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.

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

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    Benjawan Apinonkul

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

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

    Science.gov (United States)

    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

  4. The cut-off values of anthropometric variables for predicting mild cognitive impairment in Malaysian older adults: a large population based cross-sectional study

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    Won H

    2017-02-01

    Full Text Available Huiloo Won,1 Zahara Abdul Manaf,2 Arimi Fitri Mat Ludin,3 Mohd Azahadi Omar,4 Rosdinom Razali,5 Suzana Shahar2 1Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 2Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 3Biomedical Science Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 4Centre for Burden of Disease Research, Institute for Public Health, Ministry of Health Malaysia, 5Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia Purpose: Older adults are at risk of mild cognitive impairment (MCI, and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI and waist circumference (WC for predicting the risk of MCI in older Malaysian adults.Methods: A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis.Results: A BMI cut-off value of 26 kg/m2 (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8% was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8% for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7% for women. The optimum calf circumference (CC cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity

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

    Science.gov (United States)

    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

  6. Factors associated with improved survival among older colorectal cancer patients in the US: a population-based analysis

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    Earle Craig C

    2009-07-01

    Full Text Available Abstract Background The purpose of this study was to estimate the relative impact of changes in demographics, stage at detection, treatment mix, and medical technology on 5-year survival among older colorectal cancer (CRC patients. Methods We selected older patients diagnosed with CRC between 1992 and 2000 from the SEER-Medicare database and followed them through 2005. Trends in demographic characteristics, stage at detection and initial treatment mix were evaluated descriptively. Separate multivariate logistic regression models for colon (CC and rectal cancer (RC patients were estimated to isolate the independent effects of these factors along with technological change (proxied by cohort year on 5-year survival. Results Our sample included 37,808 CC and 13,619 RC patients (combined mean ± SD age: 77.2 ± 7.0 years; 55% female; 87% white. In recent years, more CC patients were diagnosed at Stage I and fewer at Stages II and IV, and more RC patients were diagnosed at Stage I and fewer at Stages II and III. CC and RC patients diagnosed in later years were slightly older with somewhat better Charlson scores and were more likely to be female, from the Northeast, and from areas with higher average education levels. Surgery alone was more common in later years for CC patients while combined surgery, chemotherapy, and radiotherapy was more common for RC patients. Between 1992 and 2000, 5-year observed survival improved from 43.0% to 46.3% for CC patients and from 39.4% to 42.2% for RC patients. Multivariate logistic regressions indicate that patients diagnosed in 2000 had significantly greater odds of 5-year survival than those diagnosed in 1992 (OR: 1.35 for CC, 1.38 for RC. Our decomposition suggests that early detection had little impact on survival; rather, technological improvements (e.g., new medical technologies or more effective use of existing technologies and changing demographics were responsible for the largest share of the change in 5

  7. Missing Teeth and Prosthodontic Replacement in an Institutionalized Dentate Population of 60 Years and Older in Qingdao, China

    NARCIS (Netherlands)

    Zhang, Q.; Li, T.T.; Gerritsen, A.E.; Witter, D.J.; Bronkhorst, E.M.; Creugers, N.H.J.

    2016-01-01

    PURPOSE: The aim of this study was to investigate missing teeth and prosthodontic replacements in an institutionalized elderly population in China, and to assess dental functionality before and after the prosthodontic replacements based on a hierarchical dental functional classification (HDFC)

  8. Online Health-Information Seeking Among Older Populations: Family Influences and the Role of the Medical Professional.

    Science.gov (United States)

    Magsamen-Conrad, Kate; Dillon, Jeanette M; Billotte Verhoff, China; Faulkner, Sandra L

    2018-02-23

    There are myriad technological devices, computer programs, and online information sources available for people to manage their health and the health of others. However, people must be technologically and health literate and capable of accessing, analyzing, and sharing the information they encounter. The authors interviewed middle-aged and older adults about their online health information seeking behavior and discovered that technology and health literacy are influenced by a collective ability to manage the health and technological needs of a family. We used information management theory to frame participants' experiences of their self-efficacy using technology to manage the health of loved ones. Findings suggest that health can be co-managed if at least one person in a family unit is technologically "savvy" and able to effectively share health information. However, individuals' confidence in their own literacy often depends on others, usually family members who tend to "do" instead of "teach."

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

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    Fei-Yuan Hsiao

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

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

    Science.gov (United States)

    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.

  11. 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

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

    Science.gov (United States)

    Steiber, Nadia

    2015-01-01

    This paper uses individual-level data from the German Socio-Economic Panel to model trends in population health in terms of cognition, physical fitness, and mental health between 2006 and 2012. The focus is on the population aged 50–90. We use a repeated population-based cross-sectional design. As outcome measures, we use SF-12 measures of physical and mental health and the Symbol-Digit Test (SDT) that captures cognitive processing speed. In line with previous research we find a highly significant Flynn effect on cognition; i.e., SDT scores are higher among those who were tested more recently (at the same age). This result holds for men and women, all age groups, and across all levels of education. While we observe a secular improvement in terms of cognitive functioning, at the same time, average physical and mental health has declined. The decline in average physical health is shown to be stronger for men than for women and found to be strongest for low-educated, young-old men aged 50–64: the decline over the 6-year interval in average physical health is estimated to amount to about 0.37 SD, whereas average fluid cognition improved by about 0.29 SD. This pattern of results at the population-level (trends in average population health) stands in interesting contrast to the positive association of physical health and cognitive functioning at the individual-level. The findings underscore the multi-dimensionality of health and the aging process. PMID:26323093

  13. A population based study of variations in operation rates for breast cancer, of comorbidity and prognosis at diagnosis: failure to operate for early breast cancer in older women.

    Science.gov (United States)

    Bates, T; Evans, T; Lagord, C; Monypenny, I; Kearins, O; Lawrence, G

    2014-10-01

    Older women are less likely to have surgery for operable breast cancer. This population-based study examines operation rates by age and identifies groups which present with early or late disease. 37 000 cancer registrations for 2007 were combined with Hospital Episode Statistics comorbidity data for England. Operation rates were examined by age, ethnicity, deprivation, comorbidity, screen-detection, tumour size, grade and nodal status. Early and late presentation were correlated with Nottingham Prognostic Index (NPI) groups and tumour size. The proportion of women not having surgery increased from 7-10% at ages 35-69 to 82% from age 90. From age 70, the proportion not having surgery rose by an average of 3.1% per year of age. Women with a Charlson Comorbidity Index score of ≥1 (which increased with age), with tumours >50 mm or who were node positive, were less likely to have surgery. Although women aged 70-79 were more likely to have larger tumours, their tumours were also more likely to have an excellent or good NPI (p ethnic groups (p ethnic groups presented with more advanced tumours. Older women had larger tumours which were otherwise of good prognosis, and this would not account for the failure to operate which may in part be related to comorbidity in this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

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    Määttä Mikko

    2012-09-01

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

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

    Science.gov (United States)

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

    2015-07-30

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

  16. Influence of Poor Oral Health on Physical Frailty: A Population-Based Cohort Study of Older British Men.

    Science.gov (United States)

    Ramsay, Sheena E; Papachristou, Efstathios; Watt, Richard G; Tsakos, Georgios; Lennon, Lucy T; Papacosta, A Olia; Moynihan, Paula; Sayer, Avan A; Whincup, Peter H; Wannamethee, S Goya

    2018-03-01

    To investigate the associations between objective and subjective measures of oral health and incident physical frailty. Cross-sectional and longitudinal study with 3 years of follow-up using data from the British Regional Heart Study. General practices in 24 British towns. Community-dwelling men aged 71 to 92 (N = 1,622). Objective assessments of oral health included tooth count and periodontal disease. Self-reported oral health measures included overall self-rated oral health; dry mouth symptoms; sensitivity to hot, cold, and sweet; and perceived difficulty eating. Frailty was defined using the Fried phenotype as having 3 or more of weight loss, grip strength, exhaustion, slow walking speed, and low physical activity. Incident frailty was assessed after 3 years of follow-up in 2014. Three hundred three (19%) men were frail at baseline (aged 71-92). Having fewer than 21 teeth, complete tooth loss, fair to poor self-rated oral health, difficulty eating, dry mouth, and more oral health problems were associated with greater likelihood of being frail. Of 1,284 men followed for 3 years, 107 (10%) became frail. The risk of incident frailty was higher in participants who were edentulous (odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.03-3.52); had 3 or more dry mouth symptoms (OR = 2.03, 95% CI = 1.18-3.48); and had 1 (OR = 2.34, 95% CI = 1.18-4.64), 2 (OR = 2.30, 95% CI = 1.09-4.84), or 3 or more (OR = 2.72, 95% CI = 1.11-6.64) oral health problems after adjustment for age, smoking, social class, history of cardiovascular disease or diabetes mellitus, and medications related to dry mouth. The presence of oral health problems was associated with greater risks of being frail and developing frailty in older age. The identification and management of poor oral health in older people could be important in preventing frailty. © 2017 The Authors The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics

  17. Contribution of chronic conditions to functional limitations using a multinomial outcome: Results for the older population in Belgium and Brazil

    NARCIS (Netherlands)

    Yokota, R.T.C. (Renata T.C.); W.J. Nusselder (Wilma); J-M. Robine (Jean-Marie); J. Tafforeau (Jean); P. Deboosere (Patrick); Moura, L. (Lenildo); Andrade, S.S.C.A. (Silvânia S.C.A.); Castro, S.S. (Shamyr S.); H. van Oyen (Herman)

    2017-01-01

    textabstractBackground: The global phenomenon of population ageing is creating new challenges in both high and middle income countries, as functional limitations are expected to increase with age. The attribution method has been proposed to identify which conditions contribute most to disability

  18. Role of Osteoarthritis, Comorbidity, and Pain in Determining Functional Limitations in Older Populations : European Project on Osteoarthritis

    NARCIS (Netherlands)

    Zambon, Sabina; Siviero, Paola; Denkinger, Michael D; Limongi, Federica; Victoria Castell, Maria; van der Pas, Suzan; Otero, Ángel; Edwards, Mark H; Peter, Richard; Pedersen, Nancy L; Sánchez-Martinez, Mercedes; Dennison, Elaine M; Gesmundo, Antonella; Schaap, Laura A; Deeg, Dorly J H; van Schoor, Natasja M; Maggi, Stefania

    OBJECTIVE: To evaluate the role of comorbidity and pain in the association between hip/knee osteoarthritis (OA) with self-reported as well as performance-based functional limitations in a general elderly population. METHODS: We analyzed the data of 2,942 individuals, ages between 65 and 85 years,

  19. A comparative study of computed tomographic techniques for the detection of emphysema in middle-aged and older patient populations

    International Nuclear Information System (INIS)

    Tanino, Michie; Nishimura, Masaharu; Betsuyaku, Tomoko; Takeyabu, Kimihiro; Tanino, Yoshinori; Kawakami, Yoshikazu; Miyamoto, Kenji

    2000-01-01

    Helical-scan computed tomography (CT) is now widely utilized as a mass screening procedure for lung cancer. By adding 3 slices of high-resolution CT (HRCT) to the standard screening procedure, we were able to compare the efficacy of helical-scan CT and HRCT in detecting pulmonary emphysema. Additionally, the prevalence of emphysema detected by HRCT was examined as a function of patient age and smoking history. The subjects (106 men and 28 women) were all community-based middle-aged and older volunteers who participated in a mass lung cancer screening program. Based on visual assessments of the CT films, emphysema was detected in 29 subjects (22%) by HRCT, but in only 4 (3%) by helical-scan CT. Although the prevalence of emphysema was higher among subjects with a higher smoking index, no correlations with age were observed. We concluded that the efficacy of helical scan CT in detecting pulmonary emphysema can be significantly improved with the inclusion of 3 slices of HRCT, and confirmed that cigarette smoking is linked to the development of pulmonary emphysema. (author)

  20. The Nordic Prudent Diet Reduces Risk of Cognitive Decline in the Swedish Older Adults: A Population-Based Cohort Study

    Directory of Open Access Journals (Sweden)

    Behnaz Shakersain

    2018-02-01

    Full Text Available Appropriate dietary pattern for preserving cognitive function in northern Europe remains unknown. We aimed to identify a Nordic dietary pattern index associated with slower cognitive decline compared to the Mediterranean-DASH Intervention for Neurodegenerative Delay, Mediterranean Diet, Dietary Approaches to Stop Hypertension, and Baltic Sea Diet indices. A total of 2223 dementia-free adults aged ≥60 were followed for 6 years. Mini-Mental State Examination was administrated at baseline and follow-ups. Dietary intake was assessed by 98-item food frequency questionnaire, and the Nordic Prudent Dietary Pattern (NPDP was identified. Data were analysed using mixed-effects and parametric survival models and receiver operating characteristic curves with adjustment for potential confounders. Moderate (β = 0.139, 95% CI 0.077−0.201 and high adherence (β = 0.238, 95% CI 0.175−0.300 to NPDP were associated with less cognitive decline compared to other four indices. High adherence to NPDP was also associated with the lowest risk of MMSE decline to ≤24 (HR = 0.176, 95% CI 0.080−0.386 and had the greatest ability to predict such decline (area under the curve = 0.70. Moderate-to-high adherence to the NPDP may predict a better-preserved cognitive function among older adults in Nordic countries. Regional dietary habits should be considered in developing dietary guidelines for the prevention of cognitive impairment and dementia.

  1. The Nordic Prudent Diet Reduces Risk of Cognitive Decline in the Swedish Older Adults: A Population-Based Cohort Study.

    Science.gov (United States)

    Shakersain, Behnaz; Rizzuto, Debora; Larsson, Susanna C; Faxén-Irving, Gerd; Fratiglioni, Laura; Xu, Wei-Li

    2018-02-17

    Appropriate dietary pattern for preserving cognitive function in northern Europe remains unknown. We aimed to identify a Nordic dietary pattern index associated with slower cognitive decline compared to the Mediterranean-DASH Intervention for Neurodegenerative Delay, Mediterranean Diet, Dietary Approaches to Stop Hypertension, and Baltic Sea Diet indices. A total of 2223 dementia-free adults aged ≥60 were followed for 6 years. Mini-Mental State Examination was administrated at baseline and follow-ups. Dietary intake was assessed by 98-item food frequency questionnaire, and the Nordic Prudent Dietary Pattern (NPDP) was identified. Data were analysed using mixed-effects and parametric survival models and receiver operating characteristic curves with adjustment for potential confounders. Moderate (β = 0.139, 95% CI 0.077-0.201) and high adherence (β = 0.238, 95% CI 0.175-0.300) to NPDP were associated with less cognitive decline compared to other four indices. High adherence to NPDP was also associated with the lowest risk of MMSE decline to ≤24 (HR = 0.176, 95% CI 0.080-0.386) and had the greatest ability to predict such decline (area under the curve = 0.70). Moderate-to-high adherence to the NPDP may predict a better-preserved cognitive function among older adults in Nordic countries. Regional dietary habits should be considered in developing dietary guidelines for the prevention of cognitive impairment and dementia.

  2. 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.

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

    Science.gov (United States)

    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.

  4. 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.

  5. 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.

  6. Lifelong Learning and Older Workers

    Science.gov (United States)

    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…

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

    OpenAIRE

    Redondo-Sendino, Áurea; Guallar-Castillón, Pilar; Banegas, José Ramón; Rodríguez-Artalejo, Fernando

    2006-01-01

    Abstract Background Compared to men, women report greater morbidity and make greater use of health-care services. This study examines potential determinants of gender differences in the utilization of health-care services among the elderly. Methods Cross-sectional study covering 3030 subjects, representative of the non-institutionalized Spanish population aged 60 years and over. Potential determinants of gender differences in the utilization of health services were classified into predisposin...

  8. Prevalence, awareness, treatment and control of dyslipidemia in older persons in urban and rural population in the Astana region, Kazakhstan.

    Science.gov (United States)

    Supiyev, Adil; Nurgozhin, Talgat; Zhumadilov, Zhaxybay; Peasey, Anne; Hubacek, Jaroslav A; Bobak, Martin

    2017-08-11

    Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan. We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured. The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction. This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.

  9. Dairy product consumption and risk of colorectal cancer in an older mediterranean population at high cardiovascular risk.

    Science.gov (United States)

    Barrubés, Laura; Babio, Nancy; Mena-Sánchez, Guillermo; Toledo, Estefania; Ramírez-Sabio, Judith B; Estruch, Ramón; Ros, Emilio; Fitó, Montserrat; Arós, Fernando; Fiol, Miquel; Santos-Lozano, José Manuel; Serra-Majem, Lluís; Pintó, Xavier; Martínez-González, Miguel Ángel; Sorlí, José Vicente; Basora, Josep; Salas-Salvadó, Jordi

    2018-04-16

    Prospective studies have reported an inverse association between the consumption of total dairy products and milk and the risk of colorectal cancer (CRC). Nonetheless, there is little and inconsistent evidence regarding subtypes of dairy product and CRC risk. We assessed the associations between the consumption of total dairy products, their different subtypes and CRC risk in older Mediterranean individuals at high cardiovascular risk. We analyzed data from 7,216 men and women (55-80 years) without CRC at baseline from the PREvención con DIeta MEDiterránea study. Individuals were recruited between 2003 and 2009 and followed up until December 2012. At baseline and yearly thereafter, consumption of total and specific dairy products was assessed using a validated 137-item food-frequency questionnaire. Cox proportional hazards ratios (HRs) of CRC incidence were estimated for tertiles of mean consumption of dairy products during the follow-up. During a median [interquartile range] follow-up of 6.0 [4.4-7.3] years, we documented 101 incident CRC cases. In the multivariable-adjusted models, HRs and 95% confidence intervals (CIs) of CRC for the comparison of extreme tertiles of total dairy product and low-fat milk consumption were 0.55 (95% CI: 0.31-0.99; p-trend = 0.037) and 0.54 (95% CI: 0.32-0.92; p-trend = 0.022), respectively. No significant associations with other dairy products (whole-fat and low-fat dairy products; total, low-fat and whole-fat yogurt; cheese; total, low-fat and whole-fat milk; concentrated full-fat dairy products, sugar-enriched dairy products and fermented dairy products) were found. A high consumption of total dairy products and low-fat milk was significantly associated with a reduced CRC risk. © 2018 UICC.

  10. Quality issues of self-report of hypertension: analysis of a population representative sample of older adults in Taiwan.

    Science.gov (United States)

    Tsai, Alan Chung-Hong; Chang, Tsui-Lan

    2012-01-01

    The study was to evaluate the quality of self-report of hypertension and examine the factors associated with under- and over-reporting of hypertension in older Taiwanese. Data for this analysis were from the Social Environment and Biomarkers Study in Taiwan 2000, which involved a national sample of 1021 Taiwanese over 54 years of age. We performed binary classification tests to compare the prevalence rates of self-reported vs. clinically measured hypertension according to World Health Organization (WHO) (blood pressure ≥ 160/95 mm Hg or on hypertension medication) and JNC-6 (140/90 mm Hg or on hypertension medication) definitions. Logistic regression analysis was performed to analyze the potential factors associated with under- or over-reporting of blood pressure status. Results showed the test characteristics of self-reports were: sensitivity 73%, specificity 93%, and kappa = 0.68 (p WHO definition; and sensitivity 51%, specificity 95% and kappa = 0.43 (p definition. Old age was associated with over-reporting whereas having no health checkup during the past 12 months was associated with under-reporting. The relatively low agreement between self-reports and clinically measured hypertension (JNC-6 definition) was mainly due to the lack of a well-defined hypertension practice guideline and the failure of clinicians to clearly inform patients of their diagnoses. The consistency of hypertension practice guidelines and the effectiveness of informing the patients of their diagnoses are two main factors impacting the quality of self-report of hypertension in elderly Taiwanese. Better self-reports of health data can improve the efficiency of public health surveillance efforts. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Informal Caregiving and Subjective Well-Being: Evidence of a Population-Based Longitudinal Study of Older Adults in Germany.

    Science.gov (United States)

    Hajek, André; König, Hans-Helmut

    2016-04-01

    The aim of this study was to examine whether informal caregiving affects subjective well-being (SWB) of the caregivers in the long run. The German Ageing Survey (DEAS) is a nationwide, representative longitudinal study of community-dwelling individuals living in Germany aged 40 and older. The surveys in 2002, 2008, and 2011 were used (11,264 observations). Several components of SWB were used, covering functional and mental health, and affective (positive affect and negative affect) as well as cognitive well-being. Although functional health was quantified by the subscale "physical functioning" of the 36-Item Short Form Health Survey (SF-36), mental health was assessed by using the Center for Epidemiologic Studies Depression Scale (CES-D). Life satisfaction (cognitive well-being) was quantified by using the Satisfaction with Life Scale (SWLS) and positive and negative affect (affective well-being) was assessed using the Positive and Negative Affect Schedule (PANAS). Longitudinal regressions revealed that informal care affected (1) mental health in the total sample and in both sexes as well as (2) cognitive well-being in women. The effect of informal care on mental health was significantly moderated by self-efficacy in the total sample. Our findings emphasize the role of informal caregiving for mental health and cognitive well-being (women). Moreover, our findings highlight the role of self-efficacy in the relation between informal care and mental health. Thus, to prevent declines in mental health due to informal care, it might be a fruitful approach to strengthen self-efficacy. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  12. The history of human populations in the Japanese Archipelago inferred from genome-wide SNP data with a special reference to the Ainu and the Ryukyuan populations.

    Science.gov (United States)

    Jinam, Timothy; Nishida, Nao; Hirai, Momoki; Kawamura, Shoji; Oota, Hiroki; Umetsu, Kazuo; Kimura, Ryosuke; Ohashi, Jun; Tajima, Atsushi; Yamamoto, Toshimichi; Tanabe, Hideyuki; Mano, Shuhei; Suto, Yumiko; Kaname, Tadashi; Naritomi, Kenji; Yanagi, Kumiko; Niikawa, Norio; Omoto, Keiichi; Tokunaga, Katsushi; Saitou, Naruya

    2012-12-01

    The Japanese Archipelago stretches over 4000 km from north to south, and is the homeland of the three human populations; the Ainu, the Mainland Japanese and the Ryukyuan. The archeological evidence of human residence on this Archipelago goes back to >30 000 years, and various migration routes and root populations have been proposed. Here, we determined close to one million single-nucleotide polymorphisms (SNPs) for the Ainu and the Ryukyuan, and compared these with existing data sets. This is the first report of these genome-wide SNP data. Major findings are: (1) Recent admixture with the Mainland Japanese was observed for more than one third of the Ainu individuals from principal component analysis and frappe analyses; (2) The Ainu population seems to have experienced admixture with another population, and a combination of two types of admixtures is the unique characteristics of this population; (3) The Ainu and the Ryukyuan are tightly clustered with 100% bootstrap probability followed by the Mainland Japanese in the phylogenetic trees of East Eurasian populations. These results clearly support the dual structure model on the Japanese Archipelago populations, though the origins of the Jomon and the Yayoi people still remain to be solved.

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

    Science.gov (United States)

    Cardarelli, Roberto; Mann, Christopher; Fulda, Kimberly G; Balyakina, Elizabeth; Espinoza, Anna; Lurie, Sue

    2011-12-29

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

  14. Genetic Diversity and Distribution of Blastocystis Subtype 3 in Human Populations, with Special Reference to a Rural Population in Central Mexico

    Directory of Open Access Journals (Sweden)

    Liliana Rojas-Velázquez

    2018-01-01

    Full Text Available Blastocystis subtype 3 (ST3 is a parasitic protist found in the digestive tract of symptomatic and asymptomatic humans around the world. While this parasite exhibits a high prevalence in the human population, its true geographic distribution and global genetic diversity are still unknown. This gap in knowledge limits the understanding of the spread mechanisms, epidemiology, and impact that this parasite has on human populations. Herein, we provided new data on the geographical distribution and genetic diversity of Blastocystis ST3 from a rural human population in Mexico. To do so, we collected and targeted the SSU-rDNA region in fecal samples from this population and further compared its genetic diversity and structure with that previously observed in populations of Blastocystis ST3 from other regions of the planet. Our analyses reveled that diversity of Blastocystis ST3 showed a high haplotype diversity and genetic structure to the world level; however, they were low in the Morelos population. The haplotype network revealed a common widespread haplotype from which the others were generated recently. Finally, our results suggested a recent expansion of the diversity of Blastocystis ST3 worldwide.

  15. Effect of implementation of the mass breast cancer screening programme in older women in the Netherlands: population based study.

    Science.gov (United States)

    de Glas, Nienke A; de Craen, Anton J M; Bastiaannet, Esther; Op 't Land, Ester G; Kiderlen, Mandy; van de Water, Willemien; Siesling, Sabine; Portielje, Johanneke E A; Schuttevaer, Herman M; de Bock, Geertruida Truuske H; van de Velde, Cornelis J H; Liefers, Gerrit-Jan

    2014-09-14

    To assess the incidence of early stage and advanced stage breast cancer before and after the implementation of mass screening in women aged 70-75 years in the Netherlands in 1998. Prospective nationwide population based study. National cancer registry, the Netherlands. Patients aged 70-75 years with a diagnosis of invasive or ductal carcinoma in situ breast cancer between 1995 and 2011 (n=25,414). Incidence rates were calculated using population data from Statistics Netherlands. Incidence rates of early stage (I, II, or ductal carcinoma in situ) and advanced stage (III and IV) breast cancer before and after implementation of screening. Hypotheses were formulated before data collection. The incidence of early stage tumours significantly increased after the extension for implementation of screening (248.7 cases per 100,000 women before screening up to 362.9 cases per 100,000 women after implementation of screening, incidence rate ratio 1.46, 95% confidence interval 1.40 to 1.52, Pbreast cancers decreased to a far lesser extent (58.6 cases per 100,000 women before screening to 51.8 cases per 100,000 women after implementation of screening, incidence rate ratio 0.88, 0.81 to 0.97, Pbreast cancer, while that of early stage tumours has strongly increased. © de Glas et al 2014.

  16. Opioids, antiepileptic and anticholinergic drugs and the risk of fractures in patients 65 years of age and older: a prospective population-based study.

    Science.gov (United States)

    Nurminen, Janne; Puustinen, Juha; Piirtola, Maarit; Vahlberg, Tero; Lyles, Alan; Kivelä, Sirkka-Liisa

    2013-05-01

    in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied. the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug. this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports. at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females. the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.

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

    Science.gov (United States)

    Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

    2018-01-01

    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. Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006). 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. 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.

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

    Science.gov (United States)

    Maskileyson, Dina

    2014-10-01

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

  19. Special foodstuffs rich in anticarcinogens and antioxidants as means of protecting the population at territories polluted by radionuclides

    International Nuclear Information System (INIS)

    Knizhnikov, V.A.; Shandala, N.K.; Komleva, V.A.; Rudintseva, T.A.

    1996-01-01

    The purpose of this work was to assess the effect of diets including foodstuffs rich in special additives on the metabolism of ecologically important radionuclides strontium-90 and cesium-137 and to assess the resistance of exposed and intact animals from changes in body weight and hemopoietic status. Three types of special meat products containing additives made of sea alga laminaria. Normalization of the ration for mineral and protein composition owing to the above foodstuffs has a favorable impact on the time course of body weight and peripheral hemopoietic system. Radiometry of bone tissue showed that accumulation of strontium 90 was reduced by half in animals fed nutritive additives of meat preserves with routine diet. Refs. 6, tabs. 5

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

    Science.gov (United States)

    2012-01-01

    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 trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3). 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. PMID:22978821

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

    Science.gov (United States)

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

    2017-04-01

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

  2. Sense of control and self-reported health in a population-based sample of older Americans: assessment of potential confounding by affect, personality, and social support.

    Science.gov (United States)

    Ward, Michael M

    2013-03-01

    Sense of control has been linked to improved health outcomes, but it is unclear if this association is independent of other psychosocial factors. The aim of this study is to test the strength of association between sense of control and self-reported health after adjustment for positive and negative affect, "Big 5" personality factors, and social support. Data on sense of control (measured by personal mastery, perceived constraints, and a health-specific rating of control), affect, personality, social support, and two measures of self-reported health (global rating of fair or poor health and presence of functional limitations) were obtained on 6,891 participants in the Health and Retirement Study, a population-based survey of older Americans. The cross-sectional association between sense of control measures and each measure of self-reported health was tested in hierarchical logistic regression models, before and after adjustment for affect, personality, and social support. Participants with higher personal mastery were less likely to report fair/poor health (odds ratio 0.76 per 1-point increase) while those with higher perceived constraints were more likely to report fair/poor health (odds ratio 1.37 per 1-point increase). Associations remained after adjustment for affect, but adjustment for affect attenuated the association of personal mastery by 37% and of perceived constraints by 67%. Further adjustment for personality and social support did not alter the strength of association. Findings were similar for the health-specific rating of control, and for associations with functional limitations. Sense of control is associated with self-reported health in older Americans, but this association is partly confounded by affect.

  3. Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Xiaoyue Xu

    2016-08-01

    Full Text Available Abstract Background Few studies explored the effects of nutritional changes on body mass index (BMI, weight (Wt, waist circumference (WC and hypertension, especially for the older Chinese population. Methods By using China Health and Nutrition Survey 2004-2011 waves, a total of 6348 observations aged ≥ 60 were involved in the study. The number of participants dropped from 2197 in 2004, to 1763 in 2006, 1303 in 2009, and 1085 in 2011. Dietary information was obtained from participants using 24 hour-recall over three consecutive days. Height, Wt, WC, systolic and diastolic blood pressure were also measured in each survey year. The dietary pattern was derived by exploratory factor analysis using principal component analysis methods. Linear Mixed Models were used to investigate associations of dietary patterns with BMI, Wt and WC. Generalized Estimating Equation models were used to assess the associations between dietary patterns and hypertension. Results Over time, older people’s diets were shifting towards a modern dietary pattern (high intake of dairy, fruit, cakes and fast food. Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Participants with a diet in the highest quartile for traditional composition had a β (difference in mean of −0.23 (95 % CI: −0.44; −0.02 for BMI decrease, β of −0.90 (95 % CI: −1.42; −0.37 for Wt decrease; and β of −1.57 (95 % CI: −2.32; −0.83 for WC decrease. However, participants with a diet in the highest quartile for modern diet had a β of 0.29 (95 % CI: 0.12; 0.47 for BMI increase; β of 1.02 (95 % CI: 0.58; 1.46 for Wt increase; and β of 1.44 (95 % CI: 0.78; 2.10 for Wt increase. No significant associations were found between dietary patterns and hypertension. Conclusions We elucidate the associations between dietary pattern and change in BMI, Wt, WC and hypertension in a 7-year follow-up study. The strong association between favourable body

  4. Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study.

    Science.gov (United States)

    Xu, Xiaoyue; Byles, Julie; Shi, Zumin; McElduff, Patrick; Hall, John

    2016-08-08

    Few studies explored the effects of nutritional changes on body mass index (BMI), weight (Wt), waist circumference (WC) and hypertension, especially for the older Chinese population. By using China Health and Nutrition Survey 2004-2011 waves, a total of 6348 observations aged ≥ 60 were involved in the study. The number of participants dropped from 2197 in 2004, to 1763 in 2006, 1303 in 2009, and 1085 in 2011. Dietary information was obtained from participants using 24 hour-recall over three consecutive days. Height, Wt, WC, systolic and diastolic blood pressure were also measured in each survey year. The dietary pattern was derived by exploratory factor analysis using principal component analysis methods. Linear Mixed Models were used to investigate associations of dietary patterns with BMI, Wt and WC. Generalized Estimating Equation models were used to assess the associations between dietary patterns and hypertension. Over time, older people's diets were shifting towards a modern dietary pattern (high intake of dairy, fruit, cakes and fast food). Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Participants with a diet in the highest quartile for traditional composition had a β (difference in mean) of -0.23 (95 % CI: -0.44; -0.02) for BMI decrease, β of -0.90 (95 % CI: -1.42; -0.37) for Wt decrease; and β of -1.57 (95 % CI: -2.32; -0.83) for WC decrease. However, participants with a diet in the highest quartile for modern diet had a β of 0.29 (95 % CI: 0.12; 0.47) for BMI increase; β of 1.02 (95 % CI: 0.58; 1.46) for Wt increase; and β of 1.44 (95 % CI: 0.78; 2.10) for Wt increase. No significant associations were found between dietary patterns and hypertension. We elucidate the associations between dietary pattern and change in BMI, Wt, WC and hypertension in a 7-year follow-up study. The strong association between favourable body composition and traditional diet, compared with an increase in BMI, WC and Wt

  5. Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study

    OpenAIRE

    Ferri, Cleusa P.; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Llibre-Rodriguez, Juan J.; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Gaona, Ciro; Liu, Zhaorui; Noriega-Fernandez, Lisseth; Jotheeswaran, A. T.; Prince, Martin J.

    2012-01-01

    Editors' Summary Background Worldwide, half of all deaths occur in people aged 60 or older. Yet mortality among older people is a neglected topic in global health. In high income countries, where 84% of people do not die until they are aged 65 years or older, the causes of death among older people and the factors (determinants) that affect their risk of dying are well documented. In Europe, for example, the leading causes of death among older people are heart disease, stroke, and other chroni...

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

    Directory of Open Access Journals (Sweden)

    Aleksey Vladimirovich Kuvshinov

    2016-12-01

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

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

    Science.gov (United States)

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

    2017-03-04

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

  8. Dietary determinants of serum total cholesterol among middle-aged and older adults: a population-based cross-sectional study in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Kakarmath, Sujay S; Zack, Rachel M; Leyna, Germana H; Fahimi, Saman; Liu, Enju; Fawzi, Wafaie W; Lukmanji, Zohra; Killewo, Japhet; Sacks, Frank; Danaei, Goodarz

    2017-06-06

    To assess the dietary determinants of serum total cholesterol. Cross-sectional population-based study. Peri-urban region of Dar es Salaam, Tanzania. 347 adults aged 40 years and older from the Dar es Salaam Urban Cohort Hypertension Study. Serum total cholesterol measured using a point-of-care device. Mean serum total cholesterol level was 204 mg/dL (IQR 169-236 mg/dL) in women and 185 mg/dL (IQR 152-216 mg/dL) in men. After adjusting for demographic, socioeconomic, lifestyle and dietary factors, participants who reported using palm oil as the major cooking oil had serum total cholesterol higher by 15 mg/dL (95% CI 1 to 29 mg/dL) compared with those who reported using sunflower oil. Consumption of one or more servings of meat per day (p for trend=0.017) and less than five servings of fruits and vegetables per day (p for trend=0.024) were also associated with higher serum total cholesterol. A combination of using palm oil for cooking, eating more than one serving of meat per day and fewer than five servings of fruits and vegetables per day, was associated with 46 mg/dL (95% CI 16 to 76 mg/dL) higher serum total cholesterol. Using palm oil for cooking was associated with higher serum total cholesterol levels in this peri-urban population in Dar es Salaam. Reduction of saturated fat content of edible oil may be considered as a population-based strategy for primary prevention of cardiovascular diseases. © 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.

  9. Stable or improved health status in the population 65 years and older in Stockholm, Sweden - an 8-year follow-up of self-reported health items.

    Science.gov (United States)

    Modig, Karin; Virtanen, Suvi; Ahlbom, Anders; Agahi, Neda

    2016-07-01

    Previous studies have reached different conclusions about whether health is improving in the ageing population. More studies with narrow age groups analyzed separately for men and women will contribute to the literature. To describe trends in self-reported indicators of health and health-related quality of life between 2002 and 2010, focusing on differences between gender and age groups. A population-based survey of individuals 65+ in the Stockholm County was used. Prevalence of health problems increased with age both among men and women. Men generally reported having no health problems to a larger extent than women, but the proportions reporting severe problems were similar. The larger picture is one of stability in health-related quality of life, even if several items developed for the better, especially among women. While the proportions reporting no health/functional problems increased for many items, the proportions reporting severe problems remained unchanged among men and improved only for two items among women. CONCLUSIONS OVERALL, IMPROVEMENTS WERE SEEN IN MANY OF THE HEALTH-RELATED QUALITY OF LIFE ITEMS AS WELL AS FOR SELF-RATED HEALTH AMONG WOMEN THE PROPORTIONS REPORTING LONG-TERM ILLNESS OR PERSISTENT HEALTH PROBLEMS INCREASED, BUT FEWER SEEM TO BE LIMITED IN THEIR DAILY ACTIVITIES BY THESE PROBLEMS THE STABLE PROPORTIONS OF POOR SELF-RATED HEALTH INDICATES THAT WHILE HEALTH AND FUNCTIONING SEEM TO BE IMPROVING FOR THE MAJORITY OF THE OLDER POPULATION, SOME GROUPS MAY BE LAGGING BEHIND FUTURE STUDIES SHOULD PAY ATTENTION TO CHANGES BOTH IN THE UPPER AND LOWER ENDS OF THE HEALTH SPECTRUM. © 2016 the Nordic Societies of Public Health.

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

    Directory of Open Access Journals (Sweden)

    Françoise A. Valentini

    2010-04-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  12. Prevalence and correlates of diabetic retinopathy in a population-based survey of older people in Nakuru, Kenya.

    Science.gov (United States)

    Mathenge, Wanjiku; Bastawrous, Andrew; Peto, Tunde; Leung, Irene; Yorston, David; Foster, Allen; Kuper, Hannah

    2014-06-01

    To estimate the prevalence of and factors associated with diabetic retinopathy (DR) among people aged ≥ 50 years in Nakuru, Kenya. Probability-proportional-to-size sampling was used to select 100 clusters of 50 people aged ≥ 50 years during 2007-2008. Households within clusters were selected through compact segment sampling. Participants underwent dilated slit lamp biomicroscopy (SLB) by an ophthalmologist and digital retinal photography. Images were graded for DR at the Moorfields Eye Hospital Reading Centre, UK. Diagnosis of DR was based on retinal images where available, otherwise on SLB. Anthropometric measures, including random glucose, and lifestyle factors were measured. We examined 4414 adults (response rate 88.1%), of whom 287 had diabetes. A total of 277 of these were screened for DR by SLB, and 195 also underwent retinal photography. The prevalence of any DR diagnosed by retinal images among diabetics was 35.9% (95% confidence interval, CI, 29.7-42.6%). The most common grade of DR was mild/moderate non-proliferative DR (NPDR; 22.1%, 95% CI 16.1-29.4%), while severe NPDR and proliferative DR were less frequent (13.9%, 95% CI 10.0-18.8%). SLB significantly underdiagnosed DR compared to retinal photography, particularly for milder grades. Of 87 individuals with DR, 23 had visual impairment (visual acuity <6/12). DR was associated with younger age, male sex, duration and control of diabetes, and treatment compliance. Coverage of photocoagulation in those needing immediate laser was low (25%). DR remains a threat to sight in people with diabetes in this elderly Kenyan population. Screening diabetics may enable those requiring treatment to be identified in time to preserve their sight.

  13. Cognitive and Physical Function in Relation to the Risk of Injurious Falls in Older Adults: A Population-Based Study.

    Science.gov (United States)

    Welmer, Anna-Karin; Rizzuto, Debora; Laukka, Erika J; Johnell, Kristina; Fratiglioni, Laura

    2017-05-01

    We aimed to quantify the independent effect of cognitive and physical deficits on the risk of injurious falls, to verify whether this risk is modified by global cognitive impairment, and to explore whether risk varies by follow-up time. Data on 2,495 participants (≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) study were analyzed using flexible parametric survival models. Two cognitive domains (processing speed and executive function) were assessed with standard tests. Physical function tests included balance (one-leg-stands), walking speed, chair stands, and grip strength. Global cognition was assessed using the Mini-Mental State Examination. A total of 167 people experienced an injurious fall over 3 years of follow-up, 310 over 5 years, and 571 over 10 years. Each standard deviation worse balance, slower walking speed, and longer chair stand time increased the risk of injurious falls over 3 years by 43%, 38%, and 23%, respectively (p risk of injurious falls over 10 years (p falls only in people with cognitive impairment, whereas deficits in processing speed and executive function were associated with injurious falls only in people without cognitive impairment. Deficits in specific cognitive domains, such as processing speed and executive function, appear to predict injurious falls in the long term. Deficits in physical function predict falls in the short term, especially in people with global cognitive impairment. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

    Vrinten, Charlotte; Wardle, Jane

    2016-03-01

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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Brehaut Jamie C

    2008-11-01

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

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

    Science.gov (United States)

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

    2009-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Banegas José

    2006-06-01

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

  19. Ancestry and Language in the United States: November 1979. Current Population Reports, Special Studies. Series P-23. No. 116.

    Science.gov (United States)

    Levin, Michael J.; Sweet, Nancy S.

    Information on the ancestry, languages, and literacy of the U.S. population based on data collected by the Bureau of the Census in 1979 is reported. Items surveyed include ancestry, country of birth of the individual and parents, citizenship, year of immigration, native language, language spoken in the home, ability to speak English, and ability…

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

    NARCIS (Netherlands)

    Eijk, van der R.H.

    1987-01-01

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

  1. The association between alcohol use and long-term care placement among older Canadians: A 14-year population-based study

    Science.gov (United States)

    Kaplan, Mark S.; Huguet, Nathalie; Feeny, David; McFarland, Bentson H.; Caetano, Raul; Bernier, Julie; Giesbrecht, Norman; Oliver, Lisa; Ramage-Morin, Pamela; Ross, Nancy A.

    2013-01-01

    Studies have shown that moderate alcohol use confers protection against some of the dominant predictors of long-term care placement, including diminished cognitive functioning, physical disability, and injury. But little is known about the association between alcohol use and the likelihood of placement in long-term care facilities. A nationally representative sample of 5,404 community-dwelling Canadians ages 50 years and older at baseline (1994/95) was obtained from the longitudinal National Population Health Survey. Alcohol use categories were developed based on the quantity and frequency of use in the 12 months before the interview. Cox proportional hazards models were used to estimate the association between alcohol use at baseline and subsequent placement in long-term care facilities after adjusting for covariates measured at baseline. During the 14-year follow-up period, 14% of lifetime abstainers, 10% of former drinkers, 7% of infrequent drinkers, 4% of moderate drinkers, and 3% of heavy drinkers were placed in long-term care facilities. Furthermore, the multivariate analysis revealed that abstainers, former drinkers, and infrequent drinkers were more than twice as likely to be placed in long-term care as moderate drinkers. Moderate drinking was protective against placement in long-term care facilities even after adjusting for an array of well-known confounders. The strong protective effect of moderate alcohol use on long-term care entry is likely due to a complex mix of physical, cognitive and psychosocial health factors. PMID:24169370

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Social participation and the onset of hypertension among the middle-aged and older population: Evidence from the China Health and Retirement Longitudinal Study.

    Science.gov (United States)

    Tu, Raoping; Inoue, Yosuke; Yazawa, Aki; Hao, Xiaoning; Cai, Guoxi; Li, Yueping; Lin, Xiuquan; He, Fei; Yamamoto, Taro

    2018-03-30

    While previous studies have examined the association between health-related behaviors and hypertension, comparatively little attention has been paid to the role of social participation (i.e. participating in community organizations). The aim of the present study was to investigate the longitudinal association between social participation and hypertension among the middle-aged and older population (aged ≥45 years) in China where the prevalence of hypertension has been increasing rapidly in the past few decades. Data came from the China Health and Retirement Longitudinal Study waves 2011 and 2013. Information was obtained from 5483 participants on blood pressure, social participation and covariates. A sex-stratified Poisson regression model with a robust variance estimator was used to examine the associations. During the period between 2011 and 2013, 20.6% of men and 17.2% of women developed hypertension. A Poisson regression model showed that participating in community organizations once a week or more frequently was inversely associated with the onset of hypertension in women (incidence rate ratio 0.80, 95% confidence interval 0.67-0.95, P = 0.012). Among men, no such association was found. The present study suggests that promoting social participation might help mitigate the disease burden associated with hypertension in China, particularly among women. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Erica Gobbi

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    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.

  7. Patterns in benthic populations in the Milford Haven waterway following the 'Sea Empress' oil spill with special reference to amphipods.

    Science.gov (United States)

    Nikitik, Christopher C S; Robinson, Andrew W

    2003-09-01

    The macrobenthic fauna of the Milford Haven Waterway was studied in detail following the 'Sea Empress' oil spill in 1996. Contamination patterns indicated heaviest contamination of sediments by oil to have occurred in the lower reaches of the waterway, although water borne hydrocarbons are likely to have penetrated throughout the Haven. Generally, the communities showed little impact of contamination by oil, although some changes were evident at the population level. A decline in the amphipod fauna was observed throughout the Haven, with the genera Ampelisca and Harpinia and the family Isaeidae particularly affected. This was accompanied by increases in both the diversity and abundance of polychaete populations as opportunist species took advantage of the decline of the amphipod fauna. However, within five years of the spill the amphipod fauna has shown clear signs of recovery. The use of the polychaete/amphipod ratio as an indicator of oil pollution is discussed.

  8. Importance of participation rate in sampling of data in population based studies, with special reference to bone mass in Sweden.

    OpenAIRE

    Düppe, H; Gärdsell, P; Hanson, B S; Johnell, O; Nilsson, B E

    1996-01-01

    OBJECTIVE: To study the effects of participation rate in sampling on "normative" bone mass data. DESIGN: This was a comparison between two randomly selected samples from the same population. The participation rates in the two samples were 61.9% and 83.6%. Measurements were made of bone mass at different skeletal sites and of muscle strength, as well as an assessment of physical activity. SETTING: Malmö, Sweden. SUBJECTS: There were 230 subjects (117 men, 113 women), aged 21 to 42 years. RESUL...

  9. An aging population and growing disease burden will require a large and specialized health care workforce by 2025.

    Science.gov (United States)

    Dall, Timothy M; Gallo, Paul D; Chakrabarti, Ritasree; West, Terry; Semilla, April P; Storm, Michael V

    2013-11-01

    As the US population ages, the increasing prevalence of chronic disease and complex medical conditions will have profound implications for the future health care system. We projected future prevalence of selected diseases and health risk factors to model future demand for health care services for each person in a representative sample of the current and projected future population. Based on changing demographic characteristics and expanded medical coverage under the Affordable Care Act, we project that the demand for adult primary care services will grow by approximately 14 percent between 2013 and 2025. Vascular surgery has the highest projected demand growth (31 percent), followed by cardiology (20 percent) and neurological surgery, radiology, and general surgery (each 18 percent). Market indicators such as long wait times to obtain appointments suggest that the current supply of many specialists throughout the United States is inadequate to meet the current demand. Failure to train sufficient numbers and the correct mix of specialists could exacerbate already long wait times for appointments, reduce access to care for some of the nation's most vulnerable patients, and reduce patients' quality of life.

  10. Special populations: vulnerability and protection - DOI: 10.3395/reciis.v2.Sup1.207en

    Directory of Open Access Journals (Sweden)

    Wendy Rogers

    2008-12-01

    Full Text Available Research with vulnerable participants raises a number of challenging issues for researchers and ethical review committees. Vulnerability arises when participants are relatively powerless compared with researchers. This may be due to extrinsic factors such as poverty or lack of education, or intrinsic factors such as severe illness or intellectual disability. Vulnerable participants risk increased harm from research because they are unable to protect their interests. This article provides examples of research with vulnerable populations and describes in detail ways in which researchers and ethical review committees can work to decrease the risks of harm for these groups. Also, the article presents a discussion of sharing research benefits fairly, and describes four conditions for ethical research with vulnerable participants.

  11. Cerebrovascular diseases in a fixed population Hiroshima and Nagasaki with special reference to relationship between type and risk factors

    International Nuclear Information System (INIS)

    Lin, Chow-How; Shimizu, Yukiko; Kato, Hiroo; Robertson, T.L.; Furonaka, Hiroshi.

    1980-10-01

    A study was made of the incidence of cerebrovascular diseases, their chronological trend, and relationship between the disease types and risk factors on 16,491 subjects of Hiroshima and Nagasaki who underwent medical examination at least once between 1958 - 74, and who were free of cerebrovascular disease at the initial examination. During the 16-year period, 1,162 cases of cerebrovascular disease developed in this study population with the diagnosis definite in 621, and the annual incidence was 3.2 per 1,000 population. By type, there were 108 cases of cerebral hemorrhage, 469 cases of cerebral infarction, 33 cases of subarachnoid hemorrhage, and 11 cases of other unclassifiable types, with cerebral infarction occurring more frequently than cerebral hemorrhage at the ratio of 4.5 : 1. The incidence of cerebrovascular diseases increased with age in both types, but the proportion of younger subjects in cerebral hemorrhage was greater than that in cerebral infarction. A secular trend of declining incidence was noted for both cerebral hemorrhage and cerebral infarction. As a risk factor of cerebral hemorrhage, elevation of systolic and diastolic blood pressure was the most closely related to onset, and left ventricular hypertrophy on electrocardiogram (ECG) and proteinuria were also related. However, a tendency was seen for the risk to be somewhat higher the lower the levels of serum cholesterol. In cerebral infarction, aging, like systolic blood pressure, was a most important risk factor. Left ventricular hypertrophy on ECG, proteinuria, and diabetes could also be risk factors. However, the relation to blood pressure, especially diastolic blood pressure, was not so great as in the case of cerebral hemorrhage. (author)

  12. CASP-19 special section: how does chronic disease status affect CASP quality of life at older ages? Examining the WHO ICF disability domains as mediators of this relationship.

    Science.gov (United States)

    Sexton, E; King-Kallimanis, B L; Layte, R; Hickey, A

    2015-07-01

    The effect of chronic disease status on quality of life (QoL) has been well established. However, less is known about how chronic diseases affect QoL. This article examines impairment in three domains of the WHO International Classification of Functioning, Health and Disability (ICF) - body function, activity and participation, as well as affective well-being, - as potential mediators of the relationship between chronic disease and QoL. A cross-sectional sample (n = 4961) of the general Irish community-dwelling population aged 50+ years was obtained from the Irish Longitudinal Study of Ageing (TILDA). The CASP measure of QoL was examined as two dimensions - control/autonomy and self-realisation/pleasure. Structural equation modelling was used to test the direct and indirect effects of chronic disease on QoL, via variables capturing body function, activity, participation and positive affect. A factor analysis showed that indicators of body function and activity loaded onto a single overall physical impairment factor. This physical impairment factor fully mediated the effect of chronic disease on positive affect and QoL. The total effect of chronic disease on control/autonomy (-0.160) was primarily composed of an indirect effect via physical impairment (-0.86), and via physical impairment and positive affect (-0.45). The decomposition of effects on self-realisation/pleasure was similar, although the direct effect of physical impairment was weaker. The model fitted the data well (RMSEA = 0.02, TLI = 0.96, CFI = 0.96). Chronic disease affects QoL through increased deficits in physical body function and activity. This overall physical impairment affects QoL both directly and indirectly via reduced positive affect.

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

    Directory of Open Access Journals (Sweden)

    Sucheta R Kulkarni

    2013-01-01

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

  14. Normal Bone Microstructure and Density But Worse Physical Function in Older Women Treated with Selective Serotonin Reuptake Inhibitors, a Cross-Sectional Population-Based Study.

    Science.gov (United States)

    Larsson, Berit; Mellström, Dan; Johansson, Lisa; Nilsson, Anna G; Lorentzon, Mattias; Sundh, Daniel

    2018-05-05

    Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women. From an ongoing population-based study, 1057 women (77.7 ± 1.5 years) were included. Validated questionnaires were used to assess information regarding medical history, medications, smoking, mental and physical health, and physical activity. Physical function was measured using clinically used tests: timed up and go, walking speed, grip strength, chair stand test, and one leg standing. Bone mineral density (BMD) was measured at the hip and spine with dual-energy X-ray absorptiometry (Hologic Discovery A). Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT). Treatment with SSRIs was associated with higher BMD at the femoral neck, total hip, and lumbar spine, whereas no associations were found for any HR-pQCT-derived measurements. The use of SSRIs was associated with lower grip strength, walking speed, and fewer chair stand rises. These associations were valid also after adjustments for known risk factors for falls. Treatment with SSRIs was, independently of covariates, associated with worse physical function without any signs of inferior bone geometry and microstructure.

  15. Longitudinal predictors of health-related quality of life in middle-aged and older adults with hypertension: results of a population-based study.

    Science.gov (United States)

    Maatouk, Imad; Wild, Beate; Herzog, Wolfgang; Wesche, Daniela; Schellberg, Dieter; Schöttker, Ben; Müller, Heiko; Rothenbacher, Dietrich; Stegmaier, Christa; Brenner, Hermann

    2012-07-01

    The aim of the study was to assess the longitudinal association between cardiovascular risk factors including albuminuria and other variables (e.g. awareness of hypertension, number of types of antihypertensive drugs, comorbidity), and health-related quality of life (HRQOL) in a large cohort of patients with hypertension, over a follow-up period of 5 years. Nine thousand nine hundred and fifty-three participants of the ESTHER (Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen) study - a population-based cohort study of middle-aged and older adults aged 50-74 years at baseline - were recruited by general practitioners (GPs) in 2000-2002 and included in the follow-up (2005-2007). HRQOL at baseline and follow-up was measured using the Short-Form General Health Survey (SF-12). Mental component scores (MCS) and physical component scores (PCS) were calculated. Multiple linear regression models were used to determine longitudinal predictors of HRQOL at follow-up. Four thousand, two hundred and three patients with hypertension (98.2%) responded to the SF-12 both at baseline and after 5 years and were therefore included in the study. Smoking status, BMI, diabetes, macroalbuminuria, comorbid diseases, history of depression, and lower HRQOL at baseline predicted lower PCS at the 5-year follow-up. Lower MCS after 5 years was predicted by smoking status, dyslipidaemia, a reported history of depression, and HRQOL at baseline. No significant association was detected between awareness of hypertension and any HRQOL component score after 5 years. Macroalbuminuria and other variables related to increased cardiovascular risk have a negative impact on PCS. Suggestions of a link of treatment and awareness of hypertension with HRQOL from previous cross-sectional studies are not supported by our longitudinal findings.

  16. Patellofemoral morphology is not related to pain using three-dimensional quantitative analysis in an older population: data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Drew, Benjamin T; Bowes, Michael A; Redmond, Anthony C; Dube, Bright; Kingsbury, Sarah R; Conaghan, Philip G

    2017-12-01

    Current structural associations of patellofemoral pain (PFP) are based on 2D imaging methodology with inherent measurement uncertainty due to positioning and rotation. This study employed novel technology to create 3D measures of commonly described patellofemoral joint imaging features and compared these features in people with and without PFP in a large cohort. We compared two groups from the Osteoarthritis Initiative: one with localized PFP and pain on stairs, and a control group with no knee pain; both groups had no radiographic OA. MRI bone surfaces were automatically segmented and aligned using active appearance models. We applied t-tests, logistic regression and linear discriminant analysis to compare 13 imaging features (including patella position, trochlear morphology, facet area and tilt) converted into 3D equivalents, and a measure of overall 3D shape. One hundred and fifteen knees with PFP (mean age 59.7, BMI 27.5 kg/m2, female 58.2%) and 438 without PFP (mean age 63.6, BMI 26.9 kg/m2, female 52.9%) were included. After correction for multiple testing, no statistically significant differences were found between groups for any of the 3D imaging features or their combinations. A statistically significant discrimination was noted for overall 3D shape between genders, confirming the validity of the 3D measures. Challenging current perceptions, no differences in patellofemoral morphology were found between older people with and without PFP using 3D quantitative imaging analysis. Further work is needed to see if these findings are replicated in a younger PFP population. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  17. Metabolic syndrome correlates poorly with cognitive performance in stroke-free community-dwelling older adults: a population-based, cross-sectional study in rural Ecuador.

    Science.gov (United States)

    Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio

    2016-04-01

    Studies investigating a possible correlation between metabolic syndrome and cognitive decline have been inconsistent. To determine whether metabolic syndrome or each of its components correlate with cognitive performance in community-dwelling older adults in rural Ecuador. Stroke-free Atahualpa residents aged ≥60 years were identified during a door-to-door survey. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Cognition was evaluated by the use of the Montreal Cognitive Assessment (MoCA). Multivariate logistic regression models estimated the association between metabolic syndrome and each of its components with cognitive performance. A total of 212 persons (mean age: 69.2 ± 7.2 years, 64 % women) were enrolled. Of these, 120 (57 %) had metabolic syndrome. Mean scores in the MoCA were 18.2 ± 4.6 for persons with and 19 ± 4.7 for those without metabolic syndrome. In fully adjusted logistic models, MoCA scores were not associated with metabolic syndrome (p = 0.101). After testing individual components of metabolic syndrome with the MoCA score, we found that only hypertriglyceridemia was independently associated with the MoCA score (p = 0.009). This population-based study showed a poor correlation of metabolic syndrome with cognitive performance after adjusting for relevant confounders. Of the individual components of metabolic syndrome, only hypertriglyceridemia correlated with worse cognitive performance.

  18. Health literacy on tuberculosis amongst vulnerable segment of population: special reference to Saharia tribe in central India.

    Science.gov (United States)

    Muniyandi, M; Rao, V G; Bhat, J; Yadav, R; Sharma, R K; Bhondeley, M K

    2015-05-01

    Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was 60 per cent among 8 per cent of respondents. The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control.

  19. Assessing perceived risk and STI prevention behavior: a national population-based study with special reference to HPV.

    Directory of Open Access Journals (Sweden)

    Amy Leval

    Full Text Available INTRODUCTION: To better understand trends in sexually transmitted infection (STI prevention, specifically low prevalence of condom use with temporary partners, the aim of this study was to examine factors associated with condom use and perceptions of STI risk amongst individuals at risk, with the underlying assumption that STI risk perceptions and STI prevention behaviors are correlated. METHODS: A national population-based survey on human papillomavirus (HPV and sexual habits of young adults aged 18-30 was conducted in Sweden in 2007, with 1712 men and 8855 women participating. Regression analyses stratified by gender were performed to measure condom use with temporary partners and STI risk perception. RESULTS: Men's condom use was not associated with STI risk perception while women's was. Awareness of and disease severity perceptions were not associated with either condom use or risk perception though education level correlated with condom use. Women's young age at sexual debut was associated with a higher risk of non-condom use later in life (OR 1.95 95% CI: 1.46-2.60. Women with immigrant mothers were less likely to report seldom/never use of condoms with temporary partners compared to women with Swedish-born mothers (OR 0.53 95% CI: 0.37-0.77. Correlates to STI risk perception differ substantially between sexes. Number of reported temporary partners was the only factor associated for both men and women with condom use and STI risk perception. CONCLUSIONS: Public health interventions advocating condom use with new partners could consider employing tactics besides those which primarily aim to increase knowledge or self-perceived risk if they are to be more effective in STI reduction. Gender-specific prevention strategies could be effective considering the differences found in this study.

  20. Type, Number or Both? A Population-Based Matched Case-Control Study on the Risk of Fall Injuries among Older People and Number of Medications beyond Fall-Inducing Drugs

    OpenAIRE

    Laflamme, Lucie; Mon?rrez-Espino, Joel; Johnell, Kristina; Elling, Berty; M?ller, Jette

    2015-01-01

    Objectives Drug use is a modifiable risk factor for fall-related injuries in older people. Whereas the injurious effect of polypharmacy is established, that of low numbers of medications has not been fully ascertained. Neither do we know whether it is the number per se or the type of medications that actually matters. We assessed this question for fall injuries leading to hospitalization. Design National register-based, population-based, matched case-control study. Setting Community dwellers ...

  1. Evaluation critique of state of the art dyslipidemia management in general and with a special emphasis on the Indian population.

    Science.gov (United States)

    Whayne, Thomas F

    2007-01-01

    Classically, there have been three well established major cardiovascular risk factors, hypercholesterolemia, hypertension and tobacco abuse. With accumulating clinical evidence, diabetes can now be added as a fourth major risk factor. Much interest in various other risk factors and possible causative factors has been generated, but it should be remembered that of all these, low density lipoproteins (LDL) remains the gold standard for evaluating risk. The common perception is that only caucasians in the western world have significant cardiovascular (CV) risk. However, much clinical information to the contrary has accumulated and now it is realized that many other ethnic groups also have significant CV disease, such as in India, especially in the urban population. Dyslipidemias of specific lipoproteins and their treatment is an important part of understanding and managing CV disease and risk. Various plasma factors such as homocysteine and lipoprotein (a) [(a)] have been considered to have definite associations with CV disease, but any treatment benefit remains in doubt. In addition, inflammatory risk factors are considered to be of significant clinical interest, especially high sensitivity C-Reactive protein (hsCRP). Where do these factors fit into routine clinical practice still awaits clarification. Only two of these inflammatory risk (Lp-factors can be tested commercially on a routine clinical basis and these are hsCRP and Lipoprotein-associated Phospholipase A2 Lp-PLA2). Their clinical utillity is not established and acceptance is limited: some third party health coverage organizations refuse to pay for such analyses. In the past, women have been looked upon as not having significant CV disease. More recently, evidence suggests that women may have more CV disease than men, and that physicians may have failed to realize this and act accordingly. The true situation is that women have less CV disease than men prior to menopause and then they slowly catch up

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

    Science.gov (United States)

    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

  3. Marketing to Older American Consumers.

    Science.gov (United States)

    Mertz, Barbara; Stephens, Nancy

    1986-01-01

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

  4. Clinical Interviewing with Older Adults

    Science.gov (United States)

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

    2012-01-01

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

  5. What Older Adults Need to Know about Retail Clinics

    Science.gov (United States)

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

  6. Striking a balance between in-person care and the use of eHealth to support the older rural population with chronic pain

    Directory of Open Access Journals (Sweden)

    Anne Roberts

    2015-09-01

    Full Text Available New and existing information communication technologies (ICT are playing an increasingly important role in the delivery of health and social care services. eHealth1 has the potential to supplement in-person home visits for older, rural adults with chronic pain. The Technology to support Older Adults' Personal and Social Interaction project—TOPS—examines interactions between older people and their health/social care providers and considers how eHealth could play a part in enhancing the life experiences of older people with chronic pain, who live in remote/rural areas. This paper reports findings from the TOPS study, drawing upon observations of health/social care home visits to chronic pain patients and interviews with patients and health/social care providers in rural Scotland. Patients and care professionals believe in-person care promotes the general well-being of older people with pain. However, our findings show that the potential recipients of eHealth are open to the use of such technologies and that although they cannot be expected to replace existing models of care, eHealth may provide opportunities to sustain and enhance these interactions.

  7. Statistical Profile of Older Hispanics

    Science.gov (United States)

    ... 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 ...

  8. Use of Primary Care Services, Care Specialized and Drug Use by Population 65 Years and More in the Community of Madrid, Spain.

    Science.gov (United States)

    Cano Pérez, María Dolores; Castell Alcalá, María Victoria; Queipo Matas, Rocío; Martín Martín, Sagrario; Mateo Pascual, Carmen; Otero Puime, Ángel

    2016-05-26

    Ageing of the Spanish population results in an increase in health services required. Therefore, determine the frequency of the health services utilization in this age group and analyze their determinants has a great interest.The aim was to analyze the utilization of health services among older people living in two urban neighborhoods of northern Madrid. A cross-sectional population-based study. It is studied a cohort of 1327 individuals ≥ 65 years, stratified by age and sex. Nine utilization indicators were defined. For each indicator frequencies and the association of each with the other variables were calculated by multivariate analysis. The distribution of indicators expressed as a percentage of the user population is: GP appoiments/month 64.8% (95%CI 62.3 to 67.4); nursing appoiments/month 44.6% (95% CI 41.2 to 47.2); home medical visits/month 3.1% (95%CI 2.2 to 4.1); home nursing visits/month 3% (95%CI 2.1 to 3.9); hospitalization/year 16.4% (95%CI 14.4 to 18.4); appoiments rheumatologist/orthopedic/year 25.1% (95%CI 22.7 to 27.4); physiotherapist appoiments/year 12.9% (95% CI 11.1 to 14.7); podiatrist appoiments/year 30.6% (95%CI 28.1 to 33.1) and polypharmacy (≥5 drugs) 55.7% (95% CI 53 to 58.4). Comorbidity was the best predictor of health care utilization ranging from OR 4.10 (95%CI: 3.07-5,49) to OR 1.39 (95%CI: 0.97-1.99) in polymedicated and visit the physiotherapist respectively. Cardiovascular disease (OR 1.34; 95%CI 1.03-1,76) and diabetes (OR 1.46; 95%CI: 1.05 -2.02) were independently associated with increased use of family doctor. Dependence was the main determinant for home healthcare (OR 3.38; 95%CI: 1.38-8.28) and nurses (OR 9.71; 95%CI: 4.19-22.48) Mood disorders were associated to polypharmacy (OR 2.06; 95%CI: 1,48-2.86) and to visits to family doctor (OR 1.52; 95%CI: 1,13-2.04). The comorbidity is the strongest predictor of health services utilization. Cardiovascular diseases and diabetes are independently associated to greater use

  9. Performance of the 16-Item Informant Questionnaire on Cognitive Decline for the Elderly (IQCODE) in an Arabic-Speaking Older Population

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Chaaya, Monique; Asmar, Khalil

    2015-01-01

    BACKGROUND/AIM: The North African and Middle Eastern region has high illiteracy rates among older people, making direct cognitive testing challenging. Validated screening instruments for dementia in Arabic are lacking. We aimed to validate the Arabic version of the 16-item Informant Questionnaire...... on Cognitive Decline for the Elderly (A-IQCODE 16) for screening for dementia through an informant. METHODS: 236 Lebanese participants older than 65 years, 143 with normal cognition and 93 with mild-to-moderate dementia according to the DSM-IV criteria, and their informants were recruited. Half...

  10. The Sex, Age, and Me study: recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population.

    Science.gov (United States)

    Lyons, Anthony; Heywood, Wendy; Fileborn, Bianca; Minichiello, Victor; Barrett, Catherine; Brown, Graham; Hinchliff, Sharron; Malta, Sue; Crameri, Pauline

    2017-09-01

    Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult's understandings and practices relating to sexual health. Data collection took place in 2015, with 2137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study's recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area.

  11. Is the naturalistic course of depression in older people related to received support over time? Results from a longitudinal population-based study

    NARCIS (Netherlands)

    Houtjes, W.; Deeg, D.J.H.; van de Ven, P.M.; van Meijel, B.; van Tilburg, T.G.; Beekman, A.T.F.

    Objectives: To test the interrelation of the naturalistic course of depression in older people with long-term support received. Design: Longitudinal cohort study. Methods: A sample of 277 adults age 55-85years participating in the Longitudinal Aging Study Amsterdam, with clinically relevant

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

    Science.gov (United States)

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

    2005-01-01

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

  13. Using existing population-based data sets to measure the American Academy of Pediatrics definition of medical home for all children and children with special health care needs.

    Science.gov (United States)

    Bethell, Christina D; Read, Debra; Brockwood, Krista

    2004-05-01

    National health goals include ensuring that all children have a medical home. Historically, medical home has been determined by the presence of a usual or primary source of care, such as a pediatrician or a family physician. More recent definitions expand on this simplistic notion of medical home. A definition of medical home set forth by the American Academy of Pediatrics (AAP) includes 7 dimensions and 37 discrete concepts for determining the presence of a medical home for a child. Standardized methods to operationalize these definitions for purposes of national, state, health plan, or medical practice level reporting on the presence of medical homes for children are essential to assessing and improving health care system performance in this area. The objective of this study was to identify methods to measure the presence of medical homes for all children and for children with special health care needs (CSHCN) using existing population-based data sets. Methods were developed for using existing population-based data sets to assess the presence of medical homes, as defined by the AAP, for children with and without special health care needs. Data sets evaluated included the National Survey of Children With Special Health Care Needs, the National Medical Expenditures Panel Survey, the Consumer Assessment of Health Plans Study Child Survey (CAHPS), and the Consumer Assessment of Health Plans Study Child Survey--Children With Chronic Conditions (CAHPS-CCC2.0H). Alternative methods for constructing measures using existing data were compared and results used to inform the design of a new method for use in the upcoming National Survey of Children's Health. Data from CAHPS-CCC2.0H are used to illustrate measurement options and variations in the overall presence of medical homes for children across managed health care plans as well as to evaluate in which areas of the AAP definition of medical home improvements may be most needed for all CSHCN. Existing surveys vary in

  14. Exploring factors related to the adoption and acceptance of an internet-based electronic personal health management tool (EPHMT) in a low income, special needs population of people living with HIV and AIDS in New York City.

    Science.gov (United States)

    Odlum, Michelle; Gordon, Peter; Camhi, Eli; Valdez, Esmerlin; Bakken, Suzanne

    2014-01-01

    Access to personal health information assists efforts to improve health outcomes and creates a population of active and informed health consumers. Understanding this significance, Healthy People 2020 retained, as a Focus Area, the need for improved interactive Health Communication and HIT. Attainment of this goal includes increasing the use of Internet-based electronic personal health management tools (EPHMT). Health information management, essential for favorable health outcomes, can be problematic in low income, special needs populations with complex chronic illnesses such as HIV/AIDS. Furthermore, barriers to the adoption and acceptance of an EPHMT in such populations have not been well explored. The current study seeks to explore the usability of an EPHMT entitled MyHealthProfile and to identify perceived health information needs in a vulnerable population of people living with HIV and AIDS (PLWH) that have access to an EPHMT through their Medicaid Special Needs Plan.

  15. Job search requirements for older unemployed workers

    OpenAIRE

    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...

  16. Gender differences in the association of perceived social support and social network with self-rated health status among older adults: a population-based study in Brazil.

    Science.gov (United States)

    Caetano, Silvana C; Silva, Cosme M F P; Vettore, Mario V

    2013-11-15

    Older adults are more likely to live alone, because they may have been predeceased by their spouse and friends. Social interaction could also be reduced in this age group due by limited mobility caused by chronic conditions. Therefore, aging is frequently accompanied by reduced social support, which might affect health status. Little is known about the role of gender in the relationship between social support and health in older adults. Hence, the present study tests the hypothesis that gender differences exist in the relationship between perceived social support, social network, and self-rated health (SRH) among older adults. A cross-sectional study using two-stage probabilistic sampling recruited 3,649 individuals aged 60 years and above. Data were collected during the national influenza vaccination campaign in Rio de Janeiro, Brazil, in 2006. Individual interviews collected information on SRH, perceived social support, social network, and other covariates. Multivariate logistic regression analyses using nested models were conducted separately for males and females. Independent variables were organised into six blocks: (1) perceived social support and social network, (2) age group, (3) socioeconomic characteristics, (4) health-related behaviours, (5) use of health care services, (6) functional status measures and somatic health problems. Older men who did not participate in group activities were more likely to report poor SRH compared to those who did, (OR = 1.63; 95% CI = 1.16-2.30). Low perceived social support predicted the probability of poor SRH in women (OR = 1.64; 95% CI = 1.16-2.34). Poor SRH was associated with low age, low income, not working, poor functional capacity, and depression in both men and women. More somatic health problems were associated with poor SRH in women. The association between social interactions and SRH varies between genders. Low social network involvement is associated with poor SRH in older men, whereas low perceived social

  17. Program specialization

    CERN Document Server

    Marlet, Renaud

    2013-01-01

    This book presents the principles and techniques of program specialization - a general method to make programs faster (and possibly smaller) when some inputs can be known in advance. As an illustration, it describes the architecture of Tempo, an offline program specializer for C that can also specialize code at runtime, and provides figures for concrete applications in various domains. Technical details address issues related to program analysis precision, value reification, incomplete program specialization, strategies to exploit specialized program, incremental specialization, and data speci

  18. 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.

    Science.gov (United States)

    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.

  19. A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls

    OpenAIRE

    Conroy, Simon; Kendrick, Denise; Harwood, Rowan; Gladman, John; Coupland, Carol; Sach, Tracey; Drummond, Avril; Youde, Jane; Edmans, Judi; Masud, Tahir

    2010-01-01

    Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process. Design: multicentre randomised controlled trial. Setting: eight general practices and three day hospitals based in the East Midlands, UK. Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at ...

  20. 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...

  1. Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study.

    Science.gov (United States)

    Ramalho, Fátima; Santos-Rocha, Rita; Branco, Marco; Moniz-Pereira, Vera; André, Helô-Isa; Veloso, António P; Carnide, Filomena

    2018-01-01

    Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program. A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15) and in a non-periodized exercise group (N=13). The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention. Both programs were tailored to older adults' functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging.

  2. Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath

    2016-04-01

    Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.

  3. Health-related quality of life is a prognostic factor for survival in older patients after colorectal cancer diagnosis: A population-based study.

    Science.gov (United States)

    Fournier, Evelyne; Jooste, Valérie; Woronoff, Anne-Sophie; Quipourt, Valérie; Bouvier, Anne-Marie; Mercier, Mariette

    2016-01-01

    Studies carried out in the context of clinical trials have shown a relationship between survival and health-related quality of life in colorectal cancer patients. We assessed the prognostic value of health-related quality of life at diagnosis and of its longitudinal evolution on survival in older colorectal cancer patients. All patients aged ≥65 years, diagnosed with new colorectal cancer between 2003 and 2005 and registered in the Digestive Cancer Registry of Burgundy were eligible. Patients were asked to complete the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at inclusion, three, six and twelve months after. Multivariate regression models were used to evaluate the prognostic value of health-related quality of life scores at diagnosis and their deterioration on relative survival. In multivariate analysis, a role functioning dimension lower than median was predictive of lower survival (hazard ratio=3.1, p=0.015). After three and six months of follow-up, patients with greater appetite loss were more likely to die, with hazard ratios of 4.7 (p=0.013) and 3.7 (p=0.002), respectively. Health-related quality of life assessments at diagnosis are independently associated with older colorectal cancer patients' survival. Its preservation should be a major management goal for older cancer patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. 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.

    Science.gov (United States)

    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.

  5. Sexual Homicide by Older Male Offenders.

    Science.gov (United States)

    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.

  6. 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.

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

    Science.gov (United States)

    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.

  8. Dehydration in the Older Adult.

    Science.gov (United States)

    Miller, Hayley J

    2015-09-01

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

  9. Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Ramalho F

    2018-04-01

    Full Text Available Fátima Ramalho,1,2 Rita Santos-Rocha,1,2 Marco Branco,1,2 Vera Moniz-Pereira,2 Helô-Isa André,2 António P Veloso,2 Filomena Carnide2 1Sport Sciences School of Rio Maior (ESDRM, Polytechnic Institute of Santarém, Rio Maior, Portugal; 2Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Centre for the Study of Human Performance (CIPER, Faculty of Human Kinetics (FMH, University of Lisbon, Cruz Quebrada, Portugal Background: Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters.Objectives: The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program.Methods: A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15 and in a non-periodized exercise group (N=13. The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention.Results: Both programs were tailored to older adults’ functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. Conclusion: These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging. Keywords: mobility, community exercise programs, active aging, plantar pressure analysis, ground reaction forces, gait properties

  10. Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study.

    Science.gov (United States)

    Chu, Wei-Min; Liao, Wen-Chun; Li, Chi-Rong; Lee, Shu-Hsin; Tang, Yih-Jing; Ho, Hsin-En; Lee, Meng-Chih

    2016-01-01

    To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007. The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55]. Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. 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...

  12. Health-Related Quality of Life and Health Behaviors in a Population-Based Sample of Older, Foreign-Born, Chinese American Adults Living in New York City

    Science.gov (United States)

    Wyatt, Laura C.; Trinh-Shevrin, Chau; Islam, Nadia S.; Kwon, Simona C.

    2014-01-01

    Although the New York City Chinese population aged =65 years increased by 50% between 2000 and 2010, the health needs of this population are poorly understood. Approximately 3,001 Chinese individuals from high-density Asian American New York City areas were included in the REACH U.S. Risk Factor Survey; 805 (26.8%) were aged =65 years and…

  13. Pulmonary hypertension in older adults.

    Science.gov (United States)

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

    2007-12-01

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

  14. An evaluation of factors associated with sexual risk taking among Black men who have sex with men: A comparison of younger and older populations

    Science.gov (United States)

    Maksut, Jessica L.; Eaton, Lisa A.; Siembida, Elizabeth J.; Driffin, Daniel D.; Baldwin, Robert

    2016-01-01

    Background In the United States, rates of human immunodeficiency virus (HIV) infection are highest among Black men who have sex with men (BMSM). Prior research indicates that younger BMSM in particular (i.e., BMSM 29 years of age and younger) are most at risk for HIV infection and that HIV incidence in this subpopulation has risen in recent years. It remains unclear, however, why younger BMSM, relative to BMSM 30 years of age and older, are at increased risk for HIV infection. Methods For the current study, we surveyed 450 BMSM located in the Atlanta, GA metropolitan and surrounding areas. We assessed BMSM’s depressive symptoms, substance use during sex, psychosocial risk factors (i.e., HIV risk perceptions, condom use self-efficacy, internalized homophobia, and perceived HIV stigmatization), and sexual risk taking (i.e., condomless anal intercourse [CAI]). Results We found that younger BMSM (YBMSM) and older BMSM (OBMSM) differed with respect to factors associated with CAI. In multivariable models, alcohol use before or during sex, lower educational attainment, and sexual orientation (i.e., bisexual sexual orientation) were significantly associated with increased CAI for YBMSM, while HIV risk perceptions and internalized homophobia were significantly, negatively associated with CAI among OBMSM. Discussion Rates of engaging in CAI were similar across the two age cohorts; however, factors related to CAI varied by these two groups. Findings emphasize the need to consider targeted interventions for different generational cohorts of BMSM. PMID:27001255

  15. Is there a clinically significant gender bias in post-myocardial infarction pharmacological management in the older (>60 population of a primary care practice?

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    Upshur Ross EG

    2002-05-01

    Full Text Available Abstract Background Differences in the management of coronary artery disease between men and women have been reported in the literature. There are few studies of potential inequalities of treatment that arise from a primary care context. This study investigated the existence of such inequalities in the medical management of post myocardial infarction in older patients. Methods A comprehensive chart audit was conducted of 142 men and 81 women in an academic primary care practice. Variables were extracted on demographic variables, cardiovascular risk factors, medical and non-medical management of myocardial infarction. Results Women were older than men. The groups were comparable in terms of cardiac risk factors. A statistically significant difference (14.6%: 95% CI 0.048–28.7 p = 0.047 was found between men and women for the prescription of lipid lowering medications. 25.3% (p = 0.0005, CI 11.45, 39.65 more men than women had undergone angiography, and 14.4 % (p = 0.029, CI 2.2, 26.6 more men than women had undergone coronary artery bypass graft surgery. Conclusion Women are less likely than men to receive lipid-lowering medication which may indicate less aggressive secondary prevention in the primary care setting.

  16. Oral health status and chewing ability is related to mini-nutritional assessment results in an older adult population in Thailand.

    Science.gov (United States)

    Samnieng, Patcharaphol; Ueno, Masayuki; Shinada, Kayoko; Zaitsu, Takashi; Wright, Fredrick Allan Clive; Kawaguchi, Yoko

    2011-01-01

    In a cross-sectional study, we investigated the relationship of Mini-Nutrition Assessment (MNA) results with chewing ability tests and oral examinations (number of teeth present and functional tooth units (FTUs)). The participants were 612 older people (Mean [SD] age: 68.8 [5.9]). According to the MNA score, 25.1% of participants were categorized as having normal nutrition, 67.2% were categorized as at risk of malnourishment, and 7.7% were categorized as having malnutrition. The mean numbers of teeth present and FTUs were [15.5] and [8.9], respectively. The ANCOVA analyses adjusted for age and gender showed that participants with malnutrition had lower numbers of teeth present (8.8), FTUs (8.4), and chewing ability (6.8) than those with normal nutrition (13.3, 10.4 and 7.8) (p Nutritional status was associated with mean numbers of teeth present, FTUs, and chewing ability. Therefore, it was concluded that retention of natural teeth with appropriate numbers of FTUs by replacing missing teeth with dentures and improving chewing ability will help the reduce risk of malnutrition in older adults.

  17. Specialization Patterns

    DEFF Research Database (Denmark)

    Schultz, Ulrik Pagh; Lawall, Julia Laetitia; Consel, Charles

    2000-01-01

    Design patterns offer many advantages for software development, but can introduce inefficiency into the final program. Program specialization can eliminate such overheads, but is most effective when targeted by the user to specific bottlenecks. Consequently, we propose that these concepts...... are complementary. Program specialization can optimize programs written using design patterns, and design patterns provide information about the program structure that can guide specialization. Concretely, we propose specialization patterns, which describe how to apply program specialization to optimize uses...... of design patterns. In this paper, we analyze the specialization opportunities provided by specific uses of design patterns. Based on the analysis of each design pattern, we define the associated specialization pattern. These specialization opportunities can be declared using the specialization classes...

  18. 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.

  19. Predictors of Transition to Hospice Care Among Hospitalized Older Adults With a Diagnosis of Dementia in Texas: A Population-Based Study.

    Science.gov (United States)

    Oud, Lavi

    2017-01-01

    Decedent older adults with dementia are increasingly less likely to die in a hospital, though escalation of care to a hospital setting, often including critical care, remains common. Although hospice is increasingly reported as the site of death in these patients, the factors associated with transition to hospice care during end-of-life (EOL) hospitalizations of older adults with dementia and the extent of preceding escalation of care to an intensive care unit (ICU) setting among those discharged to hospice have not been examined. We identified hospitalizations aged ≥ 65 years with a diagnosis of dementia in Texas between 2001 and 2010. Potential factors associated with discharge to hospice were evaluated using multivariate logistic regression modeling, and occurrence of hospice discharge preceded by ICU admission was examined. There were 889,008 elderly hospitalizations with a diagnosis of dementia during study period, with 40,669 (4.6%) discharged to hospice. Discharges to hospice increased from 908 (1.5%) to 7,398 (6.3%) between 2001 and 2010 and involved prior admission to ICU in 45.2% by 2010. Non-dementia comorbidities were generally associated with increased odds of hospice discharge, as were development of organ failure, the number of failing organs, or use of mechanical ventilation. However, discharge to hospice was less likely among non-white minorities (lowest among blacks: adjusted odds ratio (aOR): 0.67; 95% confidence interval (CI): 0.65 - 0.70) and those with non-commercial primary insurance or the uninsured (lowest among those with Medicaid: aOR (95% CI): 0.41 (0.37 - 0.46)). This study identified potentially modifiable factors associated with disparities in transition to hospice care during EOL hospitalizations of older adults with dementia, which persisted across comorbidity and severity of illness measures. The prevalent discharge to hospice involving prior critical care suggests that key discussions about goals-of-care likely took place

  20. Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study

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    Virgílio Garcia Moreira

    2013-07-01

    Full Text Available OBJECTIVE: Frailty syndrome can be defined as a state of vulnerability to stressors resulting from a decrease in functional reserve across multiple systems and compromising an individual's capacity to maintain homeostasis. The purpose of this study was to determine the prevalence of frailty and its association with social and demographic factors, functional capacity, cognitive status and self-reported comorbidities in a sample of community-dwelling older individuals who are clients of a healthcare plan. METHODS: We evaluated 847 individuals aged 65 years or older who lived in the northern area of the city of Rio de Janeiro, Brazil. The subjects were selected by inverse random sampling and stratified by gender and age. To diagnose frailty, we used the scale proposed by the Cardiovascular Health Study, which consisted of the following items: low gait speed, grip strength reduction, feeling of exhaustion, low physical activity and weight loss. The data were collected between 2009 and 2010, and the frailty prevalence was calculated as the proportion of individuals who scored positive for three or more of the five items listed above. To verify the association between frailty and risk factors, we applied a logistic regression analysis. RESULTS: The prevalence of frailty syndrome was 9.1% (95% confidence interval [CI], 7.3-11.3; 43.6% (95% CI, 40.3-47 of the individuals were considered robust, and 47.3% (95% CI 43.8-50.8 were considered pre-frail (p<0.001. The frail individuals tended to be older (odds ratio [OR] 13.2, 95% CI, 8.7-20 and have lower education levels (OR 2.1, 95% CI, 1-4.6, lower cognitive performance (OR 0.76, 95% CI, 0.73-0.79 and reduced health perception (OR 65.8, 95% CI, 39.1-110.8. Frail individuals also had a greater number of comorbidities (OR 6.6, 95% CI, 4.4-9.9 and worse functional capacity (OR 3.8, 95% CI, 2.9-5. CONCLUSION: The prevalence of frailty was similar to that seen in other international studies and was

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

    Science.gov (United States)

    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.

  2. Ohio Special Education Profile, 2011

    Science.gov (United States)

    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…

  3. The Challenges of Treating Sciatica Pain in Older Adults.

    Science.gov (United States)

    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.

  4. What's different about older people.

    Science.gov (United States)

    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

  5. Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Cleusa P Ferri

    2012-02-01

    Full Text Available Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking.The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98. Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites.Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the effectiveness of health systems in

  6. Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: a population-based cohort study.

    Science.gov (United States)

    Ferri, Cleusa P; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Llibre-Rodriguez, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D; Gaona, Ciro; Liu, Zhaorui; Noriega-Fernandez, Lisseth; Jotheeswaran, A T; Prince, Martin J

    2012-02-01

    Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the effectiveness of health systems in preventing and

  7. Effects of aging on the function of the urinary system: longitudinal changes with age in selected urine parameters in a hospitalized population of older adults

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    Chmielewski Piotr

    2016-09-01

    Full Text Available Although normal aging does not have a pernicious effect on the homeostasis of fluids, renal reserve in elderly people can be depleted. The purpose of the present study was to assess the relationship between longitudinal changes with age in basic urine parameters (specific gravity and pH in older men and women, depending on their body height and relative body weight. Longitudinal data on these two quantitative traits of the urine were available for 142 physically healthy individuals, including 68 men and 74 women. All subjects were 45 years of age at the beginning and 70 at the end of the period under investigation. All measurements were taken in accordance with internationally accepted requirements. Specific gravity was assessed using a hydrometer, and pH was measured using a pH meter. ANOVA, t-test, and regression analysis were performed. No significant sex differences in specific gravity or urine pH were observed. In both sexes, urine specific gravity decreased with age according to exponential model of regression. In men, there was a gradual increase in the pH of the urine until age 65, and the best fitting regression model was polynomial. In women, on the other hand, there was an exiguous decrease in urine pH throughout the period under study, and the best fitting regression model proved to be exponential. As the process of renal aging commences relatively early in ontogeny and manifests itself in many structural and functional changes, urinalysis and other more sophisticated methods of diagnosis of renal diseases are essential for proper assessment of health status of adults and older individuals. The rate of age-related changes in the analyzed traits of the urine was commensurate in both sexes, thereby revealing no evidence of significant sex differences in terms of renal aging in the period between 45 and 70 years of age.

  8. Relationships of leisure-time and non-leisure-time physical activity with depressive symptoms: a population-based study of Taiwanese older adults.

    Science.gov (United States)

    Chen, Li-Jung; Stevinson, Clare; Ku, Po-Wen; Chang, Yu-Kai; Chu, Da-Chen

    2012-03-14

    Limited research has explored the relationship between non-leisure-time physical activity (NLTPA), including domestic and work-related physical activities, with depressive symptoms. This study was designed to elucidate independent associations between leisure-time physical activity (LTPA), NLTPA, and specific parameters of physical activity (frequency, duration and intensity) with depressive symptoms in older adults. A total of 2,727 persons aged ≥ 65 years participating in the 2005 Taiwan National Health Interview Survey were studied. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale. Information regarding energy parameters for each type of LTPA and NLTPA during the past 2-week period was analyzed. After adjusting for socio-demographic variables, lifestyle behaviors and health status, multivariate logistic regression models were used to compute adjusted odds ratios (AOR) for LTPA and NLTPA for predicting depressive symptoms. LTPA but not NLTPA was significantly associated with depressive symptoms. Compared with participants expending 2000+ kcal/week through LTPA, the risk of experiencing depressive symptoms was significantly higher for those expending 1-999 kcal/week (AOR = 2.06, 95% CI: 1.25-3.39), and those who expending 0 kcal/week (AOR = 3.72, 95%CI: 2.28-6.06). Among the three parameters of LTPA (intensity, duration and frequency) examined, only intensity was independently associated with depressive symptoms. These findings imply that exercise recommendations for older adults should emphasize the importance of higher intensity activity, rather than frequency or duration, for improved mental well-being. However, well-designed prospective cohort studies or intervention trials are needed to confirm these findings.

  9. Cardiometabolic risk in a population of older adults with multiple co-morbidities in rural south africa: the HAALSI (Health and Aging in Africa: longitudinal studies of INDEPTH communities study

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    Thomas A. Gaziano

    2017-02-01

    Full Text Available Abstract Background A consequence of the widespread uptake of anti-retroviral therapy (ART is that the older South African population will experience an increase in life expectancy, increasing their risk for cardiometabolic diseases (CMD, and its risk factors. The long-term interactions between HIV infection, treatment, and CMD remain to be elucidated in the African population. The HAALSI cohort was established to investigate the impact of these interactions on CMD morbidity and mortality among middle-aged and older adults. Methods We recruited randomly selected adults aged 40 or older residing in the rural Agincourt sub-district in Mpumalanga Province. In-person interviews were conducted to collect baseline household and socioeconomic data, self-reported health, anthropometric measures, blood pressure, high-sensitivity C-reactive protein (hsCRP, HbA1c, HIV-status, and point-of-care glucose and lipid levels. Results Five thousand fifty nine persons (46.4% male were enrolled with a mean age of 61.7 ± 13.06 years. Waist-to-hip ratio was high for men and women (0.92 ± 0.08 vs. 0.89 ± 0.08, with 70% of women and 44% of men being overweight or obese. Blood pressure was similar for men and women with a combined hypertension prevalence of 58.4% and statistically significant increases were observed with increasing age. High total cholesterol prevalence in women was twice that observed for men (8.5 vs. 4.1%. The prevalence of self-reported CMD conditions was higher among women, except for myocardial infarction, and women had a statistically significantly higher prevalence of angina (10.82 vs. 6.97% using Rose Criteria. The HIV− persons were significantly more likely to have hypertension, diabetes, or be overweight or obese than HIV+ persons. Approximately 56% of the cohort had at least 2 measured or self-reported clinical co-morbidities, with HIV+ persons having a consistently lower prevalence of co-morbidities compared to those without

  10. Cardiometabolic risk in a population of older adults with multiple co-morbidities in rural south africa: the HAALSI (Health and Aging in Africa: longitudinal studies of INDEPTH communities) study.

    Science.gov (United States)

    Gaziano, Thomas A; Abrahams-Gessel, Shafika; Gomez-Olive, F Xavier; Wade, Alisha; Crowther, Nigel J; Alam, Sartaj; Manne-Goehler, Jennifer; Kabudula, Chodziwadziwa W; Wagner, Ryan; Rohr, Julia; Montana, Livia; Kahn, Kathleen; Bärnighausen, Till W; Berkman, Lisa F; Tollman, Stephen

    2017-02-17

    A consequence of the widespread uptake of anti-retroviral therapy (ART) is that the older South African population will experience an increase in life expectancy, increasing their risk for cardiometabolic diseases (CMD), and its risk factors. The long-term interactions between HIV infection, treatment, and CMD remain to be elucidated in the African population. The HAALSI cohort was established to investigate the impact of these interactions on CMD morbidity and mortality among middle-aged and older adults. We recruited randomly selected adults aged 40 or older residing in the rural Agincourt sub-district in Mpumalanga Province. In-person interviews were conducted to collect baseline household and socioeconomic data, self-reported health, anthropometric measures, blood pressure, high-sensitivity C-reactive protein (hsCRP), HbA1c, HIV-status, and point-of-care glucose and lipid levels. Five thousand fifty nine persons (46.4% male) were enrolled with a mean age of 61.7 ± 13.06 years. Waist-to-hip ratio was high for men and women (0.92 ± 0.08 vs. 0.89 ± 0.08), with 70% of women and 44% of men being overweight or obese. Blood pressure was similar for men and women with a combined hypertension prevalence of 58.4% and statistically significant increases were observed with increasing age. High total cholesterol prevalence in women was twice that observed for men (8.5 vs. 4.1%). The prevalence of self-reported CMD conditions was higher among women, except for myocardial infarction, and women had a statistically significantly higher prevalence of angina (10.82 vs. 6.97%) using Rose Criteria. The HIV - persons were significantly more likely to have hypertension, diabetes, or be overweight or obese than HIV + persons. Approximately 56% of the cohort had at least 2 measured or self-reported clinical co-morbidities, with HIV + persons having a consistently lower prevalence of co-morbidities compared to those without HIV. Absolute 10-year risk cardiovascular risk

  11. 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...

  12. Characteristics of New-Onset and Chronic Sleep Medication Users Among Older Adults: A Retrospective Study of a US Medigap Plan Population using Propensity Score Matching.

    Science.gov (United States)

    Musich, Shirley; Wang, Shaohung S; Slindee, Luke B; Saphire, Lynn; Wicker, Ellen

    2018-05-01

    Prescription sleep medications are often utilized to manage sleep problems among older adults even though these drugs are associated with multiple risks. The aim was to determine the prevalence and characteristics of new-onset compared to chronic sleep medication users and to examine factors associated with the conversion from new to chronic use. A secondary objective was to investigate the impact of sleep medications on health outcomes of injurious falls and patterns of healthcare utilization and expenditures. A 25% random sample of adults ≥ 65 years with 3-year continuous AARP ® Medicare Supplement medical and AARP ® MedicareRx drug plan enrollment was utilized to identify new-onset and chronic sleep medication users. Prescription sleep medication drugs were defined using National Drug Codes (NDCs); falls or hip fractures were identified from diagnosis codes. New users had no sleep medication use in 2014, but initiated medication use in 2015; chronic users had at least one sleep medication prescription in 2014 and in 2015; both groups had follow-up through 2016. Characteristics associated with new users, new users who converted to chronic use, and chronic users were determined using multivariate logistic regression. Prevalence of falls, healthcare utilization and expenditures were regression adjusted. Among eligible insureds, 3 and 9% were identified as new-onset and chronic sleep medication users, respectively. New-onset sleep medication prescriptions were often associated with an inpatient hospitalization. The strongest characteristics associated with new users, those who converted to chronic use, and chronic users were sleep disorders, depression and opioid use. About 50% of new users had > 30 days' supply; 25% converted to chronic use with ≥ 90 days' supply. The prevalence of falls for new-onset users increased by 70% compared to a 22% increase among chronic users. New-onset and chronic sleep medication users were characterized by sleep

  13. 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

  14. Brief Alcohol Intervention by Newly Trained Workers Versus Leaflets: Comparison of Effect in Older Heavy Drinkers Identified in a Population Health Examination Survey: A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Hansen, Anders Blædel Gottlieb; Becker, Ulrik; Nielsen, Anette Søgaard

    2011-01-01

    Aims: To test if a brief motivational intervention (BMI) in a non-treatment seeking population of heavy drinkers results in a reduced alcohol intake. Methods: Screening of 12,364 participants in a Danish health examination survey led to 1026 heavy drinkers of whom 772 were included and randomized...

  15. Birth cohort differences in cardiovascular risk factors in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008

    Directory of Open Access Journals (Sweden)

    Marco Polo Dias Freitas

    2011-01-01

    Full Text Available The aim of this study was to investigate whether cohort differences exist in the prevalence of cardiovascular risk factors among older elderly from the Bambuí Cohort Study of Aging. Participants were those aged 71-81 years at two points in time a decade apart: 457 in 1997 (earlier cohort and 553 in 2008 (recent cohort. The prevalence of hypertension (PR = 1.27; 95%CI: 1.19-1.36 and of diabetes mellitus (PR = 1.39; 95%CI: 1.06-1.83 was higher in the recent cohort compared to the earlier one, regardless of sex. The recent cohort had a lower prevalence of smoking (PR = 0.58; 95%CI: 0.42-0.80, and lower total cholesterol/HDL cholesterol ratio level (PR = 0.85; 95%CI: 0.80-0.89. There was a 136% increase in the pharmacologic treatment of diabetes and a 56% increase in pharmacologic management of hypertension in 2008 in comparison with 1997. Overall, the number of cardiovascular risk factors in the recent cohort remained similar to that of the early cohort.

  16. Effect of Health Comparisons on Functional Health and Depressive Symptoms - Results of a Population-Based Longitudinal Study of Older Adults in Germany.

    Directory of Open Access Journals (Sweden)

    André Hajek

    Full Text Available To investigate the effect of health comparisons on functional health and depressive symptoms in a longitudinal approach. Gender differences were examined.The German Ageing Survey (DEAS is a nationwide, representative longitudinal study of community dwelling individuals living in Germany aged 40 and older. The surveys in 2008 and 2011 were used, with n = 3,983 respondents taking part in both waves. Health comparisons were quantified by the question "How would you rate your health compared with other people your age" (Much better; somewhat better; the same; somewhat worse, much worse. Functional health was assessed by the subscale "physical functioning" of the 36-Item Short Form Health Survey (SF-36 and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D.Adjusting for sociodemographic factors, self-assessed health, social network, self-efficacy and optimism, and morbidity, fixed effects regressions revealed that functional health decreased significantly and considerably with negative health comparisons in the total sample (transitions from 'the same' to 'much worse': β = -11.8, predominantly in men. The effects of negative health comparisons (transitions from 'the same' to 'much worse': β = 4.8 on depressive symptoms were comparable (in terms of significance to the effects on functional health, with stronger effects in women. Positive comparisons did not affect functional health and depressive symptoms.Our findings underline the relevance of negative health comparisons on functional health (men and depressive symptoms (women. Comparison effects are asymmetric and mostly upwards.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  19. Factors Informing Outcomes for Older Cats and Dogs in Animal Shelters

    Directory of Open Access Journals (Sweden)

    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.

  20. Do Insect Populations Die at Constant Rates as They Become Older? Contrasting Demographic Failure Kinetics with Respect to Temperature According to the Weibull Model.

    Directory of Open Access Journals (Sweden)

    Petros Damos

    Full Text Available Temperature implies contrasting biological causes of demographic aging in poikilotherms. In this work, we used the reliability theory to describe the consistency of mortality with age in moth populations and to show that differentiation in hazard rates is related to extrinsic environmental causes such as temperature. Moreover, experiments that manipulate extrinsic mortality were used to distinguish temperature-related death rates and the pertinence of the Weibull aging model. The Newton-Raphson optimization method was applied to calculate parameters for small samples of ages at death by estimating the maximum likelihoods surfaces using scored gradient vectors and the Hessian matrix. The study reveals for the first time that the Weibull function is able to describe contrasting biological causes of demographic aging for moth populations maintained at different temperature regimes. We demonstrate that at favourable conditions the insect death rate accelerates as age advances, in contrast to the extreme temperatures in which each individual drifts toward death in a linear fashion and has a constant chance of passing away. Moreover, slope of hazard rates shifts towards a constant initial rate which is a pattern demonstrated by systems which are not wearing out (e.g. non-aging since the failure, or death, is a random event independent of time. This finding may appear surprising, because, traditionally, it was mostly thought as rule that in aging population force of mortality increases exponentially until all individuals have died. Moreover, in relation to other studies, we have not observed any typical decelerating aging patterns at late life (mortality leveling-off, but rather, accelerated hazard rates at optimum temperatures and a stabilized increase at the extremes.In most cases, the increase in aging-related mortality was simulated reasonably well according to the Weibull survivorship model that is applied. Moreover, semi log- probability hazard

  1. Gender-associated factors for frailty and their impact on hospitalization and mortality among community-dwelling older adults: a cross-sectional population-based study

    Directory of Open Access Journals (Sweden)

    Qin Zhang

    2018-02-01

    Full Text Available Background Frailty associated with aging increases the risk of falls, disability, and death. We investigated gender-associated factors for frailty. Methods Data of 3,079 geriatric subjects were retrieved from the National Health and Nutrition Examination Survey (NHANES 2007–2010 database. After excluding 1,126 subjects with missing data on frailty, medical history and survival, data of 1,953 patients were analyzed. Main endpoints were frailty prevalence, mortality rates and causes of death. Results Frailty prevalence was 5.4% in males, 8.8% in females. Significant risk factors for geriatric frailty in males were being widowed/divorced/separated, low daily total calorie intake, physical inactivity, sleeping >9 h, smoking and hospitalization history; and in females were obesity, physical inactivity, sleeping <6 h, family history of diabetes and heart attack, and hospitalization history. Frail subjects had higher mortality rates (22.5% male; 8.5% female than pre-frail (8.7% male; 6.4% female and non-frail (5.4% male; 2.5% female. Main causes of death were heart diseases (41% and chronic lower respiratory diseases (23.0% in males and nephritis/nephrosis (32.3% and chronic lower respiratory diseases (17.6% in females. Discussion Factors associated with frailty differ by gender, with higher frailty prevalence in females and higher mortality in males. Gender-associated factors for frailty identified in this study may be useful in evaluating frailty and guiding development of public health measures for prevention. Key Message Common predictive factors for frailty among older adults of both genders, including more frequent previous hospitalizations, physical inactivity, and certain gender-associated factors for frailty, are consistent with results of other NHANES studies in which self-reported higher levels of illness and sedentary behavior were directly associated with frailty.

  2. Specialization Patterns

    OpenAIRE

    Schultz , Ulrik Pagh; Lawall , Julia ,; Consel , Charles

    1999-01-01

    Design patterns offer numerous advantages for software development, but can introduce inefficiency into the finished program. Program specialization can eliminate such overheads, but is most effective when targeted by the user to specific bottlenecks. Consequently, we propose to consider program specialization and design patterns as complementary concepts. On the one hand, program specialization can optimize object-oriented programs written using design patterns. On the other hand, design pat...

  3. Special Weapons

    Data.gov (United States)

    Federal Laboratory Consortium — Supporting Navy special weapons, the division provides an array of engineering services, technical publication support services, logistics support services, safety...

  4. Older People of Tomorrow: A Psychosocial Profile.

    Science.gov (United States)

    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…

  5. Diabetes prevalence, awareness and treatment and their correlates in older persons in urban and rural population in the Astana region, Kazakhstan.

    Science.gov (United States)

    Supiyev, Adil; Kossumov, Alibek; Kassenova, Aliya; Nurgozhin, Talgat; Zhumadilov, Zhaxybay; Peasey, Anne; Bobak, Martin

    2016-02-01

    The evidence on the prevalence and distribution of diabetes and its determinants in Central Asia is sparse. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of diabetes and factors associated with these characteristics in the population of Astana (capital) city and adjacent rural area in Kazakhstan. Participants aged 50-75 years old, residing in Astana city (the capital) and Akmol village were invited to participate in a cross-sectional study. The subjects were randomly selected from polyclinic registers. A total of 953 adults were interviewed (response rate 59%), and their fasting plasma glucose, blood pressure, height and weight were measured. Diabetes was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/l (126 mg/dl) and/or being on diabetes medication. The overall prevalence of diabetes was 12.5%, and it was almost twice higher in the urban residents (16.3%) than in the rural population (8.6%). Diabetes prevalence was associated with age, men sex, hypertension, obesity, and Russian ethnicity. Among subjects with diabetes, 72.3% were aware of their condition; 65.6% were on treatment and 27.7% had controlled fasting plasma glucose. The awareness, treatment and control of diabetes were substantially higher in the urban population and among women. The large differences in all diabetes indices between urban and rural regions, if confirmed in larger studies, may suggest an impact of westernised and urbanised lifestyle as well as access to health care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  6. Comparison of orally administered bisphosphonate drugs in reducing the risk of hip fracture in older adults: a population-based cohort study.

    Science.gov (United States)

    Cadarette, Suzanne M; Lévesque, Linda; Mamdani, Muhammad; Perreault, Sylvie; Juurlink, David N; Paterson, J Michael; Carney, Greg; Gunraj, Nadia; Hawker, Gillian A; Tadrous, Mina; Wong, Lindsay; Dormuth, Colin R

    2013-09-01

    Orally administered bisphosphonate drugs (i.e., alendronate, etidronate, risedronate) can reduce the risk of vertebral fracture. However, only alendronate and risedronate have proven efficacy in reducing the risk of hip fracture. We sought to examine the comparative effectiveness of orally administered bisphosphonate drugs in reducing hip fractures among older adults. We identified new users of orally administered bisphosphonate drugs in British Columbia and Ontario between 2001 and 2008. We used province- and sex-specific propensity score-matching strategies to maximize comparability between exposure groups. We used Cox proportional hazards models to compare time-to-hip fracture within 1 year of treatment between exposures by sex in each province. Our secondary analyses considered hip fracture rates within 2 and 3 years' follow-up. We used alendronate as the reference for all comparisons and pooled provincial estimates using random effects variance-weighted meta-analysis. We identified 321 755 patients who were eligible for inclusion in the study. We found little difference in fracture rates between men (pooled hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.74-1.14) or women (pooled HR 1.15, 95% CI 0.73-1.56) taking risedronate and those taking alendronate. We similarly identified little difference in fracture rates between women taking etidronate and those taking alendronate (pooled HR 1.00, 95% CI 0.82-1.18). However, we identified lower rates of hip fracture among men taking etidronate relative to alendronate (pooled HR 0.77, 95% CI 0.60-0.94). Results extended to 2 and 3 years' follow-up were similar. However, with 3 years' follow-up, rates of hip fracture were lower among women in British Columbia who had taken alendronate. We identified little overall difference between alendronate and risedronate in reducing the risk of hip fracture in men or women. Our finding that etidronate is associated with lower fracture risk among men is likely due to

  7. 150 minutes of vigorous physical activity per week predicts survival and successful ageing: a population-based 11-year longitudinal study of 12 201 older Australian men.

    Science.gov (United States)

    Almeida, Osvaldo P; Khan, Karim M; Hankey, Graeme J; Yeap, Bu B; Golledge, Jonathan; Flicker, Leon

    2014-02-01

    Physical activity has been associated with improved survival, but it is unclear whether this increase in longevity is accompanied by preserved mental and physical functioning, also known as healthy ageing. We designed this study to determine whether physical activity is associated with healthy ageing in later life. We recruited a community-representative sample of 12 201 men aged 65-83 years and followed them for 10-13 years. We assessed physical activity at the beginning and the end of the follow-up period. Participants who reported 150 min or more of vigorous physical activity per week were considered physically active. We monitored survival during the follow-up period and, at study exit, assessed the mood, cognition and functional status of survivors. Healthy ageing was defined as being alive at the end of follow-up and having a Patient Health Questionnaire score 27, and no major difficulty in any instrumental or basic activity of daily living. Cox regression and general linear models were used to estimate HR of death and risk ratio (RR) of healthy ageing. Analyses were adjusted for age, education, marital status, smoking, body mass index and history of hypertension, diabetes, coronary heart disease and stroke. Two thousand and fifty-eight (16.9%) participants were physically active at study entry. Active men had lower HR of death over 10-13 years than physically inactive men (HR=0.74, 95% CI=0.68 to 0.81). Among survivors, completion of the follow-up assessment was higher in the physically active than inactive group (risk ratio, RR=1.18, 95% CI=1.08 to 1.30). Physically active men had greater chance of fulfilling criteria for healthy ageing than inactive men (RR=1.35, 95% CI=1.19 to 1.53). Men who were physically active at the baseline and follow-up assessments had the highest chance of healthy ageing compared with inactive men (RR=1.59, 95% CI=1.36 to 1.86). Sustained physical activity is associated with improved survival and healthy ageing in older men

  8. Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: findings from a population based survey.

    Science.gov (United States)

    Pinyopornpanish, Kanokporn; Thanamee, Sanhapan; Jiraporncharoen, Wichuda; Thaikla, Kanittha; McDonald, Jessica; Aramrattana, Apinun; Angkurawaranon, Chaisiri

    2017-12-04

    Sexual health is one of the key dimensions of health across all ages. Understanding risky sexual behaviors remains an important area of public health research. This study aimed to explore sexual health, risky sexual behaviors and factors associated with recent condom use as condom use is considered a main intervention proven to reduce negative health consequences of risky sexual behaviors, specifically related to sexually transmitted infections and unintended pregnancies. A stratified two-stage cluster sampling technique survey was conducted in Chiang Mai, Thailand. Information was obtained about age of first sexual intercourse, sexual activity, condom use, number of partners and history of drug/alcohol use prior to sexual activities within the past 3 months. A weighted analysis was performed to account for data clustering. It is estimated that most men (93%) and women (86%) in Chiang Mai have engaged in sexual intercourse. More than 70% of the people in Chiang Mai over age 30 remained sexually active in the past 3 months, even for populations over age 50. Eight percent of male teenagers reported having more than one sexual partner in the past 3 months. Regular condom use was reported in less than 5% of the population (6.6% men and 3.1% women). Our study demonstrated that sexual health is an important public health issue across all age groups. Condom use has been promoted as one way to minimize and prevent unintended consequences of sexual behavior but overall use remains low.

  9. Specialized science.

    Science.gov (United States)

    Casadevall, Arturo; Fang, Ferric C

    2014-04-01

    As the body of scientific knowledge in a discipline increases, there is pressure for specialization. Fields spawn subfields that then become entities in themselves that promote further specialization. The process by which scientists join specialized groups has remarkable similarities to the guild system of the middle ages. The advantages of specialization of science include efficiency, the establishment of normative standards, and the potential for greater rigor in experimental research. However, specialization also carries risks of monopoly, monotony, and isolation. The current tendency to judge scientific work by the impact factor of the journal in which it is published may have roots in overspecialization, as scientists are less able to critically evaluate work outside their field than before. Scientists in particular define themselves through group identity and adopt practices that conform to the expectations and dynamics of such groups. As part of our continuing analysis of issues confronting contemporary science, we analyze the emergence and consequences of specialization in science, with a particular emphasis on microbiology, a field highly vulnerable to balkanization along microbial phylogenetic boundaries, and suggest that specialization carries significant costs. We propose measures to mitigate the detrimental effects of scientific specialism.

  10. Special geometry

    International Nuclear Information System (INIS)

    Strominger, A.

    1990-01-01

    A special manifold is an allowed target manifold for the vector multiplets of D=4, N=2 supergravity. These manifolds are of interest for string theory because the moduli spaces of Calabi-Yau threefolds and c=9, (2,2) conformal field theories are special. Previous work has given a local, coordinate-dependent characterization of special geometry. A global description of special geometries is given herein, and their properties are studied. A special manifold M of complex dimension n is characterized by the existence of a holomorphic Sp(2n+2,R)xGL(1,C) vector bundle over M with a nowhere-vanishing holomorphic section Ω. The Kaehler potential on M is the logarithm of the Sp(2n+2,R) invariant norm of Ω. (orig.)

  11. The Abbott RealTime High Risk HPV test is a clinically validated human papillomavirus assay for triage in the referral population and use in primary cervical cancer screening in women 30 years and older: a review of validation studies.

    Science.gov (United States)

    Poljak, Mario; Oštrbenk, Anja

    2013-01-01

    Human papillomavirus (HPV) testing has become an essential part of current clinical practice in the management of cervical cancer and precancerous lesions. We reviewed the most important validation studies of a next-generation real-time polymerase chain reaction-based assay, the RealTime High Risk HPV test (RealTime)(Abbott Molecular, Des Plaines, IL, USA), for triage in referral population settings and for use in primary cervical cancer screening in women 30 years and older published in peer-reviewed journals from 2009 to 2013. RealTime is designed to detect 14 high-risk HPV genotypes with concurrent distinction of HPV-16 and HPV-18 from 12 other HPV genotypes. The test was launched on the European market in January 2009 and is currently used in many laboratories worldwide for routine detection of HPV. We concisely reviewed validation studies of a next-generation real-time polymerase chain reaction (PCR)-based assay: the Abbott RealTime High Risk HPV test. Eight validation studies of RealTime in referral settings showed its consistently high absolute clinical sensitivity for both CIN2+ (range 88.3-100%) and CIN3+ (range 93.0-100%), as well as comparative clinical sensitivity relative to the currently most widely used HPV test: the Qiagen/Digene Hybrid Capture 2 HPV DNA Test (HC2). Due to the significantly different composition of the referral populations, RealTime absolute clinical specificity for CIN2+ and CIN3+ varied greatly across studies, but was comparable relative to HC2. Four validation studies of RealTime performance in cervical cancer screening settings showed its consistently high absolute clinical sensitivity for both CIN2+ and CIN3+, as well as comparative clinical sensitivity and specificity relative to HC2 and GP5+/6+ PCR. RealTime has been extensively evaluated in the last 4 years. RealTime can be considered clinically validated for triage in referral population settings and for use in primary cervical cancer screening in women 30 years and older.

  12. Risk prediction for breast, endometrial, and ovarian cancer in white women aged 50 y or older: derivation and validation from population-based cohort studies.

    Directory of Open Access Journals (Sweden)

    Ruth M Pfeiffer

    Full Text Available Breast, endometrial, and ovarian cancers share some hormonal and epidemiologic risk factors. While several models predict absolute risk of breast cancer, there are few models for ovarian cancer in the general population, and none for endometrial cancer.Using data on white, non-Hispanic women aged 50+ y from two large population-based cohorts (the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [PLCO] and the National Institutes of Health-AARP Diet and Health Study [NIH-AARP], we estimated relative and attributable risks and combined them with age-specific US-population incidence and competing mortality rates. All models included parity. The breast cancer model additionally included estrogen and progestin menopausal hormone therapy (MHT use, other MHT use, age at first live birth, menopausal status, age at menopause, family history of breast or ovarian cancer, benign breast disease/biopsies, alcohol consumption, and body mass index (BMI; the endometrial model included menopausal status, age at menopause, BMI, smoking, oral contraceptive use, MHT use, and an interaction term between BMI and MHT use; the ovarian model included oral contraceptive use, MHT use, and family history or breast or ovarian cancer. In independent validation data (Nurses' Health Study cohort the breast and ovarian cancer models were well calibrated; expected to observed cancer ratios were 1.00 (95% confidence interval [CI]: 0.96-1.04 for breast cancer and 1.08 (95% CI: 0.97-1.19 for ovarian cancer. The number of endometrial cancers was significantly overestimated, expected/observed = 1.20 (95% CI: 1.11-1.29. The areas under the receiver operating characteristic curves (AUCs; discriminatory power were 0.58 (95% CI: 0.57-0.59, 0.59 (95% CI: 0.56-0.63, and 0.68 (95% CI: 0.66-0.70 for the breast, ovarian, and endometrial models, respectively.These models predict absolute risks for breast, endometrial, and ovarian cancers from easily obtainable risk factors and may

  13. Depression in Older Adults

    Science.gov (United States)

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

  14. Cancer in Older Adults

    Science.gov (United States)

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

  15. Older Adults and Alcohol

    Science.gov (United States)

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

  16. Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2012-01-01

    Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

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

    Science.gov (United States)

    Emlet, Charles A

    2016-01-01

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

  18. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study.

    Science.gov (United States)

    Bertolotti, Marco; Franchi, Carlotta; Rocchi, Marco B L; Miceli, Andrea; Libbra, M Vittoria; Nobili, Alessandro; Lancellotti, Giulia; Carulli, Lucia; Mussi, Chiara

    2017-04-01

    Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy. 2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment. In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen.

  19. Type, number or both? A population-based matched case-control study on the risk of fall injuries among older people and number of medications beyond fall-inducing drugs.

    Directory of Open Access Journals (Sweden)

    Lucie Laflamme

    Full Text Available Drug use is a modifiable risk factor for fall-related injuries in older people. Whereas the injurious effect of polypharmacy is established, that of low numbers of medications has not been fully ascertained. Neither do we know whether it is the number per se or the type of medications that actually matters. We assessed this question for fall injuries leading to hospitalization.National register-based, population-based, matched case-control study.Community dwellers aged 65+ years living in Sweden between March 2006 and December 2009.Cases (n = 64,399 were identified in the national inpatient register and four controls per case were randomly matched by gender, date of birth and residential area. The association between number of prescribed medications, assessed through linkage with the Swedish prescribed drug register, and the risk of injurious falls was estimated with odds ratios with 95% confidence intervals using conditional logistic regression, adjusted for demographic and health status.The number of medications was associated with an increased risk of fall injury in a dose-response fashion, even after adjustment for marital status, comorbidity and number of fall-risk-inducing drugs (FRIDs. Using ten or more medications was associated with an almost two-fold higher risk (adjusted OR: 1.76, 95% CI: 1.66 to 1.88. When stratified by use (or not of at least one FRID, the association weakened slightly among both non-users (adjusted OR: 1.50, 95% CI: 1.34 to 1.67 and users (adjusted OR: 1.67, 95% CI: 1.58 to 1.77.In older people, not only large but also small numbers of medications may affect the risk for them to sustain injurious falls. Although the mechanisms lying behind this are complex, the finding challenges the prevention strategies targeting either specific types of medications (FRIDs or high numbers of them.

  20. Type, number or both? A population-based matched case-control study on the risk of fall injuries among older people and number of medications beyond fall-inducing drugs.

    Science.gov (United States)

    Laflamme, Lucie; Monárrez-Espino, Joel; Johnell, Kristina; Elling, Berty; Möller, Jette

    2015-01-01

    Drug use is a modifiable risk factor for fall-related injuries in older people. Whereas the injurious effect of polypharmacy is established, that of low numbers of medications has not been fully ascertained. Neither do we know whether it is the number per se or the type of medications that actually matters. We assessed this question for fall injuries leading to hospitalization. National register-based, population-based, matched case-control study. Community dwellers aged 65+ years living in Sweden between March 2006 and December 2009. Cases (n = 64,399) were identified in the national inpatient register and four controls per case were randomly matched by gender, date of birth and residential area. The association between number of prescribed medications, assessed through linkage with the Swedish prescribed drug register, and the risk of injurious falls was estimated with odds ratios with 95% confidence intervals using conditional logistic regression, adjusted for demographic and health status. The number of medications was associated with an increased risk of fall injury in a dose-response fashion, even after adjustment for marital status, comorbidity and number of fall-risk-inducing drugs (FRIDs). Using ten or more medications was associated with an almost two-fold higher risk (adjusted OR: 1.76, 95% CI: 1.66 to 1.88). When stratified by use (or not) of at least one FRID, the association weakened slightly among both non-users (adjusted OR: 1.50, 95% CI: 1.34 to 1.67) and users (adjusted OR: 1.67, 95% CI: 1.58 to 1.77). In older people, not only large but also small numbers of medications may affect the risk for them to sustain injurious falls. Although the mechanisms lying behind this are complex, the finding challenges the prevention strategies targeting either specific types of medications (FRIDs) or high numbers of them.

  1. Gardening as the dominant leisure time physical activity (LTPA) of older adults from a post-communist country. The results of the population-based PolSenior Project from Poland.

    Science.gov (United States)

    Rowinski, Rafal; Dabrowski, Andrzej; Kostka, Tomasz

    2015-01-01

    To describe the LTPA of older Polish citizens in the nationwide, representative population-based PolSenior Project. A study group comprising 4813 randomly recruited participants aged 65 and over was surveyed. Data concerning LTPA in relation to age, gender, place of residence, and social class have been reported. Only 33.6% fulfilled the recommended LTPA criteria. Gardening (64.6%), walking (39.0%) and cycling (37.3%) were the most popular physical activities, followed by gymnastic exercises (18.2%) and dancing (12.8%). Village residents reported walking, gymnastics, swimming, tennis and dancing (32.5%, 9.1%, 1.8%, 0.1%, 8.1%) less frequently than those who live in cities, especially as compared to the residents of the largest cities (45.2%, 28.3%, 13.4%, 1.3%, 15.7%, respectively). However, the frequency of cycling generally decreased with the size of the place of residence. Village residents reported cycling and gardening more frequently (49.2% and 75.8%) than residents of the largest cities (20.6% and 45.8%, respectively). There are several differences in the LTPA of older adults in Poland compared with those in North America or Western Europe. Community-based and environmental policies should concentrate on a combination of sustaining existing favorable physical activity (PA) habits (gardening and cycling), and developing access and motivation for participation in LTPA characteristic of developed countries. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

    Directory of Open Access Journals (Sweden)

    Salas Aquiles

    2010-08-01

    Full Text Available Abstract Background The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. Methods A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India. All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF calculated. Results The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%. Other substantial contributors were limb impairment (9%, 1%-46%, stroke (8%, 2%-17%, and depression (8%, 1%-27%. Conclusion The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in

  3. The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey.

    Science.gov (United States)

    Sousa, Renata M; Ferri, Cleusa P; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, Ks; Jotheeswaran, At; Hernandez, Milagros A Guerra; Liu, Zhaorui; Pichardo, Guillermina Rodriguez; Rodriguez, Juan J Llibre; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Zuniga, Tirso; Prince, Martin

    2010-08-06

    The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India). All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF) calculated. The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%). Other substantial contributors were limb impairment (9%, 1%-46%), stroke (8%, 2%-17%), and depression (8%, 1%-27%). The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in middle income countries (MIC). The prevention and control of

  4. "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

    Science.gov (United States)

    2010-01-01

    Background The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. Methods A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India). All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF) calculated. Results The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%). Other substantial contributors were limb impairment (9%, 1%-46%), stroke (8%, 2%-17%), and depression (8%, 1%-27%). Conclusion The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in middle income countries

  5. Understanding how lake populations of arctic char are structured and function with special consideration of the potential effects of climate change: A multi-faceted approach.

    Science.gov (United States)

    Budy, Phaedra; Luecke, Chris

    2014-01-01

    Size dimorphism in fish populations, both its causes and consequences, has been an area of considerable focus; however, uncertainty remains whether size dimorphism is dynamic or stabilizing and about the role of exogenous factors. Here, we explored patterns among empirical vital rates, population structure, abundance and trend, and predicted the effects of climate change on populations of arctic char (Salvelinus alpinus) in two lakes. Both populations cycle dramatically between dominance by small (≤300 mm) and large (>300 mm) char. Apparent survival (Φ) and specific growth rates (SGR) were relatively high (40–96 %; SGR range 0.03–1.5 %) and comparable to those of conspecifics at lower latitudes. Climate change scenarios mimicked observed patterns of warming and resulted in temperatures closer to optimal for char growth (15.15 °C) and a longer growing season. An increase in consumption rates (28–34 %) under climate change scenarios led to much greater growth rates (23–34 %). Higher growth rates predicted under climate change resulted in an even greater predicted amplitude of cycles in population structure as well as an increase in reproductive output (Ro) and decrease in generation time (Go). Collectively, these results indicate arctic char populations (not just individuals) are extremely sensitive to small changes in the number of ice-free days. We hypothesize years with a longer growing season, predicted to occur more often under climate change, produce elevated growth rates of small char and act in a manner similar to a “resource pulse,” allowing a sub-set of small char to “break through,” thus setting the cycle in population structure.

  6. Understanding how lake populations of arctic char are structured and function with special consideration of the potential effects of climate change: a multi-faceted approach.

    Science.gov (United States)

    Budy, Phaedra; Luecke, Chris

    2014-09-01

    Size dimorphism in fish populations, both its causes and consequences, has been an area of considerable focus; however, uncertainty remains whether size dimorphism is dynamic or stabilizing and about the role of exogenous factors. Here, we explored patterns among empirical vital rates, population structure, abundance and trend, and predicted the effects of climate change on populations of arctic char (Salvelinus alpinus) in two lakes. Both populations cycle dramatically between dominance by small (≤300 mm) and large (>300 mm) char. Apparent survival (Φ) and specific growth rates (SGR) were relatively high (40-96%; SGR range 0.03-1.5%) and comparable to those of conspecifics at lower latitudes. Climate change scenarios mimicked observed patterns of warming and resulted in temperatures closer to optimal for char growth (15.15 °C) and a longer growing season. An increase in consumption rates (28-34%) under climate change scenarios led to much greater growth rates (23-34%). Higher growth rates predicted under climate change resulted in an even greater predicted amplitude of cycles in population structure as well as an increase in reproductive output (Ro) and decrease in generation time (Go). Collectively, these results indicate arctic char populations (not just individuals) are extremely sensitive to small changes in the number of ice-free days. We hypothesize years with a longer growing season, predicted to occur more often under climate change, produce elevated growth rates of small char and act in a manner similar to a "resource pulse," allowing a sub-set of small char to "break through," thus setting the cycle in population structure.

  7. Factors That Drive Youth Specialization.

    Science.gov (United States)

    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.

  8. Older adult education in Lithuanian ageing society

    Directory of Open Access Journals (Sweden)

    Zemaitaityte I.

    2016-01-01

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

  9. Researching older lesbians: problems and partial solutions.

    Science.gov (United States)

    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.

  10. Specialized languages

    DEFF Research Database (Denmark)

    Mousten, Birthe; Laursen, Anne Lise

    2016-01-01

    Across different fields of research, one feature is often overlooked: the use of language for specialized purposes (LSP) as a cross-discipline. Mastering cross-disciplinarity is the precondition for communicating detailed results within any field. Researchers in specialized languages work cross...... science fields communicate their findings. With this article, we want to create awareness of the work in this special area of language studies and of the inherent cross-disciplinarity that makes LSP special compared to common-core language. An acknowledgement of the importance of this field both in terms...... of more empirical studies and in terms of a greater application of the results would give language specialists in trade and industry a solid and updated basis for communication and language use....

  11. Prevalence of asthma with airflow limitation, COPD, and COPD with variable airflow limitation in older subjects in a general Japanese population: the Hisayama Study.

    Science.gov (United States)

    Matsumoto, Koichiro; Seki, Nanae; Fukuyama, Satoru; Moriwaki, Atsushi; Kan-o, Keiko; Matsunaga, Yuko; Noda, Naotaka; Yoshida, Makoto; Koto, Hiroshi; Takata, Shohei; Nakanishi, Yoichi; Kiyohara, Yutaka; Inoue, Hiromasa

    2015-01-01

    Elucidating the prevalence of asthma and chronic obstructive pulmonary disease (COPD) is important for designing a public health strategy. Recent studies have discriminated a phenotype of COPD with variable airflow limitation (COPD-VAL) associated with asthma-COPD overlap syndrome. Its prevalence remains uncertain. The age and occupational distributions in the town of Hisayama and in Japan are nearly identical. Each disease's prevalence was estimated for the town's residents. In 2008, town residents (≥ 40 years) were solicited to participate in a health checkup. Individuals with abnormal spirometry (forced expiratory volume in 1s/forced vital capacity [FEV1/FVC]fashion reviewed their medical records, including bronchodilator reversibility. Individuals with airflow limitation were classified as having asthma, COPD, COPD-VAL, or other diseases. The prevalence of each disease was then estimated. A total of 2100 residents (43.4% of residents in the age group) completed spirometry. In 455 residents with abnormal spirometry, 190 residents had further evaluations, and the medical records of 174 residents were reviewed. The prevalence of asthma with airflow limitation, COPD, and COPD-VAL, were 2.0%, 8.4%, and 0.9%, respectively. The prevalence of COPD and COPD-VAL were higher in men and smokers than in women and never-smokers. The prevalence of COPD, but not COPD-VAL or asthma, increased with age. The prevalence of asthma with airflow limitation, COPD, and COPD-VAL were estimated in a population of residents (≥ 40 years) in Hisayama. Copyright © 2014 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  12. The association of cancer survival with four socioeconomic indicators: a longitudinal study of the older population of England and Wales 1981–2000

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    Young Harriet

    2007-01-01

    Full Text Available Abstract Background Many studies have found socioeconomic differentials in cancer survival. Previous studies have generally demonstrated poorer cancer survival with decreasing socioeconomic status but mostly used only ecological measures of status and analytical methods estimating simple survival. This study investigate socio-economic differentials in cancer survival using four indicators of socioeconomic status; three individual and one ecological. It uses a relative survival method which gives a measure of excess mortality due to cancer. Methods This study uses prospective record linkage data from The Office for National Statistics Longitudinal Study for England and Wales. The participants are Longitudinal Study members, recorded at census in 1971 and 1981 and with a primary malignant cancer diagnosed at age 45 or above, between 1981 and 1997, with follow-up until end 2000. The outcome measure is relative survival/excess mortality, compared with age and sex adjusted survival of the general population. Relative survival and Poisson regression analyses are presented, giving models of relative excess mortality, adjusted for covariates. Results Different socioeconomic indicators detect survival differentials of varying magnitude and definition. For all cancers combined, the four indicators show similar effects. For individual cancers there are differences between indicators. Where there is an association, all indicators show poorer survival with lower socioeconomic status. Conclusion Cancer survival differs markedly by socio-economic status. The commonly used ecological measure, the Carstairs Index, is adequate at demonstrating socioeconomic differentials in survival for combined cancers and some individual cancers. A combination of car access and housing tenure is more sensitive than the ecological Carstairs measure at detecting socioeconomic effects on survival – confirming Carstairs effects where they occur but additionally identifying

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

    Science.gov (United States)

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

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

    Science.gov (United States)

    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.

  15. 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 an